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González-Domenech P, Gutiérrez B, Muñoz-Negro JE, Molina E, Rivera M, Cervilla JA. Epidemiology of social phobia in Andalusia. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2024; 17:88-94. [PMID: 38720187 DOI: 10.1016/j.rpsm.2021.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 08/24/2021] [Accepted: 09/27/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Population studies on social anxiety disorder (SAD) are relatively scarce and there is no previous reported evidence on prevalence or correlates of SAD in an Andalusian general population sample. MATERIAL AND METHODS We used a random representative sample previously identified via standard stratification procedures. Thus, a final sample of 4507 participants were included (response rate 83.7%). Interviewees were thoroughly assessed on sociodemographic, clinical and psychosocial factors, including: exposures to threatening life events (TLEs), childhood abuse, personality disorder and traits (neuroticism, impulsivity, paranoia), global functioning, physical health and toxics consumption. SAD diagnosis was ascertained using the Mini International Neuropsychiatric Interview. Both, pooled prevalences (with 95% confidence intervals) and risk correlates for SAD were estimated using binary logistic regression. RESULTS Estimated prevalence for SAD was 1.1% (95% CI=0.8-1.4). Having a SAD diagnosis was independently and significantly associated with younger age, poorer global functioning, higher neuroticism and paranoia personality traits, having suffered childhood abuse and exposure to previous TLEs. Furthermore, SAD was significantly associated with comorbid personality disorder, major depression, panic disorder and alcohol abuse. CONCLUSIONS Among this large Andalusian population sample, the prevalence of SAD and its associated factors are relatively similar to previously reported international studies, although no population study had previously reported such a strong association with paranoia.
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Affiliation(s)
| | - Blanca Gutiérrez
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Granada, Granada, España; Instituto de Neurociencias, Universidad de Granada, Granada, España
| | - José Eduardo Muñoz-Negro
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Granada, Granada, España; Hospital Universitario Clínico San Cecilio, Granada, España
| | - Esther Molina
- Instituto de Neurociencias, Universidad de Granada, Granada, España; Hospital Universitario Clínico San Cecilio, Granada, España
| | - Margarita Rivera
- Instituto de Neurociencias, Universidad de Granada, Granada, España; Departamento de Enfermería, Facultad de Medicina, Universidad de Granada, Granada, España
| | - Jorge A Cervilla
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Granada, Granada, España; Instituto de Neurociencias, Universidad de Granada, Granada, España; Hospital Universitario Clínico San Cecilio, Granada, España.
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Lindner SR, Scarpa S, McCarty D, Lundgren L. Addiction severity and re-employment in Sweden among adults with risky alcohol and drug use. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 156:209178. [PMID: 37820868 DOI: 10.1016/j.josat.2023.209178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 04/19/2023] [Accepted: 09/30/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND The Addiction Severity Index (ASI) assesses respondents' biopsychosocial problems in seven addiction-related domains (mental health, family and social relations, employment, alcohol use, drug use, physical health, and legal problems). This study examined the association between the seven ASI composite scores and re-employment in a sample of Swedish adults screened for risky alcohol and drug use who were without employment at assessment. METHODS We conducted a retrospective cohort analysis of employment outcomes among 6502 unemployed adults living in Sweden who completed an ASI assessment for risky alcohol and drug use. The study linked ASI scores to annual tax register data. The primary outcome was employment, defined as having earnings above an administrative threshold. We used Cox proportional hazard models to estimate the association between time to re-employment and ASI composite scores, controlling for demographic characteristics, RESULTS: Approximately three in ten individuals in the sample regained employment within five years. ASI composite scores suggested widespread biopsychosocial problems. Re-employment was associated with lower ASI composite scores for mental health (estimate: 0.775, 95 % confidence interval: 0.629-0.956), employment (estimate: 0.669, confidence interval: 0.532-0.841), drug use (estimate: 0.628, confidence interval: 0.428-0.924), and health (estimate: 0.798, confidence interval: 0.699-0.912). CONCLUSIONS This study suggests that several ASI domains may provide information on the complex factors (i.e., mental health, health, drug use) associated with long-term unemployment for people with risky substance use.
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Affiliation(s)
- Stephan R Lindner
- Center for Health Systems Effectiveness (CHSE), Oregon Health & Science University, 3030 SW Moody Ave, Portland, OR 97201, United States; OHSU-PSU School of Public Health, 1805 SW Fourth Ave, Portland, OR 97201, United States.
| | - Simone Scarpa
- Department of Social Work, Umeå University, Samhällsvetarhuset, 901 87 Umeå, Sweden.
| | - Dennis McCarty
- OHSU-PSU School of Public Health, 1805 SW Fourth Ave, Portland, OR 97201, United States; Division of General and Internal Medicine, School of Medicine, Oregon Health & Science University, 3266 SW Research Drive, Portland, OR 97239, United States.
| | - Lena Lundgren
- Department of Social Work, Umeå University, Samhällsvetarhuset, 901 87 Umeå, Sweden; Cross-National Behavioral Health Laboratory, University of Denver, 2148 S High Street, Denver, CO 80208, United States.
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Karolaakso T, Autio R, Suontausta P, Leppänen H, Suokas K, Rissanen P, Tuomisto MT, Pirkola S. Patterns of mental health services and mood disorder disability pensions: a standard comparison of Finland's three largest hospital districts. BMC Psychiatry 2023; 23:828. [PMID: 37957646 PMCID: PMC10644417 DOI: 10.1186/s12888-023-05342-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 11/02/2023] [Indexed: 11/15/2023] Open
Abstract
INTRODUCTION Mental disorders are one of the most common and disabling health conditions worldwide. There is however no consensus on the best practice of system level mental health services (MHS) provision, in order to prevent e.g. mood disorder disability pensions (DPs). We analyzed the MHS provision between Finland's three largest hospital districts Helsinki and Uusimaa (HUS), Southwest Finland and Pirkanmaa, with known differences in mood disorder DP risk but presumably equal rates of mood disorder prevalence. METHODS We used public MHS data analyzed with the standardized DEscription and Evaluation of Services and DirectoriEs for Long Term Care (DESDE-LTC) mapping tool, focusing on all MHS, outpatient care provision, local services without and with gatekeeping, and centralized services. We also collected demographic data based on the European Socio-Demographic Schedule (ESDS). As a novel approach, the Gini-Simpson Diversity Index (GSDI) was calculated for the districts. RESULTS Evident differences were observed regarding the districts' MHS factors. As the hospital district with lower DP risk, HUS was characterized by the highest level of regional socioeconomic prosperity as well as high service richness and diversity. With a nationally average DP risk, Southwest Finland had the highest number of MHS personnel in full-time equivalents (FTE) per 100 000 inhabitants. Pirkanmaa, with a higher DP risk, had overall the lowest service richness and the lowest FTE of the three districts in all MHS, outpatient care and local services with gatekeeping. CONCLUSIONS Our findings indicate that greater richness and diversity of MHS, especially in outpatient and community-based settings, may serve as indicators of a balanced, high-quality service system that is more effective in preventing mood disorder DP and meeting the different needs of the population. In addition, the need for sufficient resourcing in all MHS and outpatient services is indicated. We suggest using diversity indices to complement the measuring and reporting of regional service variation.
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Affiliation(s)
- Tino Karolaakso
- Faculty of Social Sciences (Psychology), Tampere University, Arvo Ylpön katu 34, Tampere, FI- 33520, Finland.
- Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Reija Autio
- Faculty of Social Sciences (Unit of Health Sciences), Tampere University, Tampere, Finland
| | - Petra Suontausta
- Faculty of Social Sciences (Unit of Health Sciences), Tampere University, Tampere, Finland
| | - Helena Leppänen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Kimmo Suokas
- Faculty of Social Sciences (Unit of Health Sciences), Tampere University, Tampere, Finland
| | - Päivi Rissanen
- Faculty of Social Sciences (Unit of Health Sciences), Tampere University, Tampere, Finland
| | - Martti T Tuomisto
- Faculty of Social Sciences (Psychology), Tampere University, Arvo Ylpön katu 34, Tampere, FI- 33520, Finland
| | - Sami Pirkola
- Faculty of Social Sciences (Unit of Health Sciences), Tampere University, Tampere, Finland
- Department of Adult Psychiatry, Tampere University Hospital, Tampere, Finland
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Saarinen A, Keltikangas-Järvinen L, Dobewall H, Sormunen E, Lehtimäki T, Kähönen M, Raitakari O, Hietala J. Childhood family environment predicting psychotic disorders over a 37-year follow-up - A general population cohort study. Schizophr Res 2023; 258:9-17. [PMID: 37392583 DOI: 10.1016/j.schres.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/07/2022] [Accepted: 06/19/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND Childhood adverse effects and traumatic experiences increase the risk for several psychiatric disorders. We now investigated whether prospectively assessed childhood family environment per se contributes to increased risk for psychotic disorders in adulthood, and whether these family patterns are also relevant in the development of affective disorders. METHODS We used the Young Finns Data (n = 3502). Childhood family environment was assessed in 1980/1983 with previously constructed risk scores: (1) disadvantageous emotional family atmosphere (parenting practices, parents' life satisfaction, parents' mental disorder, parents' alcohol intoxication), (2) adverse socioeconomic environment (overcrowded apartment, home income, parent's employment, occupational status, educational level), and (3) stress-prone life events (home movement, school change, parental divorce, death, or hospitalization, and child's hospitalization). Psychiatric diagnoses (ICD-10 classification) over the lifespan were collected up to 2017 from the national registry of hospital care. Non-affective psychotic disorder and affective disorder groups were formed. RESULTS Frequent stress-prone life events predicted higher likelihood of non-affective psychotic disorders (OR = 2.401, p = 0.001). Adverse socioeconomic environment or emotional family atmosphere did not predict psychotic disorders. Only disadvantageous emotional family atmosphere predicted modestly higher likelihood of affective disorders (OR = 1.583, p = 0.013). CONCLUSIONS Our results suggest that childhood family environment and atmosphere patterns as such contribute to the risk for developing adulthood mental disorders with relative disorder specificity. The results emphasize the importance of both individual and public health preventive initiatives, including family support interventions.
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Affiliation(s)
- Aino Saarinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | | | | | - Elina Sormunen
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland; Department of Clinical Chemistry, Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Health Technology, Tampere University, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Olli Raitakari
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Jarmo Hietala
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.
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Aaltonen KI, Saarni S, Holi M, Paananen M. The effects of mandatory home quarantine on mental health in a community sample during the COVID-19 pandemic. Nord J Psychiatry 2023; 77:65-72. [PMID: 35412416 DOI: 10.1080/08039488.2022.2061047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Major public and scientific interest exists on, whether quarantine as a containment measure, could have adverse effects on individual's mental health. We investigated psychic well-being and distress, symptoms of depression and anxiety among individuals imposed to home quarantine. METHODS By total population sampling in a Finnish suburban city, a total of 57 quarantined cases (participation rate 97%) were identified and followed up for two weeks until expiration of the quarantine. A randomized control group (n = 53) was formed of people seeking laboratory testing for suspected Sars-CoV-2 infection. Primary outcome was the psychic well-being and distress experienced during quarantine measured by the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM). The cases were followed up by the Clinical Outcomes in Routine Evaluation-10 (CORE-10), Patient Health Questionnaire-9 (PHQ-9), and by the Overall Anxiety Severity and Impairment Scale (OASIS). RESULTS The median CORE-OM score for the cases was 3.53 (95% CI: 2.23-4.66), and for the controls 3.24 (1.76-3.82), being mostly in the nonclinical to mild range. The difference between the groups was statistically nonsignificant (p = .19). Higher levels of psychic distress were explained by previous psychiatric disorders and living alone, but not having been quarantined. In comparison to controls, the quarantined participants experienced significantly, but slightly lower level of life functioning. At the follow-up, the quarantined participants rated further low on the CORE-10 (median 2.00; 95% CI: 1.00-3.00), the PHQ-9 (1.50; 0.00-3.00), and the OASIS (0.00; 0.00-0.00). CONCLUSIONS The distress associated with short-term home quarantine may not be to the degree of a mental disorder.
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Affiliation(s)
- Kari I Aaltonen
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Suoma Saarni
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Matti Holi
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Riihimäki K, Sintonen H, Vuorilehto M, Isometsä E. Health-related quality of life-based definition of remission from depression among primary care patients. Front Psychiatry 2023; 14:926410. [PMID: 37051167 PMCID: PMC10084667 DOI: 10.3389/fpsyt.2023.926410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 02/27/2023] [Indexed: 04/14/2023] Open
Abstract
Background Depression undermines health-related quality of life (HRQoL). Remission is the central aim of all treatments for depression, but the degree of remission necessary for depressive patients' HRQoL to correspond to the normal range of the general population remains unknown. Methods The Vantaa Primary Care Depression Study prospectively followed-up a screening-based cohort of depressive primary care patients for 5 years. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was used to diagnose major depressive disorder. HRQoL was measured by the generic 15D instrument at baseline and at 5 years (N = 106, 77% of baseline patients), and compared with the 15D results of an age-standardized general population sample from the Finnish Health 2011 Survey (N = 4,157). Receiver operating characteristic analyses determined the optimal Hamilton Depression Rating Scale (HAMD), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) cut-offs for remission, using the 15D score as the construct validator. Remission was defined as the score at which HRQoL reached the general population range (minimum mean - 1 SD). As age may influence HRQoL, patients older and younger than the median 52 years were investigated separately. Results For HAMD, the optimal cut-off point score was 8.5, for BDI 10.5, and for BAI 11.5. The differences between the findings of the younger and older patients were small. Limitations Cross-sectional analysis, small number of patients in the cohort. Conclusion Depressive primary care patients' HRQoL reaches the normal variation range of the general population when their depression and anxiety scores reach the conventional clinical cut-offs for remission.
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Affiliation(s)
- Kirsi Riihimäki
- Mental Health Research Unit, National Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Harri Sintonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Maria Vuorilehto
- Mental Health Research Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Erkki Isometsä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- *Correspondence: Erkki Isometsä,
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Seah JYH, Hong Y, Cichońska A, Sabanayagam C, Nusinovici S, Wong TY, Cheng CY, Jousilahti P, Lundqvist A, Perola M, Salomaa V, Tai ES, Würtz P, van Dam RM, Sim X. Circulating Metabolic Biomarkers Are Consistently Associated With Type 2 Diabetes Risk in Asian and European Populations. J Clin Endocrinol Metab 2022; 107:e2751-e2761. [PMID: 35390150 DOI: 10.1210/clinem/dgac212] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT While Asians have a higher risk of type 2 diabetes (T2D) than Europeans for a given body mass index (BMI), it remains unclear whether the same markers of metabolic pathways are associated with diabetes. OBJECTIVE We evaluated associations between metabolic biomarkers and incidence of T2D in 3 major Asian ethnic groups (Chinese, Malay, and Indian) and a European population. METHODS We analyzed data from adult males and females of 2 cohorts from Singapore (n = 6393) consisting of Chinese, Malays, and Indians and 3 cohorts of European-origin participants from Finland (n = 14 558). We used nuclear magnetic resonance to quantify 154 circulating metabolic biomarkers at baseline and performed logistic regression to assess associations with T2D risk adjusted for age, sex, BMI and glycemic markers. RESULTS Of the 154 metabolic biomarkers, 59 were associated with higher risk of T2D in both Asians and Europeans (P < 0.0003, Bonferroni-corrected). These included branched chain and aromatic amino acids, the inflammatory marker glycoprotein acetyls, total fatty acids, monounsaturated fatty acids, apolipoprotein B, larger very low-density lipoprotein particle sizes, and triglycerides. In addition, 13 metabolites were associated with a lower T2D risk in both populations, including omega-6 polyunsaturated fatty acids and larger high-density lipoprotein particle sizes. Associations were consistent within the Asian ethnic groups (all Phet ≥ 0.05) and largely consistent for the Asian and European populations (Phet ≥ 0.05 for 128 of 154 metabolic biomarkers). CONCLUSION Metabolic biomarkers across several biological pathways were consistently associated with T2D risk in Asians and Europeans.
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Affiliation(s)
- Jowy Yi Hoong Seah
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Yueheng Hong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | | | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Simon Nusinovici
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Pekka Jousilahti
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Annamari Lundqvist
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Markus Perola
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Veikko Salomaa
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - E Shyong Tai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | | | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Departments of Exercise and Nutrition Sciences and Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Xueling Sim
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
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Salonsalmi A, Mauramo E, Rahkonen O, Pietiläinen O, Lahelma E. Joint association of socioeconomic circumstances and minor mental health problems with antidepressant medication. Eur J Public Health 2022; 32:535-541. [PMID: 35656708 PMCID: PMC9341681 DOI: 10.1093/eurpub/ckac048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Disadvantageous socioeconomic circumstances and minor mental health problems have both been associated with mental disorders, such as depression, but their joint contribution remains unknown. Methods The Helsinki Health Study baseline survey (2000–02) of 40- to 60-year-old employees was linked with antidepressant medication data from registers of the Social Insurance Institution of Finland. The analyses were made using logistic regression with first prescribed antidepressant medication purchase during a 10-year follow-up as the outcome. Minor mental health problems were measured by the emotional well-being scale of the RAND-36. Odds ratios were calculated for joint association of the lowest quartile of the emotional well-being scale of the RAND-36 and socioeconomic circumstances. Childhood (parental education and childhood economic difficulties), conventional (education, occupational class and income) and material (housing tenure and current economic difficulties) socioeconomic circumstances were examined. This study included 5450 participants. Results Minor mental health problems dominated the joint associations. Minor mental health problems were associated with antidepressant medication irrespective of socioeconomic circumstances whereas only low income, current economic difficulties and living in rented housing showed an association without minor mental health problems at baseline. Marital status, working conditions and BMI and health behaviours had only minimal contributions to the associations. Conclusions Minor mental health problems were consistently and strongly associated with antidepressant medication and dominated the joint associations with socioeconomic circumstances. Paying attention to minor mental health problems might help prevent mental disorders such as depression.
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Affiliation(s)
- Aino Salonsalmi
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Elina Mauramo
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Olli Pietiläinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Eero Lahelma
- Department of Public Health, University of Helsinki, Helsinki, Finland
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Poor respiratory health outcomes associated with high illness worry and alexithymia: Eleven-year prospective cohort study among the working-age population. J Psychosom Res 2022; 155:110751. [PMID: 35152185 DOI: 10.1016/j.jpsychores.2022.110751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/13/2022] [Accepted: 01/31/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Poor respiratory health outcomes have been associated with poorer physical health and higher psychological distress. The aim of this study was to investigate whether illness worry, alexithymia or low sense of coherence predict i) the onset of new respiratory disease, ii) respiratory symptoms or iii) lung function among the working-age population, independently of comorbidity mood-, anxiety, or alcohol abuse disorders. METHODS The study was conducted among a nationally representative sample of the Finnish population (BRIF8901) aged 30-54 years (N = 2310) in 2000-2001 and was followed up in 2011. Individuals with a diagnosed respiratory disease or a severe psychiatric disorder at baseline were excluded. Lung function was measured by a spirometry test and psychiatric disorders were diagnosed using a structured clinical interview. Structured questionnaires were used to measure self-reported respiratory symptoms and diseases, illness worry, alexithymia, and sense of coherence. RESULTS High illness worry predicted an 11-year incidence of asthma (OR 1.47, 95% CI 1.09-1.99, p = 0.01). Alexithymia predicted shortness of breath (OR 1.32, 95% CI 1.13-1.53, p < 0.01) and 11-year incidence of COPD (OR 2.84, 95% CI 1.37-5.88, p < 0.01), even after several adjustments for physical and mental health. Psychological dispositions did not associate with lung function in 2011. CONCLUSIONS In the general population, psychological factors that modify health behaviour predicted adverse respiratory health outcomes independently of lung function after 11 years of follow-up. This indicates that considering them part of personalized treatment planning is important for promoting health-related behaviour among the working-age population.
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Punkkinen J, Nyyssönen M, Walamies M, Roine R, Sintonen H, Koskenpato J, Haakana R, Arkkila P. Behavioral therapy is superior to follow-up without intervention in patients with supragastric belching-A randomized study. Neurogastroenterol Motil 2022; 34:e14171. [PMID: 33991432 DOI: 10.1111/nmo.14171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 04/13/2021] [Indexed: 12/10/2022]
Abstract
BACKGROUND Behavioral therapy (BT) has been proven effective in the treatment of supragastric belching (SGB) in open studies. The aim was to compare BT to follow-up without intervention in patients with SGB in a randomized study. METHODS Forty-two patients were randomized to receive 5 sessions of BT, comprising diaphragmatic breathing exercises, or to follow-up without intervention. Patients were evaluated at 6 months, at which point the control group was also offered BT and evaluated after another 6 months. The frequency and intensity of belching and mental well-being were evaluated with a visual analog scale (VAS). Depression, anxiety, and health-related quality of life (HRQoL) were evaluated with four questionnaires: BDI, BAI, 15D, and RAND-36. KEY RESULTS The frequency and intensity of SGB were significantly lower in the therapy group (n = 19) than in the control group (n = 18) at the 6-month control (p < 0.001). When all patients (n = 36) were evaluated 6 months after BT, in addition to relief in the frequency and intensity of belching (p < 0.001), mental well-being had also improved (p < 0.05). Of all 36 patients, 27(75%) responded to BT. Depression scores were lower after therapy (p < 0.05). Only minor changes occurred in anxiety and HRQoL. CONCLUSIONS AND INFERENCES Behavioral therapy is superior to follow-up without intervention in patients with SGB in reducing belching and depression; it also improves mental well-being but has only a modest effect on anxiety and HRQoL.
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Affiliation(s)
- Jari Punkkinen
- Department of Gastroenterology, Helsinki University Hospital, Helsinki, Finland.,Hyvinkää Hospital, Endoscopy Outpatient Clinic, Hyvinkää, Finland
| | - Meri Nyyssönen
- Head and Neck Center, Helsinki University Hospital, Helsinki, Finland
| | - Markku Walamies
- Clinical Physiology Unit, HUS Diagnostic Center, Peijas Hospital, Vantaa, Finland
| | - Risto Roine
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Harri Sintonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Jari Koskenpato
- Department of Gastroenterology, Aava Kamppi Medical Centre, Helsinki, Finland
| | - Riikka Haakana
- Department of Gastroenterology, Helsinki University Hospital, Helsinki, Finland
| | - Perttu Arkkila
- Department of Gastroenterology, Helsinki University Hospital, Helsinki, Finland.,Department of Medicine, University of Helsinki, Helsinki, Finland
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Mattila E, Peltokoski J, Neva MH, Kaunonen M, Helminen M, Parkkila AK. COVID-19: anxiety among hospital staff and associated factors. Ann Med 2021; 53:237-246. [PMID: 33350869 PMCID: PMC7877952 DOI: 10.1080/07853890.2020.1862905] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 12/07/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, hospital staff have experienced a variety of mental health challenges. European research on anxiety and stress among hospital workers during the pandemic is limited. This study aimed to describe the anxiety levels of Finnish hospital workers during the COVID-19 pandemic. METHODS The multidimensional, cross-sectional survey was distributed to all hospital staff working at two Finnish specialized medical care centres in the spring of 2020 (n = 1,995). The Generalized Anxiety Disorder 7-item (GAD-7) scale was used to measure the workers' anxiety. RESULTS The total mean GAD-7 score was 4.88, indicating normal anxiety levels. However, 30% (n = 1,079) of the respondents had mild, 10% (n = 194) moderate and 5% (n = 88) severe anxiety. Key risk factors were young age, working in a university hospital, problems in cooperation between co-workers, difficulty concentrating at work, a health-threatening physical and psychological workload, and a fear of being infected at work. CONCLUSION Hospital staff experienced a variety of work-related stress and anxiety issues that should be visible to hospital administrators and policymakers alike. The anxiety is independent of whether the worker is directly involved in caring for or in any way coming into contact with COVID-19 patients. Key message Fifty-five percent of hospital staff have normal anxiety levels. The remaining workers may need targeted support interventions, and a smaller proportion (15%) are in danger of developing longer-term problems affecting their well-being. The anxiety experienced by hospital workers during the COVID-19 pandemic is more severe than that of the population on average. If the pandemic continues, the well-being of hospital staff may be widely threatened. Despite the different geographical locations and COVID-19 situations, hospital workers in Finland and China had similar anxiety levels. The anxiety is independent of whether staff are working in the front line of managing the COVID-19 pandemic or of the number of covid-19 patients admitted to the hospital. The hospital workers felt anxiety because they were facing a new situation which causes changes in their work and daily routine. Health care employers should engage in long-term follow-up as regards the personnel's recovery from the burden caused by the pandemic and from work in general. It is necessary to make easily attainable, flexibly delivered and cost-effective treatment interventions for anxiety available to hospital staff.
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Affiliation(s)
- Elina Mattila
- Administration Centre, Tampere University Hospital, Tampere, Finland
| | | | - Marko H. Neva
- Department of Orthopaedic and Trauma Surgery, Tampere University Hospital, Tampere, Finland
| | - Marja Kaunonen
- Administration Centre, Tampere University Hospital, Tampere, Finland
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Mika Helminen
- Tays Research Services, Tampere University Hospital, Tampere, Finland
- Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, Finland
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12
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Amiri S. Smoking and alcohol use in unemployed populations: a systematic review and meta-analysis. J Addict Dis 2021; 40:254-277. [PMID: 34747337 DOI: 10.1080/10550887.2021.1981124] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Unemployment is an economic and social phenomenon that has economic, social, personal, and health consequences. This study aimed to investigate the relationship between unemployment and alcohol use and smoking as a systematic review and meta-analysis. The two databases PubMed and Scopus were selected for the search and using a set of keywords, these two sources of scientific information were searched from 2004 to June 2021 and 1996 until June 2021, respectively. To meta-analyze the relationship between unemployment and smoking and alcohol use, odds ratio and confidence interval were calculated for this relationship. The meta-analysis was performed based on a random-effects. Subgroups were also performed for men and women. Heterogeneity in studies as well as publication bias were also examined. A total of 52 cross-sectional and cohort studies were included in the meta-analysis. In the relationship between unemployment and alcohol use, the odds ratio was 1.25 and the confidence interval was between 1.12 and 1.41. In the relationship between unemployment and smoking, the odds ratio was 1.43 and the confidence interval was between 1.13 and 1.81. According to the results, it can be said that unemployment increases the likelihood of alcohol use and smoking. Therefore, policymakers must pay more attention to the health consequences of economic problems, especially unemployment.
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Affiliation(s)
- Sohrab Amiri
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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13
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Karolaakso T, Autio R, Näppilä T, Leppänen H, Rissanen P, Tuomisto MT, Karvonen S, Pirkola S. Contextual and mental health service factors in mental disorder-based disability pensioning in Finland - a regional comparison. BMC Health Serv Res 2021; 21:1081. [PMID: 34635113 PMCID: PMC8507374 DOI: 10.1186/s12913-021-07099-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 09/23/2021] [Indexed: 11/25/2022] Open
Abstract
Background We investigated the regional differences in all mental disorder disability pensions (DP) between 2010 and 2015 in Finland, and separately in mood disorders and non-affective psychotic disorder DP. We also studied the contribution of several district-level contextual and mental health service factors to mental disorder DP. Methods Subjects were all those granted mental disorder DP for the first time between 2010 and 2015 in Finland (N = 36,879). Associations between the district-level contextual and mental health service factors and regional DP risks collected from the year 2015 were studied with negative binomial regression analysis in the Finnish hospital districts. The population number on the age (18 to 65 years), gender, occupational status and residential hospital district of the Finnish population from 2015 was used as exposure in the model. Results Significant differences in the regional mental disorder DP risks between and within hospital districts did not appear to follow the traditional Finnish health differences. A lower risk of DP was associated with contextual indicators of higher regional socioeconomic level. Furthermore, population density as a proxy for access to mental health services indicated a higher regional DP risk for lower density in all mental (IRR 1.10; 95% CI 1.06–1.14) and mood disorder (IRR 1.12; 95% CI 1.08–1.16) DP. Both the highest and the lowest regional numbers of all mental health outpatient visits were associated with a higher DP risk in all mental and mood disorder DP, whereas particularly low regional numbers of inpatient treatment periods and of patients were associated with a lower risk of DP. Conclusions In this comprehensive population-level study, we found evidence of significant regional variation in mental disorder DP and related district-level factors. This variation may at least partly relate to differences in regional mental health service systems and treatment practices. Adapting to the needs of the local population appears to be indicated for both regional mental health service systems and treatment practices to achieve optimal performance. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07099-4.
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Affiliation(s)
- Tino Karolaakso
- Faculty of Social Sciences (Psychology), Tampere University, Arvo Ylpön katu 34, FI-33520, Tampere, Finland.
| | - Reija Autio
- Faculty of Social Sciences (Unit of Health Sciences), Tampere University, Tampere, Finland
| | - Turkka Näppilä
- Tampere University Library, Tampere University, Tampere, Finland
| | - Helena Leppänen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Päivi Rissanen
- Faculty of Social Sciences (Unit of Health Sciences), Tampere University, Tampere, Finland
| | - Martti T Tuomisto
- Faculty of Social Sciences (Psychology), Tampere University, Arvo Ylpön katu 34, FI-33520, Tampere, Finland
| | - Sakari Karvonen
- Public Health and Welfare Division, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Sami Pirkola
- Faculty of Social Sciences (Unit of Health Sciences), Tampere University, Tampere, Finland.,Department of Adult Psychiatry, Tampere University Hospital, Pirkanmaa Hospital District, Tampere, Finland
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14
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Elovainio M, Lipsanen J, Pulkki-Råback L, Suvisaari J, Hakulinen C. Is symptom connectivity really the most important issue in depression? Depression as a dynamic system of interconnected symptoms revisited. J Psychiatr Res 2021; 142:250-257. [PMID: 34391079 DOI: 10.1016/j.jpsychires.2021.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/04/2021] [Accepted: 08/09/2021] [Indexed: 11/25/2022]
Abstract
According to the network theory strong associations between symptoms drive the disease process. We compared those with and without diagnosed depressive disorders (DD+/DD-) and analysed the effects of differences in (a) network connectivity, (b) symptom thresholds, and (c) autoregressive loops (i.e. how strongly specific symptoms predict themselves) on the potential activation of symptoms over time using simulations developed by Cramer and others (2016). The parameters for the simulation (symptom connectivity and symptom threshold) were obtained from Ising models and cross-lagged panel network analyses. Data were from the nationally representative samples (Health 2000-2011 Study) of 4190 participants measured in 2011 (cross-sectional analyses) and 3201 participants measured in 2000 and 2011 (longitudinal analyses). DD diagnosis was based on the Composite International Diagnostic Interview and depressive symptoms were self-reported using the 13-item version of the Beck Depression Inventory (BDI). Differences in symptom connectivity between participants with and without DD were not observed, but the mean probability (threshold) of symptom existence in the DD + group was higher than in the DD-group (0.41 vs. 0.12). Simulation showed that there are more active symptoms in the DD + group after 10 000 time points (means 1.2 vs. 4.6) than in the DD-group. This difference largely disappeared when we used longitudinal networks, including autoregressive loops, in the connectivity matrix. Our results suggest that the differences in symptom thresholds and autoregressive loops may be more important features than symptom connectivity in differentiating people with and without DD.
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Affiliation(s)
- Marko Elovainio
- Research Program Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland.
| | - Jari Lipsanen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Laura Pulkki-Råback
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jaana Suvisaari
- National Institute for Health and Welfare, Helsinki, Finland
| | - Christian Hakulinen
- National Institute for Health and Welfare, Helsinki, Finland; Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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15
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Alam N, Ali S, Akbar N, Ilyas M, Ahmed H, Mustafa A, Khurram S, Sajid Z, Ullah N, Qayyum S, Rahim T, Usman MS, Ali N, Khan I, Pervez K, Sumaira B, Ali N, Sultana N, Tanoli AY, Islam M. Association study of six candidate genes with major depressive disorder in the North-Western population of Pakistan. PLoS One 2021; 16:e0248454. [PMID: 34411117 PMCID: PMC8376078 DOI: 10.1371/journal.pone.0248454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 07/22/2021] [Indexed: 12/25/2022] Open
Abstract
People around the world are currently affected by Major Depressive Disorder (MDD). Despite its many aspects, symptoms, manifestations and impacts, efforts have been made to identify the root causes of the disorder. In particular, genetic studies have concentrated on identifying candidate genes for MDD and exploring associations between these genes and some specific group of individuals. The aim of this research was to find out the association between single nucleotide polymorphisms in 6 candidate genes linked to the neurobiology of major depressive disorder in the North-Western population of Pakistan. We performed a case-control analysis, with 400 MDD and 232 controls. A trained psychiatrist or clinical psychologists evaluated the patients. Six polymorphisms were genotyped and tested for allele and genotype association with MDD. There were no statistical variations between MDD patients and healthy controls for genotypic and allelic distribution of all the polymorphisms observed. Thus, our analysis does not support the major role of these polymorphisms in contributing to MDD susceptibility, although it does not preclude minor impact. The statistically significant correlation between six polymorphisms and major depressive disorder in the studied population was not observed. There are inconsistencies in investigations around the world. Future research, including GWAS and association analysis on larger scale should be addressed for further validation and replication of the present findings.
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Affiliation(s)
- Naqash Alam
- School of Basic Medical Sciences, Health Science Center, Xi’an Jiaotong University, Xi’an, Shaanxi, China
- Department of Biotechnology and Genetic Engineering, Hazara University, Mansehra, Pakistan
| | - Sadiq Ali
- School of Basic Medical Sciences, Health Science Center, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Nazia Akbar
- Department of Biotechnology and Genetic Engineering, Hazara University, Mansehra, Pakistan
- * E-mail:
| | - Muhammad Ilyas
- Centre for Omic Sciences, Islamia College University, Peshawar, Pakistan
| | - Habib Ahmed
- Department of Biotechnology and Genetic Engineering, Hazara University, Mansehra, Pakistan
| | - Arooj Mustafa
- Department of Biotechnology and Genetic Engineering, Hazara University, Mansehra, Pakistan
| | - Shehzada Khurram
- Department of Biotechnology and Genetic Engineering, Hazara University, Mansehra, Pakistan
| | - Zeeshan Sajid
- Department of Biotechnology and Genetic Engineering, Hazara University, Mansehra, Pakistan
| | - Najeeb Ullah
- Department of Biotechnology and Genetic Engineering, Hazara University, Mansehra, Pakistan
| | - Shumaila Qayyum
- Department of Biotechnology and Genetic Engineering, Hazara University, Mansehra, Pakistan
| | - Tariq Rahim
- Department of Biochemistry, Hazara University, Mansehra, Pakistan
| | - Mian Syed Usman
- Department of Biochemistry, Hazara University, Mansehra, Pakistan
| | - Nawad Ali
- Department of Biochemistry, Hazara University, Mansehra, Pakistan
| | - Imad Khan
- Department of Biochemistry, Hazara University, Mansehra, Pakistan
| | - Khola Pervez
- Department of Biotechnology and Genetic Engineering, Hazara University, Mansehra, Pakistan
| | - BiBi Sumaira
- Department of Biotechnology and Genetic Engineering, Hazara University, Mansehra, Pakistan
| | - Nasir Ali
- Department of Biotechnology and Genetic Engineering, Hazara University, Mansehra, Pakistan
| | - Nighat Sultana
- Department of Biochemistry, Hazara University, Mansehra, Pakistan
| | | | - Madiha Islam
- Department of Biotechnology and Genetic Engineering, Hazara University, Mansehra, Pakistan
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16
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Background of fatal pulmonary embolism: an analysis of all diagnosed fatal pulmonary embolism in 2015-2018 from Hospital District of Helsinki and Uusimaa. J Thromb Thrombolysis 2021; 53:550-556. [PMID: 34401995 PMCID: PMC8904330 DOI: 10.1007/s11239-021-02550-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/01/2021] [Indexed: 11/20/2022]
Abstract
Pulmonary embolism (PE) mortality has decreased in the last decades but acute PE is still associated with significant fatality. Specific information on fatal PE patients could guide how to efficiently improve PE management but to date this information has been scarce. All the individuals with PE defined as an immediate or underlying cause of death were collected from the death certificate archive of the Hospital District of Helsinki and Uusimaa, Finland, including approximately 1.7 million inhabitants (2015–2018). Crude and age-adjusted mortality rates and proportional mortality were calculated, and the distribution of comorbidities at death and death location (in-hospital, palliative care, or out-of-hospital) was analyzed. In total, 451 individuals with fatal PE were identified (238 females) with a mean age of 72 years (SD 13.5 year). Most of the fatal PEs (n = 264, 54.5%) occurred out-of-hospital and surprisingly, 70 (26.5%) of these individuals s had a history of mental illness or substance abuse. The out-of-hospital resuscitation was attempted in 108 (40.1%) individuals but only 7 (6.5%) received thrombolysis during resuscitation. Fatal PE occurred during hospitalization in 98 individuals and in 54 (55.1%), the diagnosis was only made postmortem. Majority of the fatal PEs occurred out-of-hospital and were diagnosed postmortem whereas only small proportion of deaths occurred to in-hospital PE patients. The earlier diagnosis of PE, which may be accomplished by raising the general awareness of PE, is necessary to prevent these sudden deaths of whom many occurred to individuals with history of mental illnesses or substance abuse.
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17
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Ämmälä AJ, Suvisaari J, Kananen L, Lönnqvist J, Ripatti S, Pirkola S, Paunio T, Hovatta I. Childhood adversities are associated with shorter leukocyte telomere length at adult age in a population-based study. Psychoneuroendocrinology 2021; 130:105276. [PMID: 34051657 DOI: 10.1016/j.psyneuen.2021.105276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 04/20/2021] [Accepted: 05/16/2021] [Indexed: 10/21/2022]
Abstract
Telomeres are repeat sequences and an associated protein complex located at the end of the chromosomes. They shorten with every cell division and are regarded markers for cellular aging. Shorter leukocyte telomere length (LTL) has been observed in many complex diseases, including psychiatric disorders. However, analyses focusing on psychiatric disorders are mainly based on clinical samples and the significance of shorter LTL on the population level remains uncertain. We addressed this question in a population-based sample from Finland (N = 7142). The survey was performed and the blood samples were collected in 2000-2001 to assess major public health problems and their determinants. DSM-IV diagnoses of major psychiatric illnesses were obtained by interview using the Composite International Diagnostic Interview. Information regarding their risk factors, including the number of self-reported childhood adversities, recent psychological distress, and sleep difficulties was collected by questionnaires. LTL was measured by qPCR. None of the studied psychiatric illnesses, sleep difficulties, or recent psychological distress associated with LTL. However, individuals with three or more childhood adversities had shorter LTL at adult age (β = -0.006, P = 0.005). Also, current occupational status was associated with LTL (β = -0.03, P = 0.04). These effects remained significant after adjusting for known LTL-associated lifestyle or sociodemographic factors. In conclusion, relatively common childhood adversities were associated with shorter LTL at adult age in a nationally representative population-based cohort, implying that childhood adversities may cause accelerated telomere shortening. Our finding has potentially important implications as it supports the view that childhood adversities have an impact on psychological and somatic well-being later in life.
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Affiliation(s)
- Antti-Jussi Ämmälä
- Department of Genetics and Biomarkers, National Institute for Health and Welfare, Mannerheimintie 166, P.O. 30, 00271 Helsinki, Finland; Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Jaana Suvisaari
- Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
| | - Laura Kananen
- Faculty of Medicine and Health Technology (MET), Tampere University, Tampere, Finland; Gerontology Research Center (GEREC), Finland; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; Research Programs Unit, Molecular Neurology, Biomedicum-Helsinki, University of Helsinki, Finland
| | - Jouko Lönnqvist
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
| | - Samuli Ripatti
- Center of Excellence in Complex Disease Genetics, Institute of Molecular Medicine Finland (FIMM), University of Helsinki, Finland; Faculty of Medicine, University of Helsinki, Finland; Broad Institute of MIT and Harvard, Finland
| | - Sami Pirkola
- Faculty of Social Sciences, Tampere University, Tampere, Finland; Department of Adult Psychiatry, Tampere University Hospital, Pirkanmaa Hospital District, Tampere, Finland
| | - Tiina Paunio
- Department of Genetics and Biomarkers, National Institute for Health and Welfare, Mannerheimintie 166, P.O. 30, 00271 Helsinki, Finland; Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; SleepWell Research Program, Faculty of Medicine, University of Helsinki, P.O. Box 21, 00014, Finland
| | - Iiris Hovatta
- Research Programs Unit, Molecular Neurology, Biomedicum-Helsinki, University of Helsinki, Finland; SleepWell Research Program, Faculty of Medicine, University of Helsinki, P.O. Box 21, 00014, Finland; Department of Psychology and Logopedics, University of Helsinki, Finland; Neuroscience Center, Helsinki Institute of Life Science HiLIFE, University of Helsinki, Finland.
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18
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Karolaakso T, Autio R, Näppilä T, Nurmela K, Pirkola S. Socioeconomic factors in disability retirement due to mental disorders in Finland. Eur J Public Health 2021; 30:1218-1224. [PMID: 32929489 PMCID: PMC7733043 DOI: 10.1093/eurpub/ckaa132] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Previous research has identified low socioeconomic status (SES) as an epidemiological risk factor for early retirement and disability pension (DP) due to mental disorders. This study aims to examine these associations in greater detail, with separate consideration of the risk factors for mood disorders (F30–39) and non-affective psychotic disorder (F20–29) DP. Methods In this case–control setting the subjects (N = 36 879) were all those granted DP due to a mental disorder for the first time between 2010 and 2015 in Finland. All the subjects were matched with three controls for their gender, age and hospital district (N = 94 388). Three measures of dimensions of SES were used: education, income and occupational status, as well as family type as a control factor. Differences between DP recipients and controls, and between diagnostic groups, were studied using calculated characteristics and conditional logistic regression models. Results DP recipients often lived alone and had low educational and income levels. These characteristics were more prominent in non-affective psychotic disorder than in mood disorder DP. In white-collar occupational groups, the risk of DP was greater compared with blue-collar workers. Students were associated with the highest level of risk for all mental and mood disorder DPs. Conclusions We found evidence of SES factors associating with mental disorder-related severe loss of working and studying ability in a disorder-specific way. Notably, white-collar workers had an increased risk of mental disorder DP. This could be related to the psychosocially demanding contemporary working life in non-manual work.
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Affiliation(s)
- Tino Karolaakso
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Reija Autio
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Turkka Näppilä
- Tampere University Library, Tampere University, Tampere, Finland
| | - Kirsti Nurmela
- Faculty of Social Sciences, Tampere University, Tampere, Finland.,Mental Health and Substance Abuse Services, City of Tampere, Tampere, Finland
| | - Sami Pirkola
- Faculty of Social Sciences, Tampere University, Tampere, Finland.,Department of Adult Psychiatry, Tampere University Hospital, Pirkanmaa Hospital District, Tampere, Finland
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19
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Eastman MR, Finlay JM, Kobayashi LC. Alcohol Use and Mental Health among Older American Adults during the Early Months of the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4222. [PMID: 33923483 PMCID: PMC8073103 DOI: 10.3390/ijerph18084222] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 12/21/2022]
Abstract
Poor mental health associated with the COVID-19 pandemic may prompt the utilization of various coping behaviors, including alcohol use. We aimed to investigate the relationships between mental health symptomatology and self-reported changes in alcohol consumption at the onset of the pandemic. Data were from the nationwide COVID-19 Coping Study of US adults aged ≥55 in April and May 2020 (n = 6548). We used population-weighted multivariable-adjusted multi-nomial logistic regression models to estimate odds ratios (ORs) for the associations between mental health (of depression, anxiety, and loneliness, each) and self-reported increased alcohol consumption (vs. no change in consumption). One in ten adults (717/6548; 11%) reported an increase in their alcohol consumption in the past week compared to their usual pre-COVID-19 drinking. Mental health symptomatology was associated with increased drinking since the pandemic onset (depression: OR = 2.66, 95% CI: 1.99-3.56; anxiety: OR = 1.80, 95% CI: 1.34-2.42; loneliness: OR = 2.45, 95% CI: 1.83-3.28). Participants who screened positive for all three mental health outcomes were substantially more likely to report increased alcohol consumption since the onset of the pandemic (OR = 3.87, 95% CI: 2.52-5.96, vs. no mental health outcomes). This study demonstrates potentially harmful changes in alcohol intake among middle-to-older aged adults experiencing mental health symptomatology during the early months of the COVID-19 pandemic.
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Affiliation(s)
- Marisa R. Eastman
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA;
| | - Jessica M. Finlay
- Survey Research Center, Institute for Social Research, University of Michigan School of Public Health, Ann Arbor, MI 48104, USA;
| | - Lindsay C. Kobayashi
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA;
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20
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Preti A, Piras M, Cossu G, Pintus E, Pintus M, Kalcev G, Cabras F, Moro MF, Romano F, Balestrieri M, Caraci F, Dell'Osso L, Sciascio GD, Drago F, Hardoy MC, Roncone R, Faravelli C, Musu M, Finco G, Nardi AE, Carta MG. The Burden of Agoraphobia in Worsening Quality of Life in a Community Survey in Italy. Psychiatry Investig 2021; 18:277-283. [PMID: 33849246 PMCID: PMC8103017 DOI: 10.30773/pi.2020.0342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 12/11/2020] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE Current nosology redefined agoraphobia as an autonomous diagnosis distinct from panic disorder. We investigated the lifetime prevalence of agoraphobia, its association with other mental disorders, and its impact on the health-related quality of life (HR-QoL). METHODS Community survey in 2,338 randomly selected adult subjects. Participants were interviewed with the Advanced Neuropsychiatric Tools and Assessment Schedule (ANTAS), administered by clinicians. The diagnoses were based on the ICD-10 criteria. The Short-Form Health Survey (SF-12) was used to quantify HR-QoL. RESULTS In the sample, 35 subjects met the criteria for agoraphobia (1.5%), with greater prevalence among women (2.0%) than men (0.9%): odds ratio (OR) 2.23; 95% CI: 1.0-5-2. Agoraphobia was more often seen among those with (n=26; 1.1%) than without (n=9; 0.4%) panic disorder: OR=8.3; 2.9-24.4. Co-morbidity with other mental disorders was substantial. The mean score of SF-12 in people with agoraphobia was 35.2±7.8, with similar levels of HR-QoL in people with (35.3±7.9) or without (34.8±7.3) panic disorder: ANOVA: F(1;33)=0.0; p=1.00. CONCLUSION One out of seventy people may suffer from agoraphobia in their lifetime. The attributable burden in terms of HR-QoL is substantial and comparable to the one observed for chronic mental disorders such as major depression, post-traumatic stress disorder, or obsessive-compulsive disorder.
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Affiliation(s)
- Antonio Preti
- Department of Neuroscience, University of Turin, Torino, Italy
| | - Martina Piras
- PhD Programme Innovation Sciences and Technologies, University of Cagliari, Cagliari, Italy
| | - Giulia Cossu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Elisa Pintus
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Mirra Pintus
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Goce Kalcev
- PhD Programme Innovation Sciences and Technologies, University of Cagliari, Cagliari, Italy
| | - Federico Cabras
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | | | | | - Filippo Caraci
- Department of Drug Sciences, University of Catania, Catania, Italy.,Oasi Research Institute-IRCCS, Troina, Italy
| | | | | | - Filippo Drago
- Department of Drug Sciences, University of Catania, Catania, Italy
| | | | | | | | - Mario Musu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Gabriele Finco
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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21
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Coelho S, Simões V, Batista R, Ribeiro C, Lamy Z, Lamy-Filho F, Carvalho C, Viola P, Queiroz R, Ferraro A, Bettiol H. Birth by cesarean section and mood disorders among adolescents of a birth cohort study in northern Brazil. Braz J Med Biol Res 2021; 54:e10285. [PMID: 33503158 PMCID: PMC7822467 DOI: 10.1590/1414-431x202010285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 11/25/2020] [Indexed: 12/14/2022] Open
Abstract
The increasing number of cesarean sections worldwide has encouraged research on the long-term effects of this birth type on the offspring's mental health. The objective of this study was to investigate whether there is an association between birth by cesarean section and the development of mood disorders (depression and bipolar disorders) in adolescents. A cohort study was carried out with 1603 adolescents from 18 to 19 years old who participated in the third phase of a birth cohort study in São Luís, MA, in 2016. Information on birth type and weight, prematurity, mother's age and schooling, parity, marital status, and smoking behavior during pregnancy, were collected at birth. The study outcomes were depression, bipolar disorder, and "mood disorder" construct. A Directed Acyclic Graph (DAG) was developed to select the variables for minimal adjustment for confounding and collision bias. Associations were estimated through propensity score weighting using a two-step estimation model, and confounders for cesarean birth were used in the predictive model. There was no significant association in the relationship between birth type and depression (95%CI: -0.037 to 0.017; P=0.47), bipolar disorder (95%CI: -0.019 to 0.045; P=0.43), and mood disorder (95%CI: -0.033 to 0.042; P=0.80) in adolescents of both sexes. Birth by cesarean section was not associated with the development of mood disorders in adolescents.
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Affiliation(s)
- S.J.D.C. Coelho
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - V.M.F. Simões
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - R.F.L. Batista
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - C.C.C. Ribeiro
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - Z.C. Lamy
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - F. Lamy-Filho
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - C.A. Carvalho
- Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - P.C.A.F. Viola
- Departamento de Nutrição, Universidade Federal do Piauí, Teresina, PI, Brasil
| | - R.C.S. Queiroz
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - A.A. Ferraro
- Departamento de Pediatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - H. Bettiol
- Departamento de Puericultura e Pediatria, Faculdade de Medicina, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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22
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Marinkovic I, Isokuortti H, Huovinen A, Trpeska Marinkovic D, Mäki K, Nybo T, Korvenoja A, Rahul R, Vataja R, Melkas S. Prognosis after Mild Traumatic Brain Injury: Influence of Psychiatric Disorders. Brain Sci 2020; 10:E916. [PMID: 33260933 PMCID: PMC7760617 DOI: 10.3390/brainsci10120916] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/15/2020] [Accepted: 11/25/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND We evaluated the prevalence of psychiatric disorders in mild traumatic brain injury (MTBI) patients and investigated psychiatric comorbidity in relation to subjective symptoms and return to work (RTW). METHODS We recruited 103 MTBI patients (mean age 40.8 years, SD 3.1) prospectively from University Hospital. The patients were followed up for one year. The Rivermead Post-Concussion Symptom Questionnaire (RPQ) and Extended Glasgow Outcome Scale (GOSE) were administered one month after MTBI. Three months after MTBI, any psychiatric disorders were assessed using the Structured Clinical Interview for DSM-IV Axis I Disorders. RESULTS Psychiatric disorders were diagnosed in 26 patients (25.2%). The most common disorders were previous/current depression. At three months, there was no difference between patients with psychiatric disorders versus those without them in RTW (95.7% vs. 87.3%, p = 0.260) or at least in part-time work (100% vs. 94.4%, p = 0.245). In Kaplan-Meier analysis, the median time to RTW was 10 days for both groups. The median RPQ score was 13.0 (Interquartile range (IQR) 6.5-19.0) in patients with a psychiatric disorder compared to 8.5 (IQR 2.3-14.0) in those without one (p = 0.021); respectively, the median GOSE was 7.0 (IQR 7.0-8.0) compared to 8.0 (IQR 7.0-8.0, p = 0.003). CONCLUSIONS Approximately every fourth patient with MTBI had a psychiatric disorder. These patients reported more symptoms, and their functional outcome measured with GOSE at one month after MTBI was worse. However, presence of any psychiatric disorder did not affect RTW. Early contact and adequate follow-up are important when supporting the patient's return to work.
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Affiliation(s)
- Ivan Marinkovic
- Neurology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4, Helsinki P.O. Box 340, FIN-00029 HUS Helsinki, Finland; (H.I.); (A.H.); (S.M.)
| | - Harri Isokuortti
- Neurology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4, Helsinki P.O. Box 340, FIN-00029 HUS Helsinki, Finland; (H.I.); (A.H.); (S.M.)
| | - Antti Huovinen
- Neurology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4, Helsinki P.O. Box 340, FIN-00029 HUS Helsinki, Finland; (H.I.); (A.H.); (S.M.)
| | - Daniela Trpeska Marinkovic
- Psychiatry, University of Helsinki and City of Helsinki, Nordenskiöldinkatu 20, P.O. Box 6800, FIN-00099 City of Helsinki, Finland;
| | - Kaisa Mäki
- Neuropsychology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4, Helsinki P.O. Box 340, FIN-00029 HUS Helsinki, Finland; (K.M.); (T.N.)
| | - Taina Nybo
- Neuropsychology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4, Helsinki P.O. Box 340, FIN-00029 HUS Helsinki, Finland; (K.M.); (T.N.)
| | - Antti Korvenoja
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4, Helsinki P.O. Box 340, FIN-00029 HUS Helsinki, Finland;
| | - Raj Rahul
- Neurosurgery, University of Helsinki and Helsinki University Hospital, Topeliuksenkatu 5, Helsinki P.O. Box 266, FIN-00029 HUS Helsinki, Finland;
| | - Risto Vataja
- Psychiatry, University of Helsinki and Helsinki University Hospital, Välskärinkatu 12, Helsinki P.O. Box 590, FIN-00029 HUS Helsinki, Finland;
| | - Susanna Melkas
- Neurology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4, Helsinki P.O. Box 340, FIN-00029 HUS Helsinki, Finland; (H.I.); (A.H.); (S.M.)
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Hyvönen K, Pylvänäinen P, Muotka J, Lappalainen R. The Effects of Dance Movement Therapy in the Treatment of Depression: A Multicenter, Randomized Controlled Trial in Finland. Front Psychol 2020; 11:1687. [PMID: 32903394 PMCID: PMC7434972 DOI: 10.3389/fpsyg.2020.01687] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 06/22/2020] [Indexed: 11/13/2022] Open
Abstract
This multicenter research investigates the effects of dance movement therapy (DMT) on participants diagnosed with depression. In total, 109 persons participated in the study in various locations in Finland. The participants were 39 years old, on average (range = 18–64 years), and most were female (96%). All participants received treatment as usual (TAU). They were randomized into DMT + TAU (n = 52) or TAU only (n = 57). The participants in the DMT + TAU group were offered 20 DMT sessions twice a week for 10 weeks in addition to standard care. The measurement points included pretreatment measurement at the baseline, posttreatment measurement at the end of the intervention, and a follow-up measurement 3 months afterward. The observed effects of the intervention among participants in the DMT+TAU group were a greater reduction in depression and in indicators of physical and psychological distress in comparison to the participants who received TAU-only. At the 3-month follow-up, the corrected between-group effect sizes (ESs) were medium and in favor of the DMT + TAU group (d = 0.60–0.72). These results are in line with the increasing number of research studies showing the benefits of DMT intervention among participants with depression, and these results indicate that DMT may improve the effectiveness of standard care. Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT04421651.
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Affiliation(s)
- Katriina Hyvönen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Päivi Pylvänäinen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Joona Muotka
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Raimo Lappalainen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
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24
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Virtanen S, Kuja-Halkola R, Mataix-Cols D, Jayaram-Lindström N, D'Onofrio BM, Larsson H, Rück C, Suvisaari J, Lichtenstein P, Latvala A. Comorbidity of substance misuse with anxiety-related and depressive disorders: a genetically informative population study of 3 million individuals in Sweden. Psychol Med 2020; 50:1706-1715. [PMID: 31328718 DOI: 10.1017/s0033291719001788] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Causes of the comorbidity of substance misuse with anxiety-related and depressive disorders (anxiety/depression) remain poorly known. We estimated associations of substance misuse and anxiety/depression in the general population and tested them while accounting for genetic and shared environmental factors. METHODS We studied individuals born in Sweden 1968-1997 (n = 2 996 398) with follow-up in nationwide register data for 1997-2013. To account for familial effects, stratified analyses were conducted within siblings and twin pairs. Substance misuse was defined as ICD-10 alcohol or drug use disorder or an alcohol/drug-related criminal conviction. Three dimensions of ICD-10 anxiety and depressive disorders and a substance misuse dimension were identified through exploratory factor analysis. RESULTS Substance misuse was associated with a 4.5-fold (95% CI 4.50-4.58) elevated risk of lifetime generalized anxiety/depression, 4.7-fold (95% CI 4.63-4.82) elevated risk of panic disorder and agora/social phobia, and 2.9-fold elevated risk of phobias/OCD (95% CI 2.82-3.02) as compared to those without substance misuse. The associations were attenuated in within-family analyses but we found elevated risks in monozygotic twin pairs discordant for substance misuse as well as significant non-shared environmental correlations. The association between anxiety/depression and substance misuse was mainly driven by generalized anxiety/depression, whereas other anxiety/depression dimensions had minor or no independent associations with substance misuse. CONCLUSIONS Substance misuse and anxiety/depression are associated at the population level, and these associations are partially explained by familial liabilities. Our findings indicate a common genetic etiology but are also compatible with a potential partially causal relationship between substance misuse and anxiety/depression.
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Affiliation(s)
- Suvi Virtanen
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - David Mataix-Cols
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Centre for Psychiatry Research, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Nitya Jayaram-Lindström
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Centre for Psychiatry Research, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Brian M D'Onofrio
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Christian Rück
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Centre for Psychiatry Research, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Jaana Suvisaari
- National Institute for Health and Welfare, Helsinki, Finland
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Antti Latvala
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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25
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Markkula N, Lindgren M, Yolken RH, Suvisaari J. Association of exposure to Toxoplasma gondii, Epstein-Barr Virus, Herpes Simplex virus Type 1 and Cytomegalovirus with new-onset depressive and anxiety disorders: An 11-year follow-up study. Brain Behav Immun 2020; 87:238-242. [PMID: 31809804 DOI: 10.1016/j.bbi.2019.12.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/27/2019] [Accepted: 12/02/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Some prevalent infections have been associated with common mental disorders, but there are few longitudinal studies, and results are inconsistent. We aimed to assess whether serological evidence of exposure to Toxoplasma gondii (T. gondii), Epstein-Barr Virus (EBV), Herpes Simplex virus Type 1 (HSV-1) and Cytomegalovirus (CMV) predict development of new-onset depressive and anxiety disorders. METHODS In a nationally representative sample of the Finnish adult population aged 30 and over (BRIF8901, n = 8028), IgG antibodies for T. gondii, EBV, HSV-1 and CMV were measured in plasma samples. The population was followed up for 11 years and new-onset depressive and anxiety disorders were diagnosed with the Composite International Diagnostic Interview. Associations were analysed controlling for sex, age, educational level, region of residence and marital status, and in separate analyses also for C-reactive protein level. RESULTS Seropositivity and serointensity of the four infectious agents were not associated with an increased risk of new-onset depressive or anxiety disorders. Seropositivity for CMV at baseline was associated with a lower risk of new-onset generalized anxiety disorder (adjusted OR 0.43, 95% CI 0.22-0.86 for CMV positive persons). CONCLUSION The results of this large, nationally representative longitudinal study suggest that common viral infections are not significant risk factors for common mental disorders. The association of CMV with a lower risk of generalized anxiety disorder warrants further investigation.
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Affiliation(s)
- Niina Markkula
- Department of Psychiatry, Helsinki University and Helsinki University Hospital, Helsinki, Finland; Faculty of Medicine Clinica Alemana, Universidad del Desarrollo, Santiago, Chile.
| | - Maija Lindgren
- Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Robert H Yolken
- Stanley Division of Developmental Neurovirology, Department of Pediatrics, John Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jaana Suvisaari
- Faculty of Medicine Clinica Alemana, Universidad del Desarrollo, Santiago, Chile
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Ekqvist E, Kuusisto K. Changes in clients’ well-being (ORS) and state hope (SHS) during inpatient substance abuse treatment. NORDIC STUDIES ON ALCOHOL AND DRUGS 2020; 37:384-399. [PMID: 35310923 PMCID: PMC8899247 DOI: 10.1177/1455072520922025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 03/16/2020] [Indexed: 11/16/2022] Open
Abstract
Aims: During inpatient substance abuse treatment, professionals seek to help clients to achieve improvement in various life domains affected by substance abuse. Progress monitoring during substance abuse treatment has been called for, and in this study we examine how clients’ levels of well-being and hope change during inpatient substance abuse treatment. Methods: Clients ( N = 168) entered the treatment facility between January 1, 2017 and August 31, 2018. The prospective data were gathered from one treatment unit located in central Finland on entry into treatment, during and at the end of treatment. Using the Outcome Rating Scale (ORS) as a therapeutic tool was standard procedure in the treatment unit. Demographic information on participants, information on their previous substance use and scores on the State Hope Scale (SHS) were collected through structured questionnaires. Non-parametrical tests (Mann–Whitney U test; Kruskal–Wallis χ2; Spearman’s rho) were used to study changes in indicators of well-being and hope. Results: As hypothesised, inpatient treatment had a positive effect on both ORS and SHS and they were interrelated. Differences in gender, living situation and previous admissions were found when studying how the background information of the participants was related to the change achieved in ORS and SHS. Conclusions: Inpatient substance abuse treatment seemed to enhance both well-being and hope of the clients of inpatient substance abuse treatment.
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27
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Skapinakis P, Lewis G, Davies S, Brugha T, Prince M, Singleton N. Panic disorder and subthreshold panic in the UK general population: Epidemiology, comorbidity and functional limitation. Eur Psychiatry 2020; 26:354-62. [DOI: 10.1016/j.eurpsy.2010.06.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Revised: 06/14/2010] [Accepted: 06/23/2010] [Indexed: 10/19/2022] Open
Abstract
AbstractObjectiveThe epidemiology of panic disorder has not been investigated in the past in the UK using a nationally representative sample of the population. The aim of the present paper was to examine the epidemiology, comorbidity and functional impairment of subthreshold panic and panic disorder with or without agoraphobia.MethodWe used data from the 2000 Office for National Statistics Psychiatric Morbidity survey (N = 8580). Panic disorder and agoraphobia were assessed with the Revised Clinical Interview Schedule (CIS-R).ResultThe prevalence of panic disorder with or without agoraphobia was 1.70% (95% confidence interval: 1.41–2.03%). Subthreshold panic was more common. Economic inactivity was consistently associated with all syndromes. The comorbidity pattern of the panic syndromes and the associated functional impairment show that panic-related conditions are important public health problems, even in subthreshold status.ConclusionsThe findings show that efforts to reduce the disability associated with psychiatric disorders should include detection and management of panic disorder.
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28
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Holma M, Holma I, Isometsä E. Comorbid alcohol use disorder in psychiatric MDD patients: A five-year prospective study. J Affect Disord 2020; 267:283-288. [PMID: 32217228 DOI: 10.1016/j.jad.2020.02.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 01/31/2020] [Accepted: 02/08/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Comorbid alcohol use disorder (AUD) is common among patients with major depressive disorder (MDD), and often complicates presentation and treatment. However, there is a scarcity of clinical studies investigating the characteristics and outcome of psychiatric MDD patients with AUD. METHODS In the Vantaa Depression Study (VDS), a five-year prospective study of psychiatric out- and inpatients (N = 269) with MDD, we investigated the clinical features of MDD, comorbid Axis I and II disorders, psychosocial factors, and long-term outcome of patients with or without AUD. RESULTS Depressed patients with comorbid AUD at baseline (n = 66/269, 24.5%) were more often male (OR=3.57, [95% CI 1.72 - 7.41], p = 0.001), had more suicidal ideation (OR=1.06 [1.02 - 1.11], p = 0.008), comorbid panic disorders (OR=3.44 [1.47 - 8.06], p = 0.004), symptoms of any personality disorder (OR=1.04 [1.00 - 1.08], p = 0.038), and more often smoked daily (OR=2.79 [1.32 - 5.88], p = 0.007) than those without. At five years, 13.9% (25/180) still had AUD. More specifically, alcohol abuse was associated with suicide attempts, and dependence with suicidal ideation, and Cluster B personality disorder. Patients with AUD spent more time depressed and had more suicide attempts during follow-up. LIMITATIONS We did not investigate other substance use disorders. The AUD diagnoses were based on DSM-IV criteria. CONCLUSIONS Psychiatric MDD patients with comorbid alcohol use disorders have characteristics consistent with the epidemiology of AUDs in the general population. They are more often males and smoke, and have more comorbid mental disorders and suicidal behavior. Prospectively they spend more time depressed, thus having worse outcomes than patients without AUDs.
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Affiliation(s)
- Mikael Holma
- Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland; Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Irina Holma
- Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland; Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Erkki Isometsä
- Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland; Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
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Riihimäki K, Sintonen H, Vuorilehto M, Jylhä P, Saarni S, Isometsä E. Health-related quality of life of primary care patients with depressive disorders. Eur Psychiatry 2020; 37:28-34. [DOI: 10.1016/j.eurpsy.2016.04.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 04/19/2016] [Accepted: 04/19/2016] [Indexed: 11/30/2022] Open
Abstract
AbstractBackgroundDepressive disorders are known to impair health-related quality of life (HRQoL) both in the short and long term. However, the determinants of long-term HRQoL outcomes in primary care patients with depressive disorders remain unclear.MethodsIn a primary care cohort study of patients with depressive disorders, 82% of 137 patients were prospectively followed up for five years. Psychiatric disorders were diagnosed with SCID-I/P and SCID-II interviews; clinical, psychosocial and socio-economic factors were investigated by rating scales and questionnaires plus medical and psychiatric records. HRQoL was measured with the generic 15D instrument at baseline and five years, and compared with an age-standardized general population sample (n = 3707) at five years.ResultsDepression affected the 15D total score and almost all dimensions at both time points. At the end of follow-up, HRQoL of patients in major depressive episode (MDE) was particularly low, and the association between severity of depression (Beck Depression Inventory [BDI]) and HRQoL was very strong (r = −0.804). The most significant predictors for change in HRQoL were changes in BDI and Beck Anxiety Inventory (BAI) scores. The mean 15D score of depressive primary care patients at five years was much worse than in the age-standardized general population, reaching normal range only among patients who were in clinical remission and had virtually no symptoms.ConclusionsAmong depressive primary care patients, presence of current depressive symptoms markedly reduces HRQoL, with symptoms of concurrent anxiety also having a marked impact. For HRQoL to normalize, current depressive and anxiety symptoms must be virtually absent.
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30
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Luo X, Ke X, Li H, Dai Q, Zhang C, Zheng W, Fang Z, Wu F, Ning Y. Prevalence and risk factors for depression in outpatient departments of three general hospitals in China: a cross-sectional study. Int J Psychiatry Clin Pract 2020; 24:88-95. [PMID: 31718347 DOI: 10.1080/13651501.2019.1687723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: To determine the prevalence and risk factors associated with depression of outpatients in three general hospitals in southern China.Methods: This hospital-based, cross-sectional descriptive study was conducted in outpatient departments of Neurology, Gastroenterology, Cardiology and Gynaecology of three general hospitals between March and June 2016. A total of 5294 adult respondents (≥18 years) in clinic waiting rooms were recruited, and 4976 were eligible to participate in the study. The nine-item Patient Health Questionnare-9 (PHQ-9) Scale was used to assess the presence of depressive symptoms. Binary logistic regression analysis was performed to identify the risk factors associated with depressive symptoms.Results: The prevalence of depressive symptoms among outpatients was 26.0% (95% CI: 24.8-27.3%). Risk factors associated with depressive symptoms included younger age (OR = 0.960; 95% CI: 0.95-0.971), social alcohol drinking (OR = 1.339; 95% CI: 1.074-1.668) and sleep disturbance (OR = 3.678; 95% CI: 3.025-4.471).Conclusions: This study provides evidence that depressive symptoms are prevalent among outpatients of general hospitals. Moreover, younger age, alcohol consumption and sleep disturbance may potentially be useful for targeted screening and prevention for outpatients with depression seen in general hospitals.KeypointsThe prevalence of self-reported depressive symptoms is common in outpatients in clinical settings.Younger age, current alcohol drinking and sleep disturbance are the associated risk factors for depression in outpatient population.Alcohol prevention and sleep quality improvement need to be incorporated into strategies aimed at the prevention and management of depression.
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Affiliation(s)
- Xinni Luo
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Xiaoyin Ke
- Shenzhen Mental Health Center, Shenzhen, China
| | - Haiyan Li
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Qing Dai
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Chanjuan Zhang
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Wei Zheng
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Ziyan Fang
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Fengchun Wu
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yuping Ning
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
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Pirkola S, Nevalainen J, Laaksonen M, Fröjd S, Nurmela K, Näppilä T, Tuulio-Henriksson A, Autio R, Blomgren J. The importance of clinical and labour market histories in psychiatric disability retirement: analysis of the comprehensive Finnish national-level RETIRE data. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1011-1020. [PMID: 31807792 PMCID: PMC7394924 DOI: 10.1007/s00127-019-01815-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 11/28/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Despite the stable incidence of mental disorders in Finland and Europe, mental health-related occupational disability has been increasing. We unveiled the paths to permanent psychiatric disability, recovery, or death, by analysing sequences of labour market participation. METHODS The RETIRE register database includes information regarding all persons (n = 42,170) awarded an ICD-10 psychiatric disability pension between 2010 and 2015 in Finland. We identified clusters of typical paths of pre-retirement labour market history. Controlling for major mental disorders, age, and sex, we evaluated factors associated with returning to work (RTW), or death, over a 5-year follow-up period. RESULTS Only 10.5% of the disabled subjects returned to work within the follow-up. Half of them ended up with a permanent disability pension. Seven distinguishable paths to disability were identified. Subjects in the cluster characterized by steady employment were relatively often females, lost their work ability due to affective disorders, and had the highest rate of returning to work (16.3%). Mortality was highest (9%) among the cluster characterized by long-term unemployment. Distributions of major diagnostic groups, as well as age and sex, differed between clusters. After their adjustment in the analysis of RTW or death, the identified labour market history paths prior to losing work ability remained as important independent prognostic factors for both outcomes. CONCLUSIONS The complex retirement process involves identifiable clinical and contextual associating factors. Labour market history patterns associate with varying prognoses after psychiatric retirement. Prolonged unemployment appears as a predictor of relatively poor prognoses, whereas employment indicates the opposite.
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Affiliation(s)
- S Pirkola
- Faculty of Social Sciences, Health Sciences Unit, Tampere University, Arvo Ylpön Katu 34, 33014, Tampereen Yliopisto, Finland.
- Department of Psychiatry, Tampere University Central Hospital, Tampere, Finland.
| | - J Nevalainen
- Faculty of Social Sciences, Health Sciences Unit, Tampere University, Arvo Ylpön Katu 34, 33014, Tampereen Yliopisto, Finland
| | - M Laaksonen
- The Finnish Centre for Pensions, Helsinki, Finland
| | - S Fröjd
- Faculty of Social Sciences, Health Sciences Unit, Tampere University, Arvo Ylpön Katu 34, 33014, Tampereen Yliopisto, Finland
| | - K Nurmela
- Faculty of Social Sciences, Health Sciences Unit, Tampere University, Arvo Ylpön Katu 34, 33014, Tampereen Yliopisto, Finland
| | - T Näppilä
- Faculty of Social Sciences, Health Sciences Unit, Tampere University, Arvo Ylpön Katu 34, 33014, Tampereen Yliopisto, Finland
| | - A Tuulio-Henriksson
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - R Autio
- Faculty of Social Sciences, Health Sciences Unit, Tampere University, Arvo Ylpön Katu 34, 33014, Tampereen Yliopisto, Finland
| | - J Blomgren
- The Social Insurance Institution of Finland, Helsinki, Finland
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Network structure of depression symptomology in participants with and without depressive disorder: the population-based Health 2000-2011 study. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1273-1282. [PMID: 32047972 PMCID: PMC7544719 DOI: 10.1007/s00127-020-01843-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 02/03/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE Putative causal relations among depressive symptoms in forms of network structures have been of recent interest, with prior studies suggesting that high connectivity of the symptom network may drive the disease process. We examined in detail the network structure of depressive symptoms among participants with and without depressive disorders (DD; consisting of major depressive disorder (MDD) and dysthymia) at two time points. METHODS Participants were from the nationally representative Health 2000 and Health 2011 surveys. In 2000 and 2011, there were 5998 healthy participants (DD-) and 595 participants with DD diagnosis (DD+). Depressive symptoms were measured using the 13-item version of the Beck Depression Inventory (BDI). Fused Graphical Lasso was used to estimate network structures, and mixed graphical models were used to assess network connectivity and symptom centrality. Network community structure was examined using the walktrap-algorithm and minimum spanning trees (MST). Symptom centrality was evaluated with expected influence and participation coefficients. RESULTS Overall connectivity did not differ between networks from participants with and without DD, but more simple community structure was observed among those with DD compared to those without DD. Exploratory analyses revealed small differences between the samples in the order of one centrality estimate participation coefficient. CONCLUSIONS Community structure, but not overall connectivity of the symptom network, may be different for people with DD compared to people without DD. This difference may be of importance when estimating the overall connectivity differences between groups with and without mental disorders.
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Maier A, Schaitz C, Kröner J, Connemann B, Sosic-Vasic Z. Imagery Rescripting: Exploratory Evaluation of a Short Intervention to Reduce Test Anxiety in University Students. Front Psychiatry 2020; 11:84. [PMID: 32184744 PMCID: PMC7058550 DOI: 10.3389/fpsyt.2020.00084] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 02/03/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Test anxiety is common in university students. Demanding schedules may contribute to the relatively low utilization of professional counseling, when compared to other anxiety disorders. A possible solution could be a psychotherapeutic short-term intervention. The present exploratory study implemented a short-term psychotherapeutic treatment, consisting of two imagery rescripting (IR) sessions. The efficacy of IR techniques has already been demonstrated in the treatment of various anxiety disorders including test anxiety. METHODS Nine students suffering from test anxiety (m = 3, f = 6) underwent two weekly applied sessions of IR. Outcome variables were examined one week prior to (t1), immediately after (t2) and three months after (t3) the intervention, using self-evaluation questionnaires on test anxiety (PAF), depressive symptoms (BDI II), life satisfaction (FLZ), general self-efficacy and study-specific self-efficacy (WIRKALL; WIRK_STUD), intrusiveness of mental images (IFES), and change and acceptance (VEV; ZUF; BFTB). RESULTS There were no dropouts. According to results from ZUF and BFTB, the participants where highly satisfied with the intervention. PAF scores decreased significantly over time (t1 to t3), whereas WIRKALL scores (t1 to t3) and WIRK_STUD scores (t1 to t3 and t2 to t3) increased significantly. IFES scores decreased immediately after the intervention (t1 compared to t2) and further after the follow-up (t1 to t3). No changes in BDI-II scores were observed. DISCUSSION The findings indicate a high acceptance and efficacy of the two-session IR-intervention. Limits are the lack of a control group, and the small sample size. Further evaluation in future controlled studies is needed.
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Affiliation(s)
- Anna Maier
- Department for Psychiatry and Psychotherapy, University Clinic of Ulm, Ulm, Germany
| | - Caroline Schaitz
- Department for Psychiatry and Psychotherapy, University Clinic of Ulm, Ulm, Germany
| | - Julia Kröner
- Department for Psychiatry and Psychotherapy, University Clinic of Ulm, Ulm, Germany
| | - Bernhard Connemann
- Department for Psychiatry and Psychotherapy, University Clinic of Ulm, Ulm, Germany
| | - Zrinka Sosic-Vasic
- Department for Psychiatry and Psychotherapy, University Clinic of Ulm, Ulm, Germany
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Choi SJ, Song P, Suh S, Joo EY, Lee SI. Insomnia Symptoms and Mood Disturbances in Shift Workers with Different Chronotypes and Working Schedules. J Clin Neurol 2020; 16:108-115. [PMID: 31942766 PMCID: PMC6974840 DOI: 10.3988/jcn.2020.16.1.108] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 09/30/2019] [Accepted: 09/30/2019] [Indexed: 12/12/2022] Open
Abstract
Background and Purpose Shift workers frequently suffer from insomnia and mood disturbances, but little is known about the relationships of these conditions with the chronotypes and different working schedules of shift workers. We hypothesized that different shift-work schedules are associated with different severities of sleep and mood disturbances, and that the individual chronotype plays a role in sleep disturbances in shift workers. Methods This study enrolled 276 participants, comprising 77 nurses working in a three-shift schedule (3S, 27.9%), 60 firefighters working in a 24-h-every-other-day shift schedule (EOD, 21.7%), and 139 day workers (DW, 50.4%). All of the participants completed the following questionnaires to assess their sleep disturbances, mood, and chronotype: Insomnia Severity Index (ISI), Epworth Sleepiness Scale, Hospital Anxiety and Depression Scale, and Morningness-Eveningness Questionnaire. Results ISI questionnaires were worse in both shift workers compare to DW, 35.1% of 3S, 23% of EOD had clinically significant insomnia (ISI score >14). Depressive mood and anxiety symptom were significantly worse in 3S compare to EOD. The sleep disturbance by ISI score had significant correlations with depressive mood and anxiety symptoms for both EOD and 3S (EOD: rho=0.57, rho=0.57, 3S: rho=0.37, rho=0.33 respectively). Chronotype type in shift workers had no significant correlation with sleep disturbance, depressive mood, nor anxiety symptom. However, after adjustment, the eveningness chronotype have relationship to the depressive mood in shift workers. Conclusions Sleep disturbances are more frequent in shift workers than DW. Depressive mood and anxiety symptoms were frequently reported in 3S, then EOD. Different shift schedules cab be a determinant of depressive mood and anxiety symptom.
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Affiliation(s)
- Su Jung Choi
- Department of Nursing, Samsung Medical Center, Department of Clinical Nursing Science, Graduate School of Clinical Nursing Science, Sungkyunkwan University, Seoul, Korea.,Department of Neurology, Neuroscience Center, Samsung Biomedical Research Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Pamela Song
- Department of Neurology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Sooyeon Suh
- Department of Psychology, Sungshin Women's University, Seoul, Korea
| | - Eun Yeon Joo
- Department of Neurology, Neuroscience Center, Samsung Biomedical Research Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Sung Ik Lee
- Department of Neurology, Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea.
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Rouhiainen A, Kulesskaya N, Mennesson M, Misiewicz Z, Sipilä T, Sokolowska E, Trontti K, Urpa L, McEntegart W, Saarnio S, Hyytiä P, Hovatta I. The bradykinin system in stress and anxiety in humans and mice. Sci Rep 2019; 9:19437. [PMID: 31857655 PMCID: PMC6923437 DOI: 10.1038/s41598-019-55947-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 11/27/2019] [Indexed: 01/06/2023] Open
Abstract
Pharmacological research in mice and human genetic analyses suggest that the kallikrein-kinin system (KKS) may regulate anxiety. We examined the role of the KKS in anxiety and stress in both species. In human genetic association analysis, variants in genes for the bradykinin precursor (KNG1) and the bradykinin receptors (BDKRB1 and BDKRB2) were associated with anxiety disorders (p < 0.05). In mice, however, neither acute nor chronic stress affected B1 receptor gene or protein expression, and B1 receptor antagonists had no effect on anxiety tests measuring approach-avoidance conflict. We thus focused on the B2 receptor and found that mice injected with the B2 antagonist WIN 64338 had lowered levels of a physiological anxiety measure, the stress-induced hyperthermia (SIH), vs controls. In the brown adipose tissue, a major thermoregulator, WIN 64338 increased expression of the mitochondrial regulator Pgc1a and the bradykinin precursor gene Kng2 was upregulated after cold stress. Our data suggests that the bradykinin system modulates a variety of stress responses through B2 receptor-mediated effects, but systemic antagonists of the B2 receptor were not anxiolytic in mice. Genetic variants in the bradykinin receptor genes may predispose to anxiety disorders in humans by affecting their function.
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Affiliation(s)
- Ari Rouhiainen
- Molecular and Integrative Biosciences Research Program, University of Helsinki, Helsinki, Finland
| | - Natalia Kulesskaya
- Molecular and Integrative Biosciences Research Program, University of Helsinki, Helsinki, Finland
| | - Marie Mennesson
- Molecular and Integrative Biosciences Research Program, University of Helsinki, Helsinki, Finland.,Department of Psychology and Logopedics, Medicum, University of Helsinki, Helsinki, Finland.,SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Neuroscience Center, Helsinki Institute of Life Science HiLIFE, University of Helsinki, Helsinki, Finland
| | - Zuzanna Misiewicz
- Molecular and Integrative Biosciences Research Program, University of Helsinki, Helsinki, Finland.,Department of Psychology and Logopedics, Medicum, University of Helsinki, Helsinki, Finland
| | - Tessa Sipilä
- Molecular and Integrative Biosciences Research Program, University of Helsinki, Helsinki, Finland
| | - Ewa Sokolowska
- Molecular and Integrative Biosciences Research Program, University of Helsinki, Helsinki, Finland
| | - Kalevi Trontti
- Molecular and Integrative Biosciences Research Program, University of Helsinki, Helsinki, Finland.,Department of Psychology and Logopedics, Medicum, University of Helsinki, Helsinki, Finland.,SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Neuroscience Center, Helsinki Institute of Life Science HiLIFE, University of Helsinki, Helsinki, Finland
| | - Lea Urpa
- Molecular and Integrative Biosciences Research Program, University of Helsinki, Helsinki, Finland
| | - William McEntegart
- Molecular and Integrative Biosciences Research Program, University of Helsinki, Helsinki, Finland
| | - Suvi Saarnio
- Molecular and Integrative Biosciences Research Program, University of Helsinki, Helsinki, Finland
| | - Petri Hyytiä
- Department of Pharmacology, Medicum, University of Helsinki, Helsinki, Finland
| | - Iiris Hovatta
- Molecular and Integrative Biosciences Research Program, University of Helsinki, Helsinki, Finland. .,Department of Psychology and Logopedics, Medicum, University of Helsinki, Helsinki, Finland. .,SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland. .,Neuroscience Center, Helsinki Institute of Life Science HiLIFE, University of Helsinki, Helsinki, Finland.
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Ueno R, Osada H, Solantaus T, Murakoshi A, Inoue T. Safety, Feasibility, Fidelity, and Perceived Benefits of an Intervention for Parents with Mood Disorders and Their Children — “Let’s Talk About Children” in Japan. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/08975353.2019.1678092] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Rie Ueno
- Department of Psychiatric and Mental Health Nursing, School of Nursing, Tokyo Medical University, Tokyo, Japan
| | - Hirokazu Osada
- Department of Psychology, School of Human Sciences, Senshu University, Kawasaki, Japan
- Department of Psychiatry, Tokyo Medical University, Tokyo, Japan
| | - Tytti Solantaus
- The Finnish Association for Mental Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Akiko Murakoshi
- Department of Psychiatry, Tokyo Medical University, Tokyo, Japan
| | - Takeshi Inoue
- Department of Psychiatry, Tokyo Medical University, Tokyo, Japan
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Luiro K, Aittomäki K, Jousilahti P, Tapanainen JS. Long-term health of women with genetic POI due to FSH-resistant ovaries. Endocr Connect 2019; 8:1354-1362. [PMID: 31505457 PMCID: PMC6790899 DOI: 10.1530/ec-19-0244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 09/09/2019] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To study the use of hormone therapy (HT), morbidity and reproductive outcomes of women with primary ovarian insufficiency (POI) due to FSH-resistant ovaries (FSHRO). DESIGN A prospective follow-up study in a university-based tertiary clinic setting. METHODS Twenty-six women with an inactivating A189V FSH receptor mutation were investigated by means of a health questionnaire and clinical examination. Twenty-two returned the health questionnaire and 14 were clinically examined. Main outcome measures in the health questionnaire were reported as HT, morbidity, medication and infertility treatment outcomes. In the clinical study, risk factors for cardiovascular disease (CVD) and metabolic syndrome (MetS) were compared to age-matched controls from a national population survey (FINRISK). Average number of controls was 326 per FSHRO subject (range 178-430). Bone mineral density and whole-body composition were analyzed with DXA. Psychological and sexual well-being was assessed with Beck Depression Inventory (BDI21), Generalized Anxiety Disorder 7 (GAD-7) and Female Sexual Function Index (FSFI) questionnaires. RESULTS HT was initiated late (median 18 years of age) compared with normal puberty and the median time of use was shorter (20-22 years) than the normal fertile period. Osteopenia was detected in 9/14 of the FSHRO women despite HT. No major risk factors for CVD or diabetes were found. CONCLUSIONS HT of 20 years seems to be associated with a similar cardiovascular and metabolic risk factor profile as in the population control group. However, optimal bone health may require an early-onset and longer period of HT, which would better correspond to the natural fertile period.
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Affiliation(s)
- Kaisu Luiro
- Department of Obstetrics and Gynecology, Reproductive Medicine Unit, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Kristiina Aittomäki
- Department of Medical Genetics, Helsinki University Hospital, Helsinki, Finland
| | - Pekka Jousilahti
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Juha S Tapanainen
- Department of Obstetrics and Gynecology, Reproductive Medicine Unit, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Obstetrics and Gynecology, University of Oulu and Oulu University Hospital, Medical Research Center, PEDEGO Research Unit, Oulu, Finland
- Correspondence should be addressed to J S Tapanainen:
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Levola J, Eskelinen S, Pitkänen T. Associations between self-rated health, quality of life and symptoms of depression among Finnish inpatients with alcohol and substance use disorders. JOURNAL OF SUBSTANCE USE 2019. [DOI: 10.1080/14659891.2019.1664667] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Jonna Levola
- HUS Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Saana Eskelinen
- HUS Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Woo J, Hong JP, Cho SJ, Lee JY, Joen HJ, Kim BS, Chang SM. Bidirectional Association between First-Episode Panic Disorder and Major Depressive Disorder in a Nationwide General Population Survey in Korea. J Korean Med Sci 2019; 34:e181. [PMID: 31269543 PMCID: PMC6609421 DOI: 10.3346/jkms.2019.34.e181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 06/16/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Panic disorder (PD) and major depressive disorder (MDD) can occur concurrently, despite different clinical manifestations. Because MDD and PD patients tend to have more complicated conditions, understanding the co-occurrence and pattern of these conditions is important. Here, we investigated the influence of PD and MDD on each other, with respect to time interval. METHODS Data from three national representative surveys were pooled (total 18,807 respondents), and the age of onset (AOO) of PD and MDD was analyzed. We performed Kaplan-Meier analysis to estimate separate survival functions, using the AOO of MDD and PD as the outcome. To understand the temporal effect of other disorders, we used a Cox proportional hazard model to estimate the hazard ratios for the onset of MDD/PD with other comorbidities as time-dependent covariates. RESULTS PD elevated the risk of subsequent MDD by 1.5-fold, whereas MDD elevated the risk of subsequent PD by 3.8-fold. The effect of such an elevation risk was significant for up to 2 years. CONCLUSION The results revealed a bidirectional relationship between MDD and PD. Each disease represents a risk of a subsequent occurrence of the other, which lasts for a considerable duration.
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Affiliation(s)
- Jungmin Woo
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jin Pyo Hong
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seong Jin Cho
- Department of Psychiatry, Gachon Medical School, Gachon University of Medicine and Science, Incheon, Korea
| | - Jun Young Lee
- Department of Neuropsychiatry, Seoul Metropolitan Boramae Medical Center, Seoul, Korea
| | - Hong Jin Joen
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byung Soo Kim
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sung Man Chang
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Korea.
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Lallukka T, Kaila-Kangas L, Mänty M, Koskinen S, Haukka E, Kausto J, Leino-Arjas P, Kaikkonen R, Halonen JI, Shiri R. Work-Related Exposures and Sickness Absence Trajectories: A Nationally Representative Follow-up Study among Finnish Working-Aged People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16122099. [PMID: 31200553 PMCID: PMC6616391 DOI: 10.3390/ijerph16122099] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 06/11/2019] [Accepted: 06/11/2019] [Indexed: 11/26/2022]
Abstract
The contribution of physically demanding work to the developmental trajectories of sickness absence (SA) has seldom been examined. We analyzed the associations of 12 physical work exposures, individually and in combination, with SA trajectories among the occupationally active in the Finnish nationally representative Health 2000 survey. We included 3814 participants aged 30–59 years at baseline, when exposure history to work-related factors was reported. The survey and interview responses were linked with the annual number of medically confirmed SA spells through 2002–2008 from national registries. Trajectory analyses identified three SA subgroups: 1 = low (54.6%), 2 = slowly increasing (33.7%), and 3 = high (11.7%). After adjustments, sitting or use of keyboard >1 year was inversely associated with the high SA trajectory (odds ratio, OR, 0.57; 95% 95% confidence interval, CI, 0.43–0.77). The odds of belonging to the trajectory of high SA increased with an increasing number of risk factors, and was highest for those with ≥4 physical workload factors (OR 2.71; 95% CI 1.99–3.69). In conclusion, these findings highlight the need to find ways to better maintain the work ability of those in physically loading work, particularly when there occurs exposure to several workload factors.
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Affiliation(s)
- Tea Lallukka
- Department of Public Health, University of Helsinki, P.O. Box 20, 00014 Helsinki, Finland.
- Finnish Institute of Occupational Health, P.O. Box 40, 00032 Helsinki, Finland.
| | - Leena Kaila-Kangas
- Finnish Institute of Occupational Health, P.O. Box 40, 00032 Helsinki, Finland.
| | - Minna Mänty
- Department of Public Health, University of Helsinki, P.O. Box 20, 00014 Helsinki, Finland.
- City of Vantaa, Asematie 7, 01300 Vantaa, Finland.
| | - Seppo Koskinen
- Unit of Statistics and research, National Institute for Health and Welfare, Helsinki, P.O. Box 30, 00271 Helsinki, Finland.
| | - Eija Haukka
- Finnish Institute of Occupational Health, P.O. Box 40, 00032 Helsinki, Finland.
| | - Johanna Kausto
- Finnish Institute of Occupational Health, P.O. Box 40, 00032 Helsinki, Finland.
| | - Päivi Leino-Arjas
- Finnish Institute of Occupational Health, P.O. Box 40, 00032 Helsinki, Finland.
| | - Risto Kaikkonen
- Department of Public Health, University of Helsinki, P.O. Box 20, 00014 Helsinki, Finland.
| | - Jaana I Halonen
- Finnish Institute of Occupational Health, P.O. Box 40, 00032 Helsinki, Finland.
| | - Rahman Shiri
- Finnish Institute of Occupational Health, P.O. Box 40, 00032 Helsinki, Finland.
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Niittyvuopio M, Liisanantti JH, Pikkupeura J, Spalding MB, Sälkiö S, Ala-Kokko TI. Factors associated with impaired physical functioning and mental health in working-age patients attending a post-intensive care follow-up clinic three months after hospital discharge. Anaesth Intensive Care 2019; 47:160-168. [PMID: 31106561 DOI: 10.1177/0310057x19838910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Patients recovering from critical illness are often suffering from remarkable limitations in their everyday life. The purpose of this study was to find factors associated with poor physical functioning and mental health after critical illness. The study was conducted among patients who met the inclusion criteria of our post-intensive care unit follow-up clinic. The patients were invited to the follow-up clinic three months after hospital discharge. The participants filled out a RAND-36 questionnaire, underwent a clinical examination and were stratified to those with good or poor recovery according to physical functioning and emotional wellbeing. Altogether 332 out of 351 follow-up clinic attendees had data available for analysis. In physical functioning 40% of patients achieved a poor outcome. In mental health the percentage was 8%. The patients with poor physical functioning had a longer hospital stay and were more likely to have received vasopressors. Eleven out of 16 (69%) multitrauma patients had poor physical functioning. Patients with poor physical functioning had more memories of pain, achieved worse results in a six-minute walk test and were less likely to be able to move independently. The patients with poor mental health had higher delirium incidence and fewer memories of relatives' visits and of nurses. The conclusions of this study were that the memories of pain, multitrauma and longer hospital stay were associated with a poor physical functioning outcome. Delirium and a lack of memories of relatives and nurses were associated with a poor mental health outcome.
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Affiliation(s)
- Miikka Niittyvuopio
- Department of Anaesthesiology and Intensive Care, Oulu University Hospital, Finland
| | - Janne H Liisanantti
- Department of Anaesthesiology and Intensive Care, Oulu University Hospital, Finland
| | - Jaana Pikkupeura
- Department of Anaesthesiology and Intensive Care, Oulu University Hospital, Finland
| | - Michael B Spalding
- Department of Anaesthesiology and Intensive Care, Oulu University Hospital, Finland
| | - Sinikka Sälkiö
- Department of Anaesthesiology and Intensive Care, Oulu University Hospital, Finland
| | - Tero I Ala-Kokko
- Department of Anaesthesiology and Intensive Care, Oulu University Hospital, Finland
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42
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Halonen JI, Merikukka M, Gissler M, Kerkelä M, Virtanen M, Ristikari T, Hiilamo H, Lallukka T. Pathways from parental mental disorders to offspring's work disability due to depressive or anxiety disorders in early adulthood-The 1987 Finnish Birth Cohort. Depress Anxiety 2019; 36:305-312. [PMID: 30329200 DOI: 10.1002/da.22847] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 08/14/2018] [Accepted: 09/22/2018] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Parental mental disorders have been shown to predict offspring's mental health problems. We examined whether pathways from parental mental disorders to offspring's psychiatric work disability in early adulthood are mediated through offspring's mental disorders and social disadvantage in adolescence. METHODS Study population consisted of the 1987 Finnish Birth Cohort. Data on parents' psychiatric care or work disability due to mental diagnosis between 1987 and 2000 and the cohort participants' health and social factors between 2001 and 2005 were derived from administrative national registers. From 2006 through 2015, 52,182 cohort participants were followed for admittance of psychiatric work disability due to depressive or anxiety disorders. First, we applied a pathway analysis to examine the occurrence of each path. We then used mediation analysis to assess the proportion of association between parental mental disorders and work disability mediated by offspring's health and social disadvantage. RESULTS The pathway model indicated that the association from parental mental disorders to offspring's work disability due to depressive or anxiety disorder is through mental disorders and social disadvantage in adolescence. Odds Ratio for the total effect of parental mental disorders on offspring's psychiatric work disability was 1.85 (95% confidence interval [CI] 1.46-2.34) in the model including offspring's mental disorders that mediated this association by 35%. Corresponding results were 1.86 (95% CI 1.47-2.35) and 28% for social disadvantage in adolescence. CONCLUSIONS These findings suggest that intergenerational determination of work disability due to mental disorders could be addressed by actions supporting mental health and social circumstances in adolescence.
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Affiliation(s)
| | - Marko Merikukka
- Department of Welfare, National Institute for Health and Welfare (THL), Oulu, Finland.,PEDEGO Research Unit, University of Oulu, Oulu, Finland
| | - Mika Gissler
- Information Services Department, National Institute for Health and Welfare (THL), Helsinki, Finland.,Research Centre for Child Psychiatry, University of Turku, Turku, Finland.,Department of Neurobiology, Care Sciences and Society, Division of Family Medicine, Karolinska Institute, Stockholm, Sweden
| | - Martta Kerkelä
- Department of Welfare, National Institute for Health and Welfare (THL), Oulu, Finland
| | - Marianna Virtanen
- Department of Public Health and Caring Sciences, University of Uppsala, Uppsala, Sweden
| | - Tiina Ristikari
- Department of Welfare, National Institute for Health and Welfare (THL), Oulu, Finland
| | - Heikki Hiilamo
- Social and Public Policy, Department of Social Research, University of Helsinki, Helsinki, Finland
| | - Tea Lallukka
- Finnish Institute of Occupational Health, Helsinki, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
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Selinheimo S, Vasankari T, Jokela M, Kanervisto M, Pirkola S, Suvisaari J, Paunio T. The association of psychological factors and healthcare use with the discrepancy between subjective and objective respiratory-health complaints in the general population. Psychol Med 2019; 49:121-131. [PMID: 29554990 DOI: 10.1017/s0033291718000582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND We examined the prevalence of self-perceived respiratory symptoms (SRS) in the absence of any objective findings of respiratory pathology, and the association of such prevalence with psychological factors and healthcare use in the general population. METHODS The study was conducted among a nationally representative sample of Finnish adults (BRIF8901). Respiratory functioning was measured by a spirometry test. Structured questionnaires were used to measure SRS, physician visits and psychological factors of alexithymia, sense of coherence, illness worry and common mental disorders. Individuals with a diagnosed respiratory disease or a severe psychiatric disorder, determined in a diagnostic interview, were excluded, giving a sample comprising 4544 participants. RESULTS Twenty-six per cent of the general population and 36% of those with no diagnosed severe psychiatric disorder or respiratory disease experienced SRS despite a normal spirometry result. Psychological factors were associated with SRS (0.0001 < p < 0.032), and on the number of physician visit explaining 42.7% of the difference in visits between individuals with and without SRS, respectively. Illness worry was associated most strongly with SRS [odds ratio (OR) 1.29, 95% confidence interval (CI) 1.19-1.41, p < 0.0001] and higher numbers of physician visits (OR 1.35, CI 1.32-1.38, p < 0.00001), even after several adjustments. CONCLUSIONS Respiratory symptoms without objective findings are common in the general population. The study results underline the role of psychological factors in the reporting of respiratory symptoms and the associated medical burden, thereby indicating the functional nature of the symptomatology.
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Affiliation(s)
| | | | - Markus Jokela
- Department of Psychology and Logopedics,Faculty of Medicine,University of Helsinki,Helsinki,Finland
| | | | - Sami Pirkola
- Health Sciences, andUniversity Hospital Psychiatric Department,University of Tampere,Tampere,Finland
| | - Jaana Suvisaari
- Department of Health,National Institute for Health and Welfare,Helsinki,Finland
| | - Tiina Paunio
- Finnish Institute of Occupational Health,Helsinki,Finland
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Koponen AM, Simonsen N, Suominen S. How to promote fruits, vegetables, and berries intake among patients with type 2 diabetes in primary care? A self-determination theory perspective. Health Psychol Open 2019; 6:2055102919854977. [PMID: 31218074 PMCID: PMC6563407 DOI: 10.1177/2055102919854977] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The results of this study showed the importance of autonomous motivation for healthy eating. Autonomous motivation and female gender were the determinants most strongly associated with fruits, vegetables, and berries intake among patients with type 2 diabetes. Other determinants of fruits, vegetables, and berries intake were high education, high social support, high age, and a strong sense of coherence. Autonomous motivation and self-care competence mediated the effect of perceived autonomy support from a physician on fruits, vegetables, and berries intake. Thus, physicians can promote patients' fruits, vegetables, and berries intake by supporting their autonomous motivation and self-care competence. The results are in line with self-determination theory.
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Affiliation(s)
- Anne M Koponen
- Folkhälsan Research Center, Finland
- University of Helsinki, Finland
| | - Nina Simonsen
- Folkhälsan Research Center, Finland
- University of Helsinki, Finland
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Ahomäki R, Kero A, Koivisto M, Madanat-Harjuoja L, Malila N, Lähteenmäki PM. Purchases of antidepressants after cancer at a young age in Finland. Int J Cancer 2018; 144:1227-1233. [PMID: 30357818 DOI: 10.1002/ijc.31942] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 09/05/2018] [Accepted: 10/04/2018] [Indexed: 12/16/2022]
Abstract
According to previous studies, childhood cancer survivors have an elevated risk for late mental health effects. However, only few studies exist on young adulthood (YA) cancer survivors' mental health outcomes. In our study, we examined first time antidepressant (AD) medication purchases of childhood and YA cancer patients compared to siblings. The first time AD medication purchases of 7,093 cancer patients aged 0-34 years at diagnosis and a sibling cohort (N = 26,882) were retrieved from the Social Insurance Institution of Finland (Kela) since 1.1.1993. Cancer patients diagnosed between 1.1.1994 and 31.12.2004 were identified from the Finnish Cancer Registry and sibling controls via the Population Registry Centre. Statistical analyses were performed via the Cox regression model, and the hazard ratios (HR) were adjusted for age and gender. Increased hazard ratios for AD purchases were found in the younger (0-19 years at cancer diagnosis) [HR 5.2, 95%CI (3.7-7.2)] and older (age 20-34 years at cancer diagnosis) [HR 4.5, 95%CI (3.9-5.2)] cancer patient groups compared to siblings. The gender effect was similar in patients and controls, showing that females have higher risk for AD purchases than males. Males in the younger patient group had highest HR (5.6) for AD purchases compared to siblings. Patients with sarcoma or CNS tumor in the younger age group and leukemia or CNS malignancy in the older age group had the highest risk for AD medication purchases. The frequency and risk for AD purchases has been increasing during recent decades in both cancer patient age groups compared to siblings. Thus, cancer patients' psychological support should be properly assessed already after primary treatment. Certain diagnostic groups as well as female patients may require more psychological support than others.
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Affiliation(s)
- Ritva Ahomäki
- Turku University Hospital, Department of Pediatrics and Adolescent Medicine, and Turku University, Turku, Finland
| | - Andreina Kero
- Turku University Hospital, Department of Pediatrics and Adolescent Medicine, and Turku University, Turku, Finland
| | - Mari Koivisto
- University of Turku, Department of Biostatistics, Turku, Finland
| | | | - Nea Malila
- Finnish Cancer Registry, Helsinki, Finland.,School of Health Sciences, University of Tampere, Tampere, Finland
| | - Päivi M Lähteenmäki
- Turku University Hospital, Department of Pediatrics and Adolescent Medicine, and Turku University, Turku, Finland
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Koskela HO, Lätti AM, Pekkanen J. The impacts of cough: a cross-sectional study in a Finnish adult employee population. ERJ Open Res 2018; 4:00113-2018. [PMID: 30443552 PMCID: PMC6230813 DOI: 10.1183/23120541.00113-2018] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 10/11/2018] [Indexed: 11/05/2022] Open
Abstract
Given the very high prevalence of cough, little is known about its impacts. A questionnaire was sent via e-mail to all public service employees in two towns in Finland. There were 373 subjects with acute cough, 174 with subacute cough and 421 with chronic cough. Cough-related quality of life was assessed with the Leicester Cough Questionnaire (LCQ) and depressive symptoms with Patient Health Questionnaire-2. In addition, data on doctor's visits and sick leave days were collected. Mean LCQ (95% CI) total scores were 16.2 (15.9-16.5), 14.5 (14.1-15.0) and 14.6 (14.3-14.9) among subjects with acute, subacute and chronic cough, respectively (p<0.001). The prevalence of depressive symptoms was 5.4%, 7.5% and 4.8%, respectively, and 5.0% among subjects without current cough (p=0.50). The respective proportions of subjects with at least one doctor's visit due to cough during the previous year were 27.6%, 44.8%, 49.6% and 16.1% (p<0.001). The respective proportions of subjects with at least one sick leave day due to cough during the previous year were 28.9%, 39.1%, 36.3% and 15.3% (p<0.001). Any current cough was associated with an increased the risk of several (three or more) yearly doctor's visit due to any reason (adjusted odds ratio (aOR) 1.49, 95% CI 1.27-1.76) and several (seven or more) yearly sick leave days due to any reason (aOR 1.43, 95% CI 1.22-1.68). Cough decreases quality of life, and has a large socioeconomic impact by increasing doctor's visits and sick leave days. However, it is not associated with depressive symptoms. The impacts of subacute and chronic cough are comparable, and larger than those of acute cough.
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Affiliation(s)
- Heikki O. Koskela
- Unit for Medicine and Clinical Research, Pulmonary Division, Kuopio University Hospital, Kuopio, Finland
- School of Medicine, Institute of Clinical Sciences, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Anne M. Lätti
- Unit for Medicine and Clinical Research, Pulmonary Division, Kuopio University Hospital, Kuopio, Finland
- School of Medicine, Institute of Clinical Sciences, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Juha Pekkanen
- Dept of Public Health, University of Helsinki, Helsinki, Finland
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
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Winkler P, Formánek T, Mladá K, Cermakova P. The CZEch Mental health Study (CZEMS): Study rationale, design, and methods. Int J Methods Psychiatr Res 2018; 27:e1728. [PMID: 29926999 PMCID: PMC6877135 DOI: 10.1002/mpr.1728] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 03/29/2018] [Accepted: 05/04/2018] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES The CZEch Mental health Study (CZEMS) was launched to inform the ongoing mental health care reform. This paper describes rationale, methods, and the plan for the future analyses of this project. METHODS A cross-sectional survey on a representative sample of the general adult noninstitutionalized population of the Czech Republic was conducted. Two-stage sampling was utilized and respondents were interviewed by centrally trained staff using a paper and pencil interviewing. The presence of mental disorders was assessed by The Mini-International Neuropsychiatric Interview. The study also collected information about disability, self-identification of having a mental illness, medical history, and help-seeking behaviour. RESULTS This survey had a 75% response rate, and the final sample consisted of 3,306 persons aged from 18 to 96 years (mean age 49 years old, 54% women) that were interviewed in their homes. The final sample is representative for the Czech Republic in terms of age, gender, education, and region. CONCLUSIONS CZEMS will provide up-to-date evidence about a prevalence of mental disorders in the Czech Republic, associated disability, and treatment gap. This will help informed decision-making about the current mental health care reform and future mental health care development in the Czech Republic.
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Affiliation(s)
- Petr Winkler
- National Institute of Mental HealthKlecanyCzech Republic
| | - Tomáš Formánek
- National Institute of Mental HealthKlecanyCzech Republic
| | - Karolína Mladá
- National Institute of Mental HealthKlecanyCzech Republic
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Psychiatric morbidity and subsequent divorce: a couple-level register-based study in Finland. Soc Psychiatry Psychiatr Epidemiol 2018; 53:823-831. [PMID: 29721590 DOI: 10.1007/s00127-018-1521-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 04/25/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE Studies that assess the role of mental health for the risk of divorce are scarce and mostly rely on individual-level data, although divorce is a couple-level phenomenon. Using data on couples, we examine the effects of both spouses' psychiatric morbidity on the risk of divorce, and whether socio-demographic factors affect these associations. METHODS We followed 96,222 Finnish married couples for 6 years using register-based data on both spouses and their household. New incidence of psychiatric morbidity and subsequent divorce was identified from dates of prescription medication purchases and hospital admissions, and dates of registered divorce. Socio-demographic factors were measured annually for both spouses and their household. The effect of incident psychiatric morbidity on divorce risk was analyzed using Cox regression. RESULTS Psychiatric morbidity in men increased the age-adjusted risk of divorce more than twofold and in women nearly twofold. The risk of divorce was particularly pronounced immediately after new incidence of psychiatric morbidity, before settling to a persistently high level. Psychiatric morbidity in both spouses increased the risk of divorce almost threefold. Adjustment for socio-economic factors had little effect on these associations. CONCLUSIONS Psychiatric morbidity is a persistent risk factor of divorce. The risk is larger when both spouses experience psychiatric morbidity compared to only one spouse. The findings are consistent with the idea that poor relationship quality and dissatisfaction in couples suffering from mental health problems have long-term consequences for marital stability. Treatment of psychiatric morbidity should not focus only on the individual but on couple-level dynamics.
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Liskola J, Haravuori H, Lindberg N, Niemelä S, Karlsson L, Kiviruusu O, Marttunen M. AUDIT and AUDIT-C as screening instruments for alcohol problem use in adolescents. Drug Alcohol Depend 2018; 188:266-273. [PMID: 29803033 DOI: 10.1016/j.drugalcdep.2018.04.015] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 04/14/2018] [Accepted: 04/16/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND The Alcohol Use Disorders Identification Test (AUDIT) is commonly used in adults to screen for harmful alcohol consumption but few studies exist on its use among adolescents. Our aim was to validate the AUDIT and its derivative consumption questionnaire (AUDIT-C) as screening instruments for the detection of problem use of alcohol in adolescents. METHODS 621 adolescents (age-range, 12-19 years) were drawn from clinical and population samples who completed the AUDIT questionnaire. Psychiatric diagnoses were assessed using K-SADS-PL. A rating based on the K-SADS-PL was used to assess alcohol use habits, alcohol use disorders, screening and symptom criteria questions. Screening performance of the AUDIT and AUDIT-C sum scores and Receiver Operating Characteristic (ROC) curves were calculated. The diagnostic odds ratios (dOR) were calculated to express the overall discrimination between cut-offs. RESULTS Comparisons of ROC between the AUDIT and AUDIT-C pairs indicated a slightly better test performance by AUDIT for the whole sample and in a proportion of the subsamples. Optimal cut-off value for the AUDIT was ≥5 (sensitivity 0.931, specificity 0.772, dOR 45.22; 95% CI: 24.72-83.57) for detecting alcohol problem use. The corresponding optimal cut-off value for the AUDIT-C was ≥3 in detecting alcohol problem use (sensitivity 0.952, specificity 0.663, dOR 39.31; 95% CI: 19.46-78.97). Agreement between the AUDIT and AUDIT-C using these cut-off scores was high at 91.9%. CONCLUSIONS Our results for the cut-off scores for the early detection of alcohol problem use in adolescents are ≥5 for AUDIT, and ≥3 for AUDIT-C.
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Affiliation(s)
- Joni Liskola
- Forensic Psychiatry, University of Helsinki and Helsinki University Hospital, Välskärinkatu 8, 00260, Helsinki, Finland; National Institute for Health and Welfare, Mental Health Unit, Mannerheimintie 160, 00300, Helsinki, Finland.
| | - Henna Haravuori
- National Institute for Health and Welfare, Mental Health Unit, Mannerheimintie 160, 00300, Helsinki, Finland; Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Välskärinkatu 12, 00260, Helsinki, Finland
| | - Nina Lindberg
- Forensic Psychiatry, University of Helsinki and Helsinki University Hospital, Välskärinkatu 8, 00260, Helsinki, Finland
| | - Solja Niemelä
- Department of Neurosciences, University of Oulu, Pentti Kaiteran katu 1, PL 8000, Oulu, Finland; Department of Psychiatry, Lapland Hospital District, Totontie 9, 97140, Muurala, Finland
| | - Linnea Karlsson
- Department of Child Psychiatry, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland
| | - Olli Kiviruusu
- National Institute for Health and Welfare, Mental Health Unit, Mannerheimintie 160, 00300, Helsinki, Finland
| | - Mauri Marttunen
- Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Välskärinkatu 12, 00260, Helsinki, Finland
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