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Majuri T, Haapea M, Nordström T, Säynäjäkangas V, Moilanen K, Tolonen J, Ala-Mursula L, Miettunen J, Jääskeläinen E. Effect of onset age on the long-term outcome of early-onset psychoses and other mental disorders: a register-based Northern Finland Birth Cohort 1986 study. Eur Child Adolesc Psychiatry 2024; 33:1741-1753. [PMID: 37568059 PMCID: PMC11211101 DOI: 10.1007/s00787-023-02279-5] [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: 01/17/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023]
Abstract
Psychiatric illnesses can affect the social transitions of adolescence and young adulthood, such as completing education and entering working life and relationships. However, associations between earlier onset age and long-term outcomes among those with early-onset psychoses (EOP) are unclear, as are the long-term outcomes of EOP compared to non-psychotic disorders. We used national register data of the Northern Finland Birth Cohort 1986 to detect persons with EOP and other early-onset psychiatric disorders. The long-term clinical and work-family outcomes of persons with onset age before 18 years (n = 41 psychoses, n = 495 non-psychoses) or between 18-22 years (n = 61 psychoses, n = 377 non-psychoses) were compared. Individuals with the onset of psychosis between 18-22 years had significantly more unfavourable long-term outcomes when compared to those with psychosis onset before 18 years. Persons with psychosis onset before the age of 18 years had similar outcomes to those with non-psychotic psychiatric disorder onset before 18 years regarding educational level, marital status, having children, and substance use disorders. Individuals with EOP were more often on a disability pension compared to those with other early-onset mental disorders. Adjusting for sex, educational level and substance use only slightly diluted these results. Unexpectedly, later onset age of EOP was associated with worse outcomes. Those with psychosis onset between 18-22 years of age are in a critical period, which underlines the importance of investing on interventions in this age group. Further studies on the effect of the onset age on later outcomes in EOP are needed.
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Affiliation(s)
- Tuomas Majuri
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O.BOX 5000, 90014, Oulu, Finland.
| | - Marianne Haapea
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O.BOX 5000, 90014, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Tanja Nordström
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O.BOX 5000, 90014, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Infrastructure for Population Studies, Northern Finland Birth Cohorts, University of Oulu, Arctic Biobank, Oulu, Finland
| | - Veera Säynäjäkangas
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O.BOX 5000, 90014, Oulu, Finland
| | | | - Jonna Tolonen
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O.BOX 5000, 90014, Oulu, Finland
| | - Leena Ala-Mursula
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O.BOX 5000, 90014, Oulu, Finland
| | - Jouko Miettunen
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O.BOX 5000, 90014, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Erika Jääskeläinen
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O.BOX 5000, 90014, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
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Bolstad I, Alakokkare A, Bramness JG, Rognli EB, Levola J, Mustonen A, Miettunen J, Niemelä S. The relationships between use of alcohol, tobacco and coffee in adolescence and mood disorders in adulthood. Acta Psychiatr Scand 2022; 146:594-603. [PMID: 36177725 PMCID: PMC9827971 DOI: 10.1111/acps.13506] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/19/2022] [Accepted: 09/19/2022] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Alcohol, tobacco and coffee are commonly used substances and use in adolescence has previously been linked to mood disorders. However, few large prospective studies have investigated adolescent use in relation to mental health outcomes in adulthood. The main aim of this study was to examine the prospective associations between alcohol use, cigarette smoking and coffee consumption at age 16 and subsequent mood disorders up to 33 years of age. METHODS Data from The Northern Finland Birth Cohort 1986 Study were used and a total of 7660 participants (49.9% male) were included. Associations between alcohol use, cigarette smoking and coffee consumption at age 16 and later diagnoses of major depression and bipolar disorder were examined using multinomial logistic regression analyses. RESULTS Mean number of cigarettes/day (OR, 1.23 [95% CI 1.01-1.50]) and mean volume of alcohol consumption (OR, 1.22 [95% CI 1.01-1.47]), but not frequency of excessive drinking, in adolescence were associated with increased risk for subsequent bipolar disorder after adjustment for sex, parental psychiatric disorders, family structure, illicit substance use, and emotional and behavioral problems at age 16. An association between cigarette smoking and major depression attenuated to statistically non-significant when adjusted for emotional and behavioral problems. No associations were observed between adolescent coffee consumption and subsequent mood disorders. CONCLUSIONS This is the first study to report an association of adolescent cigarette smoking and subsequent bipolar disorder diagnosis providing grounds for further research and pointing to a place for preventive measures among adolescents.
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Affiliation(s)
- Ingeborg Bolstad
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health DisordersInnlandet Hospital TrustBrumunddalNorway,Faculty of Social and Health SciencesInland University of Applied SciencesHamarNorway
| | - Anni‐Emilia Alakokkare
- Department of PsychiatryUniversity of TurkuTurkuFinland,Center for Life Course Health ResearchUniversity of OuluOuluFinland
| | - Jørgen G. Bramness
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health DisordersInnlandet Hospital TrustBrumunddalNorway,Norwegian Institute of Public HealthOsloNorway,Institute of Clinical MedicineUniversity of Tromsø – The Arctic University of NorwayTromsøNorway
| | - Eline B. Rognli
- Section for Clinical Addiction ResearchOslo University HospitalOsloNorway
| | - Jonna Levola
- Department of PsychiatryUniversity of HelsinkiHelsinkiFinland,Department of PsychiatryHospital District of Helsinki and UusimaaJärvenpääFinland
| | - Antti Mustonen
- Center for Life Course Health ResearchUniversity of OuluOuluFinland,Faculty of Medicine and Health TechonologyTampere UniversityTampereFinland,Department of PsychiatrySeinäjoki Central HospitalSeinäjokiFinland
| | - Jouko Miettunen
- Center for Life Course Health ResearchUniversity of OuluOuluFinland,Medical Research Center OuluOulu University Hospital and University of OuluOuluFinland
| | - Solja Niemelä
- Department of PsychiatryUniversity of TurkuTurkuFinland,Addiction Psychiatry UnitTurku University HospitalTurkuFinland
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Brokmeier LL, Firth J, Vancampfort D, Smith L, Deenik J, Rosenbaum S, Stubbs B, Schuch FB. Does physical activity reduce the risk of psychosis? A systematic review and meta-analysis of prospective studies. Psychiatry Res 2020; 284:112675. [PMID: 31757637 DOI: 10.1016/j.psychres.2019.112675] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 11/01/2019] [Accepted: 11/01/2019] [Indexed: 12/18/2022]
Abstract
Longitudinal prospective cohorts have suggested that physical activity (PA) may be a protective factor against psychosis and schizophrenia. However, no meta-analysis has been conducted. The study aims to examine the prospective relationship between PA and incident psychosis/schizophrenia. Major databases were searched from inception to July 2019 for prospective studies that calculated the odds ratio (OR) or the adjusted odds ratio (AOR) of incident psychosis/schizophrenia in people with higher PA against people with lower PA. Methodological quality was assessed using the Newcastle-Ottawa Scale (NOS). A random-effects meta-analysis was conducted, for OR and AOR, separately. Across 4 cohorts (N = 30,025 median males = 50%, median follow-up = 32 years), people with high self-reported PA (versus low PA) were at reduced odds of developing psychosis/schizophrenia (OR = 0.73, 95%CI 0.532 to 0.995, p = 0.047). Analysis including 2 cohorts presenting AOR were not statistically significant (AOR = 0.59, 95%CI 0.253 to 1.383, p = 0.226). Overall study quality was high (mean NOS = 7.0). The literature on the topic is scarce, whilst crude analysis suggests that PA may be a protective factor against the emergence of psychosis/schizophrenia, but when adjusting for covariates, the association is no longer significant. Further studies with objective physical activity and adjustment for confounders are needed.
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Affiliation(s)
| | - Joseph Firth
- NICM Health Research Institute, Western Sydney University, Westmead, Australia; Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; University Psychiatric Centre KU Leuven, Kortenberg, Belgium
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Jeroen Deenik
- GGz Centraal, Utrechtseweg 266, 3818 EW Amersfoort, The Netherlands; School for Mental Health and Neuroscience Maastricht University, Minderbroedersberg 4-6, 6211 LK Maastricht, The Netherlands
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, Australia; Black Dog Institute, Sydney, Australia
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Felipe Barreto Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil.
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