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ABSTRACT: The aim of the study was to explore whether there is an association between body size at birth measured by birth weight and ponderal index and later depression at the age of 31 years. The analyses were based on 4,007 males and 4,332 females born in 1966 in the two northernmost provinces of Finland with data on current depression measured by the Hopkins Symptom Checklist-25 questionnaire (HSCL-25) and self-reported physician-diagnosed lifetime depression at 31 years and childhood characteristics. The associations between birth measures and later depression were analysed with several confounding factors including maternal depression during pregnancy. Low birth measures did not associate with adult depression in men or women. Women with high birth weight (>or=4,500 g) had a higher risk for current depression compared to women with birth weight 3,000 g-3,499 g. Women with high ponderal index (the highest 90-95 percentiles and >or=95 percentiles) had a 1.53-1.55 higher likelihood for current depression compared with women with normal ponderal index. Based on this study, large body size at birth may be a risk factor for later depression.
Psychiatry Research 09/2008; 160(3):263-70. · 2.52 Impact Factor
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ABSTRACT: The Temperament and Character Inventory (TCI) was developed to measure the following temperament dimensions: novelty seeking (NS), harm avoidance (HA), reward dependence (RD) and persistence (P). These four dimensions of temperament were originally proposed to be independent of one another. In this study the inter-relationships between the dimensions were studied with meta-analytic techniques. We also studied the effects of sociodemographic factors (location of the study, mean age and gender distribution) on correlations between temperament dimensions. We searched studies on healthy (non-clinical) populations that used the TCI (version 9), and that had a required sample size of at least 100. The search resulted in 16 articles. The resulted pooled correlation coefficient was medium level between NS and HA (-0.27). Correlations were small for HA-P (-0.20), NS-P (-0.14), NS-RD (0.10), RD-P (0.05) and HA-RD (0.04). In meta-regression, the correlation NS-P was significantly affected by the location of the study (Asian/other) and by the gender distribution of the sample. In the HA-P correlation, the mean age of the sample affected the correlation. In conclusion, we found a medium level negative correlation between NS and HA; other correlations between the dimensions were small. These findings mainly support Cloninger's theory of independent dimensions.
Psychiatry Research 08/2008; 160(1):106-14. · 2.52 Impact Factor
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Jouko Miettunen,
Sari Törmänen,
Graham K Murray,
Peter B Jones,
Pirjo Mäki,
Hanna Ebeling,
Irma Moilanen,
Anja Taanila,
Markus Heinimaa,
Matti Joukamaa, Juha Veijola
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ABSTRACT: Recent interest has focused on the association between cannabis use and risk of psychosis. In the largest unselected, population-based study on this topic to date, we examined cannabis use and prodromal symptoms of psychosis at age 15-16 years among 6330 adolescents. Those who had tried cannabis (n=352; 5.6% of the total sample) were more likely to present three or more prodromal symptoms even after controlling for confounders including previous behavioural symptoms (OR=2.23; 95% CI 1.70-2.94). A dose-response effect was seen. We conclude that cannabis use is associated with prodromal symptoms of psychosis in adolescence.
The British Journal of Psychiatry 07/2008; 192(6):470-1. · 6.62 Impact Factor
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ABSTRACT: We investigated the strength of evidence for association of the 5-HTTLPR polymorphism and the personality trait of Harm Avoidance. We used new primary data from a large sample of adults drawn from the Finnish population. We also applied meta-analytic techniques to synthesize existing published data. The large number of studies of the 5-HTTLPR polymorphism allowed us to apply a formal test of publication bias, as well as formally investigate the impact of potential moderating factors such as measurement instrument. Univariate ANOVA of primary data (n = 3,872), with 5-HTTLPR genotype as a between-groups factor, indicated no evidence of association with Harm Avoidance (P = 0.99). Meta-analysis indicated no evidence of significant association of 5-HTTLPR with Harm Avoidance (d = 0.02, P = 0.37), or EPQ Neuroticism (d = 0.01, P = 0.71), although there was evidence of association with NEO Neuroticism (d = 0.18, P < 0.001). Our analyses indicate that the 5-HTTLPR variant is not associated with Harm Avoidance. Together with our previous analyses of a large sample of participants with extreme Neuroticism scores (defined by the EPQ), we have data that excludes a meaningful genetic effect of the 5-HTTLPR on two measures of anxiety-related personality traits. There remains the possibility that the variant influences the NEO personality questionnaire measure of Neuroticism. However, a large, well-powered primary study is required to test this hypothesis directly and adequately.
American Journal of Medical Genetics Part B Neuropsychiatric Genetics 06/2008; 150B(2):271-81. · 3.70 Impact Factor
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ABSTRACT: Delayed neuromotor development carries an increased risk of developing schizophrenia, and some authors have assumed that risk factors for schizophrenia such as delayed development are also prognostic indicators for patients with established illness. In those who do develop schizophrenia, it is not clear if these same early developmental markers influence the outcome of illness. Our aim was to examine the association between infant developmental milestones and a range of outcomes in patients with schizophrenia. Our sample was drawn from Northern Finland 1966 Birth Cohort and included 109 subjects for whom prospectively collected information on age of learning to stand, walk and talk was available and who had developed schizophrenia by the age 35 years. By utilizing national registers we examined outcomes related to service utilization, educational achievement, and occupational status. Age of illness onset was also analyzed. Based on the diagnostic interview, a subgroup of 59 cases was assessed in clinical examinations on functioning and quality of life. Contrary to a widespread assumption within the field of schizophrenia research, later attainment of developmental milestones was not associated with poor outcome. We conclude that risk factors for schizophrenia are not necessarily prognostic factors.
Schizophrenia Research 03/2008; 99(1-3):29-37. · 4.75 Impact Factor
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ABSTRACT: Adversities in the early mother-infant relation pose a hypothetical risk for addiction. We studied the association between very early separation and later development of substance use disorder.
A follow-up study was performed of subjects temporarily isolated from their family immediately after birth to adequate nursing homes in order to protect them against morbidity and mortality for tuberculosis. The average separation time was 7 months. The index cohort consisted of 3,020 subjects born in 1945-1965. For every index subject, two reference subjects were matched for sex, year of birth and place of birth. We were able to obtain the SES of the family of origin as recorded in 1971 from Statistics Finland. Finnish Hospital Discharge Register was used to identify subjects with substance use disorder arising from childhood to middle age, between January 1,1971 and December 31, 1998.
The 28-year cumulative incidence of alcohol use disorders was 4.2% in the index cohort and 3.1% in the reference cohort (rate ratio, RR 1.4, 95% CI 1.1-1.8). The incidences of hospital-treated drug abuse or dependence were 0.6% and 0.2% (RR 2.5, 95% CI 1.2-5.1), respectively. The differences in socioeconomic status of the family of origin did not explain the differences found.
Substance use disorders were more prevalent among subjects temporarily separated at birth from their mothers because of tuberculosis in the family than in the reference cohort. While risks experienced during pregnancy, delivery and childhood are alternative explanations, this result suggests that very early temporal separation from the mother at birth may have had unfavourable but modest effects on later psychological development, including vulnerability to addiction.
Social Psychiatry and Psychiatric Epidemiology 02/2008; 43(1):11-7. · 2.70 Impact Factor
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Psychiatry and Clinical Neurosciences 11/2007; 61(5):578. · 2.13 Impact Factor
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ABSTRACT: In recent years, the occurrence of alexithymia among the general population has been ascertained in a handful of studies. There are no data concerning the epidemiology of alexithymia among teenagers in the general population. We studied the prevalence of alexithymia among a representative sample of 15-16-year olds.
This study forms part of the Northern Finland Birth Cohort 1986 Study. The original material consisted of all live-born children (N=9432) in the provinces of Lapland and Oulu in Finland, with an expected delivery date between July 1, 1985, and June 30, 1986. In 2001, when the subjects were 15-16 years old, a comprehensive follow-up survey was conducted. The 20-item version of the Toronto Alexithymia Scale (TAS-20) was the measure of alexithymia. Six thousand subjects filled in the TAS-20 correctly. Subjects having a TAS-20 score over 60 were considered to be alexithymic.
Of the girls, 10%, and of the boys, 7% were alexithymic. On the other hand, when the alexithymia (TAS-20) score was analysed as a continuous variable, boys had a higher mean value than girls. Mother's low education, broken childhood home, and living in a rural area were associated with high alexithymia score.
The rate of alexithymia among 15-16-year olds was similar to that among adults but with a less obvious gender difference than in an adult population. The association of alexithymia with disadvantageous living conditions in childhood resembles, in a way, its association with poor social situation in studies on working-age subjects.
Journal of Psychosomatic Research 11/2007; 63(4):373-6. · 3.30 Impact Factor
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ABSTRACT: This study examined the role of pre-employment factors, such as maternal antenatal depression, low birth weight, childhood socioeconomic position, early adolescence health risk behaviours and academic performance, in the relationship between work characteristics (low job control and high job demands, or job strain) and psychological distress at age 31. The data of 2062 women and 2231 men was derived from the prospective unselected population-based Northern Finland 1966 Birth Cohort study. Results of linear regression models showed that being female, father's low socioeconomic position, and poor academic achievement in adolescence were linked to low control and high job strain jobs at age 31, and that low control and high job strain were associated with psychological distress at age 31. Although having lower school grades, high absence rate from school, and moderate alcohol consumption at age 14 were significant predictors of psychological distress at age 31, the associations between job control, job strain and psychological distress remained after controlling for these and other pre-employment effects. As such, pre-employment factors do seem to link people to risky work environments, which in turn seem to relate strongly to psychological distress. However, the relationship between pre-employment factors and later psychological distress in adulthood is not completely explained by job environment.
Social Science [?] Medicine 08/2007; 65(2):187-99. · 2.70 Impact Factor
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ABSTRACT: We studied occupational status of persons with schizophrenic psychoses by age 34 in a longitudinal population-based cohort and predicted which demographic and illness-related factors could support the patients to maintain their occupational capacity. Subjects of the Northern Finland 1966 Birth Cohort with the diagnosis of DSM-III-R schizophrenic psychoses (n=113) by the year 1997 were followed until the end of year 2000. Various illness and socio-demographic factors at the time of onset of illness were used as predictors. At the end of the follow-up time 50 (44%) of patients were not pensioned and 22 (20%) were also working at least half of the time during year 2000. After adjusting for gender, being unemployed at onset, educational level and proportion of time spent in psychiatric hospitals, those who were married or cohabiting at the time of onset of illness were less often on pension than those who were single (OR 6.51; 95% CI 1.83-23.12). Thus, nearly half of the patients with schizophrenic psychoses were not pensioned after an average 10 years follow-up. Based on our findings, those who were single at time of their onset of illness probably need most support to retain their contacts to work life.
Psychiatry Research 05/2007; 150(3):217-25. · 2.52 Impact Factor
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ABSTRACT: A major reason for limited validity of research is non-participation. Subjects with severe mental illness tend to cumulate in the group of non-participants, causing selection bias. We tested the hypothesis that severe psychosis is linked to non-participation in a field survey including magnetic resonance imaging (MRI) of the brain, psychiatric interviews and cognitive testing among subjects with psychosis. Furthermore, we wanted to explore other associative factors expected to affect non-participation.
Members of the Northern Finland 1966 Birth Cohort with a lifetime diagnosis of psychosis (N = 145) were invited to participate in the survey conducted in 1999-2001. Non-participation was determined by refusal or loss of contact. Data were gathered in earlier phases of the follow-up study or using register data.
Ninety-one (63%) subjects attended the study. Compared to participants, non-participants were more often patients with schizophrenia and had more psychiatric hospitalisations, they had more positive psychosis symptoms during their illness course and they were more often on disability pension. Married subjects participated more often than those who were not married.
This study suggests that among subjects with psychosis, particularly those subjects who have the most severe course of illness are less willing to participate. This may lead to biased estimates when studying subjects with severe mental disorders.
Social Psychiatry and Psychiatric Epidemiology 05/2007; 42(5):403-9. · 2.70 Impact Factor
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ABSTRACT: The aim of this study was to assess the association between temperament and metabolic syndrome markers. Cloninger's Temperament and Character Inventory and clinical examination were carried out in 1997 in the Northern Finland Birth Cohort 1966 (N = 4364 respondents). Novelty seeking was positively associated with waist circumference in both genders. Systolic blood pressure was highest in men with high harm avoidance and low persistence scores and lowest in women with high reward dependence and high persistence scores. Childhood socio-economic status did not confound these associations. Smoking and alcohol consumption were associated with higher novelty seeking. Our results suggest that temperament is associated with metabolic syndrome markers and this association may be partly mediated by lifestyle factors and socio-economic status in adulthood.
Journal of Health Psychology 04/2007; 12(2):371-82. · 1.22 Impact Factor
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ABSTRACT: We assessed somatization symptoms and their associations among a 31-year-old Finnish population sample (n=1598). Data on somatization symptoms were gathered from a review of all medical public outpatient records. Subjects with four or more somatization symptoms according to the DSM-III-R criteria were classified as somatizers. Ninety-seven (83 females) DSM-III-R somatizers (6.1%) were found. Somatization associated with female sex, lower educational level and increased psychiatric morbidity. Roughly half of the somatizers had a comorbid psychiatric disorder. Mood disorders did not associate specifically with somatization--in fact, after adjusting for sex and educational level only anxiety disorders and personality disorders associated with somatization. It may be concluded that it is important to recognize psychiatric disorders in subjects with somatization symptoms, especially as these symptoms have been shown to be treatable with both psychotherapy and psychiatric medication.
Nordic Journal of Psychiatry 02/2007; 61(3):219-24. · 0.98 Impact Factor
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ABSTRACT: We assessed the temperament profiles of young adult somatizers in an epidemiological setting. We hypothesized that somatizers would have a characteristic temperament profile.
The sample consisted of 984 subjects at the age of 31 years. Data on somatization were gathered from a review of all public health outpatient records. Subjects with four or more somatization symptoms according to the DSM-III-R criteria were classified as somatizers. Temperament profiles were assessed using the Temperament and Character Inventory (TCI).
Six males (1.3%) and 61 females (11.5%) met our criteria for somatization. Harm avoidance and reward dependence of the TCI profiles were associated with somatization symptoms in the whole sample. In logistic regression analysis, sex and psychological distress were associated with somatization but not with temperament profiles.
We did not find a characteristic temperament profile for somatizers. This finding is in contrast to suggestions that somatization is associated with temperament profiles.
Journal of Psychosomatic Research 01/2007; 61(6):841-6. · 3.30 Impact Factor
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ABSTRACT: The purpose of this study was to determine the co-occurrence of DSM- III-R personality disorders (PDs) with mood, anxiety, and substance use disorders in a young adult population. The members of the Northern Finland 1966 Birth Cohort Project, living in the city of Oulu with an age of 31 years (N = 1,609) were invited to participate in a two-phase field study. The SCID I and II were used as diagnostic instruments. One hundred and seventy-seven out of 321 interviewed subjects met the criteria for mood, anxiety, or substance use disorders. Altogether 72 (41%) of the subjects with an Axis I disorder met the criteria for at least one PD. The weighted co-occurrence rate of any PD varied from 28% for mood disorders to 47% for anxiety disorders. PDs, especially those in Cluster C, are highly associated with Axis I psychiatric disorders in population.
Journal of Personality Disorders 03/2006; 20(1):102-12. · 2.31 Impact Factor
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ABSTRACT: We report patterns of hospitalization in schizophrenic psychoses by age 34 in a longitudinal population-based cohort. We test the predictive ability of various demographic and illness-related variables on patterns of hospitalization, with a special focus on the length of the first psychiatric hospitalization. All living subjects of the Northern Finland 1966 Birth Cohort with DSM-III-R schizophrenia (n=88) and other schizophrenia spectrum cases (n=27) by the year 1997 in the Finnish Hospital Discharge Register were followed for an average of 10.5 years. Measures of psychiatric hospitalization included time to re-hospitalization (as continuous and as re-hospitalization within 2 years) and the number of hospital episodes. Length of the first hospitalization, other illness-related and various socio-demographic predictors were used to predict hospitalization patterns. After adjusting for gender, age at first admission and number of hospital days a short (1-14 days) first hospitalization (reference >30 days; adjusted odds ratio 6.39; 95% CI 2.00-20.41) and familial risk of psychosis (OR 3.36; 1.09-10.39) predicted re-hospitalization within 2 years. A short first hospitalization also predicted frequent psychiatric admissions defined as the first three admissions within 3 years (OR 13.77; 3.92-48.36). A short first hospitalization was linked to increased risk of re-hospitalizations. Although short hospitalization is recommended by several guidelines, there may be a group of patients with schizophrenic psychoses in which too short a hospitalization may lead to inadequate treatment response.
Nordic Journal of Psychiatry 01/2006; 60(4):286-93. · 0.98 Impact Factor
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ABSTRACT: The sex-specific role of stressful or traumatic childhood experiences and adverse circumstances in developing adulthood mental disorders is complex and still in need of comprehensive research.
Within the Health 2000 project in Finland, a representative sample of 4,076 subjects aged 30-64 years were investigated to examine associations between a set of retrospectively self-reported adverse environmental factors during childhood (0-16 years) and mental disorders diagnosed in the past 12 months by the Munich Composite International Diagnostic Interview.
Of the 60% of adults reporting at least one childhood adversity, 17% had a current (past 12 months) mental disorder, compared to 10% of the non-reporters. A moderate dose-response relationship between the total number of adversities and current disorders was observed. Paternal mental health problems associated particularly strongly with male depressive disorders (OR 4.46), and maternal mental health problems with female depressive disorders (OR 3.20). Although seldom reported, maternal alcohol problems associated with alcohol use disorders in both sexes. Being bullied at school and childhood family discord predicted a variety of adulthood disorders in both sexes. All these four adversity items were more typical for depressive disorders with an earlier onset. Among females, more adversities were associated with mental disorders and their statistical significance was greater than among males.
There are marked sex differences and several diagnosis-related patterns in the associations between reported childhood experiences and environmental circumstances and adulthood mental disorders. The impact of adversities is probably composed of a wide range of factors from direct causal associations to complex, interacting environmental effects. Variations in the reported associations reflect the differing genetic and environmental transmission mechanisms of mental disorders.
Social Psychiatry and Psychiatric Epidemiology 11/2005; 40(10):769-77. · 2.70 Impact Factor
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Matti Isohanni,
Erika Lauronen,
Kristiina Moilanen,
Irene Isohanni,
Liisa Kemppainen,
Hannu Koponen,
Jouko Miettunen,
Pirjo Mäki,
Sami Räsänen, Juha Veijola,
Pekka Tienari,
Karl-Erik Wahlberg,
Graham K Murray
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ABSTRACT: Subtle motor, emotional, cognitive and behavioural abnormalities are often present in apparently healthy individuals who later develop schizophrenia, suggesting that some aspects of causation are established before overt psychosis.
To outline the development of schizophrenia.
We drew on evidence from The Northern Finland 1966 Birth Cohort supplemented by selected findings from other relevant literature.
The main known risk factors in development of schizophrenia are genetic causes, pregnancy and delivery complications, slow neuromotor development, and deviant cognitive and academic performance. However, their effect size and predictive power are small.
No powerful risk factor, premorbid sign or risk indicator has been identified that is useful for the prediction of schizophrenia in the general population.
The British journal of psychiatry. Supplement 09/2005; 48:s4-7.
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ABSTRACT: Because of widely disparate findings from follow-up studies, the likelihood of recovery from schizophrenia remains controversial. We report the extent of recovery from schizophrenia in a population-based cohort.
Subjects with psychotic disorders were recruited from the Northern Finland 1966 Birth Cohort. Of the 91 subjects who agreed to participate, 59 were diagnosed with schizophrenia and 12 were diagnosed with schizophrenia spectrum disorders (schizophreniform psychosis, schizoaffective or delusional disorder) by DSM-III-R criteria. Diagnoses were established by interviewing the subjects, checking the Finnish Hospital Discharge Register, and reviewing their medical records. To assess recovery, we used the Clinical Global Impressions; the Positive and Negative Syndrome Scale; the Social and Occupational Functioning Assessment Scale; and information about psychiatric hospitalizations, use of antipsychotic medication, and occupational status.
Only 1 subject (1.7%) with DSM-III-R schizophrenia and 3 subjects (25%) with schizophrenia spectrum disorders fully recovered; 1 schizophrenia subject (1.7%) and 2 schizophrenia spectrum subjects (16.7%) experienced partial recovery.
The data indicate that, at least until age 35, complete recovery from schizophrenia is rare, and the prognosis for the disorder is far more serious than suggested by some follow-up studies.
The Journal of Clinical Psychiatry 04/2005; 66(3):375-83. · 5.80 Impact Factor
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Pirjo Mäki, Juha Veijola,
Peter B Jones,
Graham K Murray,
Hannu Koponen,
Pekka Tienari,
Jouko Miettunen,
Päivikki Tanskanen,
Karl-Erik Wahlberg,
Johanna Koskinen,
Erika Lauronen,
Matti Isohanni
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ABSTRACT: Schizophrenia is an aetiologically heterogeneous syndrome that usually becomes overtly manifest in adolescence and early adulthood, but in many cases subtle impairments in neurointegrative function are present from birth; hence it is considered to be a disorder with a neurodevelopmental component. The strongest risk factor that has been identified is familial risk with genetic loading. Other risk factors include pregnancy and delivery complications, infections during pregnancy, disturbances of early neuromotor and cognitive development and heavy cannabis use in adolescence. Unfortunately, to date it has not been possible to utilize the predictors of the disorder that have been identified in primary preventative interventions in a general population. However, some authors have claimed that in future it might be possible to reduce the risk for developing schizophrenia through general health policy. In clinical settings, it is helpful to map out possible early risk factors, at least familial risk for psychosis, especially in child, adolescent and young adult mental patients. Furthermore, in the future we may have predictive models combining data from genetic factors for schizophrenia, antenatal risk factors, childhood and adolescent development and clinical symptomatology, as well as brain structural and functional abnormalities.
British Medical Bulletin 02/2005; 73-74:1-15. · 4.54 Impact Factor
