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A Tanskanen

Publications and source records attributed to A Tanskanen.

At least 37 records · Page 2Linked to original sources

School performance in Finnish children and later development of schizophrenia: a population-based longitudinal study.

BACKGROUND: We examined whether children who are diagnosed as having schizophrenia in adulthood could be distinguished from their peers on performance in elementary school. METHODS: We used a case-control study design nested within a population-based birth cohort of all individuals born in Helsinki, Finland, between January 1, 1951, and December 31, 1960. Case ascertainment was from 3 national health care registers. Elementary school records were obtained for 400 children who were diagnosed as having schizophrenia in adulthood and for 408 controls. Results were analyzed for the 4 years of schooling (ages 7-11 years) that were common to all pupils. School subjects were entered into a principal components analysis and produced 3 factors: academic, nonacademic, and behavioral. These factors were compared between cases and controls after adjusting for sex and social group. Eligibility for high school and progression to high school were investigated among cases and controls. RESULTS: Cases performed significantly worse than controls only on the nonacademic factor (which loaded sports and handicrafts). There were no differences between the groups on the academic or behavioral factors, and there were no significant clinical correlates of factor scores. Cases were significantly less likely than controls to progress to high school, despite similar eligibility. CONCLUSIONS: Poor performance in sports and handicrafts during elementary school, which may indicate a motor coordination deficit, appears to be a risk factor for later schizophrenia. Poor academic performance in elementary school was not a risk factor for schizophrenia in this study. Lack of expected progression to high school among cases, despite good academic grades, provides evidence for deteriorating premorbid functional adjustment in schizophrenia.

Achievement↗

Gender differences in living skills and global assessment of functioning among outpatients with schizophrenia.

OBJECTIVE: The aims of this paper are to study skills in personal and domestic activities, and their associations with Global Assessment of Functioning (GAF) scale scores among outpatients with schizophrenia, and to study the impact of depressive mood on functional capacity in schizophrenia. METHOD: Three hundred and two outpatients with DSM-III-R schizophrenia completed the 13-item Beck Depression Inventory (BDI) and a questionnaire relating to their sociodemographic characteristics, and living and working conditions. Staff members completed the GAF scale and a questionnaire relating to the patient's medical history and current treatment. This questionnaire also included the staff's assessments on patient's skills in six personal or domestic activities (personal hygiene, homemaking, management of financial affairs, shopping, decision-making, getting about). RESULTS: Fifty-six percent of men and 33% of women (p < 0.001) with schizophrenia did not have independent skills in at least one personal or domestic activity but there was no difference in the mean GAF score between men and women. In men, the GAF score was independently and positively associated with all living skills studied and in women with homemaking, management of financial affairs, and decision-making, respectively. The BDI scores were not independently associated with functioning in personal and domestic activities except with getting about in women. CONCLUSIONS: The GAF scale is a simple and time-saving measure for assessing overall living skills among outpatients with schizophrenia. However, assessments on the GAF scale may be biased towards poor functioning in women. Moreover, psychosocial functioning and depression should be evaluated separately.

Activities of Daily Living↗

Association between prenatal exposure to poliovirus infection and adult schizophrenia.

OBJECTIVE: The authors' goal was to determine whether there is an association between prenatal exposure to poliovirus infection and later development of schizophrenia. METHOD: All Finnish patients born between 1951 and 1969 with discharge diagnoses of schizophrenia (N = 13,559) were identified from the Finnish Hospital Discharge Register. Information on the monthly number of cases of paralytic poliomyelitis was obtained for each province in Finland. The authors analyzed the incidence of births of individuals who later developed schizophrenia by using a Poisson regression model with year and place of birth, age, sex, season of birth, and smoothed incidence of poliomyelitis in different gestational periods as explanatory variables. RESULTS: An association between the incidence of poliomyelitis and the incidence of births 5 months later of individuals who later developed schizophrenia was observed. Without controlling for seasonality, the effect was significant throughout the second trimester. CONCLUSIONS: Second-trimester exposure to poliovirus infection may increase the risk for the later development of schizophrenia.

Adult↗

Risk factors for suicidal ideation in psychiatric patients.

Sociodemographic and clinical risk factors for suicidal ideation have been less studied than risk factors for parasuicide and suicide. No reports on associations between therapy satisfaction and suicidal ideation among psychiatric patients have been published. In this study we compared a group of patients with suicidal ideation (n = 84) with a randomly selected group of nonsuicidal patients (n = 166) in community-based psychiatric services. Patients with suicidal ideation felt a need for psychiatric treatment more often than nonsuicidal patients. They were also more likely to receive antidepressive medication, and weekly therapy sessions were more common among them. A wish to change therapist (OR 15.6, 95% CI 3.6-67.8), hopeless future orientation (OR 14.8, 95% CI 4.5-48.9), severe depression as evaluated by the Beck Depression Inventory (OR 14.0, 95% CI 4.3-45.2) and dysthymia (OR 12.8, 95% CI 1.7-97.3) were the factors most strongly associated with suicidal ideation in multivariate analysis. A wish to change therapist is an expression of therapy dissatisfaction, which may therefore be among the factors most strongly associated with suicidal ideation in psychiatric patients. To help prevent suicidality among psychiatric patients special attention to therapy factors is needed.

Adolescent↗

Suicidal ideation and parasuicide in the Finnish general population.

In a sample of the Finnish general population (n=4868), 2.4% of women and 2.3 % of men reported having thought about suicide during the preceding 12 months. The prevalence of parasuicide was correspondingly 0.9% in women and 1.1% in men, higher figures than have previously been found or estimated. Most suicidal individuals (85%) had contacted general practitioners or other primary care services during the previous 12 months, and a minority (20%) had made contact with psychiatric services. General practitioners and other primary care services are thus in a key position to identify suicidal behaviour in the Finnish general population.

Adolescent↗

Debt and suicidal behaviour in the Finnish general population.

We studied the significance of debt as a risk factor for suicidal ideation and suicide attempts in a nation-wide sample (n = 4868) of the Finnish general population. Those experiencing difficulties in repaying their debts more often than others (37 vs. 16%, P<0.001) had a probable minor mental disorder (GHQ-12 score > or =3). Nevertheless, difficulties in repaying debts were found to be a factor independently associated with suicidal ideation (OR, 2.8; 95% CI, 1.9-4.2). The clinical implication of these findings is that individuals experiencing difficulties in repaying their debts may require psychiatric evaluation as well as socio-economic counselling.

Adolescent↗

Smoking and suicidality among psychiatric patients.

OBJECTIVE: This study investigated the relationship between smoking and suicidality among psychiatric patients. METHOD: All psychiatric patients (N = 1,217) from Kuopio University Hospital in eastern Finland were examined for current smoking, suicidal ideation, previous suicide attempts, and other risk factors by using a cross-sectional, multivariate design. RESULTS: The probability of at least one previous suicide attempt was 100% higher in current smokers than in nonsmokers. Smokers also had a 43% higher risk of experiencing mild to severe suicidal ideation than nonsmokers. CONCLUSIONS: Current smoking was significantly related to suicidality in multiple logistic models, even after several confounding factors were controlled. The independence of this association seems possible, but the subject requires further research.

Adult↗

Age at onset and outcome in schizophrenia are related to the degree of familial loading.

BACKGROUND: Recent research suggests that high familial loading is associated with early onset of schizophrenia. Results concerning outcome have been controversial. METHOD: We assessed the relationship between familial loading, age at onset and outcome in all Finnish patients with schizophrenia born between 1950 and 1969. Patients and their first-degree relatives were identified using nationwide registers. Familial loading scores were calculated for schizophrenia and for combined psychotic disorders, and patients were accordingly classified into three groups: high (n = 761), intermediate (n = 14,247), and low familial loading (n = 725). Linear mixed models and the Cox proportional hazard model were used in the analyses. RESULTS: Onset was earliest, hospitalisation longest and risk of retirement in receipt of a disability pension highest in the group with high familial loading, with opposite extremes found in the group with low familial loading. CONCLUSIONS: High familial loading for schizophrenia is associated with early onset and poor outcome of schizophrenia.

Adult↗

Factors predicting psychosocial recovery in psychiatric patients.

We examined factors associated with psychosocial recovery in patients receiving specialist psychiatric treatment by means of a questionnaire directed at staff and patients (n = 1084) in an extensive study performed in North Savo, Kuopio, Finland. Psychosocial recovery was considered to have taken place if the Global Assessment Scale (GAS) score had increased from the lowest estimate obtained during the preceding year by at least 28 points at the time of the study (n = 102). The remaining cases (n = 982) served as controls. In the univariate analysis of all of the patients, the factors associated with good recovery were a high level of basic education, a diagnosis of major depression and adequate social support. The opportunity to contact a therapist outside fixed treatment visits was also a factor predicting psychosocial recovery. In the multivariate analysis, independent factors predicting recovery were the high frequency of treatment contacts in cases of schizophrenia, previous hospitalization in major depression, and a high level of basic education and hospitalization in personality disorders.

Adaptation, Psychological↗

Correlates of life satisfaction among psychiatric patients.

The aim of this study was to examine the sociodemographic and clinical variables associated with life satisfaction in psychiatric patients. The study population consisted of out-patients and in-patients (n = 1204) treated at the Department of Psychiatry of Kuopio University Hospital in North Savo, Finland, during May 1993. Sociodemographic, psychosocial and clinical correlates of life satisfaction were examined by means of two different questionnaires, one directed at patients and the other directed at the staff. Life satisfaction was assessed by means of a separate scale based on four questions. Patients with schizophrenia were less dissatisfied than patients with other disorders. The strongest correlates of dissatisfaction were depression and poor social support. Other factors relating to dissatisfaction in multiple regression analysis were self-rated health and poor financial circumstances. A psychosomatic reaction tendency or degree of psychosocial functioning at the time of the study was not independently related to life satisfaction. Psychiatric patients who are dissatisfied should be evaluated both for depression and for effectiveness of their social network.

Adult↗

Linkage analysis in two schizophrenic families originating from a restricted subpopulation of Finland.

We report here linkage data on two families with multiple cases of schizophrenia originating from the genetically isolated population of Finland. We analyzed chromosomal DNA regions containing relevant candidate genes for schizophrenia and chromosomal regions which have been among the most widely studied in schizophrenia research due to associations between chromosomal anomalies and schizophrenia observed in certain families or populations. These include the chromosomal regions 5q11-q13, 11q and 15q21 as well as gene loci coding for components of dopamine, serotonin and amino acid transmitter pathways. No evidence for linkage to any of the chromosomal regions or candidate genes could be obtained, our data in fact suggested exclusion of all these regions as the site for major predisposing loci for schizophrenia in our families. On the 11p region the lod scores obtained deviated in the two families, but the difference remained statistically insignificant. The data emphasize the importance of analyzing families even with restricted genetic background separately since locus heterogeneity is likely to be detected not only between ethnic groups but also between diagnostic classes of the schizophrenia spectrum of diseases.

Adolescent↗

Coffee consumption is correlated with serum cholesterol in middle-aged Finnish men and women.

The association between coffee consumption and serum cholesterol was studied in a cross-sectional epidemiological study in Finland where the annual per capita consumption of coffee (13.0 kg) is the highest in the world. Coffee consumption was assessed by a questionnaire in a representative population sample of 4744 men and 4495 women aged 25 to 64 years. Serum total cholesterol and HDL-cholesterol concentrations were determined in fresh sera by the enzymatic method. Data on a large number of potential confounding variables were also collected. In the age group 25 to 44 years, the level of serum total cholesterol increased linearly with increasing coffee consumption in both sexes, but in people aged 45 to 64 the peak level of serum cholesterol was found in those who consumed 4 to 6 cups of coffee per day. In the analysis of covariance controlling for age, body mass index, intake of fat, sugar, and alcohol, smoking, physical activity, and fasting time, the mean level of serum cholesterol of men was lower (p less than 0.001) in those who drank no coffee (5.9 mmol/l) than in those who drank 1 to 3 cups (6.1 mmol/l) or 4 or more cups (6.2 mmol/l) per day. In women, the corresponding mean serum cholesterol values were 5.8 mmol/l, 6.1 mmol/l, and 6.1 mmol/l (p less than 0.05). Serum HDL-cholesterol levels did not vary significantly with coffee consumption. There was a slight inverse association between tea drinking and serum total cholesterol in men (p less than 0.05) but not in women. Although our results suggest a positive association, the impact of coffee drinking on serum cholesterol seems to be minimal. The results also indicate that the possible mechanisms do not include caffeine.

Adult↗

Accuracy of self-reported body weight compared to measured body weight. A population survey.

In 1977, in the evaluation of the prevention programme for cardiovascular diseases, 11,880 persons in Eastern Finland were asked to report their own weight on a questionnaire. Each participant was weighted during the following clinical examination. The data of the self-reported body weight were analysed according to sex, age, measured weight and body-mass index (BMI). The results showed that older people underestimated their weight to a greater extent than did younger people of both sexes. The error between measured and self-reported weight was greater in heavier subjects than in thinner individuals. In both sexes weight estimate error (measured weight minus self-reported weight) correlated more strongly with high BMI than with measured weight. Associations between weight estimate error and other variables were studied using a multiple regression model. Men whose annual family income was low were more likely to underestimate their weight than the men with a high annual income. In general, women reported their weight more correctly than men did. Older women were more likely to report their weight less than younger women, whereas women who visited their doctor frequently or who had higher annual family incomes were more aware of their actual body weight than those who had few doctor's consultations or whose family income was low. In men 5.2% and in women 8.3% of the variation in the weight estimate error was explained by the regression model.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Effect of bucindolol on plasma HDL cholesterol subfractions and other plasma lipids in essential hypertensive patients.

The effect on plasma lipids of a new beta-blocker bucindolol, which possesses weak alpha-adrenergic blocking property and intrinsic sympathomimetic activity, given orally over a 3-month period as a monotherapy or with a thiazide diuretic to 44 patients with essential hypertension was studied. The mean level of plasma HDL cholesterol concentration increased significantly during 3 months monotherapy with bucindolol or with bucindolol and diuretic. This increase was due to the increase of HDL3 subfraction. There were no significant changes in the concentrations of plasma triglycerides or total cholesterol during treatment. The ratio of HDL cholesterol to total cholesterol increased significantly. The concentration of apoprotein A-I decreased significantly in both treatment groups, but the level of apoprotein B remained constant among treatment groups. The results support the earlier observations that beta-adrenergic blocking agents with different pharmacologic properties differ as regard to their effects on plasma lipids and lipoproteins.

Adrenergic beta-Antagonists↗

Effects of smoking and stopping smoking on serum high-density lipoprotein cholesterol levels in a representative population sample.

Serum high-density lipoprotein (HDL) cholesterol levels were assessed in a random sample of 939 men and 853 women ages 14-65 years in eastern Finland. Amount of daily smoking measured by serum thiocyanate concentration was negatively and independently associated with serum HDL cholesterol level and HDL/total cholesterol ratio in men. This negative association seemed largely to be due to low HDL cholesterol levels in heavy smokers. Both male and female current smokers had lower HDL cholesterol levels and HDL/total cholesterol ratios than those who had never smoked. This difference was found even after adjustment for age, body mass index, and beer drinking. The reduction of HDL cholesterol level seemed to be reversible, because those who had recently stopped smoking had higher HDL cholesterol levels and higher HDL/total cholesterol ratios than current smokers.

Adolescent↗

The effect of nifedipine on plasma lipids in patients with essential hypertension.

The effect of nifedipine on plasma lipids given over a period of one month to 14 patients with essential hypertension was studied. There were no significant changes in the concentrations of plasma total cholesterol, LDL cholesterol, VLDL cholesterol, HDL cholesterol and triglycerides during treatment. Nifedipine appears to be preferable to diuretic agents and to beta-blockers without ISA as nifedipine has no untoward effects on lipid metabolism.

Adult↗