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Biomedical subjects

H Aro

Publications and source records attributed to H Aro.

At least 37 records · Page 2Linked to original sources
PubMed1997

Depression in Finland: a computer assisted telephone interview study.

We examined the prevalence of depressive disorders and associated factors in the general population in Finland using the Computer-Assisted Telephone Interview (CATI) method. A total of 2293 (71%) of 3250 individuals randomly drawn from the population registry and representing the adult population of Finland in the age group 25-79 years were interviewed by telephone in autumn 1994. The interview included a short form of the University of Michigan version of the Composite International Diagnostic Interview (UM-CIDI) generating probability diagnoses of DSM-III-R major depressive episode and dysthymia. The age-adjusted 6-month prevalence was 4.1% for major depressive episode and 1.7% for current dysthymia; depressive mood during the preceding month was reported in 17% of cases. Major depressive episodes and depressive mood were significantly more prevalent among females than males. In the logistic regression analyses, factors associated with the depressive disorders were found to vary somewhat depending on sex and type of disorder. Only about 50% of those with major depressive episode or dysthymia reported a self-perceived need for mental health services.

Adult↗
PubMed1997

Psychosocial functioning in adolescent psychiatric patients: a prospective study on changes in psychosocial functioning among severely and moderately impaired adolescent out-patients.

Changes in psychosocial functioning during out-patient treatment among 73 adolescent male and 100 female subjects, aged 12 to 19 years, were studied. The mean number of total treatment sessions was 15 sessions among the severely impaired and 14 sessions among the moderately impaired patients. The level of psychosocial functioning improved among the severely impaired (Global Assessment Scale (GAS) at treatment entry 3.9 vs. 4.7 at the last session, 95% CI, -1.085 to -0.577) and the moderately impaired patients (GAS 5.5 vs. 6.0, 95% CI, -0.682 to -0.355). The improvement was highly dependent on the psychiatric diagnosis. The level of psychosocial impairment improved in about two-thirds of subjects with adjustment and non-comorbid mood disorders, in about one-third of those with non-comorbid personality disorders, and in about a quarter of those with disruptive disorders. Careful diagnostic evaluation and assessment of psychosocial functioning are essential elements in the development of adolescent psychiatric services.

Adjustment Disorders↗
PubMed1996

Suicide in non-major depressions.

We compared depressive suicides who had unipolar depression not fulfilling the diagnostic criteria of major depression (non-major depressions) with suicides who had major depression. A random sample of 229 suicides representing all suicides in Finland within a 12-month period were comprehensively examined using the psychological autopsy method and diagnosed according to DSM-III-R criteria. We included in this study all cases of current depressive disorder not otherwise specified (n = 48), adjustment disorder with depressed mood (n = 6) and dysthymia (n = 4). These 58 cases of suicide in non-major depressions were compared with the suicides with unipolar major depression (n = 71) in the same random sample. The non-major depressive victims were younger, and comprised more males, more cases with psychoactive substance use disorders, more secondary depressives, and more cases not having contact with health care, or cases not having communicated suicidal intent despite such contact. Recent life events were also reported more common among those with non-major depressions, particularly during the final week. The findings suggest that suicides in major depression and in unipolar depressions not fulfilling the criteria for major depression are likely to differ in several clinically relevant characteristics besides depressive symptomatology.

Adult↗
PubMed1996

Youth with chronic conditions and their transition to adulthood. Findings from a Finnish cohort study.

OBJECTIVE: To explore the effect of chronic health conditions in adolescence on eventual transitional paths and young adult functioning in a cohort of Finnish youths. DESIGN: Survey in school at age 16 years followed by postal questionnaire at age 22 years. METHODS: Youths who had reported persistent chronic conditions at ages 16 and 22 years were compared with peers without chronic health conditions, using two-way analysis of variance for continuous outcomes and logistic regression models for dichotomous outcomes, adjusting for socioeconomic differences. MAIN OUTCOME MEASURES: Health status, chronic conditions, personal characteristics (including self-esteem), health behavior, education, family background, personal relations, and depression. RESULTS: Adolescents with chronic health conditions attained levels of psychosocial well-being, education, and marriage or dating as young adults similar to their peers without chronic conditions. Most of them experienced a successful transition to adulthood. Females with chronic conditions were more likely than women without chronic conditions to have moved away from their family of origin and to be living with a spouse or steady partner. Our findings also suggest that males with chronic conditions from white-collar family backgrounds may be at increased risk for symptoms of depression in early adulthood. Youths with chronic conditions had similar rates of nicotine and alcohol consumption as their healthy peers. CONCLUSION: Our findings suggest that in this cohort, most adolescents with common chronic conditions had a successful transition to adulthood.

Adolescent↗
PubMed1996

Sex differences in coping and depression among young adults.

The main purpose of the study was to evaluate the notion that the association between sex and depression is partly mediated by differences in coping styles. The study is based on questionnaire data from 890 female and 766 male Finnish 22-year-old young adults. Of the 12 ways of coping presented, self-blame, venting anger on others, seeking comfort in sweets and drinking beer were positively, and the others negatively, associated with depression; these were called dysfunctional and functional ways of coping, respectively. Women resorted much more often than men to dysfunctional ways of coping, except drinking. They also scored lower on personal resilience and showed more depressive symptoms. The sex difference in depressiveness was eliminated when dysfunctional coping was taken into account.

Adaptation, Psychological↗
PubMed1996

Oncoprotein expression in human synovial tissue: an immunohistochemical study of different types of arthritis.

Based on the fact that synovial lining cells have some properties of transformed-appearing cells, we have examined the expression of Myc, Myb, Fos, Jun and Ras oncoproteins in synovial tissues from patients with different types of arthritis. Formalin-fixed and paraffin-embedded sections of synovial tissue from 12 patients with rheumatoid arthritis (RA), 14 with reactive arthritis (ReA), nine with other seronegative arthritis (OSA), seven with bacterial arthritis (BA), eight with probable bacterial arthritis (PBA) and eight with osteoarthritis (OA) were studied using the immunoperoxidase staining technique. The oncoproteins studied were expressed both in the synovial lining layer and in the sublining layer, consisting of lymphocytes, other inflammatory cells and blood vessels. Among the six disease entities, RA and OA appeared to be the most distinct, whereas the results obtained for ReA and OSA, and on the other hand for BA and PBA, closely resembled each other. The expression of Myc, Myb, Fos and Jun was significantly correlated both to the degree of synovial hypercellularity and the synovial lymphocytic infiltration. For Ras, such a correlation could not be seen. We conclude that we find no evidence of a cell lineage-specific or a disease-specific abnormality of proto-oncogene products in RA, and the expression of these oncoproteins is consistent with inflammation rather than with any primary abnormality of cell growth.

Adult↗
PubMed1996

Mechanical failure of the intramedullary hip screw in a subtrochanteric femoral fracture.

The Gamma nail, an implant specifically designed for intertrochanteric and subtrochanteric femoral fractures, has been criticized for its high risk of secondary shaft fractures. A modified design, the intramedullary hip screw has recently been introduced to correct this complication. We present a case of mechanical failure of this new implant that occurred in a pathological subtrochanteric fracture. The centering sleeve of the implant became loose and migrated while the head screw penetrated the acetabulum. Refixation was successful.

Aged↗
PubMed1996

Excess mortality among former adolescent male out-patients.

Mortality among 156 males and 122 females referred to an out-patient adolescent psychiatric clinic in a Finnish town between 1984 and 1989 was examined. During the follow-up (mean duration 6 years; range 0-6.3 years for the deceased, 0.6-10.3 years for the survivors), 16 male subjects but no females had died. Among those who had died, the mode of death was suicide in 11 cases. The mortality for any cause for males was 10.3% and that for suicide was 7.1%. All male victims had similar high levels of individual and familial disturbances. Current suicidal ideation and suicide attempts, poor psychosocial functioning and a recommendation for psychiatric hospital treatment during the index treatment were associated with male mortality/suicidality. A high risk for mortality for several years after psychiatric treatment was found. It is concluded that, in clinical settings, perceived current suicidal tendencies should be assessed carefully.

Adolescent↗
PubMed1996

Parental divorce and depression in young adulthood: adolescents' closeness to parents and self-esteem as mediating factor.

The mediating factors between childhood experience of parental divorce and subsequent depression in young adulthood were assessed in a follow-up study of one Finnish urban age cohort from the age of 16 to 22 (n = 1656). Depression was found to be more common among the offspring of divorced families. Low self-esteem at age 16 was an indicator of vulnerability to depression in young adulthood irrespective of family background or gender. Among girls the long-term impact of divorce was mediated via low self-esteem and lack of closeness to father. When the relationship with the father was close, no excess risk of depression was found among girls from divorced families. Conversely, in boys no statistical connection between low self-esteem or unsatisfactory relationship with parents and depression after parental divorce was found.

Adolescent↗
PubMed1995

Recent life events and completed suicide in bipolar affective disorder. A comparison with major depressive suicides.

While recent psychosocial stress has been shown to be associated with the initiation of both first and subsequent illness episodes in bipolar affective disorder, its relationship to completed suicide in bipolar disorder is not known. As a part of a nationwide psychological autopsy study, two populations representing all suicides in Finland in DSM-III-R bipolar disorder or unipolar major depression were comprehensively examined and compared. Recent life events were retrospectively examined by interviewing next of kin using a 32-item Recent Life Change Questionnaire. Life event data was available on 25 bipolar and 56 unipolar cases. In about two-thirds of both bipolar (64%) and unipolar (66%) victims, at least one life event was reported to have occurred during the last 3 months and in 42% of both groups during the final week. The events of bipolar victims were more commonly classified as possibly dependent on their own behaviour (bipolars 88% vs. unipolars 63%, P = 0.004). Among bipolars, more males than females had had recent life events (males 86% vs. females 37%, P = 0.03). The majority of completed suicides in both bipolar and unipolar affective disorders seem to be associated with recent psychosocial stress; however, the stressors are commonly likely to be dependent on the victim's behaviour.

Adult↗
PubMed1995

Project plan for studies on suicide, attempted suicide, and suicide prevention.

Completed and attempted suicide are major public health problems in most western countries. The importance of suicidal behavior as a health problem, particularly among adolescents and young adults, has been emphasized by the European Union, the WHO (Europe), as well as the Finnish authorities. Due to the exceptionally high suicide mortality, suicide prevention has been one of the main targets of Finnish health policy since the late 1980s. However, to develop feasible strategies for suicide prevention, better knowledge of the phenomenon of self-destruction is necessary. The Department of Mental Health of the National Public Health Institute has been actively involved in suicide research and the development of suicide strategies both in Finland and western Europe since 1986. The success is based on a long tradition of suicide research in Finland, the representative and reliable suicide data, a highly motivated research group, and also the necessary economic support by both the National Public Health Institute and the Finnish Academy. This article outlines our groups research plan for the next few years.

Adolescent↗
PubMed1995

Epidemiology of the colonization of inpatients and outpatients with ciprofloxacin-resistant coagulase-negative staphylococci.

We tested the skin staphylococcal flora of inpatients and hospital staff in the orthopedic unit of Turku University Central Hospital (Turku, Finland) for susceptibility to ciprofloxacin. Ciprofloxacin-resistant coagulase-negative staphylococci were detected on the skin of 14 (61%) of the 23 inpatients and 16 (53%) of the 30 members of the hospital staff. Plasmid profiles were highly similar for most of these resistant isolates, thus suggesting that cross infection was responsible for the spread of ciprofloxacin-resistant strains in the orthopedic unit. Colonization of inpatients with ciprofloxacin-resistant coagulase-negative staphylococci was significantly associated with hospitalization longer than 6 days (P = .006) and the use of antibiotics during the hospital stay (P = .009). Twelve of 30 outpatients with venous leg ulcers were treated with ciprofloxacin, and all of these 12 were colonized with ciprofloxacin-resistant coagulase-negative staphylococci; in contrast, only three (33%) of the nine outpatients who were treated with trimethoprim (P = .004) and three (33%) of the nine outpatients who were treated with placebo (P = .004) were colonized with these strains. The ciprofloxacin-resistant strains from the outpatients had distinctly different plasmid profiles, a finding that suggests that, in the community, ciprofloxacin resistance may have emerged in isolates from each treated individual.

Anti-Infective Agents↗
PubMed1995

Educational level and hospital use in mental disorders. A population-based study.

This population-based study presents socioeconomic differences in psychiatric inpatient care by diagnosis. Inpatient care among the Finnish population aged 25-64 years was studied using data from the Finnish National Hospital Discharge Register. All major mental disorders in the ICD-9 were included in the study. The socioeconomic status of individual patients was defined by years of education in the population census. Discharge rates, first-time admission rates and hospitalization risk were usually 2- to 4-fold higher in the low educational group compared with the highly educated population. The socioeconomic gradient was steepest for schizophrenia. No gradient was observed for major affective disorders. However, bipolar disorder was most common in the highest educational category. For most conditions, the socioeconomic gradient among women was lower than among men. In Finland hospitalization was more common among low than high socioeconomic groups for most mental disorders and most indicators of inpatient care. Most of these differences are fairly consistent with previous data on socioeconomic gradients in the prevalence of mental disorders.

Adult↗
PubMed1995

Socio-economic mobility among patients with schizophrenia or major affective disorder. A 17-year retrospective follow-up.

BACKGROUND: Social mobility among patients with schizophrenia or major affective disorder was compared with that among the general population. METHOD: Mobility was studied retrospectively from 1970 to 1987. Socio-economic status (SES) was defined by occupation as in the population census (upper white-collar, lower white-collar, blue-collar, entrepreneur, farmer, unemployed). All patients aged 30-60 years at discharge (2901 men and 3620 women) in 1987-88 in Finland were included in the study. The SES structure of the general population was used for comparisons. RESULTS: Among patients with schizophrenia there was a constant downward drift, commonly to unemployment. This risk was higher among men than women. In the youngest age group a marked decline from the parents' social status was observed. Among patients with major affective disorder the distribution of SES in 1970 was similar to that of the general population. By 1987, a downward drift was again observed, mainly to unemployment regardless of the initial SES group. The number of patients in occupational categories were usually 30-50% lower than expected. CONCLUSIONS: Schizophrenic patients had a high risk of social drop-out. Among patients with major affective disorder the downward drift was much less.

Adult↗
PubMed1994

Suicide in psychotic major depression.

A sample of unipolar DSM-III-R major depressive suicide victims representing all suicides in current unipolar major depression within 1 year in Finland was carefully examined by psychological autopsy. The sample was divided into currently psychotic (n = 24) or non-psychotic (n = 46) subgroups, the psychotic subgroup was described and the two subgroups were compared. The majority (79%) of psychotic as well as nonpsychotic (87%) major depressive suicide victims were found to be complicated, comorbid cases. No major differences between the psychotic and nonpsychotic subgroups were found in sociodemographic features, comorbidity, clinical history or communication of suicide intent. However, the psychotic victims were more likely to have used violent suicide methods (88% vs. 59%).

Adolescent↗
PubMed1994

Synovial fluid muramic acid in acute inflammatory arthritis.

Presence of muramic acid, a bacterial cell wall component, was analysed by gas chromatography-mass spectrometry in synovial fluid (SF) of 40 patients with acute inflammatory arthritis. SF muramic acid was observed in 4/14 patients with acute, culture negative inflammatory arthritis of unclear origin. Each of these four patients had a history of a recent bacterial disease (pansinuitis, purulent leg ulcer, erysipelas, unexplained fever with suspicion of cholecystitis and urinary tract infection). In the bacterial arthritis, SF muramic acid was detected in 6/12 patients (in 2/6 culture negative cases). In the reactive arthritis due to Salmonella or Yersinia, the rate of positivity was 2/14. Nineteen samples of traumatic SF effusion were muramic acid negative. These findings indicate that several cases of undefined acute inflammatory arthritis are of bacterial origin.

Acute Disease↗