Biomedical subjects

Irma Moilanen

Publications and source records attributed to Irma Moilanen.

At least 19 recordsLinked to original sources

PubMed2007

Use of context in pragmatic language comprehension by children with Asperger syndrome or high-functioning autism.

Utilizing relevance theory, this study investigated the ability of children with Asperger syndrome (AS) and high-functioning autism (HFA) to use context when answering questions and when giving explanations for their correct answers. Three groups participated in this study: younger AS/HFA group (age 7-9, n=16), older AS/HFA group (age 10-12, n=23) and a normally functioning control group (age 7-9, n=23). The results indicated that the younger AS/HFA group did less well when answering contextually demanding questions compared to the control group, and the performance of the older AS/HFA group fell in between the younger AS/HFA group and the control group. Both AS/HFA groups had difficulties explaining their correct answers, suggesting that they are not always aware of how they have derived answers from the context.

Aptitude↗

PubMed2006

Answering contextually demanding questions: pragmatic errors produced by children with Asperger syndrome or high-functioning autism.

UNLABELLED: This study examined irrelevant/incorrect answers produced by children with Asperger syndrome or high-functioning autism (7-9-year-olds and 10-12-year-olds) and normally developing children (7-9-year-olds). The errors produced were divided into three types: in Type 1, the child answered the original question incorrectly, in Type 2, the child gave a correct answer, but when asked a follow-up question, he/she explained the answer incorrectly, and in Type 3, the child first gave a correct answer or explanation, but continued answering, which ultimately led to an irrelevant answer. Analyses of Type 1 and 2 errors indicated that all the children tried to utilize contextual information, albeit incorrectly. Analyses of Type 3 errors showed that topic drifts were almost non-existent in the control group, but common in the clinical group, suggesting that these children had difficulties in stopping processing after deriving a relevant answer. LEARNING OUTCOMES: The reader becomes aware of the different instances which may lead to the irrelevance of answers and get knowledge about features of answers of children with AS/HFA.

Aptitude↗

PubMed2006

Processing of affective speech prosody is impaired in Asperger syndrome.

Many people with the diagnosis of Asperger syndrome (AS) show poorly developed skills in understanding emotional messages. The present study addressed discrimination of speech prosody in children with AS at neurophysiological level. Detection of affective prosody was investigated in one-word utterances as indexed by the N1 and the mismatch negativity (MMN) of auditory event-related potentials (ERPs). Data from fourteen boys with AS were compared with those for thirteen typically developed boys. These results suggest atypical neural responses to affective prosody in children with AS and their fathers, especially over the RH, and that this impairment can already be seen at low-level information processes. Our results provide evidence for familial patterns of abnormal auditory brain reactions to prosodic features of speech.

Acoustic Stimulation↗

PubMed2006

Recurrent and transient depressive symptoms around delivery and maternal sensitivity.

In this study, the continuity, timing and severity of depressive symptoms around delivery was compared to maternal sensitivity in a community-based sample of 78 first-time mothers. Maternal mood was assessed before delivery (an interview and the General Health Questionnaire), 2 weeks and 4 months after delivery (the Edinburgh Postnatal Depression Scale), and maternal sensitivity 6-8 weeks after delivery (the CARE-Index). Nearly half (46%) of the mothers reported having depressive symptoms at least once, and half of these (23%) reported having such symptoms recurrently. Depressive mothers were significantly lower in sensitivity than non-depressive ones. Both pre- and postnatal, as well as recurrent and transient symptoms, affected the maternal interactive style, and both major and minor depressive symptoms were in most cases part of depressive continuity. Most (76%) mothers who reported depressive symptoms 2 weeks after delivery also reported recurrent symptoms. The most significant finding is considered to be that most (75%) mothers who were assessed to be at the risk level in sensitivity reported depressive symptoms. The public health nurses in the well-baby clinics identified only a few depressive mothers with recurrent symptoms. The conclusion of our study was that depressive symptoms at any time point around delivery constitute a risk of maternal interactive functioning, and identification of these problems is essential for well-timed and focused interventions.

Adult↗

PubMed2006

Childhood predictors of drunkenness in late adolescence among males: a 10-year population-based follow-up study.

AIMS: To study childhood precursors of drunkenness frequency among 18-year-old boys in a representative, nation-wide 10-year follow-up study. DESIGN: In 1989, a general population sample of 2,946 8-year-old boys was collected. Three different informant sources were used: parents, teachers and the boys themselves. The follow-up was 10 years later in 1999, when the boys were called up for their obligatory military service at age 18. Information about drunkenness frequency was obtained from 78.3% (n=2306) of the original sample. SETTING: Finland, nation-wide; in 1989 at schools, in 1999 at the obligatory military call-up. PARTICIPANTS: General population sample of Finnish boys born in 1981. MEASUREMENTS: At age 8, the Rutter A2 scale, Rutter B2 scale and Child Depression Inventory (CDI) were used. At age 18, self-reported drunkenness frequency during the previous 6 months was determined. FINDINGS: Of the subjects, 15.0% reported never being drunk from alcohol, 74.6% reported being occasionally drunk and 10.4% reported being drunk at least once a week during the previous 6 months. After adjusting for other variables, teacher's estimate of the child's problem behaviour at age 8 predicted frequent drunkenness in late adolescence. Hyperactive problems predicted both occasional and frequent drunkenness. Conduct problems at age 8 predicted only frequent drunkenness. High teacher-reported scores of emotional problems predicted lower occurrence of drunkenness-orientated alcohol use. CONCLUSIONS: The educational system has a potential role in detecting boys at risk of later risk-taking behaviours, such as frequent drunkenness. Early interventions in children with conduct problems and hyperactivity are called for.

Adolescent↗

PubMed2005

Factors associated with ideation and acts of deliberate self-harm among 18-year-old boys. A prospective 10-year follow-up study.

BACKGROUND: The aims of the study were: (1) to identify the prevalence of ideation and acts of deliberate self-harm in 18-year-old boys; (2) to report the use of mental health services among these boys; (3) to identify risk factors assessed at age 8 and (4) to identify associated cross-sectional factors at age 18 of self-reported ideation and acts of deliberate self-harm. METHODS: The participants in this community-based 10-year follow-up study consisted of 2,348 boys born during 1981. At baseline, three informant sources were used: parents, teachers and the children themselves. The questionnaires used were the Rutter Parents Scale, the Rutter Teacher Scale and the Children's Depressive Inventory. At follow-up, boys' psychopathology, adaptive functioning and substance use were studied using the Young Adult Self-Report questionnaire. Further questions about demographic factors and life events were added at both stages. RESULTS: The prevalence of ideation of deliberate self-harm was 4.0%, and of acts 2.2%, during the preceding 6 months. Of the subjects who reported ideation, 9.7%, and of those who reported acts, 16.0%, had used mental health services during the previous year. Self-reported depressive symptoms at age 8 predicted ideation and acts of deliberate self-harm 10 years later. Suicidal boys' problems in many life areas were linked with suicidal tendency through psychiatric symptoms, especially anxious/depressed symptoms and aggressive behaviour. CONCLUSIONS: The connection between self-reported depressive symptoms at age 8 and ideation and acts of deliberate self-harm at age 18 is a good reason to already pay special attention to children's own intimations of distress in elementary school. It is likely that an effective way to prevent suicidality among adolescents is to search for and treat psychiatric problems among young people. Self-reported screening questionnaires used, e.g. in school healthcare, may provide an opportunity to recognize these problems.

Adolescent↗

PubMed2005

Attention and behavioural problems of Finnish adolescents may be related to the family environment.

BACKGROUND: Adolescents' attention and behavioural problems in relation to the family environment were studied in the Northern Finland 1986 Birth Cohort. METHOD: Fifteen-year-old adolescents (N=6888) completed the Youth Self-Report (YSR) questionnaire and their parents (N=6643) completed the Strengths and Weaknesses in ADHD and Normal Behaviours (SWAN) questionnaire. The ratings were compared in relation to gender and family characteristics. RESULTS: Girls scored higher than boys on the YSR attention problems subscale (means 4.61 vs. 3.41), the rule-breaking behaviour subscale (means 4.25 vs. 3.69) and the aggressive behaviour subscale (means 7.18 vs. 5.63). Parents reported more SWAN attention problems in their sons than in their daughters. Living in an other than intact family increased YSR and SWAN attention problems and YSR behavioural problems in both genders. Adolescents living in very large families (11-19 children) had least attention and behavioural problems. CONCLUSIONS: Attention and behavioural problems seem to be common among adolescents in Finland. For both genders, living in other than intact families increases especially behavioural problems. Additionally, a very large family seems to be a protective factor against those problems.

Adolescent↗

PubMed2005

Childhood predictors of psychiatric disorders among boys: a prospective community-based follow-up study from age 8 years to early adulthood.

OBJECTIVE: To study early childhood predictors for early adulthood psychiatric disorders. METHOD: The sample included 2,712 Finnish boys born in 1981. Information about the 8-year-old boys' problem behavior was obtained from parents, teachers, and children. The 10-15-year follow-up information about psychiatric disorders in early adulthood was based on the national military register between the years 1999 and 2004. RESULTS: According to the military register, 10.4% of men had a psychiatric disorder. All informant sources, parents, teachers, and the children themselves predicted early adulthood psychiatric disorders. Conduct symptoms at age 8 independently predicted substance abuse, antisocial personality, and psychotic disorders in early adulthood. Self-reported depressive symptoms, poor school performance, and living in a nonintact family had an independent predictive association with antisocial personality and depressive disorders. Parent-reported emotional symptoms and self-reported psychosomatic symptoms independently predicted anxiety disorders. About one third of those who had used services at age 8 had a psychiatric disorder in early adulthood. Among service users, conduct and hyperkinetic symptoms predicted psychiatric disorders in early adulthood. CONCLUSIONS: Efforts to prevent early adult psychiatric disturbance already present in childhood are emphasized. Active screening to detect children in need of early interventions in childhood to prevent negative development in early adulthood is justified.

Adolescent↗

PubMed2005

Recognition of psychiatric disorders, and self-perceived problems. A follow-up study from age 8 to age 18.

OBJECTIVE: To study the rate of, and factors associated with, recognition of psychiatric disorders and self-perceived problems among 18-year-old adolescent boys. METHOD: The study population consisted of 2347 Finnish boys born during 1981 attending military call-up (79.7% of the original sample). At age 8, the boys were evaluated by parental and teacher Rutter scales and by self-reports using the Child Depression Inventory (CDI). At military call-up 10 years later, the boys filled in the Young Adult Self-Report (YASR). Information about psychiatric disorders recognized at the military call-up health examination was obtained from the national military register. RESULTS: About 4.6% of boys were recognized as having a psychiatric disorder at the military call-up medical examination. In addition, 23.1% of boys reported emotional, behavioral or relational difficulties but were not recognized as having an ICD 10 psychiatric diagnosis at the military call-up medical examination. A higher level of psychopathology, problems across different life domains and early onset of problems were more strongly associated with recognition of psychiatric disorder than with self-reports of difficulties without a recognized psychiatric disorder. All informant sources, parents, teachers and children themselves at age 8, independently predicted recognition of psychiatric disorders and perceived difficulties 10 years later. CONCLUSIONS: Only a minority of adolescents with psychiatric problems are recognized as having a psychiatric disorder in the health services. Efforts to prevent psychiatric disturbance in early life are emphasized. The use of screening methods in school health settings to detect children in need of child mental health services is justified.

Adolescent↗

PubMed2005

Co-twin dependence modifies heritability of abstinence and alcohol use: a population-based study of Finnish twins.

The role of co-twin dependence (twins' closeness or reliance on the co-twin) was examined as a moderator of genetic and environmental influences on alcohol use in adolescence and early adulthood in a large longitudinal population-based study of Finnish twins (FinnTwin16). The associations between co-twin dependence and alcohol use were studied first at an individual level in adolescence (n = 3362) and early adulthood (n = 2912). Then, maximum likelihood models were fit to the two waves of data from same-sex twin pairs to assess the differences and changes in genetic and environmental influences on alcohol use (abstinence, drinking frequency, intoxication frequency); N = 1342 pairs in adolescence, and N = 1078 pairs in early adulthood. Overall, no significant associations were found between co-twin dependence and individual alcohol use. However, co-twin dependence importantly modulated genetic effects on drinking habits, especially in adolescence, but also in early adulthood. Co-twin-dependent twins reported greater similarity in their alcohol-related behavior across all alcohol-use measures at both time points, and the role of genes and environments varied according to co-twin dependence. Shared environmental factors explained most of the variation in drinking among co-twin-dependent twins in adolescence and contributed to drinking to intoxication during early adulthood. In contrast, among co-twin-independent twin pairs, genetic variance contributed significantly to all alcohol-use measures at both time-points. An interdependent sibling relationship is an important modifier of drinking habits, and it appears to reduce the impact of inherited liabilities on alcohol-related behavior especially in adolescence.

Adolescent↗

PubMed2005

Intervention,treatmentand care in autistic disorder. Challenging case reports from northern Finland.

OBJECTIVES: Autism produces characteristic patterns of behaviour, and individuals with autistic disorder (AD) have a lot in common in terms of behaviour and mannerisms. Individuals with autism, however, also have their own overall personalities, which both underlie and interact with their autism. This article focuses on challenges of identifying AD and delivering appropriate services in face of long distances and limited resources. STUDY DESIGN: This study is a retrospective descriptive chart review and cases series. Hospital records and data on the treatment/habilitation status of 187 children and adolescents with autistic disorder aged 3-18 years were evaluated from Northern Finland. METHODS: Nine subjects, representing the age group of 9- to 17-year-olds, did not show any improvement on the Childhood Autism Rating Scale (CARS) and in the clinical examination during the follow-up period 1990--97. In this study, these children and adolescents with AD were evaluated more carefully. RESULTS: The treatment programs and therapies varied, depending on the availability of trained staff. There were various reasons for the absence of the most suitable treatment, or habilitation, at the individual level. The difficulties also varied over time and between individuals. In addition, after the follow-up period, four of the nine (55.6%) individuals showed more positive outcome when the level of autism had been taken into account in the planning of the intervention for, treatment and care of AD. CONCLUSION: The possible reasons for poor outcome included the level of mental disability, impairments of speech and communication, lack of knowledge of autism at the municipal level, long distance to services, severe epilepsy, additional medical diagnosis, parental acceptance of the child's autism and late start of the intervention for, or habilitation of autism.

Adolescent↗

PubMed2004

Factors associated with depressive symptoms among 18-year-old boys: a prospective 10-year follow-up study.

BACKGROUND: The aim is to study associative and predictive factors for self-reported depressive symptoms among 18-year-old boys. METHODS: The participants in this community-based 10-year follow-up study consisted of 2348 boys born during 1981. At baseline, three informant sources were used: parents, teachers, and the children themselves. At follow-up, self-report questionnaires were used to study boys' family factors, life events, adaptive functioning, and substance use. Depressive symptoms at age 18 were established using Beck's Depression Inventory (BDI). RESULTS: Poor adaptive functioning within family and in education, having fewer than two close friends, somatic health problems, and using illicit drugs were all independently associated with a high level of depressive symptoms in the cross-sectional data at age 18. Self-reported depressive symptoms (Children's Depression Inventory, CDI) at age 8 independently predicted an increased number of depressive symptoms 10 years later. LIMITATIONS: Only self-reported questionnaires were used at follow-up. CONCLUSIONS: The high association between depressive symptoms at age 8 and at age 18 gives grounds for paying special attention to children's own intimations of distress already in the early school years. Using self-report screening questionnaires in school health care may help identify children's depressive symptoms.

Adolescent↗

PubMed2004

Seasonal variation in postnatal depression.

BACKGROUND: We evaluated the occurrence of postnatal depression in general and during different seasons as part of a larger longitudinal mother-child follow-up study. METHOD: One hundred and eighty-five mothers, from the maternity wards of University Hospital of Oulu, Finland, completed a self-rating depression scale, the Edinburgh Postnatal Depression Scale (EPDS) twice: first at hospital 2-7 days after delivery and the second time at home 4 months after the delivery. Different psychosocial variables were mapped out to avoid any confounding factors. The year was divided in two separate ways: first, three different time periods were selected by the amount of sunlight: dark (October-January), intermediate (February, March, August, September) and light (April-July), and second, the year was divided by seasons. The results were analysed by the chi(2)-test for multinomials. RESULTS: Sixteen percent (16.2) of mothers were scored as being depressed using 13 as a cut-off point immediately after the infant was born. Thirteen percent (13.0) were depressed measured 4 months postpartum. There was more mild depression in the autumn (ratio observed/expected 1,62; 95% confidence interval 1.05-2.19) immediately after delivery, using 10 as a cut-off, and less depression in the spring (0.27; 0.00-0.62) measured at home later, using 13 as a cut-off. When using classification by the amount of light there was more depression during the dark time (1.58; 1.05-2.11) immediately postpartum. LIMITATIONS: The group sizes and the amount of sample sizes collected within each month are quite small. CONCLUSIONS: It should be borne in mind that seasonal changes and alterations in the amount of light might influence the occurrence of postnatal depression.

Depression, Postpartum↗

PubMed2004

Mental health service use among 18-year-old adolescent boys: a prospective 10-year follow-up study.

OBJECTIVE: To study prevalence and factors associated with mental health service use among 18-year-old adolescent boys. METHOD: Predictors at age 8 and factors at age 18 associated with mental health service use during the preceding 12 months were studied in a general population sample of 2,316 Finnish boys born in 1981 attending military call-up (79% of the original sample). RESULTS: Within the preceding 12 months, 2.1% of the boys had used mental health services. At age 18, internalizing, anxious-depressive, and withdrawal symptoms; health problems; not living with parents; use of illicit drugs; high level of alcohol use; and regular smoking were independently associated with service use. At age 8, a high level of emotional and behavioral symptoms, need for referral, and low school performance according to teacher evaluations predicted service use 10 years later. CONCLUSIONS: Only a minority of adolescents with severe problems had used mental health services. Because of the wide range of problems and comorbidity among service users, there is a need for integration of different services. Education services have a central role in the early detection of those who will later use mental health services.

Adolescent↗

PubMed2004

Does pain relief during delivery decrease the risk of postnatal depression?

BACKGROUND: To test the hypothesis that sufficient pain relief during delivery decreases the risk of postnatal depression. METHODS: As part of a prospective follow-up study of the risk factors for postnatal depression and its impact on the mother-infant interaction and child development, 185 parturients filled in the Edinburgh Postnatal Depression Scale (EPDS), first during the first postpartum week and again (n = 162) 4 months later. The incidence and the risk of high EPDS scores was calculated according to the mode of delivery and the mode of pain relief during vaginal delivery, also after adjusting for the length of labor. RESULTS: Mothers who received epidural/paracervical blockade during their delivery spent less time in the delivery room than mothers in the nitrous oxide/acupuncture group (p = 0.033) or mothers with no pain relief (p = 0.026) and had shorter length of labor than mothers without pain relief (p = 0.04). The adjusted risk of depressive scores at the first postnatal week was decreased in the epidural/paracervical group when compared with no analgesia group (OR: 0.25, 95% CI: 0.09-0.72). This difference was not shown at 4 months postpartum. Elective or emergency cesarean section did not increase the risk of high EPDS scores at the first week or at 4 months postpartum. CONCLUSION: The mode of pain relief during vaginal delivery seems to be associated with the incidence of postpartum depression, especially immediately after delivery.

Adult↗

PubMed2004

Associated medical disorders and disabilities in children with autistic disorder: a population-based study.

A population-based survey was conducted among 152,732 Finnish children and adolescents aged under 16 years and living in northern Finland. Diagnoses and associated medical conditions were derived from the hospital and institutional records of this area. One hundred and eighty-seven children with DSM-IV autistic disorder were identified. Associated medical disorders or associated disorders of known or suspected genetic origin were found in 12.3 percent, including tuberous sclerosis, Down syndrome, fragile X syndrome, Klinefelter syndrome, XYY syndrome, chromosome 17 deletion, chromosome 46, XX, dup(8) (p) and mitochondriopathy. Other associated medical disorders identified were epilepsy, hydrocephalus, foetal alcohol syndrome and cerebral palsy. Hearing impairments were found in 8.6 percent and severe impairment of vision in 3.7 percent of the individuals with autistic disorder. Medical disorders seem to have a special impact on the genesis of autistic disorder and need to be thoroughly examined in each child with autistic disorder.

Adolescent↗

PubMed2004

Videoconferencing in child and adolescent telepsychiatry: a systematic review of the literature.

A systematic review of child and adolescent telepsychiatry was conducted. It was based on a search of the electronic databases MEDLINE and PsycINFO covering the period 1966 to June 2003. Studies were selected for review if they concerned videoconferencing for patient care or consultation, evaluated a clinical service or education, or assessed satisfaction with videoconferences. Twenty-seven articles were identified that fulfilled the selection criteria. These comprised two reports of randomized controlled experiments, 10 of descriptive questionnaire studies or observational surveys, seven case studies and eight other reports. Only three of the studies presented some calculations of cost-effectiveness. When classified by 'Quality of Evidence' criteria, only two studies were in category I (the highest), one was in II-2 and the rest fell into category III (the lowest). Most studies of child and adolescent telepsychiatry examined satisfaction with videoconferencing or described programmes or care regimens. Videoconferencing seemed to improve the accessibility of services and served an educational function. Some papers also mentioned savings in time, costs and travel. Problems with non-verbal communication and the audiovisual quality of the videoconference were mentioned as drawbacks. Telepsychiatry therefore seems to offer several benefits, at least in sparsely populated regions. Well designed and properly controlled trials are required to evaluate the clinical value of this promising method in child psychiatry, where there is a constantly increasing need for services.

Adolescent↗

PubMed2003

Deficient auditory processing in children with Asperger Syndrome, as indexed by event-related potentials.

Asperger Syndrome (AS) is characterized by normal language development but deficient understanding and use of the intonation and prosody of speech. While individuals with AS report difficulties in auditory perception, there are no studies addressing auditory processing at the sensory level. In this study, event-related potentials (ERP) were recorded for syllables and tones in children with AS and in their control counterparts. Children with AS displayed abnormalities in transient sound-feature encoding, as indexed by the obligatory ERPs, and in sound discrimination, as indexed by the mismatch negativity. These deficits were more severe for the tone stimuli than for the syllables. These results indicate that auditory sensory processing is deficient in children with AS, and that these deficits might be implicated in the perceptual problems encountered by children with AS.

Acoustic Stimulation↗