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Kari Poikolainen

Publications and source records attributed to Kari Poikolainen.

At least 19 recordsLinked to original sources
PubMed2007

The association of alcohol dependency with employment probability: evidence from the population survey 'Health 2000 in Finland'.

In this paper, we investigate to what extent alcohol-dependent individuals fare worse in the Finnish labour market, using data from a large Finnish health survey. We used the DSM-IV criteria for alcohol dependence assessed by a composite international diagnostic interview (CIDI). We find that there are substantial disadvantages for alcohol-dependent men and women in the labour market, in the sense that they have lower employment probabilities. Treating alcohol dependence as an exogenous variable, we find that alcohol dependence is associated with decrease in the probability of full-time or part-time work of around 14 percentage points for men and 11 percentage points for women. However, accounting for endogeneity increases the negative effect to some 50 percentage points for men and to some 40 percentage points for women.

Adult↗
PubMed2006

Abstaining from alcohol and labour market underperformance--have we forgotten the 'dry' alcoholics?

AIMS: To investigate whether abstainers fare worse than non-abstainers on the labour market because a subset of the abstainers are ex-drinkers with alcohol problems. METHODS: In the cross-sectional population survey 'health 2000 in Finland' (n = 10 000) carried out in 2000, alcohol dependency was measured using the DSM-IV diagnostic criteria for alcohol dependence. The CIDI (composite international diagnostic interview) was applied to ascertain lifetime DSM-IV diagnoses for substance abuse diagnoses, including alcohol dependence. Individuals were considered to be employed if they were working part-time or full-time. RESULTS: Male abstainers have on average 9.5 percentage points lower employment probability than non-abstainers. However, abstainers who have never drunk alcohol do not have lower employment probability than non-abstainers. Abstainers who are diagnosed as alcohol dependent have 27 percentage points lower employment probability than non-abstainers. CONCLUSION: The underperformance of abstainers in a labour market sense is almost entirely due to the fact that some abstainers are ex-drinkers who in our study are identified as alcohol-dependent. Otherwise abstaining does not decrease employment probability.

Adult↗
PubMed2006

Currently active and remitted alcohol dependence in a nationwide adult general population--results from the Finnish Health 2000 study.

AIMS: To study the factors relating to remission from alcohol dependence in the general population. METHODS: Within a representative, cross-sectional general population sample aged 30 years or more, the characteristics of subjects remitted from alcohol dependence were examined by comparisons with actively alcohol-dependent subjects. RESULTS: The overall lifetime prevalence of alcohol dependence was 7.9%. Comorbid depressive and anxiety disorders were diagnosed in 22% of the actively alcohol-dependent and in 19% of the remitted subjects. There were few sociodemographic, clinical or childhood-related factors differentiating the two groups of subjects. Of comorbid mental disorders, social phobia (6% vs 1%) and dysthymia (7% vs 3%) were more common among the actively alcohol-dependent, whereas other common disorders were equally common for both active and remitted alcohol dependence. Health care or other service use for alcohol problems within the previous 12 months was more frequent among the actively dependent (16% vs 4%), and the same was true for health care use for mental health problems (17% vs 8%). Any service use in the previous year for either type of problem was more common among the actively dependent than the remitted (26% vs 13%). CONCLUSIONS: In an unselected setting, only comorbid social phobia and dysthymia differentiated active alcohol dependence from a remitted state, suggesting either that they are obstacles to remission from an active state, explaining why some alcohol-dependent individuals are unable to recover, or that their symptoms are maintained by excessive alcohol use. The actively alcohol-dependent used both substance use services and mental health services more often than the remitted subjects, possibly due to needs generated by their alcohol problem. Comorbid psychopathology should be considered when developing treatment options for alcohol dependence.

Adult↗
PubMed2006

Heavy drinking occasions and depression.

AIMS: To assess the risk of depression for subjects with or without heavy drinking occasions after adjusting for the average long-term alcohol consumption, age, gender, marital status, employment status, and chronic diseases. METHODS: In a cross-sectional population survey (N = 3124) carried out in Finland in 1997, long-term average alcohol consumption was assessed by a self-administered quantity-frequency questionnaire. A heavy drinking occasion was defined as six or more drinks for men and four or more drinks for women consumed at one session. The self-administered 21-item Beck Depression Inventory score of > or = 10 was classified as clinically significant depression. RESULTS: Ex-drinkers and subjects with heavy drinking occasions had more often clinically significant depression compared with lifelong abstainers and individuals without heavy drinking occasions. In addition to the drinking habit, the risk for clinically significant depression increased also with age. Men aged 45-64 years with heavy drinking occasions had 2.3 times higher risk for depression compared with young men (aged 25-34 years) without heavy drinking occasions. The respective risk for old women was 2.2 times higher. CONCLUSIONS: Drinking pattern with heavy drinking occasions is independently associated with clinically significant depression irrespective of average long-term alcohol consumption.

Adult↗
PubMed2006

Adaptive functioning, psychopathology and service use among 18-year-old boys with drunkenness-related alcohol use.

AIMS: To study the associations between drunkenness frequency and adaptive functioning, psychopathology and service use among 18-year-old Finnish boys in a nation-wide population-based study. METHODS: Information about drunkenness frequency within the previous six months was collected from the Finnish boys born in 1981 (n = 2306) at the boys' obligatory military call-up in 1999. Self-report questionnaires were used to study demographic factors, adaptive functioning, risk behaviour, life events, and mental health service use. Psychopathology and adaptive functioning was assessed with the Young Adult Self-Report (YASR) questionnaire. RESULTS: Of the boys, 85% reported drunkenness within the previous 6 months. Most of the subjects were occasionally drunk: 39% reported drunkenness less than a month, and 35% less than once a week, while 10% reported being frequently drunk once a week or more often. Occasional drunkenness was associated with better adaptive functioning and psychosocial well-being in general. Refraining from drunkenness was associated with suicidal ideation and internalizing problems in the YASR scale. Frequent drunkenness associated with daily smoking, illicit drug use, and externalizing problems in the YASR scale, especially delinquent behaviour. In the multivariate analysis, number of friends, having a regular relationship and cigarette smoking had a linear association with frequency of drunkenness, while drunkenness-related alcohol use was less common among those with poor friendship quality. Among the participants, entering substance use treatment was rare (0.2%). Frequent drunkenness was found to be common among mental health service users. CONCLUSIONS: Among late-adolescent boys, occasional drunkenness is a normative alcohol use pattern and associates with social competence and good psychosocial functioning. Late-adolescent boys refraining from drunkenness in addition to those with frequent drunkenness may be in a need of mental health assessment. As entering substance use treatment is infrequent, establishing integrated services with multi-professional co-operation for late-adolescent males with frequent drunkenness is emphasized.

Adaptation, Psychological↗
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

DSM-IV mood-, anxiety- and alcohol use disorders and their comorbidity in the Finnish general population--results from the Health 2000 Study.

BACKGROUND: Information on prevalence, accumulation and variation of common mental disorders is essential for both etiological research and development of mental health service systems. METHODS: A representative sample (6005) of Finland's general adult (> or = 30 years) population was interviewed in the period 2000-2001 with the CIDI for presence of DSM-IV mental disorders during the last 12 months in the comprehensive, multidisciplinary Health 2000 project. RESULTS: Depressive-, alcohol use- and anxiety disorders were found in 6.5%, 4.5 % and 4.1% of the subjects, respectively. A comorbid disorder was present in 19% of those with any disorder. Males had more alcohol use disorders (7.3 % vs. 1.4 %) and females more depressive disorders (8.3 % vs. 4.6 %). Older age, marriage and employment predicted lower prevalence of mental disorders and their comorbidity. Prevalences of alcohol use- and comorbid disorders were higher in the Helsinki metropolitan area, and depressive disorders in northern Finland. CONCLUSIONS: Mental disorders and their comorbidities are distributed unevenly between sexes and age groups, are particularly associated with marital and employment status, and vary by region. There appears to be no single population subgroup at high risk for all mental disorders, but rather several different subgroups at risk for particular disorders or comorbidity patterns.

Adult↗
PubMed2005

Major depressive episode related to long unemployment and frequent alcohol intoxication.

We studied the association between two major problems--unemployment and major depressive episode--and the impact of different timing of periods of unemployment and risk factors, especially alcohol intoxication, for major depressive episode among the unemployed. Major depressive episode during the last 12 months, plus current and past employment status and frequency of alcohol intoxication, were assessed within the nationally representative, cross-sectional 1996 Finnish Health Care Survey, in which non-institutionalized individuals aged 15-75 years were interviewed by using the Short Form of the University of Michigan version of the Composite International Diagnostic Interview (the UM-CIDI Short Form). Of the 5993 subjects interviewed, 3818 (64%) were occupationally active and included in the logistic regression analysis, showing that even after adjusting for other potentially confounding variables, current unemployment was associated with major depressive episode (odds ratio, OR=1.78, 95% confidence interval, CI, 1.38-2.29). Further analysis revealed that the increased risk of major depressive episode was only related to long-term unemployment. Frequent alcohol intoxication (at least once a week) increased the risk of major depressive episode remarkably. Compared with the group "Constantly employed, no frequent alcohol intoxication", long-term unemployment with no frequent alcohol intoxication had moderately increased risk of major depressive episode (OR=1.72 (95% CI 1.29-2.30) and those with frequent alcohol intoxication had highly increased risk [OR=11.27 (95% CI 5.51-23.09) vs. OR=1.72 (95% CI 1.29-2.30]. Long-term unemployment is associated with increased risk of major depressive episode. Frequent alcohol intoxication among long-term unemployed individuals greatly increases the risk of depression.

Adolescent↗
PubMed2005

Job strain, effort-reward imbalance, and heavy drinking: a study in 40,851 employees.

OBJECTIVE: The objective of this study was to examine the relationship of the job strain model and the effort-reward imbalance model with heavy drinking. METHODS: Questionnaire survey data were obtained from 32,352 women and 8499 men employed in the Finnish public sector (participation 67%). Logistic regression analyses for all employees and for separate subgroups were undertaken by sex, adjusted for age, education, occupational position, marital status, job contract, smoking, and negative affectivity. Different cutoff points of heavy drinking were used for men and women. RESULTS: High job strain and high effort-reward imbalance as global constructs were not associated with heavy drinking. However, some components of these models were associated with heavy drinking but the relationships were not all in the expected direction and they varied by sex, age, and occupational position. CONCLUSIONS: Stressful work conditions are not consistently associated with heavy drinking.

Adolescent↗
PubMed2005

Alcohol and coronary heart disease risk--is there an unknown confounder?

AIMS: To evaluate whether confounding by several known or suspected coronary heart disease risk factors are likely to explain the lower coronary heart disease risk among light alcohol drinkers compared with never-drinkers. DESIGN: A population-based cross-sectional study. METHODS: Hypertension, body mass index (BMI), diabetes, depression, sleep disturbances, smoking, physical activity, life satisfaction, psychological distress, trait anxiety, independent and dependent life events, length of working hours, job control, job strain and effort-reward imbalance were compared between never-drinkers and light drinkers (<70 g of alcohol per week). Data on 41,099 participants (6,222 men, 34,877 women) were derived from two ongoing cohort studies, the '10-Town Study' and 'Finnish Hospital Personnel Study', in Finland in 2000-02. RESULTS: Of the 16 comparisons under study, seven showed significant differences between never-drinkers and light drinkers. Five of the differences favoured never-drinkers and two showed a disadvantage. The latter were low BMI and low leisure-time physical activity, both more common among never-drinkers than among light drinkers. In contrast, smoking, sleep disturbances, trait anxiety, effort-reward imbalance and dependent life events were less common among never-drinkers than among light drinkers. CONCLUSIONS: None of the risk factors studied was a likely candidate for an unknown confounder.

Adolescent↗
PubMed2005

Pattern of drinking and fatal injury: a population-based follow-up study of Finnish men.

AIM: To find out how the frequency of drinking one to two drinks, three to four drinks and five or more drinks of alcohol per drinking occasion predicts injury mortality in 16 years of follow-up among the Finnish 15-69-year-old male population. DESIGN: Three alcohol surveys conducted in 1969, 1976 and 1984 were pooled and linked with mortality information from the national cause of death register. METHOD: Cox proportional hazard models were used for analysing the survival time data. FINDINGS: Drinking at the level of one to two drinks, regardless of frequency, did not elevate the risk of fatal injury, nor did drinking at the level of three to four drinks. Drinking five or more drinks at a time significantly increased the risk of fatal injury in graded relation, compared with those who never drank at that level. The risk was highest for those who drank five or more drinks at a time at least weekly (RR = 5.78, 95% CI = 2.80-11.94), when adjusted for possible confounders. CONCLUSIONS: We found that besides the total volume of consumption, a drinking pattern that involves drinking occasions when consumption exceeds four drinks of alcohol at a time leads to a significant increase in the risk of fatal injury among Finnish men. The risk is highest among those who have the highest annual number of heavy drinking occasions. The finding does not support the hypothesis that alcohol tolerance would lower the risk of fatal injuries among frequent heavy drinkers.

Adult↗
PubMed2005

Heavy and nonheavy drinking occasions, all-cause and cardiovascular mortality and hospitalizations: a follow-up study in a population with a low consumption level.

OBJECTIVE: The purpose of this study was to separate the effects of heavy and nonheavy episodic drinking on mortality and hospitalizations from ischemic heart disease (IHD) and other cardiovascular disease (OCVD) and on all-cause mortality. METHOD: The respondents in Finnish drinking habit surveys in 1969, 1976 and 1984 (N = 6,394) were followed up for mortality and hospitalizations. There were 1,144 total deaths from all causes, 854 hospitalizations or deaths from IHD and 1,270 from OCVD. The main variables included total volume of consumption and total volume divided into volume consumed on heavy drinking occasions and nonheavy drinking occasions. Four alternative measures of heavy episodic drinking (HED) were also used. RESULTS: Among males, the total volume of consumption showed a protective effect against IHD. A high volume consumed on light drinking occasions was associated with a decreased risk of IHD (hazard ratio [HR] = 0.56, confidence interval [CI]: 0.34-0.92) and an increased risk of OCVD (HR = 1.48, CI: 1.00-2.18). A high volume consumed on heavy drinking occasions was associated with an increased risk of all-cause mortality (HR = 1.34, CI: 1.04-1.73). Among females, a protective effect of total and non-HED volume against all-cause mortality and non-HED volume against IHD was observed. CONCLUSIONS: The findings contribute to the cumulating evidence that drinking pattern matters. Moderate drinking is associated with a lower risk of IHD, whereas drinking in a heavy episodic manner (often referred to as "binge drinking") is not. The results underline the importance of considering, in addition to the volume of consumption, the pattern of drinking in epidemiological studies.

Adult↗
PubMed2004

Fear of nuclear war increases the risk of common mental disorders among young adults: a five-year follow-up study.

BACKGROUND: Evidence on the relation between fear of war and mental health is insufficient. We carried out a prospective cohort study to find out whether fear of nuclear war is related to increased risk of common mental disorders. METHODS: Within two months preceding the outbreak of Persian Gulf War in January 1991, 1518 adolescents [mean age 16.8 years, SD 0.9] filled in a self-administered questionnaire. Of the 1493 respondents, 47% gave their written informed consent to participate in the follow-up study. There were no material differences between those who chose to respond anonymously and those who volunteered to give their name and address for the follow-up study. In 1995, the response to the follow-up questionnaire was 92%. Common mental disorders were assessed by 36-item version of the General Health Questionnaire [GHQ]. A score 5 or higher was considered to indicate caseness. We excluded 23 cases which had used mental health services in the year 1991 or earlier and two cases with deficient responses to GHQ. This left 626 subjects for analysis [400 women]. RESULTS: After adjusting for significant mental health risk factors in logistic regression analysis, the risk for common mental disorders was found to be significantly related to the increasing frequency of fear for nuclear war, high scores of trait anxiety and high scores of immature defense style. Elevated risk was confined to the group reporting fear of nuclear war once a week or more often [odds ratio 2.05; 95% confidence interval 1.29-3.27]. CONCLUSION: Frequent fear of nuclear war in adolescents seems to be an indicator for an increased risk for common mental disorders and deserves serious attention.

Adolescent↗
PubMed2004

Use of health services for major depressive episode in Finland.

BACKGROUND: A universal finding in psychiatric epidemiology is that only a minority of currently depressed people seek or receive treatment. AIMS: To investigate the predictors of use of health care services for depression. METHODS: A representative random sample of 5993 non-institutionalised Finnish individuals aged 15-75 years was interviewed in 1996. Major depressive episode during the last 12 months was assessed using the Short Form of the University of Michigan version of the Composite International Diagnostic Interview (the UM-CIDI Short Form). Characteristics and health service use of the 557 depressed individuals were assessed. RESULTS: The proportion of people classified as having a major depressive episode who used any health services for their depression during the past 12 months was only 31% for men and 25% for women. Use of services was not predicted by sociodemographic factors. Longer duration, and greater severity and perceived disability predicted overall health service use for depression, but not significantly whether treatment was sought from primary or psychiatric care. CONCLUSIONS: The probability of use of health services for major depression increases with duration, severity and perceived disability related to depression. Only 59% of those suffering from even the most severe major depressive episodes use health services for depression. Use appears to be unrelated to sociodemographic factors in Finland.

Adolescent↗