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Biomedical subjects

M Isohanni

Publications and source records attributed to M Isohanni.

At least 55 records · Page 3Linked to original sources
PubMed1998

Education and mental disorders.

Mental health and education are crucial contributory factors in the welfare of the individual. Higher incidences of many mental disorders are found among populations with a low level of education. Difficulties in school and professional education may also predict adult mental disorders. The relationship between education and mental disorder has fairly seldom been analysed in empirical studies and further studies are therefore needed, as is an integration of educational policies in the prevention and care of mental disorders. In the Northern Finland Health and Well-being Study based on the Northern Finland 1966 Birth Cohort, education and its determinants is one of the main aspects studied.

Adolescent↗
PubMed1998

Psychiatric disorders and their predictors in young adulthood in Finland.

Mental disorders are one main focus of research interest in the 31 year study of the Northern Finland 1966 Birth Cohort Study. Mental disorders are quite common in young adulthood and they have a great impact on quality of life and working ability. Good national registers in Finland ensure the possibility to follow up treated incidence of severe mental disorders. On the other hand, a notable part of those who suffer from non-psychotic mental disorders do not receive any psychiatric treatment. That is why it is not possible to follow up psychiatric morbidity of the non-psychotic disorders from register data. In this review, principles of psychiatric diagnostics, known prevalences of psychiatric disorders in population and factors connected with mental disorder are briefly presented. Especially childhood predictors of mental disorders are reviewed.

Adolescent↗
PubMed1998

What kind of person is a thirty-year-old?

In this article we review the thirty-year-old person from the viewpoint of the development psychology, life span, physical health and family life. In his psychological development a person has at this stage become adult, but he still uses some psychic mechanisms and coping strategies which are typical for the adolescent. Intrapsychic world, the working role and the family life are stabilizing, but the changing over to the independence and working life can be more difficult today than earlier. Although with most people the adult life has settled down and physical and psychiatric illnesses are relatively rare, part of the thirty-year-olds are not independent, placed to the working life or are not healthy. In the following paper, main theories or findings in psychological and family life development and mental health of a thirty-year-old person are presented.

Adult↗
PubMed1997

Is a child's risk of early onset schizophrenia increased in the highest social class?

In a sample from the unselected, general population Northern Finland 1966 Birth Cohort, 11017 individuals alive at the age of 16 years were studied until the age of 27. The cumulative incidence of early onset schizophrenia until 23 years was higher (1.14%; 9/792) among young persons from the highest social class or class I (determined according to father's occupation) than among children from lower social classes (0.47%; 48/10225), the difference being statistically significant (p < 0.05). The incidence of schizophrenia in the highest social class was higher than expected among girls, firstborns, children of young mothers under 30 and urban residents (p < 0.05) compared with lower social classes. When cases from the highest and other social classes were compared, there was no clear difference in background factors or clinical course. Four alcoholics, one of them also schizophrenic, were found among nine social class I fathers. The results suggest that in some families in Northern Finland, a father's professional advancement, often linked to mental disorder, may be one determinant of an increased risk of schizophrenia in the child.

Adolescent↗
PubMed1997

A comparison of clinical and research DSM-III-R diagnoses of schizophrenia in a Finnish national birth cohort. Clinical and research diagnoses of schizophrenia.

As a prerequisite to the use of the Finnish National Hospital Discharge Register in psychiatric epidemiological research, we studied the diagnostic reliability of the register in terms of the psychiatric morbidity experienced by a national birth cohort. We investigated all entries to the register for a sample based upon the Northern Finland 1966 birth cohort at the age of 16 years (n = 11017). Until the end of 1993 (age 27 years), a total of 563 subjects had a register diagnosis indicating a psychiatric illness, 37 of them being schizophrenia. When operational criteria (DSM-III-R) were applied to clinical information in the available original hospital records for cases of psychosis, personality disorder and substance abuse (n = 249), 71 fulfilled criteria for schizophrenia, including all of the 37 cases in the register and an additional 34 (48% false-negatives), most frequently diagnosed in the register as schizophreniform or other psychosis. Despite the official use of DSM-III-R nomenclature, it appears that the clinical concept of schizophrenia in Finland, manifest within the register, remains very restrictive. The application of operational criteria is a necessary prerequisite for scientific research on schizophrenia.

Adolescent↗
PubMed1997

Delusional parasitosis in the elderly: a review and report of six cases from northern Finland.

A patient with delusional parasitosis has a strong conviction of being infested with parasites: for example, lice or worms. Such a patient is not satisfied with assurances or test results that no parasites are present, but is so convinced that he or she will go as far as to bring the parasites in "matchboxes" to a physician. Subjectively worried, the patient may try to pick the parasites out of the skin, causing cutaneous lesions and even ulcerations. The condition is classified as a delusional/paranoid disorder, somatic type according to DSM-III-R. Not much is known epidemiologically of this rare disorder, which usually affects older women who often are isolated socially. Therapy is regarded as difficult, and a wide variety of treatment methods have been attempted. In this article six female cases are presented, showing that a typical patient is an elderly woman who has suffered losses or is socially isolated. These patients lack deeper psychiatric insight into their problem, so they are mostly in the care of nonpsychiatric physicians. Treatment with a low dose of high-potency neuroleptics combined sometimes with antidepressants appears to be effective. Reducing social isolation is also important.

Aged↗
PubMed1997

Utilization of psychiatric in-patient care among new patients in a comprehensive community-care system: a 3-year follow-up study.

Utilization of psychiatric in-patient care among 537 new patients was studied in the Department of Psychiatry in Oulu, Finland, during a 3-year follow-up period. Hospitalization during the second and third years of the follow-up was predicted by hospitalization and number of emergency out-patient contacts during the first year of the study, diagnosis of functional psychosis or personality disorder, and previous in-patient care. In total, 5% of the cohort fulfilled our criteria for 'revolving-door' patients. The 'revolving-door' phenomenon was associated with in-patient care at the first contact with the psychiatric services and diagnosis of psychosis or personality disorder. In total, 2% of the cohort became long-stay hospital patients, and this was predicted by psychosis diagnosis. The clinical implications of these findings are that increased attention should be paid to the first assessment of new patients and to the interaction between psychiatric services and patients during the first year of care.

Adolescent↗
PubMed1997

Specific major mental disorders and criminality: a 26-year prospective study of the 1966 northern Finland birth cohort.

OBJECTIVE: The purpose of the study was to examine the quantitative risk of criminal behavior associated with specific mental disorders. METHOD: An unselected 1966 birth cohort (N = 12,058) in Northern Finland was prospectively studied until the end of 1992. The investigation started during the mothers' pregnancy, and the data on the subjects' family characteristics, mental and physical development, living habits, psychiatric morbidity, and criminal records were gathered at various times. RESULTS: The prevalence of offenses was the highest among males with alcohol-induced psychoses and male schizophrenic subjects with coexisting alcohol abuse, and more than half of the schizophrenic offenders also had problems with alcohol. Eleven (7%) of the 165 subjects who committed violent crimes were diagnosed as psychotic. Male schizophrenic subjects had a moderately high risk for violent offenses, but the risk for other types of crimes was not elevated significantly. Odds ratios for criminal behavior were adjusted according to the socioeconomic status of the childhood family and were the same as or slightly lower than the crude odds ratios for all disorders except schizophrenia and mood disorders with psychotic features. CONCLUSIONS: The results indicate that the risk of criminal behavior was significantly higher among subjects with psychotic disorders, even though the socioeconomic status of the childhood family was controlled. The higher risk for violent behavior was associated especially with alcohol-induced psychoses and with schizophrenia with coexisting substances abuse. The results suggest that schizophrenia without substance abuse may also be associated with a higher risk of offenses, but this finding is tentative and requires further investigation.

Alcoholism↗
PubMed1997

The use of bibliometric data in evaluating research on therapeutic community for addictions and in psychiatry.

The purpose of this study is to describe the publication characteristics associated with therapeutic community research and illustrate differences between addiction studies and other types of therapeutic community papers. A total of 223 published reports on research pertaining to the therapeutic community in a variety of treatment settings from 1987 to 1992 were analyzed. The articles consisted mainly of addiction studies (38%) and hospital psychiatry (36%) studies. Collaborative authorship was scanty. Quantitative studies (systematic data presented and analyzed statistically) were performed more often in addiction papers than in psychiatric therapeutic community papers. Addiction studies were also cited slightly more often. Addictions are often a rather simple and distinct focus for research, as well as a major public health problem. This may lead to the smoother use of traditional quantitative research strategies and standard publication channels than in other psychiatric therapeutic community studies.

Alcoholism↗
PubMed1996

A short DSM-III-R-based diagnostic instrument for screening mental disorders in geriatric institutions.

A screening instrument based on the DSM-III-R was developed in order to differentiate aged persons with or without a DSM-III-R mental disorder. The usefulness of this instrument was investigated in six geriatric institutions with 171 residents aged 65 to 93 years in Finland. The nursing staff independently rated the mental status of residents; researchers (a psychiatrist and general practitioner) made a diagnosis based on DSM-III-R criteria. The majority of the residents (mean 69%, varying from 33% to 84% in different institutions) had a DSM-III-R mental disorder. This screening instrument functioned well in differentiating residents without a mental disorder from those with DSM-III-R mental disorder: The nursing staff's agreement was 90%, kappa.71, sensitivity .90, and specificity .88. However, only half the cases of depression were diagnosed correctly: Sensitivity was .50 and specificity .95. With a more specific 9-class diagnostic instrument based mainly on DSM-III-R categories, agreement was only moderate (68%) and kappa .59. The instrument developed in this study seemed to be a useful screening method when applied by the staff, but accurate diagnostics require psychiatric knowledge, especially of depression.

Aged↗
PubMed1996

Unwantedness of a pregnancy and schizophrenia in the child.

BACKGROUND: Maternal stress during pregnancy has been suggested as a risk factor for schizophrenia. We tested the hypothesis that being the child of an unwanted pregnancy would be associated with later schizophrenia. METHODS: Data were collected prospectively in the Northern Finland 1966 Birth Cohort of 11 017 individuals. In the sixth or seventh month of pregnancy mothers were asked whether the pregnancy was wanted, mistimed but wanted or unwanted. Schizophrenia diagnoses in the cohort members were obtained from the Finnish Hospital Discharge Register. RESULTS: Seventy-six cases of DSM-III-R schizophrenia were identified in the whole cohort between the ages of 16 and 28 years; a cumulative incidence of 0.7%, compared with 1.5% for those born from unwanted pregnancies. The risk of later schizophrenia among unwanted children was raised compared with wanted or mistimed children, even after adjustment for confounding by sociodemographic, pregnancy and perinatal variables (OR 2.4; 95% CI 1.2-4.8). CONCLUSIONS: The results suggest that unwantedness may operate either directly as a psychosocial stress during development making children more liable to schizophrenia, or it may be a marker for behaviours associated with risk in either the mother or the child.

Adolescent↗
PubMed1995

Smoking or quitting during pregnancy: associations with background and future social factors.

Current and future social factors associated with smoking habits during pregnancy were assessed. Data on maternal smoking, social background and the family's development during the 21 years after delivery were gathered for a prospective longitudinal cohort study of 12,068 pregnant women and their children in Northern Finland in 1966 and for a second birth cohort of 9,362 mothers in 1985-86. The prevalence of smoking before pregnancy was 22% in the 1966 cohort (29% in 1985-86). 12% (18%) of the women continued smoking throughout their pregnancy. The following background factors were mainly associated with the mother's smoking and/or continuing during pregnancy in both cohorts when mother's age, parity, place of residence and social class were standardized: mother's age under 23, parity two or more, low social class, urban dwelling, unmarried, gainful employment and heavy smoking. The follow-up responses after 14 and 21 years, respectively, were mostly more favourable among the non-smoking mothers and those who quit smoking during pregnancy-e.g. stable family structure, child's smoking and drinking habits and application for intermediate education. Smoking throughout pregnancy or quitting of smoking late in pregnancy were associated with undesirable future development of the child and family in most of these aspects.

Female↗
PubMed1995

Quantitative assessment of life span of the aged persons--a preliminary study.

The life span is a concept with increasing interest in gerontology, but how to visualize it? We developed the life span assessment scale, where the participants scored their concepts on their different life periods, using a visual analogue scale. A smoothed curve line was fitted through the means of each period. The final results of this procedure resembled an arch or span, like the original metaphor. This scale was tested by two groups of aged persons. Thirty-three noninstitutionalized, active middle-class pensioners (mean age 68 years) assessed their own life curve as resembling a shallow rainbow, the age periods between 30-50 years being most highly valued. A distinct fall did not start until after 70 years. Another life curves were gathered from 50 institutionalized elderly persons, mean age 79 years. Their life curve reached its peak value between 14-20 years, and the fall started after this. The results are preliminary and further validation of the developed method is needed.

Adolescent↗