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Biomedical subjects

M Isohanni

Publications and source records attributed to M Isohanni.

At least 73 records · Page 4Linked to original sources
PubMed1994

Teenage alcohol drinking and non-standard family background.

The teenage alcohol drinking in 1980 is described in a cohort of 12,058 subjects born in Northern Finland in 1966, with special reference to non-standard families (with one or both parents absent). The percentage of boys (girls) who had been drinking alcohol at the age of 14 years, was 59.1 (58.3)%, being 57.5 (55.6%) in standard, full families and 66.0 (69.0)% in non-standard families. The percentage of having been drunk was 25.2 (25.1)%, or 22.8 (22.1)% in full families and 36.1 (37.1)% in the non-standard families. When adjusted for the maternal age at birth, place of residence, social class and child's status in the family (firstborn or not, only child or not) by means of regression modelling, the risk of alcohol drinking/having been drunk was still increased in non-standard families, especially in cases of divorce or same-sex parental death, the risk differences as compared to the standard family usually being between 10-20%. The results suggest that a non-standard family structure is associated with early juvenile alcohol drinking. Parental loss or absence may constitute one important factor leading to excessive haste in adopting the adolescent culture, including its potentially destructive habits.

Adolescent↗
PubMed1994

Length of hospitalization in an acute patients' therapeutic community ward.

A total of 1330 patients in an acute patients' therapeutic community ward were treated in 1977-1991. Their 2384 treatment episodes were analyzed, mainly 1-6 episodes per patient. The median length of hospitalization for all episodes was 40 days; during the first episode it was 39 days, during the 2nd 46 days, the 3rd 49 days, the 4th 48 days, the 5th 33 days and the 6th 47 days. The residents with a better immediate outcome usually stayed 10-20 days longer in hospital than those with an inferior outcome. The associations of length of hospitalization with some predictor variables were analyzed by a linear regression model. A long stay was associated with young age, a psychosis-level diagnosis, and active, motivated participation in individual and milieu therapy. Although economic reasons and expansion of the outpatient care may favor a short stay policy, some motivated borderline and psychosis patients seem to benefit from an individually timed inpatient experience in the therapeutic community setting.

Adult↗
PubMed1993

Gender roles in a geriatric therapeutic community.

During the years 1983-1989 an action research/intervention study in a 40-bed Finnish home for the elderly had as its goal the development of a modified therapeutic community. This paper focuses on the gender roles. Logistic regression analysis indicated that males (N = 17) were best differentiated from females (N = 38) by extramural functional activity, extramural social passivity, religious neutrality, passivity in contacts with a personal nurse, and better education. These five explanatory variables correctly predicted gender in 84% of the cases. These mild gender differences reflect the traditional sex roles of an agrarian Finnish village and were seen mainly as a positive phenomenon. The findings, and some other gender identity themes in the elderly, also were illustrated by qualitative case material. These data suggested that the therapeutic community of aged people should permit active preservation of even conservative and stereotyped gender roles, thereby aiding in the defense and continuity of their often frail identity. The search for new role elements should be supported as well, however, because some elderly continue to develop their gender roles during their final years.

Activities of Daily Living↗
PubMed1993

The relation between teenage smoking and drinking, with special reference to non-standard family background.

Associations between simultaneous teenage drinking and smoking are considered in a birth cohort born in Northern Finland in 1966 (n = 12,058), especially in non-standard, mainly single parent families. Data were collected from pregnancy until the age of 14. ROC (receiver operating characteristic curve) analysis was used to assess how well smoking predicts use of alcohol. Smoking and drinking were more interconnected in the non-standard families among both boys (p = 0.007) and girls (p = 0.018), but only among boys (p = 0.064) when the data were standardized for social class and place of residence and not among girls (p = 0.191). A similar relation between smoking and having been drunk was found among boys in non-standard families (p = 0.016), even when adjusted as above (p = 0.029), but not among girls (unadjusted p = 0.235, adjusted p = 0.469). The findings suggest that the adolescent boy's self-protective behaviour with respect to the commencement of combined experimentation with smoking and drinking is more restricted in non-standard families than in standard families.

Adolescent↗
PubMed1992

Maternal smoking during pregnancy and delinquency of the offspring: an association without causation?

The aim was to evaluate the association between maternal smoking in pregnancy and delinquency of the offspring in youth and early adulthood. The study population consisted of 5966 male members of the Northern Finland birth cohort of 1966, of whom 355 (6.0%) had committed a crime which led to a criminal record by early 1989, which was taken as an indicator of delinquency. Data collection was started during pregnancy and the development and health of the children was followed up continuously to the age of 14. The incidence of delinquency by the age of 22 was 4.6% among the sons of the mothers who did not smoke during pregnancy and 10.3% among those of the smokers. No clear dose-response gradient was observed, and those stopping smoking during the first trimester of the pregnancy had only a slightly smaller incidence of delinquency than those continuing smoking through pregnancy. The association of maternal smoking with delinquency was studied by controlling a number of social and demographic variables using an approach based on stratification by a confounder score. The adjusted incidence difference between smoking and non-smoking mothers was 4.1% (95% confidence interval [CI] : 2.5-5.8) and the ratio was 1.73 (95% CI : 1.41-2.12). A parallel analysis by logistic regression yielded an estimated odds ratio of 1.74 (95% CI : 1.37-2.11) for the same comparison. Even though the association between maternal smoking and delinquency of the offspring remained after adjustment for the available social and demographic factors, maternal smoking may be symptomatic of a certain lifestyle and norm-breaking behaviour which is likely to increase delinquency in the children rather than being an agent with a direct causal role. This is supported by the lack of any clear dose-response pattern and the minor importance of stopping smoking. Another possibility is that maternal smoking may cause some kind of brain damage which affects the behaviour of the child.

Adolescent↗
PubMed1992

Participation in group psychotherapy in a therapeutic community for acute patients.

A total of 2090 treatment episodes from 1977 to 1990 at a therapeutic community for acute patients were assessed for group psychotherapy participation and its associations with some patient and program characteristics, based on polytomous logistic regression analysis. Nonparticipation (4% of all episodes) or passivity (14%) were associated mainly with the program properties (such as the quality of the ward policy, first treatment episode and short treatment time), a diagnosis of personality disorder or typical schizophrenia and inferior outcome (assessed by attainment of treatment goals). The associations of moderate activity (45%) were very active (37%) as a reference, mainly personal properties (such as male gender, young age, low social and professional background and a diagnosis of schizophrenia) and inferior outcome. The results suggest that group participation, therapeutic program, patient properties and attainment of treatment goals are interrelated. The therapeutic program and leaders' skills should be developed to facilitate individualized group participation.

Adult↗
PubMed1991

Determinants of teenage smoking, with special reference to non-standard family background.

The prevalence of teenage smoking in a cohort of 12,058 subjects born in northern Finland in 1966 is discussed in terms of its social and family determinants, especially in "non-standard" families (with one or more of the parents absent for at least part of the child's upbringing). The prevalence of experimental or daily smoking was 67.4%, the rate being 65.5% in the standard, two-parent families and 75.5% in the non-standard families, the difference being statistically significant (p less than 0.001). The corresponding prevalence of daily smoking was 6.4%, but the rate was 5.1% in standard families and 12.1% in non-standard families (p less than 0.001). An elevated risk of smoking existed among adolescents who had experienced death of their father or divorce of their parents and among girls who had experienced death of their mother. Maternal smoking during pregnancy and maternal age under 20 years at the time of delivery increased the risk, while being the first-born child reduced it. Among family factors existing in 1980, paternal smoking increased the risk for both sexes, while more than three siblings, mother's unemployment or gainful employment (i.e. not a housewife) were associated with smoking by the boys as was urban living, and for the girls migration by the family to a town. The results suggest that juvenile smoking may be a kind of indicator of possible problems experienced by the parents and/or the adolescents themselves with respect to parenthood and family development.

Adolescent↗
PubMed1991

The dilemma of civil rights versus the right to treatment: questionable involuntary admissions to a mental hospital.

Admission to a close ward was analyzed at the Department of Psychiatry, University of Oulu using 888 patients and their 1861 assessment and treatment episodes. Of all referrals for involuntary assessment (n = 237, 12.7% of all episodes) a total of 44 (2.4%) used "questionable" juridical criteria: the final diagnosis was not psychosis. In the follow-up, the admission of the questionable patients was mainly considered a clinical necessity, and at least one third of them were diagnosed as being psychotic and 2 committed suicide. An elevated probability of belonging to the questionable group was seen among patients in their first treatment episode, with minimal professional education, female sex, short treatment time, or residence in a rural area. The result suggests that some inequality existed between women and men, less and more educated and residents of urban and rural areas. The results also reflect conflict between the ethics and clinical practice of involuntary commitment, and the phrasing of the law, especially its diagnostic limitation to psychotic states only.

Adult↗
PubMed1990

Coping with institutional life at the old people's therapeutic community.

A research project at a Finnish old people's home was carried out in 1983-1989, its aim being to explore whether therapeutic community principles can be applied to the institutional care of the elderly. Some aged seemed to adapt better to the community than others. In 1987 the group "excellent coping in institution" (N = 14) was formulated for this study, on the basis of favorable outcome, good adaptation to aging, nonproblematic behavior and a high subjective satisfaction with life. Using logistic regression analysis, the properties of this group were compared with the group "problem coping in institution" (N = 32). The following variables discriminated the excellent coping group best: therapeutic community activity, current mental health, and a socio-economically deprived childhood. This result suggested that active and mentally strong elderly coped better with the "homelike" therapeutic community method executed between 1983-87, which focused only on a pleasant atmosphere in which the old people could live together. Therefore the treatment policy has been partially reorganized since 1987, so as to include special attention for passive and mentally fragile residents. The modified therapeutic community that was developed seems to help coping in geriatric institutions if its working methods permit 1) active participation, 2) passive rest and reminiscence, and 3) support, holding, and even psychiatric intervention.

Adaptation, Psychological↗
PubMed1990

Relationship between involuntary admission and the therapeutic process in a closed ward functioning as a therapeutic community.

In a therapeutic community for acute psychiatric patients, the relationship between involuntary admission (13.6% of the episodes) and some patient and program characteristics was analyzed, using a total of 1586 treatment episodes in 838 patients between 1978-1987. Based on a logistic regression model, an elevated relative risk of involuntary admission was seen in the diagnostic groups of schizophreniform psychosis, unspecific psychosis, paranoid psychosis, and borderline psychosis. Also, the association with involuntary admission increased in the first or second treatment episode, or for patients that had a controversial or negative immediate outcome, for young patients under 21 years, and for patients who were passive in individual therapy. Still, the difference in outcome was minimal, and there were no differences in group or milieu therapy activity. The results suggest that involuntary admission is not necessarily a traumatic, negative experience in subsequent treatment episodes or in the patient career. The modified therapeutic community model presented contains peer and family support and ample opportunity to discuss and negotiate, which may alleviate the possible narcissistic pain of involuntary admission.

Adolescent↗