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Biomedical subjects

Teija Honkonen

Publications and source records attributed to Teija Honkonen.

15 recordsLinked to original sources
PubMed2006

Body mass index and functioning in long-term schizophrenia. Results of the DSP project.

OBJECTIVE: The study evaluates the association of body mass index (BMI) with functioning in male and female patients with long-term schizophrenia. METHOD: 722 long-term schizophrenia patients were interviewed three years after discharge from hospital. Their weight and height were recorded and data on their background, illness history, psychosocial functioning (Global Assessment Scale; GAS), health behaviour, daily doses of neuroleptics, and psychiatric symptoms were collected. RESULTS: BMI correlated significantly with GAS scores in male (r=0.202, p=0.000) but not in female patients. In male patients, BMI associated significantly (p=0.005) with GAS scores even when the effects of psychiatric symptoms and other confounding variables were taken into account. CONCLUSIONS: In male but not in female long-term patients with schizophrenia, low BMI associates with poor functioning. It is suggested that among male schizophrenia patients, low BMI may be an indicator of poor functioning.

Adult↗
PubMed2006

Work stress, mental health and antidepressant medication findings from the Health 2000 Study.

BACKGROUND: Population-based studies on the association between work stress and mental disorders are scarce, and it is not known whether work stress predicts mental disorders requiring treatment. AIMS: To examine the associations of work stress with DSM-IV mental disorders and subsequent antidepressant medication. METHODS: 3366 participants from a representative sample of the Finnish working population responded to a survey (The Health 2000 Study). 12-month prevalence of depressive or anxiety disorders was examined with the Composite International Diagnostic Interview. Data on antidepressant prescriptions with a 3-year follow-up period were collected from a nationwide register of Social Insurance Institution. RESULTS: In men and women, high job demands, low job control and high job strain were associated with 12-month prevalence of depressive or anxiety disorders. After adjustment for lifetime and baseline mental disorders, men with high job demands and high job strain had increased risk of future antidepressant medication. CONCLUSIONS: Work stress is associated with mental disorders among both sexes and among men it is a risk factor for mental disorders treated with antidepressant medication.

Adult↗
PubMed2006

The association between burnout and physical illness in the general population--results from the Finnish Health 2000 Study.

OBJECTIVE: The association between burnout and physical diseases has been studied very little. The purpose of this study was to examine the relationship between burnout and physical illness in a representative nationwide population health study. METHODS: As a part of the "Health 2000 Study" in Finland, 3368 employees aged 30-64 years were studied. Burnout was assessed with the Maslach Burnout Inventory-General Survey. Physical diseases were diagnosed in a comprehensive health examination by research physicians. RESULTS: Physical illness was more common among subjects with burnout than others (64% vs. 54%, P<.0001), and the prevalence of diseases increased with the severity of burnout (P<.0001). Burnout was an important correlate of cardiovascular diseases among men (OR=1.35; 95% CI, 1.13-1.61) and musculoskeletal disorders among women (OR=1.22, 95% CI, 1.07-1.38) when adjusted for age, marital status, education, socioeconomic status, physical strenuousness of work, smoking, physical activity, alcohol consumption, body mass index, and depressive symptoms. The prevalence of musculoskeletal disorders and cardiovascular diseases increased with the severity of all three dimensions of burnout, that is, exhaustion (P<.0001 and P<.001, respectively), cynicism (P=.0001 and P<.001, respectively), and lack of professional efficacy (P<.01 and P<.0001, respectively). CONCLUSIONS: Burnout is associated with musculoskeletal diseases among women and with cardiovascular diseases among men. These associations are not explained by sociodemographic factors, health behavior, or depression. Physical illnesses are associated with all three dimensions of burnout and not only with the exhaustion dimension. In the future, the causal relationships between burnout and physical diseases need to be investigated in prospective studies.

Adult↗
PubMed2006

Contribution of burnout to the association between job strain and depression: the health 2000 study.

OBJECTIVE: The objective of this study was to investigate the contribution of burnout to the association between job strain and depression. METHODS: A representative sample of 3270 Finnish employees aged 30 to 64 years responded to the Maslach Burnout Inventory-General Survey and the Beck Depression Inventory and participated in the Composite International Diagnostic Interview. RESULTS: High strain compared with low strain was associated with 7.4 (95% confidence interval [CI] = 5.6-9.7) times higher odds of burnout, 3.8 (95% CI = 2.8-5.1) times higher odds of depressive symptoms, and 1.7 (95% CI = 1.1-2.6) times higher odds of depressive disorders. The risk for depressive symptoms and for depressive disorders of high strain was reduced by 69% or more after adjusting for burnout. CONCLUSION: Burnout is strongly related to job strain and may in part mediate the association between job strain and depression.

Adult↗
PubMed2006

Alcohol dependence in relation to burnout among the Finnish working population.

AIMS: To investigate the relationship of burnout to alcohol dependence and high alcohol consumption. DESIGN: A cross-sectional population-based multi-disciplinary 'Health 2000 Study'. The analyses were performed separately for the women and the men and adjusted for socio-demographic factors. SETTING AND PARTICIPANTS: In Finland, 3276 active employees (1637 women and 1639 men), aged 30-64 years, from a representative population sample. MEASUREMENTS: The diagnosis of Diagnostic and Statistical Manual of Mental Disorders version IV (DSM-IV) alcohol dependence was based on the standardized Munich Composite International Diagnostic Interview (M-CIDI). The assessment of high alcohol consumption was based on self-reported alcohol use. Burnout was assessed with the Maslach Burnout Inventory-General Survey (MBI-GS). FINDINGS: The 12-month prevalence of alcohol dependence was associated with burnout among both men and women. Each one-point increase in burnout score was associated with an 80% increase in the incidence for alcohol dependence among women and a 51% increase among men. These associations persisted when socio-demographic factors were adjusted. The associations between burnout and high alcohol consumption were not statistically significant. CONCLUSIONS: There is an association between burnout and alcohol dependence among both genders. Among both women and men, attention to alcohol-related behaviour is warranted in the clinical context when burnout and other problems related to work are encountered. Interventions which include assessment of work conditions and management of work-related stress should be targeted at employees with alcohol dependence in addition to traditional treatment.

Adult↗
PubMed2006

Subjective life satisfaction and living situations of persons in Finland with long-term schizophrenia.

OBJECTIVE: This study measured subjective life satisfaction among patients with long-term schizophrenia who were living in the community. METHODS: A representative national sample of 2,221 persons with schizophrenia who were discharged from psychiatric hospitals in Finland in 1986, 1990, and 1994 were interviewed three years after discharge. Subjective life satisfaction was measured; patients were asked about their current level of satisfaction and the level of satisfaction they recalled having at the time of discharge. RESULTS: Patients tended to report more satisfaction at follow-up if they were female, had good psychosocial functioning, had several confidants, or were living in group homes or dormitories. Patients tended to be less satisfied at follow-up if they were divorced or had mental and physical symptoms. Patients with depressive symptoms or with low psychosocial functioning and those who were currently hospitalized reported the smallest changes in levels of satisfaction between the two time points. Patients with low psychosocial functioning who were living with their parents, in group homes or dormitories, or in institutions were relatively satisfied, whereas patients with good psychosocial functioning were more satisfied if they lived with their spouse or partner. CONCLUSIONS: Being female and having good psychosocial functioning, confidants, good physical health, and living arrangements in the community that offer support corresponding to the patient's psychosocial state are important factors of life satisfaction among patients with long-term schizophrenia.

Adaptation, Psychological↗
PubMed2005

The relationship between job-related burnout and depressive disorders--results from the Finnish Health 2000 Study.

BACKGROUND: Depression and burnout are common health problems in working populations today. They appear to be interrelated, and the need for their differential diagnosis has been highlighted in many reviews. We analysed the overlap of job-related burnout and depressive disorders, i.e., major depressive disorder, dysthymia, and minor depressive disorder. METHODS: We used the population-based 'Health 2000 Study' in Finland. Our nationally representative sample comprised 3276 employees aged 30-64 years. Burnout was assessed with the Maslach Burnout Inventory-General Survey. Diagnoses of depressive disorders were based on the Composite International Diagnostic Interview. RESULTS: Burnout and depressive disorders were clearly related. The risk of depressive disorders, especially major depressive disorder (12-month prevalence), was greater when burnout was severe. Half of the participants with severe burnout had some depressive disorder. Those with a current major depressive episode suffered from serious burnout more often than those who had suffered a major depressive episode earlier. LIMITATIONS: This study was cross-sectional. CONCLUSIONS: The concepts of burnout and depression complement each other and cover partly overlapping phenomena. Depressive disorders are related to job-related burnout, particularly when it is severe. A current major depressive episode is likely to be associated with the experience of burnout. When encountering working patients, it is recommended to assess both the occurrence of burnout and of depressive disorders.

Adult↗
PubMed2004

Violent victimization in schizophrenia.

BACKGROUND: We investigated the 3-year prevalence, and the sociodemographic and clinical correlates of violent victimization in a large and unselected nationwide sample of deinstitutionalized patients with schizophrenia. METHODS: The sample comprised 670 schizophrenic patients aged 15-64 years, who had been discharged from psychiatric hospitals in Finland in 1994. Comprehensive data were collected from psychiatric case records on the patients' sociodemographic factors and psychiatric history, as well as the patients' overall level of functioning. The patients were interviewed 3 years after discharge by each district's psychiatric professionals using a structured interview schedule specifically designed for the purposes of the present study project. RESULTS: The prevalence of self-reported violent victimization during the 3-year follow-up was 5.6%. In the multivariate analysis, a poor financial situation, alcohol abuse and being a perpetrator of a violent or some other crime were associated with violent victimization. CONCLUSIONS: The prevalence of violent victimization among schizophrenic patients in Finland was markedly lower than that reported on patients in the United States or Great Britain, but correlates were similar. Patients with a poor financial situation and a history of alcohol misuse, as well as of violent behaviour, seem to have an increased risk for violent victimization, and constitute a vulnerable subgroup in this respect. This subgroup of deinstitutionalized patients with schizophrenia may need additional care and protection from the danger posed to them from other members of the society.

Adolescent↗
PubMed2003

Negative symptoms and neuroleptics in catatonic schizophrenia.

The association between neuroleptic treatment and the negative symptom dimension (ND) was evaluated in 1528 schizophrenia patients. In patients receiving more than 820 mg chlorpromazine (CPZ), those with catatonic-type disorder had significantly (p<0.05) higher ND scores than those in any of the other diagnostic subtypes. Even in patients receiving 450 mg CPZ or more, catatonic patients had significantly (p=0.046) higher ND scores than other patients. Patients with catatonic schizophrenia are highly vulnerable to negative symptoms related to neuroleptic drugs, probably because of a defect in their dopaminergic neuronal pathways.

Adolescent↗
PubMed2003

Women have later onset than men in schizophrenia--but only in its paranoid form. Results of the DSP project.

According to the literature, schizophrenia begins in men earlier than in women. It has been argued that the gender-bound age difference is due to the protective antidopaminergic effect of estrogens in women. However, the effect of gender on the age of onset may vary between different types of schizophrenias, and can also be modulated by marital status and by age at onset of illness. Comprehensive data were collected on 3306 DSM IIR schizophrenia patients, aged 15-64 years, who had been discharged from psychiatric hospitals in Finland in 1982, 1986 and 1990. The age of onset of illness (AOI) was defined by the age at the first admission (AFA). Male patients were admitted earlier than female patients, and a small second peak in women appeared at the age of 40-44. However, there were no gender differences in AFA within diagnostic subgroups, except in paranoid schizophrenia in which AFA was lower in men than in women even when marital status was taken into account. Within paranoid schizophrenia, this effect of gender was significant only in those of the patients whose AFA was higher than 30 years. It is suggested that there is no gender difference in AOI in early onset schizophrenia. In later onset, paranoid schizophrenia, the illness seems to manifest in women later than in men.

Adolescent↗
PubMed2003

Schizophrenic patients in different treatment settings during the era of deinstitutionalization: three-year follow-up of three discharge cohorts in Finland.

OBJECTIVE: We investigated differences in psychosocial and clinical characteristics, as well as the use of services, of schizophrenic patients in different treatment settings three years after their discharge from a psychiatric hospital. Furthermore, we examined secular changes in these phenomena during the era of rapid deinstitutionalization in Finland. METHOD: Three nationally representative samples comprised 3257 schizophrenic patients who had been discharged in 1986, 1990 and 1994. The patients were interviewed three years after discharge by each district's psychiatric professionals using a structured interview schedule specifically designed for the purposes of the present study. Psychosocial functioning was assessed on the Global Assessment Scale and on a modified version of the Medical Research Council Practices Profile. RESULTS: In the 1990s, more patients with a poor clinical and psychosocial state were transferred from hospital to alternative outpatient facilities, such as sheltered workshops or supported residences. In successive cohorts, the proportion of patients who had dropped out of treatment decreased and the psychiatric and somatic state of the drop-outs improved. CONCLUSION: In general, the psychiatric treatment system has worked well for most deinstitutionalized patients. In the future, however, it is important that the quality of care and adequate resources in the alternative outpatient facilities are ensured.

Adolescent↗
PubMed2002

Mortality in chronic schizophrenia during decreasing number of psychiatric beds in Finland.

Mortality, especially mortality due to suicides, is higher among patients suffering from schizophrenia than among the general population. Little is known about the factors predicting the mortality of schizophrenia patients. It has also been suggested that mortality among psychiatric patients increases as the number of beds in mental hospitals decreases. These questions were studied in 4338 schizophrenia patients discharged in 1982, 1986, 1990 and 1994 from mental hospitals in Finland. During this period, the number of beds in mental hospitals in Finland decreased from 3.8 to 1.3 per 1000 inhabitants. During the three-year follow-up, 226 patients or 5.2% died. There were no statistically significant differences in mortality between the cohorts. The total mortality was higher in males than in females. Age, physical illness and number of hospital days predicted increased mortality due to natural causes. Mortality due to unnatural causes (suicides and accidents) was predicted by number of prescribed psychosedatives, number of hospitalisations and short duration of illness. Mortality due to unnatural causes was higher in the first year after index discharge from hospital. The reduction in number of beds in mental hospitals does not seem to be associated with increased mortality in chronic schizophrenia. The high mortality of schizophrenia patients indicates the need for careful medical examinations and treatment of physical illnesses, as well as counselling for a healthy lifestyle. Need for psychosedative medication at discharge from hospital and multiple previous hospitalisations may indicate an increased suicide risk and thus requires special attention. In outpatient treatment, it is important to remember that the risk of unnatural death increases during the first years after discharge from hospital.

Adolescent↗
PubMed2002

Symptom dimensions and their association with outcome and treatment setting in long-term schizophrenia. Results of the DSP project.

National representative samples of 1571 schizophrenia patients discharged from mental hospitals in Finland in 1990 and 1994 were interviewed 3 years after discharge. The symptom items assessed by the PANSS were factorized and orthogonal rotations were performed. Five factor dimensions, negative, positive, depressive, hostile and disorganization dimension, were obtained and correlated with data of patients' socio-demographic background, clinical history, condition and outcome. The negative dimension was more prominent in male and single patients, the depressive dimension in female and divorced patients. Patients with early onset and long duration of illness had high disorganization scores. Patients with disorganized subtype of schizophrenia had high scores in positive and disorganization dimensions. High scores in all, especially in negative and positive dimensions, were associated with poor psychosocial situation. Symptom dimensions varied also according to treatment setting at follow-up. Symptom dimensions of long-term schizophrenia patients in the community are closely associated with patients' socio-demographic background, clinical history and conditions, as well as with outcome and the treatment patients receive. A dimensional approach, instead of a categorical one, seems to be important in assessing symptomatology and its relation to outcome and interventions in schizophrenia.

Adolescent↗