PubMed Health⌕ Search

Biomedical subjects

Timo Partonen

Publications and source records attributed to Timo Partonen.

At least 19 recordsLinked to original sources

Lifetime prevalence of psychotic and bipolar I disorders in a general population.

CONTEXT: Recent general population surveys of psychotic disorders have found low lifetime prevalences. However, this may be owing to methodological problems. Few studies have reported the prevalences of all specific psychotic disorders. OBJECTIVE: To provide reliable estimates of the lifetime prevalences of specific psychotic disorders. DESIGN: General population survey. SETTING AND PARTICIPANTS: A nationally representative sample of 8028 persons 30 years or older was screened for psychotic and bipolar I disorders using the Composite International Diagnostic Interview, self-reported diagnoses, medical examination, and national registers. Those selected by the screens were then re-interviewed with the Structured Clinical Interview for DSM-IV. Best-estimate DSM-IV diagnoses were formed by combining the interview and case note data. Register diagnoses were used to estimate the effect of the nonresponders. MAIN OUTCOME MEASURES: Diagnosis of any psychotic or bipolar I disorder according to the DSM-IV criteria. RESULTS: The lifetime prevalence of all psychotic disorders was 3.06% and rose to 3.48% when register diagnoses of the nonresponder group were included. Lifetime prevalences were as follows: 0.87% for schizophrenia, 0.32% for schizoaffective disorder, 0.07% for schizophreniform disorder, 0.18% for delusional disorder, 0.24% for bipolar I disorder, 0.35% for major depressive disorder with psychotic features, 0.42% for substance-induced psychotic disorders, and 0.21% for psychotic disorders due to a general medical condition. The National Hospital Discharge Register was the most reliable of the screens (kappa = 0.80). Case notes supplementing the interviews were essential for specific diagnoses of psychotic disorders. CONCLUSIONS: Multiple sources of information are essential for accurate estimation of lifetime prevalences of psychotic disorders. The use of comprehensive methods reveals that their lifetime prevalence exceeds 3%.

Adult↗

Cognitive functioning in patients with familial bipolar I disorder and their unaffected relatives.

BACKGROUND: Impairments in verbal learning and memory, executive functions and attention are manifest in some euthymic patients with bipolar disorder (BPD). However, evidence is sparse on their putative role as aetiologically important genetic vulnerability markers for the disorder. This population-based study examined the cognitive functions of affected and unaffected individuals in families with BPD. The aim was to discover whether any cognitive function would indicate genetic liability to the disorder and could thus be regarded as endophenotypes of BPD. METHOD: A diagnostic interview and a neuropsychological test battery were administered to 32 familial bipolar I disorder patients, 40 of their unaffected first-degree relatives and 55 controls, all representing population-based samples. RESULTS: Unaffected first-degree relatives showed impairment in psychomotor performance speed and slight impairment in executive function. Bipolar patients were impaired in verbal learning and memory compared with unaffected relatives and controls. They also differed from controls in tasks of executive functions. There were no difference between the groups in simple attention and working memory tasks. CONCLUSIONS: Impaired psychomotor performance speed and executive function may represent endophenotypes of BPD, reflecting possible underlying vulnerability to the disorder. Verbal memory impairments appear to be more related to the fully developed disorder.

Bipolar Disorder↗

Families with the risk allele of DISC1 reveal a link between schizophrenia and another component of the same molecular pathway, NDE1.

We have previously reported a robust association between an allelic haplotype of 'Disrupted in Schizophrenia 1' (DISC1) and schizophrenia in a nationwide collection of Finnish schizophrenia families. This specific DISC1 allele was later identified to associate with visual working memory, selectively in males. DISC1 association to schizophrenia has since been replicated in multiple independent study samples from different populations. In this study, we conditioned our sample of Finnish families for the presence of the Finnish tentative risk allele for DISC1 and re-analyzed our genome-wide scan data of 443 markers on the basis of this stratification. Two additional loci displayed an evidence of linkage (LOD > 3) and included a locus on 16p13, proximal to the gene encoding NDE1, which has been shown to biologically interact with DISC1. Although none of the observed linkages remained significant after multiple test correction through simulation, further analysis of NDE1 revealed an association between a tag-haplotype and schizophrenia (P = 0.00046) specific to females, which proved to be significant (P = 0.011) after multiple test correction. Our finding would support the concept that initial gene findings in multifactorial diseases will assist in the identification of other components of complex genetic etiology. Notably, this and other converging lines of evidence underline the importance of DISC1-related functional pathways in the etiology of schizophrenia.

Alleles↗

Transition to daylight saving time reduces sleep duration plus sleep efficiency of the deprived sleep.

Daylight saving time (DST) is widely adopted. We explored the effects of transition to daylight saving time on sleep. With the use of wrist-worn accelerometers, we monitored the rest-activity cycles on a sample of 10 healthy adults for 10 days around the transition to summer time. Identical measurement protocols were carried out twice on the same individuals during the transitions in the years of 2003 and 2004, yielding data on 200 person-days for analysis. Both sleep duration and sleep efficiency were reduced after the transition both years. After the transition sleep time was shortened by 60.14min (P<0.01) and sleep efficiency was reduced by 10% (P<0.01) on average. Transition to daylight saving time appears to compromise the process of sleep by decreasing both sleep duration and sleep efficiency.

Adaptation, Physiological↗

Affective flattening and alogia associate with the familial form of schizophrenia.

Family history of schizophrenia has been associated with negative symptoms in the clinical picture. Our aim was to examine the signs and symptoms of schizophrenia in a genetically homogeneous isolate and a nationwide multiplex family sample, and to investigate the symptom dimensions and their association with the degree of familial loading for psychotic disorders and with consanguinity. For factor analysis of the Scales for the Assessment of Negative and Positive Symptoms, we included 290 patients with a DSM-IV diagnosis of schizophrenia: 63 multiplex family and 133 singleton patients from the isolate, and 94 nationwide multiplex family patients. The factor analysis yielded four factors. There was a significant difference between the multiplex and singleton patients, the former having more severe affective flattening and alogia. Further, the patients in isolate groups had fewer delusions and hallucinations compared with the whole country multiplex patients regardless of their familial loading for schizophrenia. This may be related to genetic homogeneity in the isolate. We conclude that patients with first-degree relatives with psychotic disorder have more severe negative symptoms.

Adult↗

Psychosis among "healthy" siblings of schizophrenia patients.

BACKGROUND: Schizophrenia aggregates in families and accurate diagnoses are essential for genetic studies of schizophrenia. In this study, we investigated whether siblings of patients with schizophrenia can be identified as free of any psychotic disorder using only register information. We also analyzed the emergence of psychotic disorders among siblings of patients with schizophrenia during seven to eleven years of follow-up. METHODS: A genetically homogenous population isolate in north-eastern Finland having 365 families with 446 patients with a diagnosis of schizophrenia was initially identified in 1991 using four nationwide registers. Between 1998 and 2002, 124 patients and 183 siblings in 110 families were contacted and interviewed using SCID-I, SCID-II and SANS. We also compared the frequency of mental disorders between siblings and a random population comparison group sample. RESULTS: Thirty (16%) siblings received a diagnosis of psychotic disorder in the interview. 14 siblings had had psychotic symptoms already before 1991, while 16 developed psychotic symptoms during the follow-up. Over half of the siblings (n = 99, 54%) had a lifetime diagnosis of any mental disorder in the interview. CONCLUSION: Register information cannot be used to exclude psychotic disorders among siblings of patients with schizophrenia. The high rate of emergence of new psychotic disorders among initially healthy siblings should be taken into account in genetic analysis.

Adult↗

Transition into daylight saving time influences the fragmentation of the rest-activity cycle.

BACKGROUND: Daylight saving time is widely adopted. Little is known about its influence on the daily rest-activity cycles. We decided to explore the effects of transition into daylight saving time on the circadian rhythm of activity. METHODS: We monitored the rest-activity cycles with the use of wrist-worn accelerometer on a sample of ten healthy adults for ten days around the transition into summer time. Identical protocols were carried out on the same individuals in two consecutive years, yielding data on 200 person-days for analysis in this study. RESULTS: There was no significant effect on the rest-activity cycle in the sample as a whole. Fragmentation of the rest-activity cycle was enhanced in a subgroup of persons having sleep for eight hours or less (P = 0.04) but reduced in those who preferred to sleep for more than eight hours per night (P = 0.05). The average level of motor activity was increased in persons having the morning preference for daily activity patterns (P = 0.01). CONCLUSION: Transition into daylight saving time may have a disruptive effect on the rest-activity cycle in those healthy adults who are short-sleepers or more of the evening type.

Journal Article↗

Time patterns of attempted suicide.

BACKGROUND: The association of mental disorders with time patterns of attempted suicide is poorly understood. METHODS: The study material consisted of all consecutive suicide attempts admitted to health care in Helsinki during a one-year period from 15 January 1997 to 14 January 1998. Clinical diagnosis was made according to ICD-10. RESULTS: Overall, the rate of suicide attempts varied markedly during the study period, peaking in autumn and being lowest during winter. Substance use disorders best explained suicide attempts occurring at weekends. There was considerable temporal variation among patients with mood disorders, compared to only slight variation among patients with schizophrenia spectrum disorders. Study subjects tended to contact health services in the late evening and around midnight. Those contacting health services outside normal hours received psychiatric consultation less frequently than others and were referred to aftercare less often. LIMITATIONS: Structured Clinical Interviews for DSM-IV Axis I and II Disorders were not used. CONCLUSIONS: There were marked time patterns of attempted suicide, especially among patients with mood disorders and substance use disorders. This contrasted with the limited fluctuation among patients with schizophrenia spectrum disorders. Contacts with the health care system occurred most often in the late evening and around midnight. The findings question the adequacy of staff numbers for psychiatric consultations and of time to plan aftercare.

Adolescent↗

Self-reported sleep duration in Finnish general population.

Self-reported short or long sleep duration has been repeatedly found to be associated with increased mortality and health risks. However, there is still an insufficient amount of detailed knowledge available to characterize the short and long sleep duration groups in general population. Consequently, the underlying mechanisms potentially explaining the health risks associated with short and long sleep duration are unclear. In the present study, the self-reported sleep duration in a sample of Finnish general population was studied, and its possible associations with such factors as self-perceived health, sociodemographic characteristics, lifestyle, sleep difficulties and daytime concomitants were analyzed. In particular, an effort was made to define mutually statistically-independent determinants of sleep duration. In the Finnish Health 2000 Survey, a representative sample of 8,028 subjects of 30 years of age or older and a sample of 1,894 subjects of 18-29 years of age were invited to take part in the health interview and health examination. The participation rate of the study was over 80%. The most important and statistically-independent determinants of short and long sleep duration were gender, physical tiredness, sleep problems, marital status, main occupation and physical activity. However, in the multivariable model they only accounted for approximately 16% of the variance in sleep duration in short and long sleepers, suggesting multiple sources of variance. The present study also suggests a dose-response like relationship between the sleep duration and many of its determinants within both short and long sleepers. A more detailed analysis of the clinical status of the short and long sleep duration groups is needed to evaluate the possible importance of these findings for health risks associated with sleep duration.

Adolescent↗

[Not Available].

Explore the source record for details and available documents.

Letter↗

Prevalence and diagnosis of schizophrenia based on register, case record and interview data in an isolated Finnish birth cohort born 1940-1969.

INTRODUCTION: Schizophrenia occurs worldwide but the prevalence varies markedly. In Finland, schizophrenia is most prevalent in the northeastern region. Our aims were to reassess the register-, case record- and interview-based lifetime prevalence in a genetically homogeneous birth cohort from an isolate population with earlier reported high prevalence of schizophrenia and a chromosome linkage to chromosome 1q. METHODS: We identified all patients with a diagnosis of schizophrenia [International Classification of Diseases (ICD)-8, ICD-9 or ICD-10 codes], born 1940-1969 in the isolate (n=282) and alive (n=237) in 1998 using the Hospital Discharge, Disability Pension and Free Medicine Registers. The corresponding birth cohort of 14,817 persons and 12,368 alive in 1998 was identified from the National Population Register. We validated 69% of the register diagnosis by making DSM-IV consensus diagnoses, and interviewed 131 (55%) of the 237 patients with SCID-I and SCID-II. RESULTS: The register-based lifetime prevalence was 1.5% for schizophrenia and 1.9% for schizophrenia spectrum psychotic disorders: in birth cohorts born 1945 to 1959, the latter prevalence was especially high (2.4%). Of those with a register diagnosis of schizophrenia spectrum psychotic disorder, 69% or 63% also received a record-based consensus diagnosis or SCID interview diagnosis of schizophrenia, and the prevalence was 0.9-1.3 and 0.7-1.2%, respectively, when we reassessed most of the register-based cases. The cumulative incidence of schizophrenia spectrum psychotic disorders in the total birth cohort was 1.9%. CONCLUSION: In this isolate, the register, DSM-IV consensus and SCID interview-based lifetime prevalence of schizophrenia was internationally high. For genetic research work, the register diagnosis should be reassessed using either structured interview or the best estimate consensus diagnosis.

Adult↗

Memory and verbal learning functions in twins with bipolar-I disorder, and the role of information-processing speed.

BACKGROUND: Euthymic bipolar-I disorder (BP I) patients and their siblings have shown impairments in verbal learning and memory functions compared with controls, suggesting that these impairments may be genetic in origin. Reduced information-processing speed has been associated with impaired memory in the elderly, and recently in schizophrenia. The authors compared verbal learning and memory functioning in twins with BP I and co-twins to control twins, and examined whether the observed deficits are related to information-processing speed. METHOD: Finnish Medical and Population Registers and Twin Cohorts were used to identify the BP I and control twins. Neuropsychological tests assessing verbal learning and memory, working memory, facial recognition, visual memory, and information-processing speed were administered to 26 BP I twins, 19 non-bipolar co-twins, and 114 controls. Group differences were analyzed by generalized estimation equation modeling. RESULTS: BP I patients, but not co-twins, showed impairments in all memory tests compared with controls. Female co-twins showed impairment in verbal learning and memory. Information-processing speed had a significant effect on encoding and learning efficiency. CONCLUSIONS: This study showed for the first time that information-processing speed is related to memory functioning and verbal learning in BP I in a population-based, representative and euthymic sample. Furthermore, the data support the view that defects in verbal memory may be related to the genetic factors predisposing to BP I in females.

Adult↗

The diagnosis, symptomatology, and epidemiology of seasonal affective disorder.

The operational criteria for seasonal affective disorder (SAD) have undergone several changes since first proposed in 1984. SAD is currently included as a specifier of either bipolar or recurrent major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The International Classification of Diseases, Tenth Edition has provisional diagnostic criteria for SAD. The most characteristic quality of SAD is that the symptoms usually present during winter and remit in the spring. Furthermore, the symptoms tend to remit when the patients are exposed to daylight or bright light therapy. The cognitive and emotional symptoms are as in other types of depression but the vegetative symptoms are the reverse of classic depressive vegetative symptoms, namely increased sleep and increased appetite. SAD is a common condition, but the exact prevalence rates vary between different studies and countries and is consistently found to be more common in women and in youth. SAD probably possibly occurs in children although not as commonly as in young adults. Some studies have found that certain ethnic groups who live at high northern latitudes may have adapted to the long arctic winter.

Adult↗

Food and nutrient intake in relation to mental wellbeing.

BACKGROUND: We studied food consumption and nutrient intake in subjects with depressed mood, anxiety and insomnia as indices of compromised mental wellbeing. METHODS: The study population consisted of 29,133 male smokers aged 50 to 69 years who entered the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study in 1985-1988. This was a placebo-controlled trial to test whether supplementation with alpha-tocopherol or beta-carotene prevents lung cancer. At baseline 27,111 men completed a diet history questionnaire from which food and alcohol consumption and nutrient intake were calculated. The questionnaire on background and medical history included three symptoms on mental wellbeing, anxiety, depression and insomnia experienced in the past four months. RESULTS: Energy intake was higher in men who reported anxiety or depressed mood, and those reporting any such symptoms consumed more alcohol. Subjects reporting anxiety or depressed mood had higher intake of omega-3 fatty acids and omega-6 fatty acids. CONCLUSIONS: Our findings conflict with the previous reports of beneficial effects of omega-3 fatty acids on mood.

Journal Article↗

Drop-out and mood improvement: a randomised controlled trial with light exposure and physical exercise [ISRCTN36478292].

BACKGROUND: Combining bright light exposure and physical exercise may be an effective way of relieving depressive symptoms. However, relatively little is known about individual factors predicting either a good response or treatment failure. We explored background variables possibly explaining the individual variation in treatment response or failure in a randomised trial. METHODS: Participants were volunteers of working-age, free from prior mental disorders and recruited via occupational health centres. The intervention was a randomised 8-week trial with three groups: aerobics in bright light, aerobics in normal room lighting, and relaxation/stretching in bright light. Good response was defined as a 50% decrease in the symptom score on either the Hamilton Depression Rating Scale (HDRS) or 8-item scale of atypical symptoms. Background variables for the analysis included sex, age, body-mass index, general health habits, seasonal pattern, and sleep disturbances. RESULTS: Complete data were received from 98 subjects (11 men, 87 women). Of them, 42 (5 men, 37 women) were classified as responders on the HDRS. Overall, light had a significant effect on the number of responders, as assessed with the HDRS (X2 =.02). The number needed to treat (NNT) for light was 3.8. CONCLUSIONS: We investigated the effect of bright light and exercise on depressive symptoms. Problems with sleep, especially initial insomnia, may predict a good response to treatment using combined light and exercise. Bright light exposure and physical exercise, even in combination, seem to be well tolerated and effective on depressive symptoms.

Adult↗

Family-based clusters of cognitive test performance in familial schizophrenia.

BACKGROUND: Cognitive traits derived from neuropsychological test data are considered to be potential endophenotypes of schizophrenia. Previously, these traits have been found to form a valid basis for clustering samples of schizophrenia patients into homogeneous subgroups. We set out to identify such clusters, but apart from previous studies, we included both schizophrenia patients and family members into the cluster analysis. The aim of the study was to detect family clusters with similar cognitive test performance. METHODS: Test scores from 54 randomly selected families comprising at least two siblings with schizophrenia spectrum disorders, and at least two unaffected family members were included in a complete-linkage cluster analysis with interactive data visualization. RESULTS: A well-performing, an impaired, and an intermediate family cluster emerged from the analysis. While the neuropsychological test scores differed significantly between the clusters, only minor differences were observed in the clinical variables. CONCLUSIONS: The visually aided clustering algorithm was successful in identifying family clusters comprising both schizophrenia patients and their relatives. The present classification method may serve as a basis for selecting phenotypically more homogeneous groups of families in subsequent genetic analyses.

Adult↗

Search for cognitive trait components of schizophrenia reveals a locus for verbal learning and memory on 4q and for visual working memory on 2q.

Research to identify predisposing genes for complex diseases relying solely on clinical diagnosis is probably not ideal. Here, we analyzed genome-wide data for 168 schizophrenia families using neuropsychological variables associated with disease susceptibility, with the aid of SOLAR, a program for variance-component analysis. The linkage signal was greatly accentuated by application of the quantitative traits compared with diagnosis. We found evidence for a locus for verbal learning and memory on 4q21 (Z=3.01, Z(mp)=3.84 and empiric P=0.031 for delayed memory; Z=2.96, Z(mp)=3.4 and P=0.026 for verbal learning) and suggestive evidence for visual working memory on 2q36 (Z=2.80, Z(mp)=2.08 and P=0.093). In addition, some evidence emerged for a locus for recognition memory on 10p13, visual attention on 15q22 and executive function on 9p22 in the complete sample, as well as for delayed memory on 8q12, semantic clustering and intrusions on 1q42 and visual attention on 3p25 in the genealogically distinctive sample subsets. Of the loci linked to schizophrenia in diverse populations, in addition to the earlier mentioned regions, some evidence of linkage was observed for 2q, 6q, 7q, 11q, 13q, 14q, 18q and 22q. Our results reveal initial information on the effect of the loci associated with schizophrenia in multiple studies, and emphasize the value of trait components in the search for susceptibility loci for complex diseases.

Analysis of Variance↗