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Biomedical subjects

V Lehtinen

Publications and source records attributed to V Lehtinen.

At least 37 records · Page 2Linked to original sources
PubMed1998

Sex differences in the association between childhood experiences and adult depression.

BACKGROUND: In the present paper, sex differences in the association between adult depression and childhood experiences were examined. METHODS: The study series of the Finnish UKKI Study consisted of a population sample of 501 men and 499 women. Information concerning childhood experiences was gathered retrospectively in a baseline survey carried out in 1969-72. After the initial phase, the mental health of the subjects was evaluated by interviews, questionnaires and register data at the 5-year follow-up (1974-6) and at the 16-year follow-up (1985-7). RESULTS: Twelve per cent of men and 21% of women had suffered from depression during the 16-year follow-up period. A disturbed mother-child relationship and neurotic symptoms in childhood were associated with depression in women but not in men in the logistic model that included gender interaction. In separate analyses by gender several childhood factors showed statistically significant associations with depression in women but only a few in men. CONCLUSIONS: The finding suggests that childhood experiences are more highly predisposing factors to depression in women than in men.

Adolescent↗
PubMed1998

The Finnish National Schizophrenia Project 1981-1987: 10-year evaluation of its results.

This study reports the 10-year evaluation of the Finnish National Schizophrenia Project. The aims of the national project were achieved. The number of long-stay schizophrenic patients in psychiatric hospitals decreased by 63% between 1982 and 1992. Both the treatment of schizophrenic patients and the structure of mental health services have changed greatly in Finland. Psychosocial treatment methods in particular have developed. The major innovations of the Project are the acute psychosis teams now serving over 50% of the country, and social skills training programmes. The 10-year evaluation of the Finnish National Schizophrenia Project shows that it is possible to conduct successfully nation-wide projects to develop the treatment of schizophrenic patients and psychiatric practices across an entire country.

Activities of Daily Living↗
PubMed1998

Regional differences in the use of psychiatric hospital beds in Finland: a national case-register study.

We investigated the possible differences in the utilization of psychiatric hospital beds among five social security areas in Finland, and the association between the variables related to the psychiatric services and the use of hospital beds. The use of hospital beds varied quite distinctly among these areas, as did the total rate of in-patients, readmissions, and rates of in-patients with psychotic and affective disorders. The treatment practices appeared to vary as the length of stay (LOS) and the rate of committal differed regionally in a significant manner. There was a significant positive correlation between the total rate of in-patients and the rate of readmitted patients (r=0.92, P<0.001), and a significant negative correlation between the number of visits per worker in out-patient care and the rate of readmissions (r=-0.94, P<0.001).

Adult↗
PubMed1998

Outcomes of Depression International Network (ODIN). Background, methods and field trials. ODIN Group.

BACKGROUND: ODIN aims (a) to provide data on the prevalence, risk factors and outcome of depressive disorders in rural and urban settings within the European Union (EU) based on an epidemiological sampling frame; and (b) to assess the impact of two psychological interventions on the outcome of depression and on service utilisation and costs. METHOD: Five centres across the EU are participating in ODIN. The centres are linked electronically and members meet regularly for training and strategic reviews. Urban and rural areas have been identified in each centre. The sampling frame is of adults aged 18-64, identified via primary care databases or electoral registers. Potential cases of depressive disorders are identified using the Beck Depression Inventory SCAN II and other validated measures are used to assign caseness against DSM-IV and ICD-10 criteria; assess comorbidity, disability, genetic/familial susceptibility, psychosocial stressors, personality traits and cognitive factors; and utilisation of local health care services. A randomised controlled trial of individual problem-solving treatment and a group educational programme is undertaken for respondents identified as cases of depressive disorder individuals are followed-up at six and 12 months. RESULTS AND CONCLUSIONS: ODIN has already stimulated the development of an effective international research partnership.

Adult↗
PubMed1997

Frequent attender profiles: different clinical subgroups among frequent attender patients in primary care.

Psychiatric and physical morbidity among frequently attending patients in primary care is high. However, very few efforts have been made to sort out the complex patterns of problems these patients have. We developed a clinical grouping of these patients. Our sample consisted of 67 frequent attenders. The measures included physical and psychiatric illnesses, presenting symptoms, sociodemographic data, psychosocial situation, level of distress, global functioning, experienced life satisfaction, illness attribution, and current psychiatric treatment. We identified five groups with different profiles: (1) patients with entirely physical illnesses; (2) patients with clear psychiatric illnesses; (3) crisis patients; (4) chronically somatizing patients; and (5) patients with multiple problems. The grouping was based on multidimensional operational criteria. The majority in all groups attended for solely physical illnesses or symptoms suggesting different forms of somatization. Only a few patients were undergoing any psychiatric treatment. Differences between groups were found regarding sociodemographic factors, physical illnesses, global functioning, and satisfaction.

Adolescent↗
PubMed1997

Psychiatric morbidity in primary public health care: a multicentre investigation. Part II. Hidden morbidity and choice of treatment.

A total of 1,281 patients were examined during consultation with their GP in a Nordic multicentre study focusing on the prevalence of psychiatric illness, hidden psychiatric morbidity, treatment and pathways to specialized care. The methodology and prevalence were reported in an accompanying paper. The present paper presents results concerning the variables hidden psychiatric morbidity, treatment and pathways to specialized care. The GPs detected 44% of the psychiatric cases compared with the result of a diagnostic interview (PSE). The distinction between psychosis and non-psychosis did not influence the GPs' ability to detect a mental illness. According to the GPs' assessment the majority of patients suffering from a mental disorder consulted their GP about physical complaints. The GPs treated the patients themselves, and only a limited number of cases were referred to psychiatrists or psychologists.

Adolescent↗
PubMed1996

Elevated lung cancer risk among persons with depressed mood.

Although it has been hypothesized that depressive persons have an excess risk of cancer, few prospective data are available. The association between depressiveness and subsequent incidence of lung cancer was studied in the nationally representative Mini-Finland Health Survey. The study population comprised 7,018 adult men and women, free from cancer at the baseline, carried out in 1978-1980. During a 14-year follow-up, 605 cancer cases occurred, of which 70 were male lung cancer patients. Mental problems and disorders were assessed at the baseline examination using standard interview techniques (General Health Questionnaire and Present State Examination). The relative risk of lung cancer between depressive persons and individuals with a normal depressiveness score was 3.32 (95% confidence interval 1.53-7.20). Neither adjustment for the potential confounding factors of age, education, geographic area, smoking, alcohol consumption, body mass index, serum cholesterol, leisure-time exercise, general health, and use of antidepressant medication nor exclusion of cancer cases occurring during the first 4 years of follow-up notably altered the results. There was a strong interaction between depressiveness and smoking. The relative risks of lung cancer between smokers and nonsmokers were 3.38 (95% confidence interval 1.09-10.52) at normal depressiveness score levels and 19.67 (95% confidence interval 2.57-150.7) at strongly elevated levels, respectively. It is possible that depressiveness modifies the effect of smoking on lung cancer risk either by biologic mechanisms or by affecting smoking behavior.

Adult↗
PubMed1996

Alexithymia and psychological distress among frequent attendance patients in health care.

BACKGROUND: The aim of the present study was to find out whether alexithymia is common in frequently attending primary health care patients and whether alexithymia and psychological distress are associated in these patients. METHODS: Alexithymia was measured by the TAS-26 and psychological distress by the SCL-25 in a random sample of 394 working-age primary health care patients. Frequent attendance was defined as a minimum of 11 visits during 1 year to different kinds of outpatient health care services, excluding specialized psychiatric care. RESULTS: Frequently attending patients with psychological distress were found to be alexithymic more commonly than other patients, but this was not the case with other frequently attending patients. In other words, frequent attendance and alexithymia had an association mediated by psychological distress. CONCLUSIONS: There is a subgroup of frequently attending patients, who are alexithymic and have psychological distress, too. They usually visit health-care services because of a somatic complaint. We hypothesize that their expression of psychological distress was masked and somatized just because of alexithymia.

Adolescent↗
PubMed1996

Incidence of mental disorders in the Finnish UKKI Study.

BACKGROUND: The aim was to give estimates of the incidence of different mental disorders from a Finnish prospective epidemiological follow-up study, the UKKI Study. METHOD: The original probability sample consisted of 1000 persons, aged 15-64 years. The baseline survey took place in 1969-71, and follow-up surveys were conducted 5 and 16 years after the baseline survey. The research methods included a personal psychiatric interview and data collection from different registers. The diagnostic system was based on the ICD-8 classification. RESULTS: The estimated annual incidence of all mental disorders was close to 15 per 1000 both between baseline and the 5-year follow-up as well as between the 5-year and the 16-year follow-up. During the entire 16-year follow-up period the annual incidence of all disorders was 14 per 1000 in men and 17 per 1000 in women. The annual income of neurotic disorders was 10 per 1000 in men and 14 per 1000 in women, and that of psychotic disorders 2 per 1000. CONCLUSIONS: In the literature, there are huge differences in the results concerning incidence of mental disorders. The results of the present study were rather close to those of the Swedish Lundby Study, but nowhere near the results of the American ECA Study.

Adolescent↗
PubMed1995

Alexithymia in primary health care patients.

Although many studies have been published about the relationship between alexithymia and different somatic diseases, little is known about the occurrence of alexithymia in primary health care patients. The aim of the present study was to shed light on this problem. The study forms part of a larger project dealing with psychiatric morbidity in primary health care patients. The original material consisted of 1,000 randomly selected adult patients in Turku in 1989-90. As part of a follow-up study (N = 748) three years later, alexithymia was measured using the Toronto Alexithymia Scale (TAS). Primary care patients seemed to have commonly alexithymic features: The mean of the TAS-score was 64.41 +/- 11.71 for male and 63.51 +/- 11.86 for female patients. The results indicated that alexithymia was associated with psychological distress, age, educational level, and socioeconomic status. The nature of alexithymia is discussed.

Adolescent↗
PubMed1995

Psychiatric morbidity among frequent attender patients in primary care.

In this study, 96 frequent attender patients in primary care were compared with 466 other primary care patients. The focus was on psychiatric morbidity, current and former psychiatric treatment, and self-perceived need for treatment. The prevalence of psychiatric illness was much greater among frequent attender patients than other patients (54.0% vs. 24.0%, p < 0.001), and subclinical symptoms were common in both groups (34.0% vs. 43.2%). Depression and anxiety were the most common clinical entities among frequent attender patients. However, very few patients had psychiatric treatment and the self-perceived need for treatment was low. The significance of these findings is discussed in the paper.

Attitude to Health↗
PubMed1995

The prescription of psychotropic drugs in primary health care.

We followed the prescription of psychotropic drugs by primary health care physicians over a 3-year period. The material consisted of 1000 randomly selected adult primary health care patients. At least one psychotropic drug was prescribed to one third (n = 307) of the sample during the follow-up period. The most commonly used drug category was that of benzodiazepines, which was prescribed to 24% of the sample. An antidepressive was prescribed to 8%, a neuroleptic to 2% and "other psychotropic drugs" to 10% of the sample. The most important predictor for prescribing psychotropic drugs was recognition of mental problems at the initial survey, but age and marital status also had an association with the prescription. No gender difference was found after controlling for mental problems. Psychotropic medication was also prescribed to 13% of the patients who had no sign of mental disorder.

Adolescent↗
PubMed1995

The ability of general practitioners to detect mental disorders in primary health care.

The ability to detect mental disorders varies greatly among general practitioners in primary health care. The aim of this study was to determine the factors underlying the differences between general practitioners in the ability to recognize mental disorders in Finnish patient populations. The group studied consisted of 1000 randomly selected adult patients of primary care facilities in the city of Turku. The Symptom Checklist (SCL-25) was used as the reference method in the identification of psychiatric cases. According to the SCL-25, one fourth of the sample had mental disorders. A good recognition ability was associated with postgraduate psychiatric training and qualification as a specialist in general practice. Surprisingly, Balint group training, which is a method intended to improve the ability of general practitioners to manage their patients' mental health problems, was associated rather with poor than good detection ability.

Adult↗
PubMed1995

Are frequent attenders of primary health care distressed?

OBJECTIVE: To measure the level of distress among frequent attenders of primary health care. DESIGN: A cross-sectional study. SETTING: Two public primary health care stations in Turku, south-western Finland PARTICIPANTS: 96 frequent attenders (eleven or more visits to a physician during the previous 12 months) and 466 control patients. MAIN OUTCOME MEASURE: SCL-25, GP evaluations, self-reported symptoms and self-experienced need for care. RESULTS: Frequent attenders were significantly more distressed than other patients in primary care. However, their self-experienced need for psychiatric care was very low and it did not differ from other patients self-experienced need. The GPs estimated that over 1/3 of frequent attenders suffered from mixed (physical and psychiatric) illnesses and over 1/2 from subclinical or clinical psychiatric symptoms. The corresponding proportions for other patients were significantly lower.

Cross-Sectional Studies↗
PubMed1994

Striatal D2 dopamine receptor characteristics in neuroleptic-naive schizophrenic patients studied with positron emission tomography.

BACKGROUND: According to the D2 dopamine receptor hypothesis of schizophrenia, there is an increased number of D2 receptors in the brains of schizophrenic patients than in those of healthy controls. We tested this hypothesis in 13 newly admitted neuroleptic-naive schizophrenic patients and 10 healthy volunteers using positron emission tomography. METHOD: The quantification of striatal D2 dopamine receptor density (Bmax) and affinity (Kd) was done using an equilibrium model described for raclopride labeled with carbon 11. RESULTS: No statistically significant alterations were found in D2 receptor densities or affinities between the patient and control groups. However, a subgroup of four patients with a relatively high striatal D2 dopamine density was identified. Two patients, especially, had D2 dopamine densities almost twice as high as the mean control Bmax value. The Kd values also tended to be higher in this subset of patients than in the controls. No consistent striatal D2 dopamine receptor laterality was observed in schizophrenic patients or controls. However, an association of high D2 dopamine density in the left striatum and the mass of raclopride injected in the scan with low-specific radioactivity was observed in patients but not in controls. CONCLUSIONS: There are no general changes in D2 dopamine receptor Bmax or Kd values in neuroleptic-naive schizophrenics, but there may be a subgroup of patients with aberrant striatal D2 dopamine receptor characteristics in vivo.

Adult↗