Browsing by Subject "ANXIETY DISORDERS"

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  • Stubbs, Brendon; Vancampfort, Davy; Mänty, Minna; Svärd, Anna; Rahkonen, Ossi; Lahti, Jouni (2017)
    This study aimed to examine the bidirectional relationship between psychotropic medication use and changes in leisure-time physical activity (LTPA) among a population cohort study. Phase 1 data were collected by mail surveys in 2000-2002 among 40-60-year-old employees of the City of Helsinki, Finland, and phase 2 follow up survey was conducted in 2007. Based on self-report, the respondents were classified as inactive and active (.14.75 MET-hours/week) at the phases 1 and 2. Hazard ratios (HR) were calculated for subsequent (2007-10) psychotropic medication purchasing according to changes in physical activity (phases 1-2). Odds ratios (OR) for physical inactivity at phase 2 were calculated according to the amount of psychotropic medication between phases 1-2. Overall, 5361 respondents were included (mean age 50 years, 80% women). Compared with the persistently active, the persistently inactive, those decreasing and adopting LTPA had an increased risk for psychotropic medication. Only the persistently inactive remained at increased risk for psychotropic medication use, following the adjustment for prior psychotropic medication use. Compared with those having no medication, the risk for physical inactivity increased as the psychotropic medication increased. Our data suggest that physical activity has an important role in maintaining wellbeing and reducing psychotropic medication usage.
  • Castaneda, Anu E.; Tuulio-Henriksson, Annamari; Aronen, Eeva T.; Marttunen, Mauri; Kolho, Kaija-Leena (2013)
  • Kerkelä, Martta; Gyllenberg, David; Gissler, Mika; Sillanmäki, Lauri; Keski-Säntti, Markus; Hinkka-Yli-Salomäki, Susanna; Filatova, Svetlana; Hurtig, Tuula; Miettunen, Jouko; Sourander, Andre; Veijola, Juha (2021)
    Objective The aim of this study was to explore changes in the incidences of childhood and early adulthood hospital-treated psychiatric disorders in five large Finnish birth cohorts of individuals born between 1966 and 1997. Methods The five birth cohorts were as follows: Northern Finland Birth Cohort 1966 (NFBC 1966) and 1986 (NFBC 1986), 1987 Finnish Birth Cohort (FBC 1987) and 1997 (FBC 1997), and Finnish 1981 Birth Cohort Study (FBCS 1981). Incidences of hospital-treated psychiatric disorders in each cohort were calculated separately for males (N = 71,209) and females (N = 65,190). Poisson regression was used to test difference in proportions of psychiatric disorders in wide range of diagnosis classes separately in childhood and adolescence, and early adulthood. Results The total incidences of psychiatric disorders in childhood and adolescence among males has increased in the birth cohorts over decades (Incidence Rate Ratio, IRR = 1.04 (1.04-1.05); p <0.001). Similar result was seen among females (IRR = 1.04 (1.03-1.04); p <0.001). In early adulthood, there was significant increase among females (IRR = 1.04 (1.03-1.05); p <0.001), but among males, the change was not significant (IRR = 0.99 (0.99-1.00), p = 0.051). Conclusions The main finding was that the cumulative incidence of hospital-treated psychiatric disorders increased over the decades in Finland. The increasing trend in hospital-treated psychiatric disorders in early adulthood was detected in females but not in males. In the youngest cohorts, the cumulative incidence of hospital-treated psychiatric disorders was at the same level in males and females, whereas in oldest cohort, males had higher incidence than females.
  • Poikolainen, Kari; Aalto-Setala, Terhi; Tuulio-Henriksson, Annamari; Marttunen, Mauri; Lönnqvist, Jouko (2004)
    Background: Evidence on the relation between fear of war and mental health is insufficient. We carried out a prospective cohort study to find out whether fear of nuclear war is related to increased risk of common mental disorders. Methods: Within two months preceding the outbreak of Persian Gulf War in January 1991, 1518 adolescents [mean age 16.8 years, SD 0.9] filled in a self-administered questionnaire. Of the 1493 respondents, 47% gave their written informed consent to participate in the follow-up study. There were no material differences between those who chose to respond anonymously and those who volunteered to give their name and address for the follow-up study. In 1995, the response to the follow-up questionnaire was 92%. Common mental disorders were assessed by 36-item version of the General Health Questionnaire [GHQ]. A score 5 or higher was considered to indicate caseness. We excluded 23 cases which had used mental health services in the year 1991 or earlier and two cases with deficient responses to GHQ. This left 626 subjects for analysis [400 women]. Results: After adjusting for significant mental health risk factors in logistic regression analysis, the risk for common mental disorders was found to be significantly related to the increasing frequency of fear for nuclear war, high scores of trait anxiety and high scores of immature defense style. Elevated risk was confined to the group reporting fear of nuclear war once a week or more often [ odds ratio 2.05; 95% confidence interval 1.29-3.27]. Conclusion: Frequent fear of nuclear war in adolescents seems to be an indicator for an increased risk for common mental disorders and deserves serious attention.
  • Laine, Mikaela A.; Trontti, Kalevi; Misiewicz, Zuzanna; Sokolowska, Ewa; Kulesskaya, Natalia; Heikkinen, Aino; Saarnio, Suvi; Balcells, Ingrid; Ameslon, Pierre; Greco, Dario; Mattila, Pirkko; Ellonen, Pekka; Paulin, Lars; Auvinen, Petri; Jokitalo, Eija; Hovatta, Iiris (2018)
    Anxiety disorders often manifest in genetically susceptible individuals after psychosocial stress, but the mechanisms underlying these gene-environment interactions are largely unknown. We used the chronic social defeat stress (CSDS) mouse model to study resilience and susceptibility to chronic psychosocial stress. We identified a strong genetic background effect in CSDS-induced social avoidance (SA) using four inbred mouse strains: 69% of C57BL/6NCrl (B6), 23% of BALB/cAnNCrl, 19% of 129S2/SvPasCrl, and 5% of DBA/2NCrl (D2) mice were stress resilient. Furthermore, different inbred mouse strains responded differently to stress, suggesting they use distinct coping strategies. To identify biological pathways affected by CSDS, we used RNA-sequencing (RNAseq) of three brain regions of two strains, B6 and D2: medial prefrontal cortex (mPFC), ventral hippocampus (vHPC), and bed nucleus of the stria terminalis (BNST). We discovered overrepresentation of oligodendrocyte (OLG)-related genes in the differentially expressed gene population. Because OLGs myelinate axons, we measured myelin thickness and found significant region and strain-specific differences. For example, in resilient D2 mice, mPFC axons had thinner myelin than controls, whereas susceptible B6 mice had thinner myelin than controls in the vHPC. Neither myelin-related gene expression in several other regions nor corpus callosum thickness differed between stressed and control animals. Our unbiased gene expression experiment suggests that myelin plasticity is a substantial response to chronic psychosocial stress, varies across brain regions, and is genetically controlled. Identification of genetic regulators of the myelin response will provide mechanistic insight into the molecular basis of stress-related diseases, such as anxiety disorders, a critical step in developing targeted therapy.
  • Taipale, Heidi; Särkilä, Hanna; Tanskanen, Antti; Kurko, Terhi; Taiminen, Tero; Tiihonen, Jari; Sund, Reijo; Tuulio-Henriksson, Annamari; Saastamoinen, Leena; Hietala, Jarmo (2020)
    This cohort study uses national longitudinal data from the Social Insurance Institution of Finland to investigate the incidence of long-term use of benzodiazepines and related drugs among new users and factors associated with development of long-term use. Importance The proportion of patients who develop long-term benzodiazepine use remains controversial, as do the length of time before long-term use develops and the factors associated with long-term use. Objective To investigate the incidence of long-term benzodiazepine and related drug (BZDR) use and factors associated with the development of long-term use implementing a follow-up design with new BZDR users. Design, Setting, and Participants This population-based cohort study used a nationwide cohort of 129x202f;732 new BZDR users in Finland. New users of BZDRs aged 18 years or older were identified from the prescription register maintained by the Social Insurance Institution of Finland as individuals who initiated BZDR use during 2006 and had not used BZDRs from 2004 to 2005. The follow-up continued until death, long-term hospitalization, a gap of 2 years in BZDR use, or December 31, 2015. The population was analyzed according to age at treatment initiation, categorized into younger (= 65 years) subcohorts. Analyses were conducted from May 2019 to February 2020. Exposures Use of BZDRs, modeled from register-based data using the PRE2DUP (from prescriptions to drug use periods) method. Main Outcomes and Measures Long-term BZDR use, defined as continuous use of 180 days or longer, and factors associated with long-term vs short-term use, compared using Cox proportional hazards models. Results Among the 129x202f;732 incident BZDR users, the mean (SD) age was 52.6 (17.7) years, and 78x202f;017 (60.1%) individuals were women. During the follow-up period, 51x202f;099 BZDR users (39.4%) became long-term users. Long-term treatment was more common in the older subcohort (19x202f;103 individuals [54.5%]) than the younger subcohort (31x202f;996 individuals [33.8%]). At 6 months, 28x202f;586 individuals (22.0%) had become long-term users: 11x202f;805 (33.7%) in the older subcohort and 16x202f;781 (17.7%) in the younger subcohort. The largest proportions of initiators who became long-term users were those persons who initiated treatment with nitrazepam (76.4%; 95% CI, 73.6%-79.1%), temazepam (63.9%; 95% CI, 62.9%-65.0%), lorazepam (62.4%; 95% CI, 59.7%-65.1%), or clonazepam (57.5%; 95% CI, 55.9%-59.2%). Factors associated with the development of long-term use included male sex, older age, receipt of social benefits, psychiatric comorbidities, and substance abuse. Conclusions and Relevance The findings of this population-based cohort study conducted in Finland suggest that the incidence of subsequent long-term BZDR use in individuals who initiate use of BZDRs is high, especially among older persons, and that the specific BZDR used initially is associated with the development of long-term BZDR use and should be carefully considered when prescribing BZDRs. The observed factors that appear to be associated with development of long-term BZDR use also should be considered in clinical decision-making when starting and monitoring BZDR treatment. Questions What is the incidence of long-term use of benzodiazepines and related drugs (BZDRs) in persons who start new BZDR treatment, and what factors are associated with the development of long-term use? Findings In a cohort study of 129x202f;732 new BZDR users in Finland, 34% of working-aged persons and 55% of older persons developed long-term use. Higher rates of long-term use were associated with specific drugs, namely, nitrazepam, temazepam, lorazepam, and clonazepam. Meaning Despite guidelines and recommendations, BZDRs are still prescribed frequently for long-term treatment, especially in older persons, and the initial choice of a specific BZDR is associated with development of long-term BZDR use.
  • Loponen, Tiina; Lallukka, Tea; Holstila, Ansku; Lahti, Jouni (2015)
    Background: Physical activity level and overweight have shown associations with mental health problems but it is not known whether the risk of mental health problems due to overweight varies by physical activity. We examined joint association of physical activity and overweight with subsequent psychotropic medication among 40-60-year-old employees. Methods: The questionnaire survey data were derived from Helsinki Health Study baseline postal questionnaires in 2000-02 among employees of the City of Helsinki aged 40-60 years (n = 8960, response rate 67 %). Baseline survey data were linked with prospective register data on prescribed psychotropic medication (ATC-codes N05 and N06, except N06D) among those with written consent (74 %) for such linkage. The analyses included 6169 responders (78 % women, corresponding to the target population). We divided participants into six groups according to their baseline self-reported body mass index and leisure-time physical activity using physically highly active normal-weight participants as a reference group. We used Cox regression analysis adjusted for age, gender, psychotropic medication prior to baseline, and socioeconomic position, marital status, working conditions, limiting long-standing illness, alcohol use, and smoking. Results: At baseline, 49 % were overweight and 23 % were physically inactive. After adjusting for age and gender, inactive normal-weight (hazard ratio (HR) 1.3, 95 % CI 1.1-1.5), moderately active overweight (HR 1.3, 95 % CI 1.1-1.5) and inactive overweight (HR 1.4, 95 % CI 1.2-1.6) had higher risk for any psychotropic medication compared with group of highly active normal-weight. After adjusting for prior medication, only the inactive overweight group had higher risk (HR 1.4, 95 % CI 1.2-1.6). Other covariates made but a minor contribution to the examined associations. For antidepressants the associations were somewhat stronger than for sedatives. Conclusions: Both normal-weight and physical activity help prevent psychotropic medication but physical activity dominates the association over normal-weight.
  • Uusitalo, Susanne; Tuominen, Jarno; Arstila, Valtteri (2020)
    How to classify the human condition? This is one of the main problems psychiatry has struggled with since the first diagnostic systems. The furore over the recent edi- tions of the diagnostic systems DSM-5 and ICD-11 has evidenced it to still pose a wicked problem. Recent advances in techniques and methods of artificial intelligence and computing power which allows for the analysis of large data sets have been pro- posed as a possible solution for this and other problems in classification, diagnosing, and treating mental disorders. However, mental disorders contain some specific inherent features, which require critical consideration and analysis. The promises of AI for mental disorders are threatened by the unmeasurable aspects of mental disor- ders, and for this reason the use of AI may lead to ethically and practically undesir- able consequences in its effective processing. We consider such novel and unique questions AI presents for mental health disorders in detail and evaluate potential novel, AI-specific, ethical implications.
  • Baryshnikov, I.; Suvisaari, J.; Aaltonen, K.; Koivisto, Maaria; Naatanen, P.; Karpov, Boris; Melartin, T.; Oksanen, J.; Suominen, K.; Heikkinen, Martti; Paunio, T.; Joffe, G.; Isometsa, E. (2016)
    Background: Distinguishing between symptoms of schizotypal (SPD) and borderline personality disorders (BPD) is often difficult due to their partial overlap and frequent co-occurrence. We investigated correlations in self-reported symptoms of SPD and BPD in questionnaires at the levels of both total scores and individual items, examining overlapping dimensions. Methods: Two questionnaires, the McLean Screening Instrument (MSI) for BPD and the Schizotypal Personality Questionnaire Brief (SPQ-B) for SPD, were filled in by patients with mood disorders (n = 282) from specialized psychiatric care in a study of the Helsinki University Psychiatric Consortium. Correlation coefficients between total scores and individual items of the MSI and SPQ-B were estimated. Multivariate regression analysis (MRA) was conducted to examine the relationships between SPQ-B and MSI. Results: The Spearman's correlation between total scores of the MSI and SPQ-B was strong (rho = 0.616, P <0.005). Items of MSI reflecting disrupted relatedness and affective dysregulation correlated moderately (r(phi) varied between 0.2 and 0.4, P <0.005) with items of SPQ. Items of MSI reflecting behavioural dysregulation correlated only weakly with items of SPQ. In MRA, depressive symptoms, sex and MSI were significant predictors of SPQ-B score, whereas symptoms of anxiety, age and SPQ-B were significant predictors of MSI score. Conclusions: Items reflecting cognitive-perceptual distortions and affective symptoms of BPD appear to overlap with disorganized and cognitive-perceptual symptoms of SPD. Symptoms of depression may aggravate self-reported features of SPQ-B, and symptoms of anxiety features of MSI. Symptoms of behavioural dysregulation of BPD and interpersonal deficits of SPQ appear to be non-overlapping. (C) 2016 Elsevier Masson SAS. All rights reserved.
  • Sokka, Laura; Leinikka, Marianne; Korpela, Jussi; Henelius, Andreas; Lukander, Jani; Pakarinen, Satu; Alho, Kimmo; Huotilainen, Minna (2017)
    Individuals with prolonged occupational stress often report difficulties in concentration. Work tasks often require the ability to switch back and forth between different contexts. Here, we studied the association between job burnout and task switching by recording event-related potentials (ERPs) time-locked to stimulus onset during a task with simultaneous cue-target presentation and unpredictable switches in the task. Participants were currently working people with severe, mild, or no burnout symptoms. In all groups, task performance was substantially slower immediately after task switch than during task repetition. However, the error rates were higher in the severe burnout group than in the mild burnout and control groups. Electrophysiological data revealed an increased parietal P3 response for the switch trials relative to repetition trials. Notably, the response was smaller in amplitude in the severe burnout group than in the other groups. The results suggest that severe burnout is associated with inadequate processing when rapid shifting of attention between tasks is required resulting in less accurate performance. (C) 2016 Elsevier B.V. All rights reserved.
  • Middeldorp, C. M.; de Moor, M. H. M.; McGrath, L. M.; Gordon, S. D.; Blackwood, D. H.; Costa, P. T.; Terracciano, A.; Krueger, R. F.; de Geus, E. J. C.; Nyholt, D. R.; Tanaka, T.; Esko, T.; Madden, P. A. F.; Derringer, J.; Amin, N.; Willemsen, G.; Hottenga, J-J; Distel, M. A.; Uda, M.; Sanna, S.; Spinhoven, P.; Hartman, C. A.; Ripke, S.; Sullivan, P. F.; Realo, A.; Allik, J.; Heath, A. C.; Pergadia, M. L.; Agrawal, A.; Lin, P.; Grucza, R. A.; Widen, E.; Cousminer, D. L.; Eriksson, J. G.; Palotie, A.; Barnett, J. H.; Lee, P. H.; Luciano, M.; Tenesa, A.; Davies, G.; Lopez, L. M.; Hansell, N. K.; Medland, S. E.; Ferrucci, L.; Schlessinger, D.; Montgomery, G. W.; Wright, M. J.; Aulchenko, Y. S.; Janssens, A. C. J. W.; Oostra, B. A.; Metspalu, A.; Abecasis, G. R.; Deary, I. J.; Räikkönen, Katri; Bierut, L. J.; Martin, N. G.; Wray, N. R.; van Duijn, C. M.; Smoller, J. W.; Penninx, B. W. J. H.; Boomsma, D. I. (2011)