Browsing by Subject "ANXIETY"

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  • Sarviaho, R.; Hakosalo, O.; Tiira, K.; Sulkama, S.; Niskanen, J. E.; Hytonen, M. K.; Sillanpää, M. J.; Lohi, H. (2020)
    The complex phenotypic and genetic nature of anxieties hampers progress in unravelling their molecular etiologies. Dogs present extensive natural variation in fear and anxiety behaviour and could advance the understanding of the molecular background of behaviour due to their unique breeding history and genetic architecture. As dogs live as part of human families under constant care and monitoring, information from their behaviour and experiences are easily available. Here we have studied the genetic background of fearfulness in the Great Dane breed. Dogs were scored and categorised into cases and controls based on the results of the validated owner-completed behavioural survey. A genome-wide association study in a cohort of 124 dogs with and without socialisation as a covariate revealed a genome-wide significant locus on chromosome 11. Whole exome sequencing and whole genome sequencing revealed extensive regions of opposite homozygosity in the same locus on chromosome 11 between the cases and controls with interesting neuronal candidate genes such as MAPK9/JNK2, a known hippocampal regulator of anxiety. Further characterisation of the identified locus will pave the way for molecular understanding of fear in dogs and may provide a natural animal model for human anxieties.
  • Komulainen, Emma; Heikkila, Roope; Meskanen, Katarina; Raij, Tuukka T.; Nummenmaa, Lauri; Lahti, Jari; Jylhä, Pekka; Melartin, Tarja; Harmer, Catherine J.; Isometsa, Erkki; Ekelund, Jesper (SAGE SCIENCE PRESS (UK), 2016)
    Increased self-focus is a core factor in the psychopathology of depression. Cortical midline structures (CMS) are implicated in the neurobiology of self, depression and antidepressant treatment response. Mirtazapine, an antidepressant that increases serotonin and norepinephrine release, enhances processing of positive and attenuates processing of negative emotional information in healthy volunteers after a single dose. These early changes, which are opposite to the negative information bias in depression, may be important for the therapeutic effect of mirtazapine. It nevertheless remains unresolved whether/how mirtazapine specifically influences processing of self-referential emotional information. Half of the healthy volunteers (n=15/30) received a single dose of mirtazapine, in an open-label design, two hours before functional magnetic resonance imaging (fMRI), and the other half was scanned as a control group without medication. During fMRI the participants categorized positive and negative self-referential adjectives. Mirtazapine attenuated responses to self-referential processing in the medial prefrontal cortex and the anterior cingulate cortex. Mirtazapine further decreased responses to positive self-referential processing in the posterior cingulate cortex and parietal cortex. These decreased responses of the CMS suggest that mirtazapine may rapidly improve the ability of the CMS to down-regulate self-referential processing. In depressed patients, this could lead to decreased self-focus and rumination, contributing to the antidepressant effect.
  • Komulainen, Emma; Heikkila, Roope; Meskanen, Katarina; Raij, Tuukka T.; Nummenmaa, Lauri; Lahti, Jari; Jylhä, Pekka; Melartin, Tarja; Harmer, Catherine J.; Isometsa, Erkki; Ekelund, Jesper (2016)
    Increased self-focus is a core factor in the psychopathology of depression. Cortical midline structures (CMS) are implicated in the neurobiology of self, depression and antidepressant treatment response. Mirtazapine, an antidepressant that increases serotonin and norepinephrine release, enhances processing of positive and attenuates processing of negative emotional information in healthy volunteers after a single dose. These early changes, which are opposite to the negative information bias in depression, may be important for the therapeutic effect of mirtazapine. It nevertheless remains unresolved whether/how mirtazapine specifically influences processing of self-referential emotional information. Half of the healthy volunteers (n=15/30) received a single dose of mirtazapine, in an open-label design, two hours before functional magnetic resonance imaging (fMRI), and the other half was scanned as a control group without medication. During fMRI the participants categorized positive and negative self-referential adjectives. Mirtazapine attenuated responses to self-referential processing in the medial prefrontal cortex and the anterior cingulate cortex. Mirtazapine further decreased responses to positive self-referential processing in the posterior cingulate cortex and parietal cortex. These decreased responses of the CMS suggest that mirtazapine may rapidly improve the ability of the CMS to down-regulate self-referential processing. In depressed patients, this could lead to decreased self-focus and rumination, contributing to the antidepressant effect.
  • Karppanen, Tiina; Kaartokallio, Tea; Klemetti, Miira M.; Heinonen, Seppo; Kajantie, Eero; Kere, Juha; Kivinen, Katja; Pouta, Anneli; Staff, Anne Cathrine; Laivuori, Hannele (2016)
    Background: Preeclampsia is a common and heterogeneous vascular syndrome of pregnancy. Its genetic risk profile is yet unknown and may vary between individuals and populations. The rs4606 3'UTR polymorphism of the Regulator of G-protein signaling 2 gene (RGS2) in the mother has been implicated in preeclampsia as well as in the development of chronic hypertension after preeclampsia. The RGS2 protein acts as an inhibitor of physiological vasoconstrictive pathways, and a low RGS2 level is associated with hypertension and obesity, two conditions that predispose to preeclampsia. We genotyped the rs4606 polymorphism in 1339 preeclamptic patients and in 697 controls from the Finnish Genetics of Preeclampsia Consortium (FINNPEC) cohort to study the association of the variant with preeclampsia. Results: No association between rs4606 and preeclampsia was detected in the analysis including all women. However, the polymorphism was associated with preeclampsia in a subgroup of overweight women (body mass index >= 25 kg/m(2), and <30 kg/m(2)) (dominant model; odds ratio, 1.64; 95 % confidence interval, 1.10-2.42). Conclusions: Our results suggest that RGS2 might be involved in the pathogenesis of preeclampsia particularly in overweight women and contribute to their increased risk for hypertension and other types of cardiovascular disease later in life.
  • Vincent, John; Hovatta, Iiris; Frissa, Souci; Goodwin, Laura; Hotopf, Matthew; Hatch, Stephani L.; Breen, Gerome; Powell, Timothy R. (2017)
    Background: Studies have provided evidence that both childhood maltreatment and depressive disorders are associated with shortened telomere lengths. However, as childhood maltreatment is a risk factor for depression, it remains unclear whether this may be driving shortened telomere lengths observed amongst depressed patients. Furthermore, it's unclear if the effects of maltreatment on telomere length shortening are more pervasive amongst depressed patients relative to controls, and consequently whether biological ageing may contribute to depression's pathophysiology. The current study assesses the effects of childhood maltreatment, depression case/control status, and the interactive effect of both childhood maltreatment and depression case/control status on relative telomere length (RTL). Method: DNA samples from 80 depressed subjects and 100 control subjects were utilized from a U.K. sample (ages 20-84), with childhood trauma questionnaire data available for all participants. RTL was quantified using quantitative polymerase chain reactions. Univariate linear regression analyses were used to assess the effects of depression status, childhood maltreatment and depression by childhood maltreatment interactions on RTL. The false discovery rate (q <0.05) was used for multiple testing correction. Results: Analysis of depression case/control status showed no significant main effect on RTL. Four subtypes of childhood maltreatment also demonstrated no significant main effect on RTL, however a history of physical neglect did significantly predict shorter RTL in adulthood (F(1, 174)=7.559, p=0.007, q=0.042, Variance Explained=4.2%), which was independent of case/control status. RTL was further predicted by severity of physical neglect, with the greatest differences observed in older maltreated individuals ( > 50 years old). There were no significant depression case/control status by childhood maltreatment interactions. Limitations: A relatively small sample limited our power to detect interaction effects, and we were unable to consider depression chronicity or recurrence. Conclusion: Shortened RTL was specifically associated with childhood physical neglect, but not the other subtypes of maltreatment or depression case/control status. Our results suggest that the telomere-eroding effects of physical neglect may represent a biological mechanism important in increasing risk for ageing-related disorders. As physical neglect is more frequent amongst depressed cases generally, it may also represent a confounding factor driving previous associations between shorter RTL and depression case status.
  • Ma, Li; Piirainen, Sami; Kulesskaya, Natalia; Rauvala, Heikki; Tian, Li (2015)
    Background: Social deficit is one of the core symptoms of neuropsychiatric diseases, in which immune genes play an important role. Although a few immune genes have been shown to regulate social and emotional behaviors, how immune gene network(s) may jointly regulate sociability has not been investigated so far. Methods: To decipher the potential immune-mediated mechanisms underlying social behavior, we first studied the brain microarray data of eight inbred mouse strains with known variations in social behavior and retrieved the differentially expressed immune genes. We then made a protein-protein interaction analysis of them to find the major networks and explored the potential association of these genes with the behavior and brain morphology in the mouse phenome database. To validate the expression and function of the candidate immune genes, we selected the C57BL/6 J and DBA/2 J strains among the eight inbred strains, compared their social behaviors in resident-intruder and 3-chambered social tests and the mRNA levels of these genes, and analyzed the correlations of these genes with the social behaviors. Results: A group of immune genes were differentially expressed in the brains of these mouse strains. The representative C57BL/6 J and DBA/2 J strains displayed significant differences in social behaviors, DBA/2 J mice being less active in social dominance and social interaction than C57BL/6 J mice. The mRNA levels of H2-d1 in the prefrontal cortex, hippocampus, and hypothalamus and C1qb in the hippocampus of the DBA/2 J strain were significantly down-regulated as compared to those in the C57BL/6 J strain. In contrast, Polr3b in the hippocampus and Tnfsf13b in the prefrontal cortex of the DBA/2 J strain were up-regulated. Furthermore, C1qb, Cx3cl1, H2-d1, H2-k1, Polr3b, and Tnfsf13b were predicted to be associated with various behavioral and brain morphological features across the eight inbred strains. Importantly, the C1qb mRNA level was confirmed to be significantly correlated with the sociability in DBA/2 J but not in C57BL/6 J mice. Conclusions: Our study provided evidence on the association of immune gene network(s) with the brain development and behavior in animals and revealed neurobiological functions of novel brain immune genes that may contribute to social deficiency in animal models of neuropsychiatric disorders.
  • Levola, Jonna; Eskelinen, Saana; Pitkanen, Tuuli (2020)
    Background: Alcohol and substance use disorders (SUDs) are known to be associated with various health problems and somatic comorbidities however, not much is known on how individuals with SUDs themselves view their own health. Depression is common in SUDs and it is also associated with various health problems. The aim of this study was to assess how individuals undergoing inpatient treatment for SUDs perceived their health status and quality of life (QoL) and how having symptoms of depression affected these perceptions. Methods: Data regarding a convenience sample of eighty inpatients with a diagnosis of alcohol or substance dependence were analyzed. Data were collected through a clinical interview and validated questionnaires. Results: Individuals undergoing inpatient treatment for SUDs reported various somatic comorbidities and their self-rated health was moderate. Back pain, high blood pressure and liver disease were the most commonly reported somatic comorbidities. More severe symptoms of depression were associated with poorer self-rated health, more comorbidities and poorer QoL after adjusting for potential confounders such as age. Conclusions: Individuals with SUDs have many health-related concerns and their QoL is impaired. Symptoms of depression are associated with self-rated health and QoL in this population.
  • Laine, Mikaela A.; Sokolowska, Ewa; Dudek, Mateusz; Callan, Saija-Anita; Hyytia, Petri; Hovatta, Iiris (2017)
    Chronic psychosocial stress is a well-established risk factor for neuropsychiatric diseases. Abnormalities in brain activity have been demonstrated in patients with stress-related disorders. Global brain activation patterns during chronic stress exposure are less well understood but may have strong modifying effects on specific brain circuits and thereby influence development of stress-related pathologies. We determined neural activation induced by chronic social defeat stress, a mouse model of psychosocial stress. To assess chronic activation with an unbiased brain-wide focus we used manganese-enhanced magnetic resonance imaging (MEMRI) and immunohistochemical staining of Delta FOSB, a transcription factor induced by repeated neural activity. One week after 10-day social defeat we observed significantly more activation in several brain regions known to regulate depressive and anxiety-like behaviour, including the prefrontal cortex, bed nucleus of stria terminalis, ventral hippocampus and periaqueductal grey in stressed compared to control mice. We further established that the correlation of Delta FOSB positive cells between specific brain regions was altered following chronic social defeat. Chronic activation of these neural circuits may relate to persistent brain activity changes occurring during chronic psychosocial stress exposure, with potential relevance for the development of anxiety and depression in humans.
  • PIPARI Study Grp; Lind, Annika; Salomaki, Susanna; Parkkola, Riitta; Haataja, Leena; Rautava, Paivi; Junttila, Niina; Koikkalainen, Juha; Lötjönen, Jyrki; Saunavaara, Virva; Korja, Riikka (2020)
    Introduction The aim of the present study was to assess how regional brain volumes associate with self-experienced social and emotional loneliness and social competence in very preterm and term-born preadolescents. Materials and methods Thirty-four very preterm subjects (birthweight Results In the very preterm group, a number of significant associations were found between smaller regional brain volumes and self-experienced emotional loneliness, more impulsivity and more disruptiveness. In the control group, brain volumes and loneliness were not associated, and brain volumes and social competence were associated with a lesser degree than in the very preterm group. Conclusion Experiences of emotional loneliness and poorer social competence appear to be more related to brain volumes in very preterm preadolescents than in those born full-term. It also appears that in very preterm preadolescents, emotional loneliness may be more reflected in brain development than social loneliness.
  • Airo (Toivanen), Riikka; Korja, Riikka; Saisto, Terhi; Rouhe, Hanna; Muotka, Joona; Salmela-Aro, Katariina (2018)
    The changes in emotions, subjective fear of childbirth, and personal goals were examined during a group intervention to treat fear of childbirth (FOC). The objective was to gain a more detailed understanding of the changes occurring during the group intervention of FOC. The changes in emotions, subjective FOC, and personal goals were studied in primiparous pregnant women with severe FOC participating in a group intervention (n = 105). The group intervention contained six sessions during pregnancy and one after childbirth. At every session, the participants filled in a questionnaire regarding their experiences of current positive and negative emotions and the subjective FOC. The participants also set and reported their personal goals in their preparation for childbirth and parenthood. The negative emotions decreased from the beginning of the intervention. The change became significant after the fourth session. The amount of positive emotions increased but became statistically significant only after the delivery. The subjective FOC decreased significantly from the beginning of the intervention. Personal goals shifted from being mainly self-related to being mostly related to parenthood. The group intervention decreased FOC and promoted changes in emotions and personal goals that foster emotional preparedness for childbirth. It seems that the decrease in FOC was made possible through gaining a better capacity to regulate emotions, especially negative emotions. As negative emotions and fear decreased, personal goals simultaneously changed in the direction known to be adaptive for the new life situation as a parent of a newborn.
  • Ämmälä, Antti-Jussi; Suvisaari, Jaana; Kananen, Laura; Lönnqvist, Jouko; Ripatti, Samuli; Pirkola, Sami; Paunio, Tiina; Hovatta, Iiris (2021)
    Telomeres are repeat sequences and an associated protein complex located at the end of the chromosomes. They shorten with every cell division and are regarded markers for cellular aging. Shorter leukocyte telomere length (LTL) has been observed in many complex diseases, including psychiatric disorders. However, analyses focusing on psychiatric disorders are mainly based on clinical samples and the significance of shorter LTL on the population level remains uncertain. We addressed this question in a population-based sample from Finland (N = 7142). The survey was performed and the blood samples were collected in 2000-2001 to assess major public health problems and their determinants. DSM-IV diagnoses of major psychiatric illnesses were obtained by interview using the Composite International Diagnostic Interview. Information regarding their risk factors, including the number of self-reported childhood adversities, recent psychological distress, and sleep difficulties was collected by questionnaires. LTL was measured by qPCR. None of the studied psychiatric illnesses, sleep difficulties, or recent psychological distress associated with LTL. However, individuals with three or more childhood adversities had shorter LTL at adult age (13 = -0.006, P = 0.005). Also, current occupational status was associated with LTL (13 = -0.03, P = 0.04). These effects remained significant after adjusting for known LTLassociated lifestyle or sociodemographic factors. In conclusion, relatively common childhood adversities were associated with shorter LTL at adult age in a nationally representative population-based cohort, implying that childhood adversities may cause accelerated telomere shortening. Our finding has potentially important implications as it supports the view that childhood adversities have an impact on psychological and somatic wellbeing later in life.
  • Vuokko, Aki; Karvala, Kirsi; Suojalehto, Hille; Lindholm, Harri; Selinheimo, Sanna; Heinonen-Guzejev, Marja; Leppamaki, Sami; Cederstrom, Sebastian; Hublin, Christer; Tuisku, Katinka; Sainio, Markku (2019)
    Background: Chronic nonspecific symptoms attributed to indoor nonindustrial work environments are common and may cause disability, but the medical nature of this disability is unclear. The aim was to medically characterize the disability manifested by chronic, recurrent symptoms and restrictions to work participation attributed to low-level indoor pollutants at workplace and whether the condition shares features with idiopathic environmental intolerance. Methods: We investigated 12 patients with indoor air-related work disability. The examinations included somatic, psychological, and psychiatric evaluations as well as investigations of the autonomic nervous system, cortisol measurements, lung function, and allergy tests. We evaluated well-being, health, disability, insomnia, pain, anxiety, depression, and burnout via questionnaires. Results: The mean symptom history was 10.5 years; for disabling symptoms, 2.7 years. Eleven patients reported reactions triggered mainly by indoor molds, one by fragrances only. Ten reported sensitivity to odorous chemicals, and three, electric devices. Nearly all had co-occurrent somatic and psychiatric diagnoses and signs of pain, insomnia, burnout, and/or elevated sympathetic responses. Avoiding certain environments had led to restrictions in several life areas. On self-assessment scales, disability showed higher severity and anxiety showed lower severity than in physician assessments. Conclusion: No medical cause was found to explain the disability. Findings support that the condition is a form of idiopathic environmental intolerance and belongs to functional somatic syndromes. Instead of endless avoidance, rehabilitation approaches of functional somatic syndromes are applicable. (C) 2019 Occupational Safety and Health Research Institute, Published by Elsevier Korea LLC.
  • Popova, Dina; Agustsdottir, Arna; Lindholm, Jesse; Mazulis, Warns; Akamine, Yumiko; Castren, Eero; Karpova, Nina N. (2014)
  • Grano, Niklas; Karjalainen, Marjaana; Ranta, Klaus; Lindgren, Maija; Roine, Mikko; Therman, Sebastian (2016)
    The aim of the present study was to compare change in functioning, affective symptoms and level of psychosis-risk symptoms in symptomatic adolescents who were treated either in an early intervention programme based on a need-adapted Family- and Community-orientated integrative Treatment Model (FCTM) or in standard adolescent psychiatric treatment (Treatment As Usual, TAU). 28 pairs were matched by length of follow-up, gender, age, and baseline functioning. At one year after the start of treatment, the matched groups were.compared on change in functioning (GAF-M), five psychosis-risk dimensions of the Structured Interview for Psychosis-Risk Syndromes (SIPS), and self-reported anxiety, depression, and hopelessness symptoms (BAI, BDI-II, BHS). FCTM was more effective in improving functioning (20% vs. 6% improvement on GAF-M), as well as self-reported depression (53% vs. 14% improvement on BDI-II) and hopelessness (41% vs. 3% improvement on BHS). However, for psychosis-risk symptoms and anxiety symptoms, effectiveness differences between treatment models did not reach statistical significance. To conclude, in the present study, we found greater improvement in functioning and self-reported depression and hopelessness among adolescents who received a need-adapted Family and Community-orientated integrative Treatment than among those who were treated in standard adolescent psychiatry. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
  • Tammilehto, Jaakko; Punamäki, Raija-Leena; Flykt, Marjo; Vänskä, Mervi; Heikkilä, Lotta M.; Lipsanen, Jari; Poikkeus, Piia; Tiitinen, Aila; Lindblom, Jallu (2021)
    The quality of parenting shapes the development of children's emotion regulation. However, the relative importance of parenting in different developmental stages, indicative of sensitive periods, has rarely been studied. Therefore, we formulated four hypothetical developmental timing models to test the stage-specific effects of mothering and fathering in terms of parental autonomy and intimacy in infancy, middle childhood, and late adolescence on adolescents' emotion regulation. The emotion regulation included reappraisal, suppression, and rumination. We hypothesized that both mothering and fathering in each developmental stage contribute unique effects to adolescents' emotion regulation patterns. The participants were 885 families followed from pregnancy to late adolescence. This preregistered study used data at the children's ages of 1 year, 7 to 8 years, and 18 years. At each measurement point, maternal and paternal autonomy and intimacy were assessed with self- and partner reports using the Subjective Family Picture Test. At the age of 18 years, adolescents' reappraisal and suppression were assessed using the Emotion Regulation Questionnaire and rumination using the Cognitive Emotion Regulation Questionnaire. Stage-specific effects were tested comparing structural equation models. Against our hypotheses, the results showed no effects of mothering or fathering in infancy, middle childhood, or late adolescence on adolescents' emotion regulation patterns. The results were consistent irrespective of both the reporter (i.e., self or partner) and the parental dimension (i.e., autonomy or intimacy). In addition to our main results, there were relatively low agreement between the parents in each other's parenting and descriptive discontinuity of parenting across time (i.e., configural measurement invariance). Overall, we found no support for the stage-specific effects of parent-reported parenting in infancy, middle childhood, or late adolescence on adolescents' emotion regulation. Instead, our findings might reflect the high developmental plasticity of emotion regulation from infancy to late adolescence.
  • Tiira, Katriina (2021)
    Separation-related behaviour problems are common in domestic dogs. Vocalization is one of the most common symptoms in dogs, and neighbors often complain about dog barking and howling. We investigated the effect of digital application Digital Dogsitter® on the dogs’ vocalization (barking, howling, whining) when left alone. Digital Dogsitter® is an application, used via laptop or pc, and it activates as a reaction to the dog's vocalization and then plays a short owner-recorded feedback. Altogether 40 participants who had a laptop/pc at home and a dog that suffered from separation related symptoms, specifically vocalization, completed the study. Dogs’ vocalization (when alone at home) was recorded before and after using Digital Dogsitter® for two weeks, in order to investigate whether Digital Dogsitter® reduces dog's vocalization. The amount of total dog vocalization noise (in milliseconds) was significantly reduced (P < 0.001, N = 40) after using Digital Dogsitter® for two weeks. The reduction in the dogs’ vocalization after Digital Dogsitter® was 95.7%, which is very large compared to earlier studies. Owners’ opinions were also asked, and only 9.4% of the owners felt that no improvement was seen. Finally, we wanted to know, whether the effect of Digital Dogsitter® was long lasting, and sent a questionnaire to participants an average of eight months after the first study. Out of 35 participants that responded, 68.7% felt that Digital Dogsitter® did reduce the vocalization either rather well / extremely well, and only 14.3% felt, that no long-lasting effect was noticed. In addition, after eight months the owners also reported significantly less dogs’ destructive behavior compared to the starting situation. Digital Dogsitter® clearly reduces dogs’ vocalization, possibly also alleviating the separation-related stress.
  • Elovainio, Marko; Kuula, Liisa; Halonen, Risto; Pesonen, Anu-Katriina (2020)
    Background: Very late sleep rhythms are risks for social adjustment problems in adolescence. Using ecological momentary assessment data, we quantified and visualized temporal and contemporaneous within-persons dynamical relations of sleepiness and emotions in adolescents with and without late sleep rhythms. Methods: We analyzed a temporal network via multilevel vector autoregression (mlVAR) modeling and a contemporaneous network through the partial associations between the residuals of temporal and the between-subject multilevel models. We tested whether these networks were different between those with a late circadian rhythm [concurrent delayed sleep phase (DSP) N = 172, 37% boys, 63% girls] and those without (N = 143, 22% boys, 78% girls). Results: In adolescents without DSP, the temporal networks showed continuity only for low mood from the previous to the following time point. In adolescents with DSP, there were more predictable patterns of emotions. Feelings of depression led to a decrease of positive emotions and increase of irritation and anxiety. The contemporaneous networks showed clusters of positive and negative emotions in both groups and sleepiness decreased the experience of positive emotions concurrently. Limitations: DSP in our current study was based only on one out of three diagnostic criteria of the full disorder (DSM-5) and it was assessed only once. Conclusions: These findings indicate that the dynamic organization of emotions and sleepiness is different in adolescents with and without DSP. DSP adolescents have more predictable and maladaptive emotional patterns during the day. Results provide new insight about why individuals with DSP are at a heightened risk for decreased emotional adjustment.
  • Ni, Qianqian; Cheng, Guizhi; Chen, An; Heinonen, Seppo (2020)
    Background The mental health of pregnant women, particularly those with elevated risks, has been an issue of global concern. Thus far, few studies have addressed the mental health of pregnant women with threatened preterm labour (TPL). This study investigated the prevalence of self-perceived burden (SPB) among Chinese women hospitalized due to TPL during pregnancy and early postpartum depressive disorders, exploring the effect of SPB and other potential risk factors on the early signs of postpartum depressive disorders. Methods A self-reported survey was conducted in the obstetrics department of Anhui Provincial Hospital, China. Women hospitalized with TPL were approached 1 week after delivery. One hundred fifty women were recruited from January 2017 to December 2017. The Self-Perceived Burden Scale (SPBS) and Edinburgh Postnatal Depression Scale (EPDS) were the main measures. Descriptive statistics, Spearman correlations, and a multiple logistic regression were employed for data analysis. Results SPB and early postpartum depressive disorders were commonly experienced by Chinese women hospitalized with TPL, and SPB was positively and significantly correlated with depressive symptoms. A multiple logistic regression analysis revealed that for the women hospitalized with TPL during pregnancy, the emotional aspect of SPB (OR = 1.42, 95% CI = 1.11-1.83, p = 0.006), age (OR = 1.14, 95% CI = 1.02-1.27, p = 0.023), occupation (OR = 3.48, 95% CI = 1.18-10.20, p = 0.023), the history of scarred uterus (OR = 7.96, 95% CI = 1.49-42.48, p = 0.015), the delivery mode of the present birth (OR = 6.19, 95% CI = 1.72-22.30, p = 0.005), and family support during pregnancy (OR = 0.60, 95% CI = 0.45-0.82, p = 0.001) were significant factors predicting early postpartum depressive symptoms. Conclusion This study indicates that SPB and early postpartum depressive disorders are prevalent mental issues among Chinese women hospitalized with TPL, and that SPB, especially perceived emotional burden, is a strong predictor of early postpartum depressive disorders. Our study suggests the necessity of paying attention to mental health issues, e.g. SPB and postpartum depressive symptoms among hospitalized women with TPL, and providing appropriate interventions at the prenatal stage to prevent adverse consequences.
  • Lindblom, Jallu; Peltola, Mikko J.; Vanska, Mervi; Hietanen, Jari K.; Laakso, Anu; Tiitinen, Aila; Tulppala, Maija; Punamaki, Raija-Leena (2017)
    The family environment shapes children's social information processing and emotion regulation. Yet, the long-term effects of early family systems have rarely been studied. This study investigated how family system types predict children's attentional biases toward facial expressions at the age of 10 years. The participants were 79 children from Cohesive, Disengaged, Enmeshed, and Authoritarian family types based on marital and parental relationship trajectories from pregnancy to the age of 12 months. A dot-probe task was used to assess children's emotional attention biases toward threatening (angry) and affiliative (happy) faces at the early (500 ms) and late (1250 ms) stages of processing. Situational priming was applied to activate children's sense of danger or safety. Results showed that children from Cohesive families had an early-stage attentional bias toward threat, whereas children from Enmeshed families had a late-stage bias toward threat. Children from Disengaged families had an early-stage attentional bias toward threat, but showed in addition a late-stage bias away from emotional faces (i.e., both angry and happy). Children from Authoritarian families, in turn, showed a late-stage attentional bias toward emotional faces. Situational priming did not moderate the effects of family system types on children's attentional biases. The findings confirm the influence of early family systems on the attentional biases, suggesting differences in the emotion regulation strategies children have developed to adapt to their family environments.
  • Markkula, N.; Lehti, V.; Adhikari, P.; Pena, S.; Heliste, J.; Mikkonen, E.; Rautanen, M.; Salama, E.; Guragain, B. (2019)
    Background. An essential strategy to increase coverage of psychosocial treatments globally is task shifting to non-medical counsellors, but evidence on its effectiveness is still scarce. This study evaluates the effectiveness of lay psychosocial counselling among persons with psychological distress in a primary health care setting in rural Nepal. Methods. A parallel randomized controlled trial in Dang, rural Nepal (NCT03544450). Persons aged 16 and older attending primary care and with a General Health Questionnaire (GHQ-12) score of 6 or more were randomized (1:1) to receive either non-medical psychosocial counselling (PSY) or enhanced usual care (EUC). PSY was provided by lay persons with a 6-month training and consisted of 5-weekly counselling sessions of 35-60 min with a culturally adapted solution-focused approach. EUC was provided by trained primary health workers. Participants were followed up at 1 (T1) and 6 months (T2). The primary outcome, response to treatment, was the reduction of minimum 50% in the Beck Depression Inventory (BDI) score. Results. A total of 141 participants, predominantly socially disadvantaged women, were randomized to receive PSY and 146 to EUC. In the PSY, 123 participants and 134 in the EUC were analysed. In PSY, 101 participants (81.4%) had a response compared with 57 participants (42.5%) in EUC [percentage difference 39.4% (95% CI 28.4-50.4)]. The difference in BDI scores at T2 between PSY and EUC was -7.43 (95% CI -9.71 to -5.14). Conclusions. Non-medical (lay) psychosocial counselling appears effective in reducing depressive symptoms, and its inclusion in mental health care should be considered in low-resource settings.