Browsing by Subject "Anxiety"

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  • Lång, Sakari (Helsingin yliopisto, 2018)
    Aims: Adolescent sleep is impacted by numerous biological, psychosocial and contextual factors. The sheer number of new elements capable of affecting adolescent sleep has grown steadily, most notably the amount of electronic devices available. In this adolescent-based sample, we first seek to characterize, and secondly investigate the relationship between gaming, and adolescent sleep, depression and anxiety. Methods. Total of 1374 respondents, aged from 15 to 17 years of age, provided sufficient data in SleepHelsinki! Helsinki university research project. The associations between study parameters were analyzed using correlational comparisons and canonical correlations. Gender differences were also evaluated. The relationships between gaming, sleep, depression and anxiety were further studied using mediation model. Results and Conclusions. In our study the adolescents sleep duration averaged 7:10 hours (SD 1:07) which is well under the recommended amount 8-9 hours of sleep per night. Severe restriction of less than 6 hours of sleep existed in 17.3% of respondents. Negative associations between sleep duration and sleep quality were established on depression, anxiety, chronotype, gaming and alcohol consumption. Positive connections were found between good self-control and sleep hygiene. Girls fared systematically worse than their male counterparts: significantly having more severe sleep restrictions, longer sleep onset latency, worse sleep hygiene and sleep quality. The gaming addiction score was found to mediate the effect of both depression and anxiety on total sleep time. The hours of gaming also mediated the effect of anxiety, but not depression. This study confirms many findings indicating both risk factors and protective factors regarding adolescent sleep. The gaming is established as an integral component when examining adolescent sleep – it should be studied in unison with particularly anxiety and depression symptoms.
  • Chen, Zuyue; Wei, Hong; Sagalajev, Boriss; Koivisto, Ari; Pertovaara, Antti (2019)
    Background: The central amygdaloid nucleus (CeA) is involved in processing and descending regulation of pain. Amygdaloid mechanisms underlying pain processing and control are poorly known. Here we tested the hypothesis that perioperative CeA administration of tetrapentylammonium (TPA), a non-selective THIK-1 channel blocker and thereby inhibitor of microglia, attenuates development of chronic neuropathic pain and comorbid anxiety-like behavior. Methods: Rats with a spared nerve injury (SNI) model of neuropathy or sham operation had a chronic cannula for drug microinjections into the CeA or a control injection site. Monofilament test was used to evaluate pain, and light-dark box (LDB) to assess anxiety. Results: Perioperative CeA treatment with TPA (30 mu g/day up to the third postoperative day, D3) significantly attenuated the development of pain and anxiety-like behavior. In the late phase (> D14), CeA administration of TPA (3-30 mu g) failed to influence pain. Perioperative minocycline (microglia inhibitor; 25 mu g), MK-801 (an N-Methyl-D-aspartate receptor antagonist; 0.1 mu g), vehicle or TPA in a control injection site failed to attenuate pain development. Conclusions: Perioperative treatment of the CeA with TPA delayed development of neuropathic pain and comorbid anxiety-like behavior, while TPA treatment failed to influence maintenance of established neuropathic pain. The failures to attenuate pain development with CeA administrations of minocycline or MK-801 do not support the hypothesis that the TPA-induced prophylactic effect was due to inhibition of amygdaloid microglia or N-methyl-D-aspartate receptors. While TPA in the CeA proved to have a prophylactic effect on SNI-induced pain behavior, the underlying mechanism still remains to be studied. (c) 2018 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier B.V. All rights reserved.
  • Abdulhamed, Rekar; Lonka, Kirsti; Hietajärvi, Lauri; Ikonen, Riikka; Klemetti, Reija (2022)
    The focus in the present study is on how experienced discrimination, being able to discuss personal matters with parents, and having someone to discuss personal worries with relate to symptoms of depression and generalized anxiety among first-and second-generation immigrant background adolescents (aged 14-15) living in Finland. The data used was collected for the National School Health Promotion Study (2017) conducted by The Finnish Institute for Health and Welfare (N = 73,690). Mental health was assessed on the PHQ-2 (depression) and GAD-7 (generalized anxiety disorder) scales. The findings indicated that first-generation adolescents from immigrant families were significantly more likely than their second-generation counterparts to report mental-health symptoms, and they also provided worse scores on all measures examined. It was alarming that 42 per cent of the first-generation immigrant group reported that they could not discuss their personal worries with anyone, and more than one-fifth of these youth hardly ever talked about personal matters with their parents. Experienced discrimination was a slightly stronger predictor of generalized anxiety than depressive symptoms and it predicted both symptoms of depression and anxiety more prominently among first-generation immigrant adolescents compared with their second-generation counterparts. Being able to discuss personal matters with parents functioned as a protective factor with similar predictor values in both groups, whereas the possibility of having someone with whom to discuss personal worries was significantly associated to lower levels of anxiety only among first-generation immigrant adolescents.
  • Karpov, B.; Joffe, G.; Aaltonen, K.; Suvisaari, J.; Baryshnikov, I.; Naatanen, P.; Koivisto, M.; Melartin, T.; Oksanen, J.; Suominen, K.; Heikkinen, M.; Paunio, T.; Isometsa, E. (2016)
    Background: Comorbid anxiety symptoms and disorders are present in many psychiatric disorders, but methodological variations render comparisons of their frequency and intensity difficult. Furthermore, whether risk factors for comorbid anxiety symptoms are similar in patients with mood disorders and schizophrenia spectrum disorders remains unclear. Methods: The Overall Anxiety Severity and Impairment Scale (OASIS) was used to measure anxiety symptoms in psychiatric care patients with schizophrenia or schizoaffective disorder (SSA, n = 113), bipolar disorder (BD, n = 99), or depressive disorder (DD, n = 188) in the Helsinki University Psychiatric Consortium Study. Bivariate correlations and multivariate linear regression models were used to examine associations of depressive symptoms, neuroticism, early psychological trauma and distress, self-efficacy, symptoms of borderline personality disorder, and attachment style with anxiety symptoms in the three diagnostic groups. Results: Frequent or constant anxiety was reported by 40.2% of SSA, 51.5% of BD, and 55.6% of DD patients; it was described as severe or extreme by 43.8%, 41.4%, and 41.2% of these patients, respectively. SSA patients were significantly less anxious (P = 0.010) and less often avoided anxiety-provoking situations (P = 0.009) than the other patients. In regression analyses, OASIS was associated with high neuroticism, symptoms of depression and borderline personality disorder and low self-efficacy in all patients, and with early trauma in patients with mood disorders. Conclusions: Comorbid anxiety symptoms are ubiquitous among psychiatric patients with mood or schizophrenia spectrum disorders, and in almost half of them, reportedly severe. Anxiety symptoms appear to be strongly related to both concurrent depressive symptoms and personality characteristics, regardless of principal diagnosis. (C) 2016 Elsevier Masson SAS. All rights reserved.
  • Virtanen, Suvi; Lagerberg, Tyra; Khemiri, Lotfi; Suvisaari, Jaana; Larsson, Henrik; Lichtenstein, Paul; Chang, Zheng; Latvala, Antti (2022)
    Background and aims Selective serotonin reuptake inhibitors (SSRIs) are widely prescribed medications for patients with anxiety/depression. These patients often have problems with substance use, but it remains unclear whether the risk of substance misuse is influenced by SSRI treatment. We aimed to determine whether SSRI treatment is associated with a decreased risk of acute substance misuse-related outcomes. Design Cohort study following individuals through Swedish nation-wide registers between July 2005 and December 2013 and comparing the risk of substance misuse outcomes during periods on- versus off-treatment within the same individual. Setting Swedish general population. Participants Individuals with a newly dispensed prescription of SSRIs between July 2006 and December 2013 and an ICD-10 diagnosis of anxiety/depressive disorder before the first treatment initiation. The cohort included 146 114 individuals (60.7% women). Measurements Substance misuse outcomes included ICD-10 diagnoses of acute intoxications (F10.0-F19.0), accidental poisonings by alcohol or drugs (X41-X42, X45-X46) and substance-related criminal offenses. Findings The absolute rate of substance misuse increased sharply before the onset of SSRI treatment and decreased after treatment initiation. Stratified Cox regression models showed an elevated risk [hazard ratio (HR) = 1.70, 95% confidence interval (CI) = 1.62-1.78] of substance misuse outcomes during a 1-month period preceding treatment initiation, compared with the reference period of more than 1 month before treatment start. The on-treatment estimates (1-30 days, HR = 1.29, 95% CI = 1.23-1.37; 31-120 days, HR = 1.30, 95% CI = 1.24-1.35; and > 120 days, HR = 1.24, 95% CI = 1.18-1.30 after treatment initiation] were consistently lower than the 1-month pre-treatment estimate, but still elevated compared with the reference period. Conclusions For people with anxiety/depression, the risk of substance misuse appears to be particularly elevated immediately before initiating selective serotonin reuptake inhibitor (SSRI) treatment, which may reflect the emergence or worsening of substance use problems concurrently with anxiety/depression. SSRI treatment appears to be associated with a lower risk of substance misuse compared with the 1-month period preceding treatment initiation, but causality remains uncertain.
  • Arkkila, Juuso; Suominen, Auli; Nolvi, Saara; Rantavuori, Kari; Karlsson, Hasse; Karlsson, Linnea; Lahti, Satu (2022)
    We evaluated associations between dental anxiety and four temperament dimensions: effortful control, extraversion/surgency, negative affect and orienting sensitivity among 2558 parents in the FinnBrain Birth Cohort Study. Dental anxiety was measured with the Modified Dental Anxiety Scale, and temperament with the Adult Temperament Questionnaire. Associations between dental anxiety and temperament dimensions were modelled using linear and logistic (cut-off >= 19 for high dental anxiety) regression analyses adjusting for general anxiety and depressive symptoms, age and education. In women and men, dental anxiety was positively associated with negative affect (women beta = 1.10; 95%CI 1.06-1.15; men beta = 1.11; 95%CI 1.05-1.18) and negatively associated with effortful control (women beta = 0.95; 95% CI0.92-0.99, men beta = 0.90; 95% CI 0.85-0.95). In women, extraversion/surgency was also positively associated with dental anxiety (beta = 1.04; 95%CI 1.00-1.08). For high dental anxiety, negative affect in women (OR = 2.00; 95%CI 1.31-3.06) and men (OR = 5.21; 95%CI 1.72-15.83) and for extraversion/surgency in women (OR = 1.50; 95%CI 1.01-1.47) associated positively with dental anxiety, but for effortful control, the association was not statistically significant. Dentists should understand that temperament dimensions affect the risk for dental anxiety more strongly than general anxiety or depressive symptoms. Dimensions negative affect and extraversion/surgency may increase and effortful control decrease the risk.
  • Heinonen, Erkki; Knekt, Paul; Härkänen, Tommi; Virtala, Esa; Lindfors, Olavi (2018)
    Childhood adversities frequently precede adulthood depression and anxiety. Yet, how they impact needed treatment duration, type or focus in these common disorders, is unclear. For developing more individualized and precise interventions, we investigated whether specific early adversities associate with patients' distinct psychiatric problems, psychological vulnerabilities, and suitability for psychotherapy. A total of 221 depressed and anxious adult outpatients (excluding psychotic, severe personality, bipolar, and substance abuse disorders) referred from community, student, occupational, and private healthcare services filled the Childhood Family Atmosphere Questionnaire (CFAQ). They also filled self-reports on interpersonal behavior and problems, perceived competence, dispositional optimism, sense of coherence, defenses, and psychiatric history. Clinicians assessed the patients' symptomatology, personality, object relations, cognitive performance, and psychotherapy suitability. Regression analyses were conducted. Childhood adversities predicted both worse current psychological functioning (e.g., interpersonal problems), and better clinician-rated capacities for benefiting from psychotherapy (e.g. self-reflection, capacity for interaction). Parental problems had the most numerous negative associations to psychological functioning. Best capacities for psychotherapy were predicted by recollected family unhappiness. Associations with psychiatric criteria were, however, largely non-significant. In conclusion, for psychosocial treatment planning, patients' early adversities may indicate both vulnerability and resources. As childhood adversities are frequent among treatment-seekers, further studies examining how early adversities predict psychotherapy outcome are needed.
  • Castrén, Eero; Kojima, Masami (2017)
    Levels of brain-derived neurotrophic factor (BDNF) are reduced in the brain and serum of depressed patients and at least the reduction in serum levels is reversible upon successful treatment. These data, together with a wealth of reports using different animal models with depression-like behavior or manipulation of expression of BDNF or its receptor TrkB have implicated BDNF in the pathophysiology of depression as well as in the mechanism of action of antidepressant treatments. Recent findings have shown that posttranslational processing of BDNF gene product can yield different molecular entities that differently influence signaling through BNDF receptor TrkB and the pan-neurotrophin receptor p75(NTR). We will here review these data and discuss new insights into the possible pathophysiological roles of those new BDNF subtypes as well as recent findings on the role of BDNF mediated neuronal plasticity in mood disorders and their treatments. (C) 2016 Elsevier Inc All rights reserved.
  • Antila, Henna; Arola, Riikka; Hakko, Helina; Riala, Kaisa; Riipinen, Pirkko; Kantojarvi, Liisa (2017)
    We examined the association of bullying behavior in adolescence to personality disorder (PD) diagnosed in early adulthood. The study sample consisted of 508 adolescents (300 girls, 208 boys) who were admitted to psychiatric inpatient treatment between April 2001 and March 2006. Data were based on semi-structured K-SADSPL-interviews and hospital treatments extracted from the Care Register for Health Care (CRHC). At the end of 2013, details of psychiatric diagnoses recorded on hospital discharges and outpatient visits were extracted from the CRHC. This study showed that female victims of bullying have an almost fourfold likelihood of developing a PD later in life compared to adolescents with no involvement in bullying behavior. Most of the females had Borderline PD. Female adolescents diagnosed with anxiety disorder during adolescence had an over threefold risk of developing a PD during late adolescence or early adulthood. Conversely, we found no associations between bullying involvement among men in adolescence and subsequent PDs. Bullying victimization may influence the development of PDs among females. Adolescent services should pay particular attention to female victims of bullying and those displaying symptoms of anxiety disorders.
  • Helminen, Vilja; Elovainio, Marko; Jokela, Markus (2022)
    Conservative political ideologies have been suggested to correlate with elevated sensitivity to threat. However, it is unclear whether the associations between threat sensitivity and political attitudes can be observed with clinical measures of mental health. We examined how anxiety disorders predicted attitudes on several political issues. Participants were 7253 individuals from the 1958 British Birth Cohort study. Symptoms of generalised anxiety disorder, phobia and panic were assessed in a clinical interview at age 44, and opinions about political issues were self-reported by the participants 6 years later. Anxiety symptoms were associated with higher concerns about economic inequality, preservation of the environment, distrust in politics and lower work ethic. No associations were observed with racist or authoritarian attitudes, or support for traditional family values. We also assessed how political attitudes at ages 33 and 42 predicted anxiety disorder symptoms at age 44, revealing a possible bidirectional association between concern for economic inequality and anxiety disorder symptoms. These findings do not support an association between conservative political attitudes and elevated threat sensitivity. Rather, elevated anxiety may increase concerns about social inequality and the environment.
  • Kieseppä, Valentina; Holm, Minna; Jokela, Markus; Suvisaari, Jaana; Gissler, Mika; Lehti, Venla (2021)
    Background: The aims of this study were to (1) compare differences in psychiatric comorbidity of depression and anxiety disorders between immigrants and native Finns and to (2) compare differences in the intensity of psychiatric care received by different immigrant groups and Finnish-born controls with depression and/or anxiety disorders. Methods: The study uses registered-based data, which includes all immigrants living in Finland at the end of 2010 and matched Finnish-born controls. For this study, we selected individuals who had received a diagnosis of depression and/or an anxiety disorder during the follow-up (2011?2015) (immigrants n = 6542, Finnish-born controls n = 9281). We compared differences in comorbidity between the immigrants and the Finnish-born controls using chi-squared tests. Multinomial logistic regression was used to predict psychiatric treatment intensity by immigrant status, region of origin, and other background factors. Results: In both diagnosis groups, Finnish-born participants exhibited greater comorbidity of other psychiatric disorders. Immigrants more often received lower intensity treatment and less often higher intensity treatment. These differences were most striking among those from Eastern Europe, the Middle East, and Africa. Limitations: We did not have the information on the perceived need for the services, which limits us from drawing further conclusions about the mechanisms behind the observed patterns. Conclusions: Immigrants in Finland receive less intensive treatment for depression and anxiety disorders compared to the Finnish-born population. Since lower symptom levels can unlikely alone explain these differences, they could reflect a need for improvement in the psychiatric services for immigrants.
  • Shiju, Rashmi; Thomas, Daisy; Al Arouj, Monira; Sharma, Prem; Tuomilehto, Jaakko; Bennakhi, Abdullah (2019)
    Aim: This pilot study in Kuwait was aimed to assess the effect of Sudarshan kriya yoga (SKY) on anxiety, depression and total quality of life in people with type 2 diabetes mellitus (T2DM). Methods: 26 T2DM patients aged greater than 30, male and female visiting the outpatient clinic of Dasman Diabetes Institute were enrolled for the study. Pre and post 5 day SKY intervention responses of participants on psychosocial problems were evaluated using four questionnaires (Hamilton anxiety, patient health questionnaire (PHQ-9), Hospital anxiety depression and WHO total quality of life (QOL). Biochemical parameters; such as lipid profile, glycated hemoglobin (HbA1c) were measured at baseline and after 15 weeks of SKY practice. Results: The mean age of the participants was 56.7 (+/- 11.4 SD) years, and mean duration of diabetes 15.0 (+/- 9.3 SD) years. Comparison of responses before and after intervention indicated a significant improvement in the QOL, depression, anxiety and insomnia. But no significant improvement in glycemic control. Conclusion: Results indicate that SKY can be potentially beneficial for treating anxiety, insomnia, and depression associated in people with T2DM and in improving the quality of life in people with T2DM. (C) 2019 Diabetes India. Published by Elsevier Ltd. All rights reserved.
  • Diniz, C. R. A. F.; Becari, C.; Lesnikova, A.; Biojone, C.; Salgado, M. C. O.; Salgado, H. C.; Resstel, L. B. M.; Guimaraes, F. S.; Castren, E.; Casarotto, P. C.; Joca, S. R. L. (2018)
    Several pieces of evidence indicate that elastase-2 (ELA2; chymotrypsin-like ELA2) is an alternative pathway to the generation of angiotensin II (ANGII). Elastase-2 knockout mice (ELA2KO) exhibit alterations in the arterial blood pressure and heart rate. However, there is no data on the behavioral consequences of ELA2 deletion. In this study, we addressed this question, submitting ELA2KO and wild-type (WT) mice to several models sensitive to anxiety- and depression-like, memory, and repetitive behaviors. Our data indicates a higher incidence of barbering behavior in ELA2KO compared to WT, as well as an anxiogenic phenotype, evaluated in the elevated plus maze (EPM). While a decrease in locomotor activity was observed in ELA2KO in EPM, this feature was not the main source of variation in the other parameters analyzed. The marble-burying test (MBT) indicated increase in repetitive behavior, observed by a higher number of buried marbles. The actimeter test indicated a decrease in total activity and confirmed the increase in repetitive behavior. The spatial memory was tested by repeated exposure to the actimeter in a 24-h interval. Both ELA2KO and WT exhibited decreased activity compared to the first exposure, without any distinction between the genotypes. However, when submitted to the cued fear conditioning, ELA2KO displayed lower levels of freezing behavior in the extinction session when compared to WT, but no difference was observed during the conditioning phase. Increased levels of BDNF were found in the prefrontal cortex but not in the hippocampus of ELA2KO mice compared to WT. Finally, in silico analysis indicates that ELA2 is putatively able to cleave BDNF, and incubation of the purified enzyme with BDNF led to the degradation of the latter. Our data suggested an anxiogenic- and antidepressant-like phenotype of ELA2KO, possibly associated with increased levels of BDNF in the prefrontal cortex.
  • Selinheimo, Sanna; Vuokko, Aki; Hublin, Christer; Järnefelt, Heli; Karvala, Kirsi; Sainio, Markku; Suojalehto, Hille; Suvisaari, Jaana; Paunio, Tlina (2019)
    Objective: Nonspecific health complaints associated with indoor air are common in work environments. In some individuals, symptoms become persistent without an adequate explanation. The aim was to study factors that associate with the health-related quality of life (HRQoL) of employees with persistent, nonspecific indoor-air-related symptomatology. Methods: We present baseline results of a randomized controlled trial of interventions targeted on the HRQoL of the employees with indoor-air-associated nonspecific symptoms. The main participant-inclusion criterion was the presence of persistent indoor-air-related multiorgan symptoms with no known pathophysiological or environment-related explanation. As a comparison for participants' HRQoL (n = 52) we used data from the general-population Health 2011 study (BRIF8901) including information on subjects matched to the participants' working status and age and subjects with asthma, anxiety or depressive disorder, or other chronic conditions with work disability. Results: The participants showed greater and a clinically significant impairment of HRQoL [M = 0.83, SE = 0.013] than individuals from the general population [M = 0.95, SE = 0.001, p <.001, Hedges' g = 2.33] and those with asthma [M = 0.93, SE = 0.005, p <.001, Hedges' g = 1.46], anxiety and depressive disorder [M = 0.89, SE = 0.006, p <.001, Hedges' g = 0.73], or a chronic condition with work disability [M = 0.91, SE = 0.003, p <.001, Hedges' g = 1.11]. Prevalent symptoms of depression, anxiety, and insomnia and poor recovery from work were associated with a poor HRQoL. Conclusions: Individuals with nonspecific indoor-air-associated symptoms have a poorer HRQoL than individuals in the general population with a globally burdensome disease. Psychological distress associated with a poor HRQoL should be considered in the making of decisions about the treatment of these patients.
  • Kesanen, Jukka; Leino-Kilpi, Helena; Lund, Teija; Montin, Liisa; Puukka, Pauli; Valkeapaa, Kirsi (2017)
    Purpose To assess the impact of preoperative knowledge on anxiety, health-related quality of life (HRQoL), disability, and pain in surgically treated spinal stenosis patients. Methods One hundred patients were randomised into an intervention group (IG, n = 50) or control group (CG, n = 50). Both groups received routine preoperative patient education. IG additionally underwent a feedback session based on a knowledge test. Primary outcome measure was anxiety at the time of surgery. HRQoL, disability, and pain constituted the secondary outcome measures during a 6-month follow-up. Results In IG, a significant reduction in anxiety was noted after the intervention, whereas in CG, anxiety reduced only after the surgery. In both groups, a significant improvement in HRQoL, disability, and pain was noticed at the 6-month follow-up, but there were no between-group differences. Conclusions Higher knowledge level may reduce preoperative anxiety but does not seem to affect the self-reported clinical outcomes of surgery.
  • Biddle, Daniel J.; Hermens, Daniel F.; Lallukka, Tea; Aji, Melissa; Glozier, Nick (2019)
    Objectives: We evaluated whether insomnia symptoms and short or long sleep duration, alone or in combination, are robustly associated with subsequent trajectory of mental health symptoms. Methods: Participants were 2598 individuals (15 to 94 years of age) with elevated mental health symptoms at baseline (2013-14). Associations of baseline insomnia symptoms and sleep duration with two-year trajectory of mental health were estimated and adjusted for multiple potential confounders. Outcomes included recovery (well at both follow-up timepoints), intermittent symptoms (unwell at one follow-up timepoint), and chronic symptoms (unwell at each follow-up timepoint). Results: Adjusted for age and sex, baseline insomnia symptoms predicted intermittent (OR 1.43, 95% CI 1.15-1.80) and chronic (OR 2.16, 95% CI 1.77-2.68) trajectories of mental health symptoms. Short sleep duration (= 6 to Conclusion: A focus on just sleep duration or insomnia symptoms in those with elevated mental health symptoms will not be adequate to address chronicity. Both components of sleep disturbance, and in particular their co-occurrence, should be addressed. (c) 2018 Elsevier B.V. All rights reserved.
  • Aukia, Linda; Paavonen, E. Juulia; Jänkälä, Tuire; Tolvanen, Mimmi; Korja, Riikka; Karlsson, Linnea; Karlsson, Hasse; Polo-Kantola, Päivi (2020)
    Objective: To evaluate alteration in insomnia and sleepiness symptoms during pregnancy and assess early pregnancy risk factors for these symptoms, especially depressive and anxiety symptoms. Methods: A cohort of 1858 women was enrolled from the FinnBrain Birth Cohort Study. Insomnia and sleepiness symptoms were measured in early, mid- and late pregnancy with the Basic Nordic Sleep Questionnaire. Depressive symptoms were measured using the Edinburgh Postnatal Depression Scale and anxiety symptoms with the Symptom Checklist-90/Anxiety Scale. General linear models for repeated measures were conducted. Results: General sleep quality decreased (p < 0.001) and all insomnia types (p < 0.001) and sleep latencies (p < 0.001) increased as pregnancy proceeded. Snoring increased, but witnessed apneas remained rare. Nevertheless, morning (p ¼ 0.019) and daytime (p < 0.001) sleepiness decreased from early to both mid-pregnancy and late pregnancy (p ¼ 0.006 and p ¼ 0.039). Women took more naps in early and late pregnancy compared to mid-pregnancy (both p < 0.001). Women with higher baseline anxiety symptoms had greater increase in sleep latency. At each pregnancy point, higher depressive and anxiety symptoms were associated with higher insomnia (p < 0.001) and sleepiness scores (p < 0.001) and higher depressive symptoms with longer sleep latencies (p < 0.001). Conclusion: We found a marked increase in insomnia symptoms throughout pregnancy. However, sleepiness symptoms did not increase correspondingly. Both depressive and anxiety symptoms in early pregnancy were associated with higher insomnia and sleepiness symptoms in later stages of pregnancy which emphasizes the importance of their assessment in early pregnancy.
  • Paavonen, E. Juulia; Huhdanpää, Hanna; Raaska, Hanna; Repokari, Leena (2021)
    LÄHTÖKOHDAT Pelot ja ahdistuneisuushäiriöt ovat lapsilla yleisiä, joten perusterveydenhuollossa joudutaan usein arvioimaan niihin liittyvää hoidon tarvetta. MENETELMÄT Selvitimme ahdistuneisuuden vuoksi erikoissairaanhoitoon ohjautuneiden lasten oirekuvaa, hoitoa ja jatkohoidon tarvetta potilasasiakirjamerkinnöistä. Aineisto poimittiin systemaattisella otannalla ajalta 17.5.2018–27.9.2019. Siihen sisällytettiin kaikki lapset (n = 181), joilla oli masennus-, ahdistus- tai pakko-oireita ja jotka olivat niiden takia ohjautuneet tutkittaviksi lastenpsykiatrian tutkimus-, akuutti- ja konsultaatioyksikköön. Lopullinen aineisto käsitti 80 lasta, joilla oli ensisijaisesti pelko- tai ahdistusoireita. TULOKSET Valtaosa lapsista hyötyi lyhyestä fokusoidusta käyttäytymisterapeuttisesta hoitointerventiosta, ja yli puolella (55,7 %) käyntimäärä erikoissairaanhoidossa jäi vähäiseksi (≤ 8 käyntiä). PÄÄTELMÄT Suuri osa ahdistusoireisista lapsista voitaisiin hoitaa jo perustasolla. Psykoedukaation lisäksi tulisi tarjota apua oireiden hallintaan yksilöllisesti tai ryhmässä.
  • van der Zwan, Judith Esi; de Vente, Wieke; Tolvanen, Mimmi; Karlsson, Hasse; Buil, J. Marieke; Koot, Hans M.; Paavonen, E. Juulia; Polo-Kantola, Paivi; Huizink, Anja C.; Karlsson, Linnea (2017)
    Background: For many women, pregnancy-related sleep disturbances and pregnancy-related anxiety change as pregnancy progresses and both are associated with lower maternal quality of life and less favorable birth outcomes. Thus, the interplay between these two problems across pregnancy is of interest. In addition, psychological resilience may explain individual differences in this association, as it may promote coping with both sleep disturbances and anxiety, and thereby reduce their mutual effects. Therefore, the aim of the current study was to examine whether sleep quality and sleep duration, and changes in sleep are associated with the level of and changes in anxiety during pregnancy. Furthermore, the study tested the moderating effect of resilience on these associations. Methods: At gestational weeks 14, 24, and 34, 532 pregnant women from the FinnBrain Birth Cohort Study in Finland filled out questionnaires on general sleep quality, sleep duration and pregnancy-related anxiety; resilience was assessed in week 14. Results: Parallel process latent growth curve models showed that shorter initial sleep duration predicted a higher initial level of anxiety, and a higher initial anxiety level predicted a faster shortening of sleep duration. Changes in sleep duration and changes in anxiety over the course of pregnancy were not related. The predicted moderating effect of resilience was not found. Conclusions: The results suggested that pregnant women reporting anxiety problems should also be screened for sleeping problems, and vice versa, because women who experienced one of these pregnancy-related problems were also at risk of experiencing or developing the other problem. (C) 2017 Elsevier B.V. All rights reserved.