Browsing by Subject "GENDER DIFFERENCES"

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  • Pitkänen, Joonas; Remes, Hanna; Aaltonen, Mikko; Martikainen, Pekka (2019)
    Introduction Previous studies suggest that childhood experience of parental adversities increases the risk of subsequent offspring self-harm, but studies on distinct paternal and maternal characteristics are few and it remains unclear how these interact with childhood social position. The study aims to assess whether paternal and maternal adversities have different associations with offspring self-harm in adolescence and young adulthood. Interaction by offspring gender and childhood income are investigated, as well as cumulative effects of multiple adversities. Methods The study uses administrative register data on a 20% random sample of Finnish households with children aged 0–14 years in 2000. We follow children born in 1986–1998 (n=155 855) from their 13th birthday until 2011. Parental substance abuse, psychiatric disorders, criminality and hospitalisations due to interpersonal violence or self-harm are used to predict offspring self-harm with Cox proportional hazards models. Results The results show a clear increase in the risk of self-harm among those exposed to maternal or paternal adversities with HRs between 1.5 and 5.4 among boys and 1.7 and 3.9 among girls. The excess risks hold for every measure of maternal and paternal adversities after adjusting for childhood income and parental education. Evidence was found suggesting that low income, accumulation of adversity and female gender may exacerbate the consequences of adversities. Conclusions Our findings suggest that both parents’ adversities increase the risk of self-harm and that multiple experiences of parental adversities in childhood are especially harmful, regardless of parent gender. Higher levels of childhood income can protect from the negative consequences of adverse experiences.
  • Lahelma, Eero; Pietilainen, Olli; Rahkonen, Ossi; Lahti, Jouni; Lallukka, Tea (2016)
    Background: Mental symptoms are prevalent among populations, but their associations with premature mortality are inadequately understood. We examined whether mental symptoms contribute to cause-specific mortality among midlife employees, while considering key covariates. Methods: Baseline mail survey data from 2000-02 included employees, aged 40-60, of the City of Helsinki, Finland ( n = 8960, 80 % women, response rate 67 %). Mental symptoms were measured by the General Health Questionnaire 12-item version ( GHQ-12) and the Short Form 36 mental component summary ( MCS). Covariates included sex, marital status, social support, health behaviours, occupational social class and limiting long-standing illness. Causes of death by the end of 2013 were obtained from Statistics Finland ( n = 242) and linked individually to survey data pending consent ( n = 6605). Hazard ratios ( HR) and 95 % confidence intervals ( 95 % CI) were calculated using Cox regression analysis. Results: For all-cause mortality, only MCS showed a weak association before adjustments. For natural mortality, no associations were found. For unnatural mortality ( n = 21), there was a sex adjusted association with GHQ ( HR = 1.96, 95 % CI = 1.45-2.64) and MCS ( 2.30, 95 % CI = 1.72-3.08). Among unnatural causes of death suicidal mortality ( n = 11) was associated with both GHQ ( 2.20, 95 % CI = 1.47-3.29) and MCS ( 2.68, 95 % CI = 1.80-3.99). Of the covariates limiting long-standing illness modestly attenuated the associations. Conclusions: Two established measures of mental symptoms, i.e. GHQ-12 and SF-36 MCS, were both associated with subsequent unnatural, i.e. accidental and violent, as well as suicidal mortality. No associations were found for natural mortality due to diseases. These findings need to be corroborated in further populations. Supporting mental health through workplace measures may help counteract subsequent suicidal and other unnatural mortality among midlife employees.
  • Aaltonen, Kari I.; Isometsä, Erkki; Sund, Reijo; Pirkola, Sami (2019)
    Objective To examine longitudinally risk factors for suicide in depression, and gender differences in risk factors and suicide methods. Method We linked data from (i) The Finnish Hospital Discharge Register, (ii) the Census Register of Statistics Finland, and (iii) Statistics Finland's register on causes of deaths. All 56 826 first-hospitalized patients (25 188 men, 31 638 women) in Finland in 1991-2011 with a principal diagnosis of depressive disorder were followed up until death (2587 suicides) or end of the year 2014 (maximum 24 years). Results Clinical characteristics (severe depression adjusted hazard ratio [AHR] 1.19 [95% CI 1.08-1.30]; psychotic depression AHR 1.45 [1.30-1.62]; and comorbid alcohol dependence AHR 1.26 [1.13-1.41]), male gender (AHR 2.07 [1.91-2.24]), higher socioeconomic status and living alone at first hospitalization were long-term predictors of suicide deaths. Highest risk was associated with previous suicide attempts (cumulative probability 15.4% [13.7-17.3%] in men, 8.5% [7.3-9.7%] in women). Gender differences in risk factors were modest, but in lethal methods prominent. Conclusion Sociodemographic and clinical characteristics at first hospitalization predict suicide in the long term. Inpatients with previous suicide attempts constitute a high-risk group. Despite some gender differences in risk factors, those in lethal methods may better explain gender disparity in risk.