Browsing by Subject "masennusoireet"

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  • Ketvel, Laila (Helsingin yliopisto, 2021)
    Objective: Both stress-related exhaustion and depression have previously been associated with a decline in cognitive performance, but there is a lack of evidence on whether these conditions have different associations with different cognitive domains and whether they have additive effects on cognitive performance. Furthermore, very little is known about the cognitive effects of chronic stress-related exhaustion. Consequently, the aims of this study were to 1) examine the associations between current stress-related exhaustion and cognitive performance, 2) investigate whether different developmental trajectories of stress-related exhaustion are differently associated with cognitive performance, 3) compare the association between stress-related exhaustion and cognitive performance to the relationship between depressive symptoms and cognitive performance, 4) examine if individuals with comorbid stress-related exhaustion and depression have lower cognitive performance than individuals with at most one of these conditions (i.e., whether clinical stress-related exhaustion and clinical depression might have additive effects on cognitive performance). Methods: The data used in the study was a Finnish population-based sample of six cohorts born between 1962 and 1977 from the Cardiovascular Risk in Young Finns Study. Stress-related exhaustion was assessed using the Maastricht Questionnaire, depressive symptoms with the Beck Depression Inventory, and cognitive performance with four subtests of the Cambridge Neuropsychological Test Automated Battery, measuring visuospatial associative learning, reaction time, sustained attention, and executive functions. Cognitive performance and depressive symptoms were assessed in 2012, and stress-related exhaustion in 2001, 2007, and 2012. Participants were 35 to 50 years old in 2012. Linear associations between stress-related exhaustion and cognitive performance (N = 905) and depressive symptoms and cognitive performance (N = 904) were examined by conducting multivariate regression analyses. Age, sex, socioeconomic status, and parents’ socioeconomic status were controlled in the regression models. Additionally, multivariate analyses of variance were performed to investigate the different developmental trajectories of stress-related exhaustion and their relation to cognitive performance (N = 541) and the associations of comorbid stress-related exhaustion and depression with cognitive performance (N = 1273). Results and conclusion: The main finding was that high stress-related exhaustion is associated with slower reaction times, but not with performance in spatial working memory, visuospatial associative learning, or executive functions. Ongoing, chronic stress-related exhaustion was more strongly associated with slower reaction times than short-term exhaustion experienced years ago. Compared to depressive symptoms, high stress-related exhaustion was associated with slower reaction times also when subclinical cases were included, whereas only clinical levels of depressive symptoms had an association with slower reaction times. There were no differences in cognitive performance between individuals with only stress-related exhaustion or depression and those with comorbid stress-related exhaustion and depression, which supports the notion that these conditions do not have additive effects on cognitive performance. These findings add to the existing evidence of the cognitive effects of stress-related exhaustion in the general population and have several practical implications. Further research is needed on the topic, preferably with longitudinal designs, more comprehensive cognitive measures, and clinical assessment of the psychiatric symptoms.
  • Jääskeläinen, Maria (Helsingin yliopisto, 2017)
    Objectives. Depression is one of the most significant public health problems worldwide. In many ways depression affects not only the well-being and capacity of an individual, but also the environment and interpersonal relationships of the depressed individual, as well as the society as a whole at population level. This study examined whether childhood problem behaviours (internalizing and externalizing symptoms) are associated with later depressive symptoms, and whether an emotionally warm and supportive family environment or socio-economic status of the family at childhood explains the association between problem behaviour and depressive symptoms. As depression and depressive symptoms differ between women and men, current study also examined gender differences in the associations. Methods. The study data was from the longitudinal Cardiovascular Risk in Young Finns Study (YFS), which began in 1980 when the participants were 3–18 years of age. The sample size included in this study was 1331 men and women. Childhood problem behaviours (internalizing and externalizing symptoms) and child-rearing attitudes (parents' experience of emotional significance of their child and tolerance towards their child) were assessed from self-evaluation forms completed by parents in 1983. Depressive symptoms were assessed with a modified Beck's Depression Inventory (mBDI) conducted in 1992 and 1997. Associations between childhood problem behaviour and parents' child-rearing attitudes, and later depressive symptoms, were examined using linear and multinomial logistic regression analyses. The age and childhood socio-economic status of the participants were controlled in the analyses. Results and conclusions. Results showed that childhood internalizing and externalizing symptoms were associated with depressive symptoms in both men and women nine years later, and in women fourteen years later. In addition, mother's experience of the emotional significance of their child was associated with depressive symptoms in men nine years later. Furthermore, the mother's experience of tolerance towards their child was associated with changes in depressive symptoms in women. The socio-economic status of the childhood family was not found to have any direct impact on subsequent depressive symptoms. The study confirmed earlier research findings on the connection between childhood problem behaviour and subsequent mental health. As childhood problem behaviour has long-lasting effects on the individual's life, interventions aimed at families with children should be developed in the direction of early identification of problems, and providing families with more help in dealing with the behavioural and emotional problems of children.
  • Mikkonen, Janne (Helsingfors universitet, 2015)
    Studies on the intergenerational transmission of depressive symptoms form a long research tradition. Numerous studies have indicated that children of depressed mothers face an up to 3-fold risk of exhibiting depressive symptoms later in life compared with those children whose mother has not had depressive symptoms. Later studies have observed that paternal depressive symptoms pose an almost equal risk factor particularly for boys. After having established the association between parental and offspring depressive symptoms, research has focused on exploring the mechanisms underlying the transmission of risk. These are also the principal point of interest in the present thesis that gives particular weight to the role of gender, socioeconomic circumstances (parental education and household income) and timing of exposure, belonging to often-hypothesized but seldom-examined shapers of the transmission of risk. Besides these, the study sheds light on the significance of gender of which previous research has produced mixed results. The interpretation of the results leans on the conceptual framework of life course epidemiology, which understands the development of a disease or a disorder as the outcome of biological, psychosocial, and environmental processes that entangle with each other throughout the life course. The study utilized the register-based EKSY014 data set that contains a 20% random sample of all Finnish households with at least one child aged 0-14 years at the end of 2000. Information on the purchases of prescription medicines and visits to inpatient and outpatient care were used as proxy for the incidence of depressive symptoms. Cox proportional hazards regression model, which belongs to the field of survival analysis, was used to compare the event rates between the groups of interest. Exposure to depression of biological parents was measured when persons were 9-14 years old, and the follow-up of an individual’s own depressive symptoms started on the first day of the year the person turned 15 and ended on the last day of the year the person turned 20. Altogether, the principal study population included more than 130,000 persons born between 1986 and 1996. A smaller sub-sample was used to study the effects of an early-life exposure at age 0-5 years and recurrent parental depressive symptoms. According to the analysis, exposure to maternal depressive symptoms at age 9-14 years poses an equally large 2-fold risk for boys and girls. Paternal depressive symptoms put boys at an equal risk as maternal depressive symptoms, but for girls, they pose a smaller 1.5-fold risk. Among those persons who are living with their biological parents, controlling for the effects of socioeconomic factors weakens the association only little and no differences are seen in the risk of intergenerational transmission across the groups of socioeconomic status. Exposure to both maternal depressive symptoms and paternal depressive symptoms poses a bigger risk than a single exposure among both girls and boys. The analysis conducted with the smaller sub-sample implies that an exposure at age 9-14 years poses a bigger risk than an exposure at age 0-5 years. Recurrent exposure to maternal depressive symptoms appears to be a particularly severe risk factor. The results of the study support the life course epidemiological processes of accumulation of risk and chains of risk: Exposure to depressive symptoms in both parents and the long-term chaining of parental depressive symptoms put the person at the greatest risk. Parental depressive symptoms and socioeconomic status appear as largely independent risk factors of adolescent depressive symptoms; thus, those adolescents having a low socioeconomic status and a history of parental depressive symptoms face a particularly elevated risk of exhibiting depressive symptoms. The preliminary analysis did not give support to the assumed sensitive period in the first years of life, but the question should be examined further with a larger sample. Overall, the results advocate a more holistic approach to the prevention of adolescent depressive symptoms, beginning from the identification of familial risk and leading to actions that target all members of the family.
  • Nikolainen, Paula (Helsingfors universitet, 2015)
    Objectives: Depression is one of the most common mental disorders. It causes significant individual suffering as well as societal economic burden. In this study hostility refers to a multidimensional personality trait, which includes cynicity and paranoia towards others and feelings of anger. Previous studies have shown that hostility is associated with depressive symptoms and different psychosocial problems. However, it is not known if there is a two-way relationship between depressive symptoms and hostility over time. Thus, the aim of the current study was to examine, whether depressive symptoms predict higher levels of hostility, and also, whether hostility predicts later depressive symptoms. The hypothesis was that depressive symptoms would predict higher hostility. No hypothesis was set to whether hostility would predict later depressive symptoms. Methods: The sample of this study (n=1528) has been collected in a longitudinal and still ongoing study (the Young Finns study) started in 1980 of the risk factors for coronary heart disease of Finns of age 24–39 in 2001. Depressive symptoms were measured in 2001 and 2007 using a modified version of Beck's depression inventory (mBDI). Hostility was evaluated in 2001 and 2007 using three different scales which measure cognitive and affective dimensions of hostility. The scales of cognitive dimensions (cynicity and paranoia) are originally a part of the MMPI and SCL-90R inventories. Affective dimensions were measured using the anger scale included in Buss and Durkee's hostility scale. The research setting controlled for perceived social support, socioeconomic status and health behavior and they were assessed in 2001. Results and conclusions: A two-way relationship between depressive symptoms and hostility was found. The controlled factors did not attenuate the association between depressive symptoms and hostility. In addition, this study found that perceived low level of social support, a lower socioeconomic status, smoking and the male sex were weak predictors of hostility. This study also supports earlier results that depressive symptoms and hostility are relatively permanent traits. Recognizing a two-way relationship of depression and hostility may help in developing interventions for both conditions.
  • Halinen, Henri (Helsingin yliopisto, 2015)
    Objectives of the study Depression is one of the greatest factors to decrease the quality of life. However, its etiology has no clear scientific base. It has been thought that depression is a latent variable, but this view has been questioned. According to the network approach stressful life events are directly linked to depressive symptoms without a latent variable. Body image dissatisfaction is a more long-lasting and stable depressive symptom than the other symptoms. In addition, body image dissatisfaction predicts depression, but depression does not predict body image dissatisfaction. It is probable that body image dissatisfaction is linked to appearance. In this study I examine if different adverse effects of unattractive appearance are associated with body image dissatisfaction, when the level of depression is controlled. If this is true it would indicate that body image dissatisfaction cannot be explained by one-dimensional depression. In this study the adverse effects of unattractive appearance were low income level and living alone, which are both linked to unattractive appearance according to previous studies. Methods In this study there were 1638–2969 participants depending on the analysis. The Cardiovascular Risk in Young Finns Study was used as the research material. Item response theory model and logistic regression were used to examine differential item functioning (DIF) in this study. DIF appears when an item of some latent variable has different scores in different groups even if the groups have the same score in the latent variable. Therefore I examined if equally depressed people do differ in body image dissatisfaction if they belong to the low income or living alone groups. Results and conclusions According to this study it is possible that depression is not a one-dimensional phenomenon. Low income level and living alone were inked to depressive symptoms and body image dissatisfaction. In addition, income level was associated differently to body image dissatisfaction than other depressive symptoms [χ² = 459.01, P < 0.001]. Living alone was not. Regardless, questioning the one-dimensionality of depression demands same kind of examination of other depressive symptoms in the future research.
  • Virtanen, Suvi (Helsingfors universitet, 2016)
    Depression is a psychiatric disorder composed of several clusters of symptoms, which do not necessarily reflect common pathways of pathophysiological processes. Thus, a new conceptualization of depression has been proposed, which suggests that depression should be dissected to its key components instead of treating it as one homogeneous concept. Personality trait neuroticism is a risk factor that is consistently linked with depression. Several models have been suggested for the association between neuroticism and depression. One of them is a so-called common cause -model, which assumes that a shared etiology explains the co-occurrence of the two. Research from twin studies supports this notion, as neuroticism and depression have been found to share a large proportion of their genetic basis. However, earlier research has examined depression as a composite concept, and there are no studies to date which would have examined the shared genetic basis of specific symptoms of depression in relation with neuroticism. This study tests the common cause -model by estimating, whether the same genetic and environmental components are relevant in explaining the covariation between neuroticism and specific symptoms of depression. The data used in this study was from the Swedish Adoption/Twin Study (n = 1515, av. age = 62.0). Depression was measured with The Center for Epidemiological Studies - Depression Scale (CES-D), and separate analyses were conducted for three factors: somatic complaints, (lack of) positive affect and depressed affect. The results showed that all of the depressive symptoms shared the same genetic and environmental components when modeling the association with neuroticism, which supports the common cause -model. Over a half of the phenotypic correlation was explained by genetic influences between neuroticism and somatic complaints, as well as neuroticism and positive affect. Half of the co-variation between neuroticism and depressed affect was due to genetic influences. Findings of the current study suggest, that genetic and individual specific environmental influences are important in explaining the relationship in all of the symptoms. For future endeavors, it is suggested to search for concrete risk factors and neurobiological endophenotypes that are shared between specific symptoms and neuroticism. While the use of composite concept of depression was supported in this study, the research question has not been yet examined in molecular genetic studies. A twin model can only differentiate sources of variation, not concrete risk factors. Thus, the results presented here only apply in the context of twin modeling. Also, the robustness of the results should be tested by replicating the results among younger samples.
  • Nurminen, Eva (Helsingin yliopisto, 2017)
    Tavoitteet: Masennus on yksi yleisimmistä psykiatrisista häiriöistä, joka vaikuttaa merkittävästi yksilön hyvinvointiin ja aiheuttaa myös yhteiskunnalle taloudellista kuormitusta. Sosiaaliset suhteet ja sosiaalisen tuen saaminen edistävät yksilön hyvinvointia ja toimivat myös masennukselta suojaavana tekijänä. Aiemmat tutkimukset ovat osoittaneet, että sosiaalinen tuki on yhteydessä masennusoireiluun, mutta yhteyttä toisinpäin ei ole tutkittu paljoa. Tässä tutkimuksessa selvitettiin, löytyykö sosiaalisen tuen ja masennusoireiden välillä kaksisuuntainen yhteys. Lisäksi tutkimuksessa selvitettiin, selittävätkö perheympäristöön liittyvät tekijät masennusoireiden ja sosiaalisen tuen välisiä yhteyksiä. Perheympäristöön liittyvien tekijöiden on todettu olevan yhteydessä masennusoireisiin, mutta aiempaa näyttöä ei ole liittyen perheympäristön yhteydestä sosiaaliseen tukeen. Aiempaa tutkimusta ei myöskään löydy siitä, toimiiko perheympäristö välittävänä tekijänä masennusoireiden ja sosiaalisen tuen välisissä yhteyksissä. Menetelmät: Tutkimuksen otos (1203) koostui vuonna 1980 aloitetusta Lasten Sepelvaltimotaudin Riskitekijät (LASERI) pitkittäistutkimuksesta, jonka osallistujat olivat vuonna 1992 15-30 –vuotiaita ja vuonna 1997 20-35 –vuotiaita. Masennusoireita mitattiin vuosina 1992 ja 1997 Beckin masennuskyselyn muunnelmalla (mBDI). Koettua sosiaalista tukea mitattiin vuosina 1992 ja 1997 koetun sosiaalisen tuen mittarilla. Vanhempien kasvatusasenteita mitattiin vuonna 1983 itsearviointilomakkeella, joka mittaa kasvatusasenteita merkityksen ja toleranssin näkökulmista. Perheen sosioekonomista asemaa tarkasteltiin yhdistämällä perheen tulot ja vanhempien koulutus. Yhteyksiä tarkasteltiin lineaarisen regressioanalyysin avulla. Tulokset ja johtopäätökset: Tutkimuksessa havaittiin, että masennusoireilla ja sosiaalisella tuella on kaksisuuntainen yhteys ja ne ennustavat toisiaan sekä poikittais- että pitkittäisasetelmalla tarkasteltuna. Tutkimus vahvisti myös sitä, että masentuneisuus on melko pysyvä ominaisuus. Perheympäristön yhteydet masennusoireisiin ja sosiaaliseen tukeen jäivät vähäisiksi, eikä perheympäristön havaittu tämän tutkimuksen perusteella toimivan suojaavana tekijänä masennusoireiden ja sosiaalisen tuen välisissä yhteyksissä. Tieto masentuneisuuden ja sosiaalisen tuen välisestä kaksisuuntaisesta yhteydestä voi auttaa masentuneisuuden vähentämiseen pyrkivien interventiomenetelmien kehittämisessä.
  • Heikkilä, Lotta (Helsingfors universitet, 2016)
    Objective. Depression is a prevalent mental disorder with negative impact on health and well-being. After decades of research, there remains a need for a better understanding of its etiology and developing its treatment. Network theory views depression as a heterogeneous system, as opposed to a unidimensional, latent factor that causes its symptoms. In network theory, depressive symptoms are assumed to differ in their risk factors, such as personality traits. High neuroticism is a well-known risk factor for depression while extraversion and conscientiousness protect from it. However, only a few studies have examined personality traits as risk factors for individual depressive symptoms. The purpose of this study was to examine whether individual depressive symptoms are predicted by different personality traits. Depressive symptoms were assumed to vary in their risk and protective factors. The connections were assumed to remain when controlling for the latent depression factor. Methods. The data used was a part of the Wisconsin Longitudinal Study (WLS) (N = 4852). Depressive symptoms were measured with CES-D (The Center for Epidemiological Studies - Depression Scale), which consists of 20 symptoms. Personality was measured with an abbreviated version of BFI-54 (Big Five Inventory). Personality was assessed in 1993 and depressive symptoms in 2004. Associations between personality traits and individual depressive symptoms were examined with ordinal regression analyses. To test whether the connections were locally independent of latent depression, an ordinal regression procedure for detecting differential item functioning (DIF) was used. Results and conclusions. Depressive symptoms differed in their personality risk and protective factors. Connections between personality traits and depressive symptoms could not be explained by a latent depression factor. High neuroticism was a risk factor while extraversion and conscientiousness were protective factors for several central and common symptoms of depression. Also openness to experience and agreeableness mostly protected from some depressive symptoms. The results apply to less severe depressive symptoms in the general population and support earlier findings of depressive symptoms having qualitative differences. Deeper knowledge on the risk and protective factors of individual depressive symptoms can contribute to the development of more specific methods for preventing and treating depression.
  • Nurminen, Milka (Helsingin yliopisto, 2018)
    Tavoitteet. Aiemmissa tutkimuksissa on havaittu yksittäisten stressaavien elämäntapahtumien olevan yhteydessä voimakkaampaan masennusoireiluun. Poikittaistutkimuksissa on myös havaittu stressaavien elämäntapahtumien korkeamman kumulatiivisen kertymän olevan yhteydessä voimakkaampaan masennusoireiluun. Sosiaalisen tuen vaikutusta tätä yhteyttä muuntavana tekijänä on tutkittu, mutta tulokset ovat olleet ristiriitaisia. Tämän tutkimuksen tavoitteena oli pitkittäisasetelmalla tutkia stressaavien elämäntapahtumien kumulatiivisen kertymän yhteyttä masennusoireiluun sekä selventää sosiaalisen tuen roolia mahdollisena yhteyttä muuntavana tekijänä. Menetelmät. Tutkimuksen aineisto oli peräisin suomalaisesta Lasten Sepelvaltimotaudin Riskitekijät -pitkittäistutkimuksesta. Otokseen valittiin ne henkilöt (N=753), jotka olivat vastanneet kaikkiin tutkimuksessa tarkasteltaviin kyselyihin. Masennusoireilua arvioitiin osallistujien vuosina 2007 ja 2012 täyttämällä Beckin Depressiokyselyllä (Beck Depression Inventory II; BDI-II). Sosiaalista tukea arvioitiin osallistujien vuonna 2001 tai 2007 täyttämällä Multidimensional Scale of Perceived Social Support (MSPSS) -kyselylomakkeella. Stressaavien elämäntapahtumien määrää arvioitiin osallistujien vuosina 2001 ja 2007 täyttämien kyselylomakkeiden avulla, joissa osallistujat raportoivat olivatko he olleet työttöminä, kokeneet avioeron, oliko heidän puolisonsa tai lapsensa kuollut, tai olivatko he muuttaneet toiselle paikkakunnalle. Stressaavien elämäntapahtumien määrän sekä stressaavien elämäntapahtumien ja sosiaalisen tuen interaktion vaikutuksia masennusoireiluun tutkittiin lineaarisilla regressiomalleilla, joissa kontrolloitiin sukupuoli, ikä, sosioekonominen asema, terveyskäyttäytyminen ja aiempi masennusoireilu. Tulokset ja johtopäätökset. Stressaavien elämäntapahtumien suurempi määrä oli yhteydessä korkeampaan masennusoireiluun riippumatta sosiaalisen tuen määrästä. Stressaavat elämäntapahtumat eivät kuitenkaan ennustaneet muutosta masennusoireilussa pidemmän ajan kuluessa. Tulosten perusteella ennaltaehkäisevien toimien suuntaaminen useita stressaavia elämäntapahtumia kokeneille henkilöille voisi mahdollisesti vähentää elämäntapahtumien kertymän aiheuttamaa masennusoireilua ja siten myös masennushäiriöitä.
  • Silvonen, J; Vuori, J (Kela, 1998)
    Sosiaali- ja terveysturvan tutkimuksia 34
    Työhön-ryhmien vaikutus työttömien masennusoireisiin Tutkimuksessa selvitetään Työhön-ryhmäohjelman vaikutusta työttömien masennus- ja muihin psyykkisiin oireisiin. Työhön-ohjelma on työttömille tarkoitettu itseluottamusta ja työnhakutaitoja kehittävä viikon kurssi, joka tukee osallistujien työnhakupystyvyyden tunnetta ja kykyä selviytyä tulevista vastoinkäymisistä. Puolivuotisseurannassa kurssiin osallistuneiden psyykkisen oireilun todettiin vähentyneen merkitsevästi enemmän kuin heidän vastinpareillaan vertailuryhmässä. Kurssista hyötyivät erityisesti ne, joilla oli alkumittauksessa havaittu riski psyykkisiin häiriöihin sekä ne, jotka olivat edelleen työttömiä.
  • Åberg, Veera (Helsingin yliopisto, 2019)
    Objective. Parenting sense of competence (PSOC) is a key factor in parenting and for the development and well-being of a child. Preterm birth is one of the risk factors for early parenting, which can challenge early development of PSOC, and can increase the risk for parents’ depressive symptoms. The results about associations between preterm birth and PSOC are controversial. Research has also focused only on the first year after preterm birth and the dimensions of PSOC have been studied narrowly. Additionally, the factors which can affect the relationship between preterm birth and PSOC, are largely unknown. The aim of the current study was to investigate the associations between preterm birth and PSOC, and its subdimensions parenting self-efficacy and satisfaction, when the child was between 1–6 years old. Additionally, it was explored whether mothers’ symptoms of depression moderate or mediate these associations. Methods. The data in this study is part of the Finnish Prediction and prevention of preeclampsia and intrauterine growth restriction (PREDO) study. The sample (N=2420) includes 101 mothers whose child was born preterm (< 37 weeks of gestation) and 2319 mothers of children born full-term (37 – 41+6 weeks of gestation). Mothers evaluated their parenting sense of competence (Parenting Sense of Competence) and symptoms of depression (Beck Depression Inventory-II) when the child was between 1–6 years old. The associations, including steps of mediation analysis, were examined with linear and logistic regression models. Results and conclusions. The results of this study show that preterm birth is associated with lower PSOC and its subdimension of parenting self-efficacy, but not with satisfaction, when the child was between 1–6 years old. Mothers’ symptoms of depression did not moderate or mediate these associations. The results indicate that preterm birth can be one of the risk factors for PSOC and especially for parenting self-efficacy, and also regardless of mothers’ depression symptoms. The results add to previous knowledge about how preterm birth can affect parenting after child’s first year of life. Thus, after preterm birth, supporting PSOC as part of other parenting is recommendable long into childhood.
  • Lindström, Matilda (Helsingin yliopisto, 2019)
    Tavoitteet: Monet masennuksesta kärsivät eivät saa tarvitsemaansa hoitoa. Masennuksesta kärsivien hoitoon hakeutumista on tutkittu paljon, ja on havaittu, että masennuksen vakavuusaste vaikuttaa hoitoon hakeutumiseen. Masennuksen arvioimisessa on nykyään alettu kiinnittää huomiota eri oireisiin ja oireiden välisiin eroihin. On havaittu, että eri oireet vaikuttavat eri tavalla psykososiaalisiin toiminnan häiriöihin ja että osa masennusoireista on voimakkaammin yhteydessä vakava-asteiseen masennukseen kuin toiset. Tämän vuoksi on syytä olettaa, että eri masennusoireiden välillä saattaa ilmetä eroja, kun tutkitaan yksittäisten oireiden vaikutuksia hoitoon hakeutumiseen. Tämän tutkimuksen tavoitteena on tutkia eri masennusoireiden yhteyksiä hoitoon hakeutumiseen, ja tarkastella, vaikuttavatko eri oireet eri tavoin hoitoon hakeutumiseen. Menetelmät: Tutkimuksen otos (N=2352) koostui Survey of Health, Aging and Retirement in Europe kyselyn toisesta vaiheesta. Otos on kerätty 12:sta eri Euroopan maasta. Masennusta arvioitiin EURO-D itsearviointikyselyllä, jossa arvioitiin 12:ta eri masennusoiretta. Hoitoon hakeutumista tutkittiin kysymällä tutkittavilta ovatko he koskaan hakeutuneet lääkärille tai psykiatrille masennuksen vuoksi, tai ovatko he koskaan joutuneet psykiatriseen osastohoitoon. Masennusoireiden ja hoitoon hakeutumisen välisiä yhteyksiä tutkittiin korrelaatioanalyysilla sekä logistisella regressioanalyysilla. Tulokset ja johtopäätökset: Tutkimuksessa havaittiin, että eri oireet ennustavat hoitoon hakeutumista eri tavoin. Masentunut mieliala, itsetuhoiset ajatukset, syyllisyyden tunteet ja univaikeudet ennustivat hoitoon hakeutumista. Sen sijaan henkilöt, joilla ilmeni ärsyyntyvyyttä ja nautinnon puutetta, hakeutuivat epätodennäköisemmin hoitoon. Muut oireet eivät ennustaneet tilastollisesti merkitsevästi hoitoon hakeutumista. Tuloksista nähdään, että masennusoireiden välillä ilmenee eroja hoitoon hakeutumisessa. Tämä tutkimus antoi viitteitä, että masennusoireita kannattaisi jatkossa tutkia yksittäisinä tekijöinä, eikä vain yhdenvertaisina kriteereinä masennusdiagnoosille. Masennuksen arvioimisessa yksittäisten oireiden tarkastelu saattaisi antaa enemmän kliinistä tietoa masennuksesta, mitä puolestaan voitaisiin hyödyntää myös sopivimman hoitomuodon löytämisessä.
  • Heinonen, Helmi (Helsingin yliopisto, 2018)
    The aim of the study: In research literature depressive symptoms in mothers have been associated with lower parental sense of competence. The developmental mechanisms responsible for this relation are poorly understood and there is a need for longitudinal study especially. The study of this master’s thesis explores the association of both postnatal and later depressive symptoms with parental sense of competence when the child is 1–5 years. It also explores whether demographic factors have an impact to the relation and does later depressive symptomology in mothers mediate the relation between postnatal depressive symptomology and later parental competence. Method: Data is part of the Finnish cohort of The Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction (PREDO) research. The sample includes 2255 mothers who gave birth between years 2006-2010. Mothers evaluated their depressive symptoms 2 weeks / 6 months after birth (Center for Epidemiologic Studies Depression Scale ) and at the follow-up when the child was between 1–5 years old (Beck´s Depression Inventory). Mothers also evaluated their parental sense of competence (Parenting Sense of Competence Scale) at the follow-up. Data was analysed using linear regression and mediation analysis. Results and Conclusion: Both postnatal and later depressive symptoms were associated to lower parental sense of competence when the child was 1–5 years and demographic background did not have any impact to the relations. A significant mediation model was found where later depressive symptomology in mothers partly mediated the relation between postnatal depressive symptomology and later parental competence. Therefore effective screening and early treatment of postnatal depressive symptoms are important. Evaluating parental competence could potentially be a valuable part of screening and treatment of depressive symptomology in mothers.