Browsing by Subject "mental health"

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  • Gagnon, Joseph Calvin; Swank, Jacqueline M. (2021)
    A national study of clinical directors examined professional development (PD) focused on mental health provided to professionals in juvenile justice facilities for adjudicated youth. A total of 85 clinical directors responded to a mail survey (45% return rate). The survey questions related to (a) topics of staff training and the basis for choosing topics, (b) which professionals participated in each PD topic, (c) training format and frequency of PD, (d) recommended attributes of PD, (e) methods of evaluating PD, and (f) adequacy of PD and how can it be improved. For each topic, PD was typically provided once per year and face to face, rather than online. PD participation rates were commonly in the 30% and 40% ranges for professionals other than clinical directors and counselors, with teachers, correctional officers, administrators, and teaching assistants receiving PD the least. Rarely did PD include recommended attributes of PD, and it was commonly viewed as ineffective. Implications for research and practice related to PD and its relationship to youth reentry from juvenile justice facilities are discussed.
  • Treanor, Charlene J; Kouvonen, Anne; Lallukka, Tea; Donnelly, Michael (2021)
    Background: Mental ill-health presents a major public health problem. A potential part solution that is receiving increasing attention is computer-delivered psychological therapy, particularly during the COVID-19 pandemic as health care systems moved to remote service delivery. However, computerized cognitive behavioral therapy (cCBT) requires active engagement by service users, and low adherence may minimize treatment effectiveness. Therefore, it is important to investigate the acceptability of cCBT to understand implementation issues and maximize potential benefits. Objective: This study aimed to produce a critical appraisal of published reviews about the acceptability of cCBT for adults. Methods: An umbrella review informed by the Joanna Briggs Institute (JBI) methodology identified systematic reviews about the acceptability of cCBT for common adult mental disorders. Acceptability was operationalized in terms of uptake of, dropping out from, or completion of cCBT treatment; factors that facilitated or impeded adherence; and reports about user, carer, and health care professional experience and satisfaction with cCBT. Databases were searched using search terms informed by relevant published research. Review selection and quality appraisal were guided by the JBI methodology and the AMSTAR tool and undertaken independently by 2 reviewers. Results: The systematic searches of databases identified 234 titles, and 9 reviews (covering 151 unique studies) met the criteria. Most studies were comprised of service users with depression, anxiety, or specifically, panic disorder or phobia. Operationalization of acceptability varied across reviews, thereby making it difficult to synthesize results. There was a similar number of guided and unguided cCBT programs; 34% of guided and 36% of unguided users dropped out; and guidance included email, telephone, face-to-face, and discussion forum support. Guided cCBT was completed in full by 8%-74% of the participants, while 94% completed one module and 67%-84% completed some modules. Unguided cCBT was completed in full by 16%-66% of participants, while 95% completed one module and 54%-93% completed some modules. Guided cCBT appeared to be associated with adherence (sustained via telephone). A preference for face-to-face CBT compared to cCBT (particularly for users who reported feeling isolated), internet or computerized delivery problems, negative perceptions about cCBT, low motivation, too busy or not having enough time, and personal circumstances were stated as reasons for dropping out. Yet, some users favored the anonymous nature of cCBT, and the capacity to undertake cCBT in one's own time was deemed beneficial but also led to avoidance of cCBT. There was inconclusive evidence for an association between sociodemographic variables, mental health status, and cCBT adherence or dropping out. Users tended to be satisfied with cCBT, reported improvements in mental health, and recommended cCBT. Overall, the results indicated that service users' preferences were important considerations regarding the use of cCBT. Conclusions: The review indicated that "one size did not fit all" regarding the acceptability of cCBT and that individual tailoring of cCBT is required in order to increase population reach, uptake, and adherence and therefore, deliver treatment benefits and improve mental health.
  • Flykt, Marjo; Vänskä, Mervi; Punamäki, Raija-Leena; Heikkilä, Lotta M.; Tiitinen, Aila; Poikkeus, Piia; Lindblom, Jallu (2021)
    This person-oriented study aimed to identify adolescents’ hierarchical attachment profiles with parents and peers, and to analyze associations between the profiles and adolescent psychosocial adjustment. Participants were 449 Finnish 17–19-year-olds reporting their attachments to mother, father, best friend, and romantic partner and details on mental health (internalizing symptoms, inattention/hyperactivity, and anger control problems) and risk-taking behavior (substance use and sexual risk-taking). Attachment was measured with Experiences in Close Relationships – Relationship Structures (ECR-RS); internalizing, inattention/hyperactivity, and anger control problems with Self-Report of Personality — Adolescent (SRP—A) of the Behavior Assessment System for Children, third edition (BASC-3); substance use with the Consumption scale of the Alcohol Use Disorders Identification Test (AUDIT-C) and items from the Finnish School Health Promotion Study; and sexual risk-taking behavior with the Cognitive Appraisal of Risky Events (CARE). Latent profile analysis identified five attachment profiles: “All secure” (39%), “All insecure” (11%), “Parents insecure – Peers secure” (21%), “Parents secure – Friend insecure” (10%), and “Parents secure – Partner insecure” (19%). “All insecure” adolescents showed the highest and “All secure” adolescents the lowest levels of mental health problems and substance use. Further, parental attachment security seemed to specifically prevent substance use and anger control problems, while peer attachment security prevented internalizing problems. Our findings help both understand the organization of attachment hierarchies in adolescence and refine the role of specific attachment relationships in psychosocial adjustment, which can be important for clinical interventions in adolescence.
  • Bosqui, Tania; Väänänen, Ari; Buscariolli, Andre; Koskinen, Aki; O’Reilly, Dermot; Airila, Auli; Kouvonen, Anne (2019)
    Background A higher risk of common mental health disorders has been found for first-generation migrants in high income countries, but few studies have examined the use of mental health care. This study aimed to identify the level of antidepressant use amongst the largest first generation migrant groups resident in Finland. Methods This cohort study used record-based data linkage methodology to examine the hazard of antidepressant use between migrant groups in Finland using Cox proportional hazard models. Data was derived using socio-demographic and prescription data from Statistics Finland and the Finnish Population Registry. The cohort included a random sample of 33% of the working age population in 2007 (N = 1,059,426, 49.8% women, 2.5% migrants) and dispensed antidepressant prescriptions from 2008 to 2014. Results After adjustment for socio-demographic characteristics, results show higher antidepressant use for female migrants from North Africa and the Middle East compared to the Finland-born majority, a similar level of use for migrants from Western countries, and lower use for migrants from other non-Western countries. Conclusions The gender and country of origin dependent use of antidepressant medication is discussed in terms of socio-political and cultural between-group differences. Recommendations are made to address inequalities in accessing services, particularly for migrants from non-Western countries.
  • Ranta, Hertta (Helsingin yliopisto, 2020)
    Mental health problems are a major public health concern globally. Many developed countries are facing the challenge of ageing populations and simultaneously an increase in labour market inactivity due to mental health problems among the working-age population. To be able to prolong working careers, it is important to pay attention to the work ability of young adults. As working life has become more psychosocially demanding while the burden of adverse physical working conditions has diminished, it is important to gain a better understanding of the association between working conditions and mental health functioning among younger workers in order to find ways to enhance work ability and alleviate the social and economic burden of mental health problems. The aim of this study was to examine the association between adverse working conditions and poor mental health functioning among under 40-year-old employees of the City of Helsinki. The data (n=4 315) was collected in 2017 through survey questionnaires for the Helsinki Health Study. Logistic regression analysis was conducted to analyse the association of psychosocial working conditions (job control and job demands) and physical working conditions (physical workload) with mental health functioning. Mental health functioning was measured with the SF-36 measurement and was dichotomised from the lowest quartile. Sociodemographic characteristics and health behaviours were used as covariates in the analysis. The results showed that after full adjustments, respondents with high job demands were nearly twice as likely (OR=1.9; 95% CI=1.6-2.3) and those with low job control 1.5 times as likely (OR=1.5; 95% CI=1.2-1.7) to have poor mental health functioning than others. Adjusting for covariates did not affect the OR for job control, but adjusting for adverse health behaviours decreased the OR for high job demands slightly. High physical workload had a weak association with poor mental health functioning, which slightly decreased after adjusting for adverse health behaviours and was not statistically significant in the full model (OR=0.9; 95% CI=0.8-1.1). The results of this study highlight the significance of adverse psychosocial working conditions for poor employee mental health functioning. Thus, in order to increase individual wellbeing and work productivity, work organizations could consider ways to decrease employees’ job demands and enhance employee job control. As the present study was cross-sectional, further research is needed to investigate the long-term effects of adverse working conditions on mental health functioning among younger employees.
  • Tarkiainen, Lasse; Moustgaard, Heta; Korhonen, Kaarina; Noordzij, J. Mark; Beenackers, Marielle A.; van Lenthe, Frank J.; Burstrom, Bo; Martikainen, Pekka (2021)
    Background Research evidence on the association between neighbourhood characteristics and individual mental health at older ages is inconsistent, possibly due to heterogeneity in the measurement of mental-health outcomes, neighbourhood characteristics and confounders. Register-based data enabled us to avoid these problems in this longitudinal study on the associations between socioeconomic and physical neighbourhood characteristics and individual antidepressant use in three national contexts. Methods We used register-based longitudinal data on the population aged 50+ from Turin (Italy), Stockholm (Sweden), and the nine largest cities in Finland linked to satellite-based land-cover data. This included individual-level information on sociodemographic factors and antidepressant use, and on neighbourhood socioeconomic characteristics, levels of urbanicity, green space and land-use mix (LUM). We assessed individual-level antidepressant use over 6 years in 2001-2017 using mixed-effects logistic regression. Results A higher neighbourhood proportion of low-educated individuals predicted lower odds for antidepressant use in Turin and Stockholm when individual-level sociodemographic factors were controlled for. Urbanicity predicted increased antidepressant use in Stockholm (OR=1.02; 95% CI 1.01 to 1.03) together with more LUM (OR=1.03; 1.01-1.05) and population density (OR=1.08; 1.05-1.10). The two latter characteristics also predicted increased antidepressant use in the Finnish cities (OR=1.05; 1.02-1.08 and OR=1.14; 1.02-1.28, respectively). After accounting for all studied neighbourhood and individual characteristics of the residents, the neighbourhoods still varied by odds of antidepressant use. Conclusions Overall, the associations of neighbourhood socioeconomic and physical characteristics with older people's antidepressant use were small and inconsistent. However, we found modest evidence that dense physical urban environments predicted higher antidepressant use among older people in Stockholm and the Finnish cities.
  • Vuorio, Alpo; Bor, Robert (2020)
  • Kosola, Silja; Culnane, Evelyn; Loftus, Hayley; Tornivuori, Anna; Kallio, Mira; Telfer, Michelle; Miettinen, Päivi J.; Kolho, Kaija-Leena; Aalto, Kristiina; Raivio, Taneli; Sawyer, Susan (2021)
    Introduction More than 10% of adolescents live with a chronic disease or disability that requires regular medical follow-up as they mature into adulthood. During the first 2 years after adolescents with chronic conditions are transferred to adult hospitals, non-adherence rates approach 70% and emergency visits and hospitalisation rates significantly increase. The purpose of the Bridge study is to prospectively examine associations of transition readiness and care experiences with transition success: young patients' health, health-related quality of life (HRQoL) and adherence to medical appointments as well as costs of care. In addition, we will track patients' growing independence and educational and employment pathways during the transition process. Methods and analysis Bridge is an international, prospective, observational cohort study. Study participants are adolescents with a chronic health condition or disability and their parents/guardians who attended the New Children's Hospital in Helsinki, Finland, or the Royal Children's Hospital (RCH) in Melbourne, Australia. Baseline assessment took place approximately 6 months prior to the transfer of care and follow-up data will be collected 1 year and 2 years after the transfer of care. Data will be collected from patients' hospital records and from questionnaires completed by the patient and their parent/guardian at each time point. The primary outcomes of this study are adherence to medical appointments, clinical health status and HRQoL and costs of care. Secondary outcome measures are educational and employment outcomes. Ethics and dissemination The Ethics Committee for Women's and Children's Health and Psychiatry at the Helsinki University Hospital (HUS/1547/2017) and the RCH Human Research Ethics Committee (38035) have approved the Bridge study protocol. Results will be published in international peer-reviewed journals and summaries will be provided to the funders of the study as well as patients and their parents/guardians.
  • Metsa-Simola, Niina S.; Remes, Hanna M.; Hiltunen, Elina M.; Martikainen, Pekka T. (2022)
    Background Symptoms of depression and anxiety are elevated among parents of children with cancer. However, knowledge of parents' psychotropic medication use following child's cancer diagnosis is scarce. Methods We use longitudinal Finnish register data on 3266 mothers and 2687 fathers whose child (aged 0-19) was diagnosed with cancer during 2000-2016. We record mothers' and fathers' psychotropic medication use (at least one annual purchase of anxiolytics, hypnotics, sedatives, or antidepressants) 5 years before and after the child's diagnosis and assess within-individual changes in medication use by time since diagnosis, cancer type, child's age, presence of siblings, and parent's living arrangements and education using linear probability models with the individual fixed-effects estimator. The fixed-effects models compare each parent's annual probability of psychotropic medication use after diagnosis to their annual probability of medication use during the 5-year period before the diagnosis. Results Psychotropic medication use was more common among mothers than fathers already before the child's diagnosis, 11.2% versus 7.3%. Immediately after diagnosis, psychotropic medication use increased by 6.0 (95% CI 4.8-7.2) percentage points among mothers and by 3.2 (CI 2.1-4.2) percentage points among fathers. Among fathers, medication use returned to pre-diagnosis level by the second year, except among those whose child was diagnosed with acute lymphoblastic leukemia or lymphoblastic lymphoma. Among mothers of children with a central nervous system cancer, medication use remained persistently elevated during the 5-year follow-up. For mothers with other under-aged children or whose diagnosed child was younger than 10 years, the return to pre-diagnosis level was also slow. Conclusions Having a child with cancer clearly increases parents' psychotropic medication use. The increase is smaller and more short-lived among fathers, but among mothers its duration depends on both cancer type and family characteristics. Our results suggest that an increased care burden poses particular strain to the long-term mental well-being of mothers.
  • Pihkala, Panu (Suomen mielenterveysseura, 2019)
    This first, more extensive Finnish-language report on climate anxiety is based on multidisciplinary re-search and observations made from practical actions taken to alleviate it. Climate anxiety is an aspect of the wider phenomenon of eco-anxiety: it encompasses challenging emotions, experienced to a significant degree, due to environmental issues and the threats they pose. On a wider scale, both eco-anxiety and climate anxiety are components of a phenomenon, in which the state of the world (i.e. the so-called macro social factors) impacts our mental health. Climate anxiety can be a problem if it is so intense that a person may come paralysed, but climate anx-iety is not primarily a disease. Instead it is an understandable reaction to the magnitude of the envi-ronmental problems that surround us. Climate anxiety can often be an important resource as well, but this entails that a person finds, along with others, a) enough time and space to deal with their emotions and b) enough constructive activity to help mitigate climate change. The report places climate anxiety as one of the health effects of climate change (Chapter 2). Two cen-tral psychological challenges and tasks (Chapter 3) are a) adjusting to changing circumstances, i.e. re-maining functional, and b) accepting one’s own ethical responsibility and keeping a healthy perspec-tive, i.e. living with ambivalence. The report publishes, for the first time in Finnish, a review of the various symptoms of climate anxiety, with reference to international studies (Chapter 4). The symp-toms can be placed on a scale of the mildest to the most severe and they can also manifest as psy-chophysical symptoms. What makes identifying the symptoms more difficult is that they are multidi-mensional (climate change impacts almost everything). Social pressures that relate to climate change also influence this. Chapter 5 deals with vulnerabilities and the role of social context when coping with climate change. The chapter includes a list of people who are especially vulnerable and life situations that create vul-nerabilities. Some of these groups of people identify with climate anxiety (e.g. young people) and some (e.g. farmers) experience symptoms relating to the phenomenon but call it something else. The sixth chapter raises the issue of the importance of experiencing that life is meaningful, when dealing with climate anxiety (meaning-focused coping, existential well-being.) Chapter 7 discusses the various emotions, such as sadness, fear and guilt, which may possibly relate to climate anxiety. Cli-mate anxiety can also be approached from the perspective of shock and trauma. Emotional skills and mental health skills can help when dealing with climate anxiety. The report also emphasizes that strong emotions can be a powerful resource. Chapter 8 offers an extensive overview of the various initiatives and resource materials, that have been developed in the last few years to deal with climate anxiety, both internationally and in Finland. The focus is on third sector initiatives. Basic formats include a) self-help and support materials, b) group activities, c) events and d) peer support. The report takes a broad look at the resources and initiatives created in, e.g. Australia and the United Kingdom. In addition to psychologist organizations’ initiatives, those created by environmental organizations, ecopsychologists, artists and environmental educators are also discussed.
  • Juyani, Anne; Oksanen, Tuula; Virtanen, Marianna; Salo, Paula; Pentti, Jaana; Kivimaki, Mika; Vahtera, Jussi (2018)
    Objectives The aim of this study was to examine the association between co-occurring work stressors and risk of disability pension. Methods The work stressors job strain, effort-reward imbalance (ERI), and organizational injustice were measured by a survey in 2008 of 41 862 employees linked to national records of all-cause and cause-specific disability pensions until 2011. Co-occurring work stressors were examined as risk factors of work disability using Cox regression marginal models. Results Work stressors were clustered: 50.8% had no work stressors [observed-to-expected ratio (O/E)=1.2], 27.4% were exposed to one stressor (O/E=0.61-0.81), 17.7% to two stressors (O/E=0.91-1.73) and 6.4% to all three stressors (O/E=2.59). During a mean follow-up of 3.1 years, 976 disability pensions were granted. Compared to employees with no work stressors, those with (i) co-occurring strain and ERI or (ii) strain, ERI and injustice had a 1.9-2.1-fold [95% confidence interval (CI) 1.7-2.6] increased risk of disability retirement. The corresponding hazard ratios were 1.2 and 1.5 (95% CI 1.0-1.8) for strain and ERI alone. Risk of disability pension from depressive disorders was 4.4-4.7-fold (95% CI 2.4-8.0) for combinations of strain+ERI and strain+ERI+injustice, and 1.9-2.5-fold (95% CI 1.1-4.0) for strain and ERI alone. For musculoskeletal disorders, disability risk was 1.6-1.9-fold (95% CI 1.3-2.3) for strain+ERI and ERI+injustice combinations, and 1.3-fold (95% CI 1.0-1.7) for strain alone. Supplementary analyses with work stressors determined using work-unit aggregates supported these findings. Conclusions Work stressors tend to cluster in the same individuals. The highest risk of disability pension was observed among those with work stressor combinations strain+ERI or strain+ERI+injustice, rather than for those with single stressors.
  • van Hedel, Karen; Martikainen, Pekka; Moustgaard, Heta; Myrskylä, Mikko (2018)
    Marriage is associated with better mental health. While research on the mental health of cohabiting individuals has increased in recent years, it has yielded mixed results thus far. We assessed whether the mental health of cohabiters is comparable to that of married individuals or those living alone using longitudinal data on psychotropic medication purchases. Panel data from an 11% random sample of the population residing in Finland for the years 1995 to 2007, with annual measurements of all covariates, were used. Ordinary least squares (OLS) models were applied to disentangle the relation between cohabitation and psychotropic medication purchases while controlling for relevant time-varying factors (age, education, economic activity, and number of children), and individual fixed effects (FE) models to further account for unobserved time-invariant individual factors. Our sample consisted of 63,077 men and 61,101 women aged 25 to 39 years in 1995. Descriptive results and the OLS model indicated that the likelihood of purchasing psychotropic medication was lowest for married individuals, higher for cohabiters, and highest for individuals living alone. This difference between cohabiting and married individuals disappeared after controlling for time-varying covariates (percent difference [% diff] for men: 0.3, 95% confidence interval [CI]: -0.0, 0.6; % diff for women: -0.2, 95% CI: -0.6, 0.2). Further controlling for unobserved confounders in the FE models did not change this non-significant difference between cohabiting and married individuals. The excess purchases of psychotropic medication among individuals living alone compared to those cohabiting decreased to 1.2 (95% CI: 1.0, 1.4) and 1.4 (95% CI: 1.1, 1.6) percentage-points in the fully-adjusted FE model for men and women, respectively. Similar results were found for all subcategories of psychotropic medication. In summary, these findings suggested that the mental health difference between cohabiting and married individuals, but not the difference between cohabiting individuals and those living alone, was largely due to selection.
  • Cable, Noriko; Chandola, Tarani; Lallukka, Tea; Sekine, Michikazu; Lahelma, Eero; Tatsuse, Takashi; Marmot, Michael G. (2016)
  • Junna, Liina; Moustgaard, Heta; Martikainen, Pekka (2022)
    Poor mental health among the unemployed-the long-term unemployed in particular-is established, but these associations may be driven by confounding from unobserved, time-invariant characteristics such as past experiences and personality. Using longitudinal register data on 2,720,431 residents aged 30-60 years, we assessed how current unemployment and unemployment history predict visits to specialized care due to psychiatric conditions and self-harm in Finland in 2008-2018. We used linear ordinary-least-squares and fixed-effects models. Prior to adjusting for time-invariant characteristics, current unemployment was associated with poor mental health, and the risk increased with longer unemployment histories. Accounting for all time-invariant characteristics with the fixed-effects models, these associations attenuated by approximately 70%, yet current unemployment was still associated with a 0.51 (95% confidence interval: 0.48, 0.53) percentage-point increase in the probability of poor mental health among men and women. Longer unemployment histories increased the probability among men in their 30s but not among older men or among women. The results indicate that selection by stable characteristics may explain a major part of the worse mental health among the unemployed and especially the long-term unemployed. However, even when controlling for this selection, current unemployment remains associated with mental health.
  • Edgren, Robert (Helsingfors universitet, 2015)
    Objectives: This thesis examined the relationship between disordered gambling (DG) with mental health, loneliness, perceived general health, risky alcohol consumption, tobacco smoking and computer gaming frequency by age and gender among adolescents and emerging adults. Gambling types were also examined for their association to DG, mental health, loneliness, perceived health, risky alcohol consumption and tobacco smoking. DG is conceptualized as a behavioural addiction, and its development is influenced by the availability of gambling opportunities, prevalence of other addictive behaviours, and psychological well-being. Previous studies have indicated that specific types of gambling are more strongly associated to DG that others. The purpose of the present study was to identify the strength of the various risk factors of disordered gambling, examine whether specific risk factors are associated to certain gambling types and if there are age and gender related differences in regards to the associations between disordered gambling and its risk factors. Methods: A cross-sectional population based random sample (n = 822, 49.3 % female) of individuals aged 15 to 28 from the self-reported Finnish Gambling Survey 2011 was utilized. DG was assessed with the Problem Gambling Severity Index, such that a score of 2 or more indicated DG. Mental health was measured with the five item Mental Health Inventory and risky alcohol consumption was assessed with the Alcohol Use Disorders Identification Test -Consumption. The remainder of examined variables were assessed with single Likert-scaled items. The correlates of DG and gambling types were examined with logistic regression models. Results and conclusions: Male gender, risky alcohol consumption, tobacco smoking, and frequently feeling lonely were significantly associated to DG. Slot machine gambling, online gambling other than poker, private betting, and casino betting were strongly associated to DG. The aforementioned gambling types were strongly associated to risky alcohol consumption and tobacco smoking along with sports betting. Feeling lonely was associated to online poker, casino betting and private betting. There were indications of gender differences in regards to the gambling types associated to feeling lonely. Risky alcohol consumption seemed to be a stronger risk factor for DG among males, and tobacco smoking stronger among females. Current findings warrant further investigation of DG in regards to loneliness, and reconsideration of national gambling policies.
  • Prescott, Susan L.; Hancock, Trevor; Bland, Jeffrey; van den Bosch, Matilda; Jansson, Janet K.; Johnson, Christine C.; Kondo, Michelle; Katz, David; Kort, Remco; Kozyrskyj, Anita; Logan, Alan C.; Lowry, Christopher A.; Nanan, Ralph; Poland, Blake; Robinson, Jake; Schroeck, Nicholas; Sinkkonen, Aki; Springmann, Marco; Wright, Robert O.; Wegienka, Ganesa (2019)
    inVIVO Planetary Health (inVIVO) is a progressive scientific movement providing evidence, advocacy, and inspiration to align the interests and vitality of people, place, and planet. Our goal is to transform personal and planetary health through awareness, attitudes, and actions, and a deeper understanding of how all systems are interconnected and interdependent. Here, we present the abstracts and proceedings of our 8th annual conference, held in Detroit, Michigan in May 2019, themed "From Challenges, to Opportunities". Our far-ranging discussions addressed the complex interdependent ecological challenges of advancing global urbanization, including the biopsychosocial interactions in our living environment on physical, mental, and spiritual wellbeing, together with the wider community and societal factors that govern these. We had a strong solutions focus, with diverse strategies spanning from urban-greening and renewal, nature-relatedness, nutritional ecology, planetary diets, and microbiome rewilding, through to initiatives for promoting resilience, positive emotional assets, traditional cultural narratives, creativity, art projects for personal and community health, and exploring ways of positively shifting mindsets and value systems. Our cross-sectoral agenda underscored the importance and global impact of local initiatives everywhere by contributing to new normative values as part of a global interconnected grass-roots movement for planetary health.
  • Talvitie, Emma (Helsingin yliopisto, 2018)
    Objectives: The unmet need in treatment utilization is a major public issue and therefore it is important to study factors associated with it. This study examines how intelligence, more specifically verbal intelligence, and transdiagnostic psychopathology are associated with treatment utilization and does socioeconomic status mediate these associations. Methods: The current study utilizes a vast cross-sectional data The Adult Psychiatric Morbidity Survey 2007 (APMS 2007). The study sample included 4,707 participants (56% women). The structure of psychopathology was first examined with series of confirmatory factor analysis (CFA). The associations of verbal IQ, psychopathology and socioeconomic status to treatment utilization were examined with series of structural equation models (SEM). Multiple imputation procedures were conducted to correct for any possible bias resulting from missing values and the abovementioned analyses were rerun with the imputed data (n=7,403). Results and Conclusions: The results showed comorbidity of mental disorders can be modelled with two latent transdiagnostic factors, namely internalization and externalization. Psychopathology, especially internalization, seems to be the best predictor of treatment utilization. This notion emphasizes the utility of transdiagnostic approach in examining those who seek treatment and further their utility in the context of mental health care.
  • Laine, Anna; Välimäki, Maritta; Pekurinen, Virve; Löyttyniemi, Eliisa; Marttunen, Mauri; Anttila, Minna (2019)
    Background: Web-based interventions are promising tools for increasing the understanding of illness and treatment among patients with serious mental disorders. Objective: This study aimed to test the feasibility and acceptability of a Web-based patient education intervention using a quasi-experimental cluster design to report feedback on patient education sessions and the website used and to report preliminary evidence of the intervention's impact on patients with schizophrenia spectrum disorder. Methods: A single-blind, parallel, quasi-experimental cluster study over a 6-month period comparing Web-based education (n=33) with a nonequivalent control group (treatment as usual, n=24) for people with schizophrenia spectrum disorder was conducted. Participants (N=57) were recruited from one psychiatric hospital (6 wards). Feasibility was assessed by participants' commitment (refusal rate, dropout rate) to the study. Acceptability was assessed as participants' commitment to the intervention. Patient education sessions and website feedback were assessed by the patients and health care professionals. The preliminary impact of the sessions on patients' self-efficacy, self-esteem, illness cognition, and knowledge level was measured at baseline and follow-ups (8 weeks, 6 months) with self-rated questionnaires. Results: The refusal rate among patients was high with no statistically significant difference (69% [74/107] in the intervention group, 76% [76/100] in the control group; P =.21). The same result was found for the dropout rates (48% [16/33] vs 58% [14/24]; P=. 46). The acceptability of the intervention was good; 31 participants out of 33 (94%) completed all five sessions. Feedback on the intervention was mainly positive; three out of four subscales of session were rated above the midpoint of 4.0. Feedback on the website was also positive, with a grade of good for content (69%, 20/29 patients; 75%, 21/28 professionals), layout (62%, 18/29 patients; 61%, 17/28 professionals), and usability (62%, 18/29 patients; and 68%, 19/28 professionals). The patients using the intervention had significantly higher scores 6 months after the sessions in self-efficacy (baseline mean 26.12, SD 5.64 vs 6-month mean 29.24, SD 6.05; P=.003) and regarding knowledge level about schizophrenia (mean 11.39, SD 4.65 vs 6-month mean 15.06, SD 5.26; P=. 002), and lower scores in the subscale of helplessness in illness cognition (mean 2.26, SD 0.96 vs 6-month mean 1.85, SD 0.59; P=.03). Differences from the control group were not significant. No differences were found in patients' self-esteem or other subscales in illness cognition. Conclusions: The patients were reluctant to participate in the study and tended to drop out before the follow-ups. Once they had participated, their acceptance of the intervention was high. A more effective recruitment strategy and monitoring method will be needed in future studies. To assess the impact of the intervention, a more rigorous study design with an adequately powered sample size will be used in cooperation with outpatient mental health services.
  • Holzinger, Brigitte; Nierwetberg, Franziska; Chung, Frances; Bolstad, Courtney J.; Bjorvatn, Bjorn; Chan, Ngan Yin; Dauvilliers, Yves; Espie, Colin A.; Han, Fang; Inoue, Yuichi; Leger, Damien; Macedo, Taina; Matsui, Kentaro; Merikanto, Ilona; Morin, Charles M.; Mota-Rolim, Sergio A.; Partinen, Markku; Plazzi, Giuseppe; Penzel, Thomas; Sieminski, Mariusz; Wing, Yun Kwok; Scarpelli, Serena; Nadorff, Michael R.; De Gennaro, Luigi (2022)
    Purpose: The COVID-19 pandemic affects mental health and sleep, resulting in frequent nightmares. Therefore, identifying factors associated with nightmare frequency is important, as it can indicate mental health issues. The study aimed to investigate increases in nightmare frequency comparing the pre-pandemic and pandemic period, and identify its risk factors. Further, the mediating role of post-traumatic stress disorder symptoms between the pandemic and nightmares is explored. Patients and Methods: For this cross-sectional survey data were obtained via self-rating online survey (ICOSS: details in Partinen et al, 2021), which was open to anyone older than 18 years. The final volunteer sample consisted of 15,292 participants, divided according to their nightmare frequency (high: >= 1-2 nights/week; low:
  • Buscariolli, Andre; Kouvonen, Anne Maria; Kokkinen, Lauri; Halonen, Jaana; Koskinen, Aki; Väänänen, Ari (2018)
    Objectives To examine antidepressant use among male and female human service professionals. Methods A random sample of individuals between 25 years and 54 years of age (n=752 683; 49.2% women; mean age 39.5 years). Information about each individual’s filled antidepressant prescriptions from 1995 to 2014 was provided by the Social Insurance Institution. First, antidepressant use in five broad human service categories was compared with that in all other occupations grouped together, separately for men and women. Then, each of the 15 human service professions were compared with all other occupations from the same skill/education level (excluding other human services professions). Cox models were applied and the results are presented as HRs for antidepressant use with 95% CIs. Results The hazard of antidepressant use was higher among men working in human service versus all other occupations with the same skill/occupational level (1.22, 95% CI 1.18 to 1.27), but this was not the case for women (0.99, 95% CI 0.98 to 1.01). The risks differed between professions: male health and social care professionals (including medical doctors, nurses, practical nurses and home care assistants), social workers, childcare workers, teachers and psychologists had a higher risk of antidepressant use than men in non-human service occupations, whereas customer clerks had a lower risk. Conclusions Male human service professionals had a higher risk of antidepressant use than men working in non-human service occupations. Gendered sociocultural norms and values related to specific occupations as well as occupational selection may be the cause of the elevated risk.