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  • Yazdani, Reza (2009)
    The aim of the present study was to assess dental health and its determinants among 15-year-olds in Tehran, Iran and to evaluate the impact of a school-based educational intervention on their oral cleanliness and gingival health. The total sample comprised 506 students. Data collection was performed through a clinical dental examination and a self-administered structured questionnaire. This questionnaire covered the student s background information, socio-economic status, self-perceived dental health, tooth-brushing, and smoking. The clinical dental examination covered caries experience, gingival status, dental plaque status, and orthodontic treatment needs. Participation was voluntary, and all students responded to the questionnaire. Only three students refused the clinical dental examination. The intervention was based on exposing students to dental health education through a leaflet and a videotape designed for the present study. The outcome examinations took place 12 weeks after the baseline among the three groups of the intervention trial (leaflet, videotape, and control). High participation rates at the baseline and scanty drop-outs (7%) in the intervention speak for reliability of the results. Mean value of the DMFT (D=decayed, M=missing, and F=filled teeth) index of the 15-year-olds was 2.1, which comprised DT=0.9, MT=0.2, and FT=1.0 with no gender differences. Dental plaque existed on at least one index tooth of all students, and healthy periodontium (Community Periodontal Index=0) was found in less than 10% of students. Need for caries treatment existed in 40% of students, for scaling in 24%, for oral hygiene instructions in all, and for orthodontic treatment in 26%. Students with the highest level of parents education had fewer dental caries (36% vs. 48%) and less dental plaque (77% vs. 88%). Of all students, 78% assessed their dental health as good or better. Even more of those with their DMFT=0 (73% vs. 27%) and DT=0 (68% vs. 32%) assessed their dental health as good or better. Smokers comprised 5% of the boys and 2% of the girls. Smoking was common among students of less-educated parents (6% vs. 3%). Of all students, 26% reported twice-daily tooth-brushing; girls (38% vs. 15%) and those of higher socio-economic background (33% vs. 17%) did so more frequently. The best predictors for a good level of oral cleanliness were female gender or twice-daily tooth-brushing. The present study demonstrated that a school-based educational intervention can be effective in the short term in improving the oral cleanliness and gingival health of adolescents. At least 50% reduction in numbers of teeth with dental plaque compared to baseline was achieved by 58% of the students in the leaflet group, by 37% in the videotape group, and by 10% of the controls. Corresponding figures for gingival bleeding were 72%, 64%, and 30%. For improving the oral cleanliness and gingival health of adolescents in countries such as Iran with a developing oral health system, school-based educational intervention should be established with focus on oral self-care and oral health education messages. Emphasizing the immediate gains from good oral hygiene, such as fresh breath, clean teeth, and attractive appearance should be key aspects for motivating these adolescents to learn and maintain good dental health, whilst in planning school-based dental health intervention, special attention should be given to boys and those with lower socio-economic status. Author s address: Reza Yazdani, Department of Oral Public Health, Institute of Dentistry, University of Helsinki, P.O. Box 41, FI-00014 Helsinki, Finland. E-mail: reza.yazdani@helsinki.fi
  • Varkkola, Olli (Helsingin yliopisto, 2011)
    Tsunami waves of the Sumatra-Andaman earthquake on 26 December 2004 claimed approximately 230 000 lives and started the biggest identification operation in Interpol's history. The aim of this study was to resolve methods of the identification and results received. The viewpoint is mainly that of forensic odontology, but also includes other means of identification and results of the medico-legal examination performed in Finland. Of the 5395 victims in Thailand, approximately 2 400 were foreigners from 36 nations including 177 Finnish nationals. Additionally, a Finnish woman perished in Sri Lanka and a severely injured man after the evacuation in a hospital. The final numbers of missing persons and dead bodies registered in the Information Management Centre in Phuket,Thailand, were 3 574 ante-mortem (AM) and 3 681 post-mortem (PM) files. The number of identifications by December 2006 was 3 271 or 89% of the victims registered. Of Finnish victims, 172 have been identified in Thailand and 163 repatriated to Finland. One adult and four children are still missing. For AM data, a list of Finnish missing persons including 178 names was published on 30 December 2004. By February 2005 all useful dental AM data were available. Five persons on the list living in Finland lacked records. Based on the AM database, for the children under age 18 years (n=60) dental identification could be established for 12 (20%). The estimated number for adults (n=112) was 96 (86%). The final identification rate, based on PM examinations in Finland, was 14 (25%) for children (n= 56) and 98 (90%) for adults (n= 109). The number of Finnish victims identified by dental methods, 112 (68%), was high compared to all examined in Thailand (43%). DNA was applied for 26 Finnish children and for 6 adults, fingerprints for 24 and 7, respectively. In 12 cases two methods were applied. Every victim (n=165) underwent in Finland a medico-legal investigation including an autopsy with sampling specimens for DNA, the toxicological and histological investigation. Digital radiographs and computed tomography were taken of the whole body to verify autopsy findings and bring out changes caused by trauma, autolysis, and sampling for DNA in Thailand. Data for identification purposes were also noted. Submersion was the cause of death for 101 of 109 adults (92.7%), and trauma for 8 (7.3%). Injuries were 33 times contributing factors for submersion and 3 times for trauma-based death. Submersion was the cause of death for 51 (92.7%) children and trauma for 4 (7.3%). Injuries were in 3 cases contributing factors in submersion and once in trauma-based death. The success of the dental identification of Finnish victims is mainly based on careful registration of dental records, and on an education program from 1999 in forensic odontology.
  • Nguyen, Lien (Helsingin yliopisto, 2008)
    This thesis is grounded on four articles. Article I generally examines the factors affecting dental service utilization. Article II studies the factors associated with sector-specific utilization among young adults entitled to age-based subsidized dental care. Article III explores the determinants of dental ill-health as measured by the occurrence of caries and the relationship between dental ill-health and dental care use. Article IV measures and explains income-related inequality in utilization. Data employed were from the 1996 Finnish Health Care Survey (I, II, IV) and the 1997 follow-up study included in the longitudinal study of the Northern Finland 1966 Birth Cohort (III). Utilization is considered as a multi-stage decision-making process and measured as the number of visits to the dentist. Modified count data models and concentration and horizontal equity indices were applied. Dentist s recall appeared very efficient at stimulating individuals to seek care. Dental pain, recall, and the low number of missing teeth positively affected utilization. Public subvention for dental care did not seem to statistically increase utilization. Among young adults, a perception of insufficient public service availability and recall were positively associated with the choice of a private dentist, whereas income and dentist density were positively associated with the number of visits to private dentists. Among cohort females, factors increasing caries were body mass index and intake of alcohol, sugar, and soft drinks and those reducing caries were birth weight and adolescent school achievement. Among cohort males, caries was positively related to the metropolitan residence and negatively related to healthy diet and education. Smoking increased caries, whereas regular teeth brushing, regular dental attendance and dental care use decreased caries. We found equity in young adults utilization but pro-rich inequity in the total number of visits to all dentists and in the probability of visiting a dentist for the whole sample. We observed inequity in the total number of visits to the dentist and in the probability of visiting a dentist, being pro-poor for public care but pro-rich for private care. The findings suggest that to enhance equal access to and use of dental care across population and income groups, attention should focus on supply factors and incentives to encourage people to contact dentists more often. Lowering co-payments and service fees and improving public availability would likely increase service use in both sectors. To attain favorable oral health, appropriate policies aimed at improving dental health education and reducing the detrimental effects of common risk factors on dental health should be strengthened. Providing equal access with respect to need for all people ought to take account of the segmentation of the service system, with its two parallel delivery systems and different supplier incentives to patients and dentists.
  • Byskata, Stig-Göran (1980)
  • Lindholm, Erika (2014)
    Erikas abstrakt-2-2.pdf
  • Tervanotko, Hanna (Bookwell, 2013)
    The task of this study is twofold. First, it aims to analyze the treatment and the development of the figure of Miriam as a literary character in ancient Jewish texts by taking into account all the references to this figure preserved in the ancient Jewish literature from the exilic period to the early second century C.E.: Exodus 15:20-21, Numbers 12:1-15; 20:1; 26:59, Deuteronomy 24:8-9, 1 Chronicles 5:29, Micah 6:4, the Septuagint, the Dead Sea Scrolls (4Q365 6 II, 1-7; 4Q377 2 I, 9; 4Q543 1 I, 6 = 4Q545 1 I, 5; 4Q546 12, 4; 4Q547 4 I, 10; 4Q549 2, 8), Jubilees 47:4, Ezekiel the Tragedian 18, Demetrius Chronographer frag. 3, texts by Philo of Alexandria: De vita contemplativa 87; Legum allegoriae 1.76; 2.66-67; 3.103; De agricultura 80-81; Liber antiquitatum biblicarum 9:10; 20:8, and finally texts by Josephus: Antiquitates judaicae 2.221; 3.54; 3.105; 4.78. The passages referring to Miriam demonstrate that the picture of Miriam preserved in the ancient Jewish texts is richer than the Hebrew Bible suggests. Her function extends beyond the household-responsibility role that is often assigned to women in antiquity. The peak of Miriam traditions falls to the 3rd and 2nd centuries B.C.E. when this figure was used to promote the family of Levi. After this period, the figure of Miriam lost, at least partly, her prominence, and she became the target of different interpretations. She did not fit into the ideal of a woman in the Roman era, and she became more marginalized in a number of texts. Second, in light of poststructuralist literary studies that treat texts as reflections of specific social situations, I argue that the treatment of Miriam in ancient Jewish literature mostly reflects a reality in which women had little space as active agents. In particular, the interpretation of Miriam in the Greco-Roman era shows that when the political goals in the texts are emphasized, the room for women gets narrower. Despite this general tendency, prominent women may have enjoyed occasional freedom. Miriam continues to be given the title prophetess during the Greco-Roman era. That demonstrates that female prophecy was a known phenomenon even in a context that generally downplayed women.
  • Stevanovic, Melisa (Helsingin yliopisto, 2013)
    This dissertation describes people s orientations to "deontic rights" -that is, their rights to determine actions. Through analyses of video-recorded church workplace meetings between pastors and cantors as data, and conversation analysis as a theoretical and methodological framework, the study examines how participants in interaction may establish their own and each other s deontic rights in the turn-by-turn sequential unfolding of interaction. The dissertation consists of six original articles and an introduction, which introduces the central concepts of the study, provides an overview of its results, and discusses the ways in which the study contributes to the existing knowledge of social interaction. The study considers deontic rights from two different angles. First, it describes how participants in interaction may claim or mitigate their claims of deontic rights by virtue of their overt interactional conduct: Article 1 discusses the participants ways of dealing with those claims of deontic rights that arise from their participation in an encounter, and Articles 2 4 consider how participants in joint decision making may establish and maintain the symmetrical distribution of deontic rights at different sequential loci. Second, the study describes the ways in which participants may deploy their deontic rights as interactional resources, as they design their communicative actions so as to be recognizable as such. The central argument presented in Articles 5 and 6 is that, instead of always needing to claim their deontic rights (deontic stance), participants may also trust in their co-participants being aware of, and taking into account, these rights (deontic status). It is thus the complementarity and relative weight of deontic stances and deontic statuses that constitutes a fundamental mechanism by which people may engage in tough power negotiations without yet causing any overt face threats to their mutual solidarity. The study highlights the significance of face-to-face interaction as a locus of social order and seeks to enhance our understanding of the linkages between the local and wider aspects of social organization that pertain to people s interactional conduct.
  • Kangasniemi, Heikki (1986)
  • Koskinen, Arja (1992)
  • Nurmi, Ville (Helsingin yliopisto, 2009)
    This thesis is a study of a rather new logic called dependence logic and its closure under classical negation, team logic. In this thesis, dependence logic is investigated from several aspects. Some rules are presented for quantifier swapping in dependence logic and team logic. Such rules are among the basic tools one must be familiar with in order to gain the required intuition for using the logic for practical purposes. The thesis compares Ehrenfeucht-Fraïssé (EF) games of first order logic and dependence logic and defines a third EF game that characterises a mixed case where first order formulas are measured in the formula rank of dependence logic. The thesis contains detailed proofs of several translations between dependence logic, team logic, second order logic and its existential fragment. Translations are useful for showing relationships between the expressive powers of logics. Also, by inspecting the form of the translated formulas, one can see how an aspect of one logic can be expressed in the other logic. The thesis makes preliminary investigations into proof theory of dependence logic. Attempts focus on finding a complete proof system for a modest yet nontrivial fragment of dependence logic. A key problem is identified and addressed in adapting a known proof system of classical propositional logic to become a proof system for the fragment, namely that the rule of contraction is needed but is unsound in its unrestricted form. A proof system is suggested for the fragment and its completeness conjectured. Finally, the thesis investigates the very foundation of dependence logic. An alternative semantics called 1-semantics is suggested for the syntax of dependence logic. There are several key differences between 1-semantics and other semantics of dependence logic. 1-semantics is derived from first order semantics by a natural type shift. Therefore 1-semantics reflects an established semantics in a coherent manner. Negation in 1-semantics is a semantic operation and satisfies the law of excluded middle. A translation is provided from unrestricted formulas of existential second order logic into 1-semantics. Also game theoretic semantics are considerd in the light of 1-semantics.
  • Khan, Md. Anichul Hoque (2000)
    This paper consists both theoretical and empirical views of various features of the deposit insurance scheme/system (DIS) and its impact on likelihood of banking crises. There are hypothetical views of different kinds of features of the DIS that can have impact on banking sector fragility. On the basis of available and reliable observations the study has empirically tested four features effect on probability of banking crises. These are, 1) the presence of explicit DIS instead of implicit one, 2) the presence of voluntary membership system for the banks in the explicit DIS instead of compulsory membership system, 3) the presence of governmental administration in the explicit DIS instead of private or joint administration, and 4) the presence of ex ante funding in the explicit DIS instead of funding under ex post assessment when a bankruptcy takes place. The panel data includes both the industrial and developing countries for the period of 1980-1995 and the econometric model is a multivariate logit model (and in some case the probit model). The results suggest that the presence of an explicit DIS in a country has positive association with the likelihood of banking crises. When the study is limited only in explicit DIS countries, the presence of a voluntary membership system, instead of compulsory membership, tends to increase the banking crisis probability at 10% significance level. The presence of a governmental administration in a country using the explicit DIS, instead of a private or joint administration, is also positively associated with the banking sector fragility (at 5% significance level). The funding feature (ex ante or ex post) in explicit DIS countries is found insignificant when the standard errors are calculated in the traditional way without country and yearly fixed effects. It is significant at 10% level when the logit model is estimated with only fixed yearly effects. The similar model separating the panel data between industrial and developing countries is also estimated. None of the above features are significant for industrial countries. In the case of developing countries the presence of explicit DIS is significant at 1% level having positive association with the likelihood of banking crises, but other feature variables are not significant.
  • Grönholm, Tiia (Helsingin yliopisto, 2012)
    Dry and wet deposition are removal mechanisms of atmospheric aerosol particles. Historically, there are very scarce scientic publications reporting experimentally determined dry deposition values for the ultra-fine size range. The physics of deposition is studied both using micrometeorological field measurements conducted at SMEAR II site in Hyytiälä, Southern Finland and by modeling approaches. Dry deposition velocity depends mainly on particle size and magnitude of the atmospheric surface layer turbulence. We present experimentally determined dry deposition velocity (vd) as a function of particle size for the ultra- fine aerosol size range (10 - 150 nm) using relaxed eddy accumulation and eddy-covariance (EC) methods accompanied by particle number size distribution measurements. The highest vd was found for 10 nm particles and in all size classes vd increased with increasing friction velocity. By combining two-layer (above and sub-canopy) EC measurements and a new multi-layer canopy deposition model, we addressed how dry deposition is distributed within the forest canopy and between the canopy and the underlying ground. According to the measurements, about 20 - 30 % of particles penetrated the canopy and deposited on the forest floor. The model results showed that turbophoresis, when accounted for at the leaf scale in vertically resolved models, could increase vd for 0.1 - 2 nm particles and explain why the observations over forests generally do not support the pronounced minimum of deposition velocity for particles of that size. The developed multi-layer model was further used to study the effect of canopy structure (leaf-area shape and density) on vd. Scavenging coefficients for rain and snow deposition were calculated based on measurements of particle size distribution and precipitation. Parameterizations for both rain and snow wet deposition were derived for example to be applied in air quality and global models. Also a model including both in-cloud and below cloud wet deposition was developed and compared to the field measurements. Both snow and rain scavenging efficiency increased with increasing precipitation intensity. We also found, that the effectiveness of snow scavenging depends on the crystal or snow flake structure and the air relative humidity. Wet deposition was found to be an order of magnitude more effective "air cleaner" compared to dry deposition.
  • Paile-Hyvärinen, Maria (Helsingin yliopisto, 2011)
    Background: Type 2 diabetes is linked to several complications which add to both physical and mental distress. Depression is a common co-morbidity of diabetes which can occur both as a cause and a consequence of type 2 diabetes. Depression has been shown to correlate with glucose regulation and treating depression might prove beneficial for glucose regulation as well as for mental well being. Another complication which might affect diabetes management is cognitive decline. Several risk factors and complications of diabetes might modify the risk for developing cognitive impairment, which is increased 1.5 times among subjects with type 2 diabetes. Type 2 diabetes, depression and impaired cognitive performance have all been linked to low birth weight. This thesis aimed to explore the effects and interactions of birth weight, depression and cognitive ability in relation to type 2 diabetes from a life course perspective. Subjects and methods: Studies I, II and V were part of the Helsinki Birth Cohort Study. 2003 subjects participated in an extensive clinical examination at an average age of 61 years. A standard glucose tolerance test (OGTT) was performed and depressive symptoms were assessed using the Beck Depression Inventory (BDI). In addition data was obtained from child welfare clinics and national registers. A subset of the cohort (n=1247) also performed a test on cognitive performance (CogState ®) at the average age of 64. Studies III and IV were randomised clinical trials where mildly depressed diabetic subjects were treated with paroxetine or placebo and the effect on metabolic parameters and quality of life was assessed. The first trial included 14 women and lasted 10 weeks, while the second trial included 43 subjects, both men and women, and lasted 6 months. Results: Type 2 diabetes was positively associated with the occurrence of depressive symptoms. Among diabetic subjects 23.6% had depressive symptoms, compared to 16.7% of subjects with normal glucose tolerance (OR = 1.77, p<0.001). Formal mediation analysis revealed that cardiovascular disease (CVD) is likely to act as a mediator in the association. Furthermore, low birth weight was found to modify the association between type 2 diabetes, CVD and depression. The association between BDI score and having type 2 diabetes or CVD was twice as strong in the subgroup with low birth weight (≤ 2500g) compared with the group with birth weight > 2500g (p for interaction 0.058). In the six months long randomised clinical trial (study IV) paroxetine had a transient beneficial effect on glycosylated haemoglobin A1c (GHbA1c) and quality of life when compared to placebo after three months of treatment. In study V we found that subjects with known diabetes had a consistently poorer level of cognitive performance than subjects with normal glucose tolerance in most of the tested cognitive domains. This effect was further amplified among those born with a small birth weight (p for interaction 0.002). Conclusions: Type 2 diabetes is associated with a higher occurrence of depressive symptoms compared to subjects with normal glucose tolerance. This association is especially strong among subjects with CVD and those born with a low birth weight. Treating depressed diabetic subjects with paroxetine has no long term effect on glucose regulation. Physicians should be aware of depression as an important co-morbidity of type 2 diabetes. Both depression and the cognitive decline often seen among diabetic subjects are increased if the subject is born with a low birth weight. Physicians should recognise low birth weight as an additional risk factor and modifier of diabetic complications.
  • Vataja, Risto (Helsingin yliopisto, 2005)
  • Berg, Anu (Helsingin yliopisto, 2010)
    Approximately one-third of stroke patients experience depression. Stroke also has a profound effect on the lives of caregivers of stroke survivors. However, depression in this latter population has received little attention. In this study the objectives were to determine which factors are associated with and can be used to predict depression at different points in time after stroke; to compare different depression assessment methods among stroke patients; and to determine the prevalence, course and associated factors of depression among the caregivers of stroke patients. A total of 100 consecutive hospital-admitted patients no older than 70 years of age were followed for 18 months after having their first ischaemic stroke. Depression was assessed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R), Beck Depression Inventory (BDI), Hamilton Rating Scale (HRSD), Visual Analogue Mood Scale (VAMS), Clinical Global Impression (CGI) and caregiver ratings. Neurological assessments and a comprehensive neuropsychological test battery were performed. Depression in caregivers was assessed by BDI. Depressive symptoms had early onsets in most cases. Mild depressive symptoms were often persistent with little change during the 18-month follow-up, although there was an increase in major depression over the same time interval. Stroke severity was associated with depression especially from 6 to 12 months post-stroke. At the acute phase, older patients were at higher risk of depression, and a higher proportion of men were depressed at 18 months post-stroke. Of the various depression assessment methods, none stood clearly apart from the others. The feasibility of each did not differ greatly, but prevalence rates differed widely according to the different criteria. When compared against DSM-III-R criteria, sensitivity and specificity were acceptable for the CGI, BDI, and HRSD. The CGI and BDI had better sensitivity than the more specific HRSD. The VAMS seemed not to be a reliable method for assessing depression among stroke patients. The caregivers often rated patients depression as more severe than did the patients themselves. Moreover, their ratings seemed to be influenced by their own depression. Of the caregivers, 30-33% were depressed. At the acute phase, caregiver depression was associated with the severity of the stroke and the older age of the patient. The best predictor of caregiver depression at later follow-up was caregiver depression at the acute phase. The results suggest that depression should be assessed during the early post-stroke period and that the follow-up of those at risk of poor emotional outcome should be extended beyond the first year post-stroke. Further, the assessment of well-being of the caregivers of stroke patients should be included as a part of a rehabilitation plan for stroke patients.
  • Jylhä, Pekka (Kansanterveyslaitos, 2008)
    This study is part of the Mood Disorders Project conducted by the Department of Mental Health and Alcohol Research, National Public Health Institute, and consists of a general population survey sample and a major depressive disorder (MDD) patient cohort from Vantaa Depression Study (VDS). The general population survey study was conducted in 2003 in the cities of Espoo and Vantaa. The VDS is a collaborative depression research project between the Department of Mental Health and Alcohol Research of the National Public Health Institute and the Department of Psychiatry of the Peijas Medical Care District (PMCD) beginning in 1997. It is a prospective, naturalistic cohort study of 269 secondary-level care psychiatric out- and inpatients with a new episode of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) MDD. In the general population survey study, a total of 900 participants (300 from Espoo, 600 from Vantaa) aged 20 70 years were randomly drawn from the Population Register Centre in Finland. A self-report booklet, including the Eysenck Personality Inventory (EPI), the Temperament and Character Inventory Revised (TCI-R), the Beck Depression Inventory and the Beck Anxiety Inventory was mailed to all subjects. Altogether 441 participants responded (94 returned only the shortened version without TCI-R) and gave their informed consent. VDS involved screening all patients aged 20-60 years (n=806) in the PMCD for a possible new episode of DSM-IV MDD. 542 consenting patients were interviewed with a semi-structured interview (the WHO Schedules for Clinical Assessment in Neuropsychiatry, version 2.0). 269 patients with a current DSM-IV MDD were included in the study and further interviewed with semi-structured interviews to assess all other axis I and II psychiatric diagnoses. Exclusion criteria were DSM-IV bipolar I and II, schizoaffective disorder, schizophrenia or another psychosis, organic and substance-induced mood disorders. In the present study are included those 193 (139 females, 54 males) individuals who could be followed up at both 6 and 18 months, and their depression had remained unipolar. Personality was investigated with the EPI. Personality dimensions associated not only to the symptoms of depression, but also to the symptoms of anxiety among general population and in depressive patients, as well as to comorbid disorders in MDD patients, supporting the dimensional view of depression and anxiety. Among the general population High Harm Avoidance and low Self-Directedness associated moderately, whereas low extraversion and high neuroticism strongly with the depressive and anxiety symptoms. The personality dimensions, especially high Harm Avoidance, low Self-Directedness and high neuroticism were also somewhat predictive of self-reported use of health care services for psychiatric reasons, and lifetime mental disorder. Moreover, high Harm Avoidance associated with a family history of mental disorder. In depressive patients, neuroticism scores were found to decline markedly and extraversion scores to increase somewhat with recovery. The predictive value of the changes in symptoms of depression and anxiety in explaining follow-up neuroticism was about 1/3 of that of baseline neuroticism. In contrast to neuroticism, the scores of extraversion showed no dependence on the symptoms of anxiety, and the change in the symptoms of depression explained only 1/20 of the follow-up extraversion compared with baseline extraversion. No evidence was found of the scar effect during a one-year follow-up period. Finally, even after controlling for symptoms of both depression and anxiety, depressive patients had a somewhat higher level of neuroticism (odds ratio 1.11, p=0.001) and a slightly lower level of extraversion (odds ratio 0.92, p=0.003) than subjects in the general population. Among MDD patients, a positive dose-exposure relationship appeared to exist between neuroticism and prevalence and number of comorbid axis I and II disorders. A negative relationship existed between level of extraversion and prevalence of comorbid social phobia and cluster C personality disorders. Personality dimensions are associated with the symptoms of depression and anxiety. Futhermore these findings support the hypothesis that high neuroticism and somewhat low extraversion might be vulnerability factors for MDD, and that high neuroticism and low extraversion predispose to comorbid axis I and II disorders among patients with MDD.