Nuorena vanhemmaksi tulemista ja raskaudenkeskeytystä ennustavat lapsuusiän tekijät

Tämän tutkimuksen tavoitteena oli tutkia kahdeksan vuoden iässä arvioitujen perhetekijöiden, psyykkisten oireiden ja kiusaamiskäyttäytymisen yhteyttä äidiksi tulemiseen alle 20-vuotiaana, isäksi tulemiseen alle 22-vuotiaana ja raskaudenkeskeytyksen tekemiseen alle 29-vuotiaana. Tutkimus perustui suomalaiseen LAPSET-kohorttiin, joka on yleisväestöotos (n=5813) vuonna 1981 syntyneistä henkilöistä. Vuonna 1989 tutkittavat sekä heidän vanhempansa ja opettajansa vastasivat psyykkistä oireilua ja kiusaamista koskeviin kyselyihin. Vanhemmat antoivat tietoa myös perhetekijöistä ja opettajat koulumenestyksestä. Tiedot tyttöjen (n=2694, 94 % osallistuneista tytöistä) synnytyksistä ja raskaudenkeskeytyksistä kerättiin hoitoilmoitusrekisteristä ja raskaudenkeskeyttämisrekisteristä. Poikien (n=2721, 92 % osallistuneista pojista) osalta nuorena isäksi tuleminen selvitettiin väestötietojärjestelmästä. Nuorten äitien tyttäret tulivat vanhempien äitien tyttäriä todennäköisemmin nuorena äidiksi ja nuorten isien pojat nuorena isäksi. Matalasti koulutettujen äitien pojilla oli kohonnut todennäköisyys nuorena isäksi tulemiseen ja tyttärillä raskaudenkeskeytykseen. Muu kuin kahden biologisen vanhemman muodostama perherakenne oli yhteydessä nuorena äidiksi tulemiseen ja raskaudenkeskeytykseen. Lapsuuden käytösongelmat olivat yhteydessä nuorena vanhemmaksi tulemiseen sekä raskaudenkeskeytykseen. Ylivilkkaus oli yhteydessä nuorena äidiksi tulemiseen. Tytöistä ne, jotka olivat kiusaajia tai kiusaaja-kiusattuja, tulivat todennäköisimmin nuorena äidiksi ja pojista kiusaaja-kiusatut nuorena isäksi. Kiusaaminen ei ollut yhteydessä raskaudenkeskeytyksen tekemiseen. Tutkimustuloksia voidaan hyödyntää terveydenhuollossa kohdattaessa nuoria vanhempia ja muita nuoria. Lisäksi niillä voi olla merkitystä esimerkiksi suunniteltaessa toimenpiteitä, joiden tavoitteena on nuorten epätoivottujen raskauksien ehkäiseminen.The aim of this study was to examine associations between family factors, psychiatric symptoms and bullying behaviour measured at age eight and becoming a mother under the age of 20, becoming a father under the age of 22 and having an abortion under the age of 29. The study was based on the Finnish 1981 Birth Cohort, which is a general population based birth cohort (n=5813) of Finnish people who were born in 1981. In 1989 the participants as well as their parents and teachers completed questionnaires on psychiatric symptoms and bullying. Parents also gave information about family factors and teachers about school performance. For girls (n=2694, 94% of the female participants), information about deliveries and abortions was collected from the Finnish Hospital Discharge Register and the Register on Induced Abortions and Sterilisations. For boys (n=2721, 92% of the male participants), information about becoming a father was collected from the Finnish Population Information System. The daughters of young mothers had an increased likelihood of becoming young mothers and the sons of young fathers had an increased likelihood of becoming young fathers. Compared with the children of high-educated mothers, the sons of loweducated mothers became more often young fathers and the daughters of low-educated mothers were more likely to have an abortion. Family structure other than two biological parents was associated with becoming a young mother and having an abortion. Childhood conduct problems were associated with becoming a young parent as well as having an abortion. Hyperactivity was associated with becoming a young mother. Girls, who were bullies or bully-victims and boys, who were bully-victims were most likely to become young parents. Bullying behaviour was not associated with having an abortion. The findings could be taken into account in clinical work with young parents and other young people. They may also have implications in developing interventions for the prevention of unwanted pregnancies.Siirretty Doriast

Mielenterveystyöhön tarvitaan kulttuurista osaamista

Maahanmuuttajan psykiatrinen arvio edellyttää kulttuurista ¬osaamista myös terveydenhuoltojärjestelmältä. Alkuun pääsee kuuntelemalla tarkasti ja suhtautumalla potilaaseen yksilönä eikä esimerkiksi tietyn etnisen ryhmän edustajana

The assessment of traumatized refugees : clinical practices at the Cultural Psychiatry Outpatient Clinic

Peer reviewe

Katsaus: Maahanmuuttajien mielenterveyspalvelujen käyttö, erot kantaväestöihin ja erojen taustatekijät

Peer reviewe

Parental immigration and offspring post-traumatic stress disorder : A nationwide population-based register study

Objectives: The aim of this study was to investigate the association between parental immigration status and a diagnosis of post-traumatic stress disorder (PTSD) in their offspring. Methods: This nested matched case-control study was based on a Finnish national birth cohort for 1987-2010 and cases were diagnosed with PTSD by 2012 from the Care Register for Health Care. We identified 3639 cases and 14,434 controls individually matched for gender, place and date of birth ( +/- 30 days). Conditional logistic regression analyses were conducted to examine the association between parental immigration status, parents' region of birth and time since paternal immigration, and PTSD after controlling for confounding factors. Results: The likelihood of being diagnosed with PTSD was significantly increased among children with an immigrant father (OR 1.8, 95% CI 1.3 - 2.4) than those with two Finnish parents and one immigrant mother. There was no significant association between having an immigrant mother or two immigrant parents and receiving a diagnosis of PTSD. The likelihood of being diagnosed with PTSD was increased if the children's fathers had migrated less than five years before their birth (OR 1.4, 95% CI 1.03 - 1.9) and if their immigrant fathers had been born in North Africa or the Middle East (OR 2.1, 95% CI 1.4 - 3.3). Limitations: The sample included a heterogeneous migrant group without information on the reason for migration. The cases were identified from hospital diagnosis that may have only included severe cases. Conclusion: The increased likelihood of a diagnosis of PTSD underlines the need for psychosocial services among second-generation immigrants.Peer reviewe

Depression and anxiety disorders among immigrants living in Finland: Comorbidity and mental health service use

Background: The aims of this study were to (1) compare differences in psychiatric comorbidity of depression and anxiety disorders between immigrants and native Finns and to (2) compare differences in the intensity of psychiatric care received by different immigrant groups and Finnish-born controls with depression and/or anxiety disorders. Methods: The study uses registered-based data, which includes all immigrants living in Finland at the end of 2010 and matched Finnish-born controls. For this study, we selected individuals who had received a diagnosis of depression and/or an anxiety disorder during the follow-up (2011?2015) (immigrants n = 6542, Finnish-born controls n = 9281). We compared differences in comorbidity between the immigrants and the Finnish-born controls using chi-squared tests. Multinomial logistic regression was used to predict psychiatric treatment intensity by immigrant status, region of origin, and other background factors. Results: In both diagnosis groups, Finnish-born participants exhibited greater comorbidity of other psychiatric disorders. Immigrants more often received lower intensity treatment and less often higher intensity treatment. These differences were most striking among those from Eastern Europe, the Middle East, and Africa. Limitations: We did not have the information on the perceived need for the services, which limits us from drawing further conclusions about the mechanisms behind the observed patterns. Conclusions: Immigrants in Finland receive less intensive treatment for depression and anxiety disorders compared to the Finnish-born population. Since lower symptom levels can unlikely alone explain these differences, they could reflect a need for improvement in the psychiatric services for immigrants.Peer reviewe

Finnish-born children of immigrants are more likely to be diagnosed with developmental disorders related to speech and language, academic skills and coordination

Aim: We examined the association between having at least one parent born abroad and being diagnosed with a developmental disorder related to speech and language, academic skills or coordination. Methods: This nested case–control study was based on Finnish population records for 1996–2007. Cases from the Finnish Hospital Discharge Register were diagnosed with developmental disorders of speech and language, academic skills and coordination by the end of 2012. We identified 28 192 cases and 106 616 matched controls. Results: Children were more likely to be diagnosed with developmental disorders if they had an immigrant mother than children with two Finnish‐born parents, with an adjusted odds ratio (aOR) of 1.3 and 95% confidence interval (95% CI) of 1.2–1.4, an immigrant father (aOR 1.2, 95% CI 1.1–1.3) or two immigrant parents (aOR 1.5, 95% CI 1.3–1.6). The level of development of the parental country of origin was not associated with receiving a diagnosis. Conclusion: Children of immigrant parents were more likely to be diagnosed with developmental disorders and the association was strongest with regard to speech and language disorders. There were similar adjusted odds ratios for mothers, fathers and both parents. The development level of the country of origin was irrelevant.</p

Immigrants’ mental health service use compared to that of native Finns: a register study

Purpose Many aspects related to migration might predispose immigrants to mental health problems. Yet immigrants have been shown to underuse mental health services. The aim of this study was to compare the intensity of psychiatric care, as an indicator of treatment adequacy, between natives and immigrants living in Finland. Methods We used nationwide register data that included all the immigrants living in Finland at the end of 2010 (n = 185,605) and their matched controls. Only those who had used mental health services were included in the analyses (n = 14,285). We used multinomial logistic regression to predict the categorized treatment intensity by immigrant status, region and country of origin, length of residence, and other background variables. Results Immigrants used mental health services less than Finnish controls and with lower intensity. The length of residence in Finland increased the probability of higher treatment intensity. Immigrants from Eastern Europe, sub-Saharan Africa, the Middle East, and Northern Africa were at the highest risk of receiving low-intensity treatment. Conclusions Some immigrant groups seem to persistently receive less psychiatric treatment than Finnish-born controls. Identification of these groups is important and future research is needed to determine the mechanisms behind these patterns.Peer reviewe