Lifetime psychiatric diagnoses among adolescents with severe conduct problems-A register-based follow-up study

Background: Both delinquency and out-of-home care (OOHC) are associated with a wide spectrum of psychiatric disorders. Reform schools (RS) are Finnish OOHC institutions for adolescents with severe conduct problems. Objective: We investigated the prevalence of psychiatric diagnoses among individuals with a history of RS placement. Participants and setting: The data consisted of individuals placed in a RS on the last day of the years 1991, 1996, 2001, 2006 or 2011 (N = 1074) and a matched comparison group (N = 5313). Methods: Information on lifetime psychiatric diagnoses, grouped into eight categories, was collected from the nationwide health care registry. The follow-up time ranged from 17 to 44 years. Results: Among RS population, 59.5 % had some psychiatric diagnosis, which was 12-fold compared to general population peers (hazard ratio HR = 12.4). The most prevalent categories were Conduct disorders and/or ADHD (30.7 %, HR = 41.5), Substance use disorders (29.3 %, HR = 16.8,), Other childhood disorders (8.6 %, HR = 11.9) and Personality disorders (10.9 %, HR = 11.6) followed by Mental retardation (6.4 %, HR = 8.4), Schizophrenia spectrum disorders (9.7 %, HR = 7.9), Affective disorders (17.9 %, HR = 7.3), and Disorders of psychological development (6.1 %, HR = 4.4). All differences were statistically significant (p < .001). Conclusions: RS background associates with an excess of psychiatric disorders, which adds to the burden of other known risk factors for adult age well-being. Effective screening and intervention for psychiatric problems should be available both during the RS placement and after-care.Peer reviewe

Mediators between adverse childhood experiences and suicidality

We investigated whether psychiatric symptomatology, impulsivity, family and social dysfunction, and alcohol use mediate the relationship between adverse childhood experiences (ACEs) and suicidality. The study population comprised 206 adolescent psychiatric inpatients and 203 age- and gender-matched adolescents from the community. ACEs and suicidality were assessed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime version, the Life Events Checklist, and a structured background data collection sheet. Psychiatric symptomatology was measured using the Symptom Checklist -90. Impulsivity, social dysfunction, and family dysfunction were measured using the Offer Self-Image Questionnaire, and alcohol use was assessed with the Alcohol Use Disorders Identification Test. A simple mediation test and multiple mediation analyses were conducted. A positive direct effect of ACEs on suicidality was observed. Also seen was a positive indirect effect of ACEs on suicidality through psychiatric symptomatology, impulsivity, and family and social dysfunctions. Alcohol misuse did not, however, mediate the relationship between ACEs and suicidality. According to the multiple mediation analyses, psychiatric symptomatology was the most significant mediator, followed by impulsivity. Psychiatric symptoms, impulsivity, and family and social dysfunctions are factors that should be taken into consideration when assessing suicidality in adolescents.Peer reviewe

Risk factors related to self-harming behavior in Finnish adolescent inpatients with a history of non-suicidal self-injury, suicidal behavior or both

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High Beck Depression Inventory 21 scores in adolescents without depression are associated with negative self-image and immature defense style

Beck Depression Inventory (BDI) is widely used in assessing adolescents' psychological wellbeing, but occasionally the result diverges from diagnostics. Our aim was to identify factors associated with discrepancies between BDI scores and diagnostic assessment in adolescent psychiatric patients and general population. The study comprised 206 inpatients (13-17 years old) and 203 age and gender matched non -referred adolescents. Study subjects filled self-reports on depression symptoms (BDI-21), alcohol use (AUDIT), defense styles (DSQ-40) and self-image (OSIQ-11), and on background information and adverse life events. Diagnostics was based on K-SADS-PL interview, and/or clinical interview and clinical records when available. We compared subjects who scored in BDI-21 either 0-15 points or 16-63 points firstly among subjects without current unipolar depression (n = 284), secondly among those with unipolar depression (n = 105). High BDI-21 scores in subjects without depression diagnosis (n = 48) were associated with female sex, adverse life events, parents' psychiatric problems, higher comorbidity, higher AUDIT scores, worse self-image and more immature defense styles. Low BDI-21 scores among subjects with depression diagnosis (n = 23) were associated with male sex, more positive self-image and less immature defense style. In conclusion, high BDI-21 scores in the absence of depression may reflect a broad range of challenges in an adolescent's psychological development.Peer reviewe

Dynaamiset DMP:t -työryhmän loppuraportti

publishedVersio

Tieteelliset kirjastot pandemian jälkeen: poikkeusaika kiihdytti työn muutosta

Koronaviruspandemia hiipuu ja vähitellen voidaan puhua pandemian jälkeisestä ajasta. Tieteellisten kirjastojen tilanne on erilainen kuin kaksi vuotta sitten. Nyt on aika luoda katsaus siihen, mitä oikeastaan tapahtui, ja pohtia vaikutusten kauaskantoisuutta. Tässä artikkelissa kirjastolaiset — kevään 2020 Signumin koronakirjeenvaihtajat — jatkavat koronaraportointia omista kirjastoistaan ja analysoivat mennyttä poikkeusaikaa

Väkirehun koostumus ja intensiteetti hereford-sonnien loppukasvatuksessa d)Sorkkaterveys

ei saatavill

Koulutuksen ja työn ulkopuolella olevien nuorten ja nuorten aikuisten mielenterveys- ja päihdehoito : Suosituksia perusterveydenhuollon toimijoille

NEET-tilanteessa olevalla nuorella tarkoitetaan 15 29-vuotiaita koulutuksen ja työn ulkopuolella olevia nuoria ja nuoria aikuisia. Näillä nuorilla on muita nuoria enemmän syrjäytymisen riskitekijöitä ja heille on niukasti palveluja tarjolla. Tämä opas antaa konkreettisia ohjeistuksia ja malliehdotuksia siitä, millaista mielenterveyden hoitoa ja päihdehoitoa NEET-tilanteessa oleville nuorille tarjotaan perusterveydenhuollossa, ehkäisevä työ mukaan lukien. Oppaaseen on koottu sellaisia toimintamalleja ja interventioita, jotka edistävät monialaista yhteistyötä ja ottavat huomioon NEET-tilanteessa olevien nuorten erityistarpeet. Opas on tarkoitettu käytännön työn tueksi. Se soveltuu myös hyvin erityisesti palveluista vastaavien hyvinvointialueiden käyttöön niiden muodostaessa palvelukokonaisuuksia. Samalla opas kiinnittää huomiota NEET-tilanteessa olevien nuorten ja nuorten aikuisten joukkoon ja heidän yleisimpiin terveysongelmiinsa

Psychometric properties of the Symptom Checklist-90 in adolescent psychiatric inpatients and age- and gender-matched community youth

Background: The Symptom Checklist-90 (SCL-90) is a questionnaire that is widely used to measure subjective psychopathology. In this study we investigated the psychometric properties of the SCL-90 among adolescent inpatients and community youth matched on age and gender. Methods: The final SCL-90 respondents comprised three subsets: 201 inpatients at admission, of whom 152 also completed the instrument at discharge, and 197 controls. The mean age at baseline was 15.0 years (SD 1.2), and 73 % were female. Differential SCL-90 item functioning between the three subsets was assessed with an iterative algorithm, and the presence of multidimensionality was assessed with a number of methods. Confirmatory factor analyses for ordinal items compared three latent factor models: one dimension, nine correlated dimensions, and a one-plus-nine bifactor model. Sensitivity to change was assessed with the bifactor model's general factor scores at admission and discharge. The accuracy of this factor in detecting the need for treatment used, as a gold standard, psychiatric diagnoses based on clinical records and the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime (K-SADS-PL) interview. Results: Item measurement properties were largely invariant across subsets under the unidimensional model, with standardized factor scores at admission being 0.04 higher than at discharge and 0.06 higher than those of controls. Determination of the empirical number of factors was inconclusive, reflecting a strong main factor and some multidimensionality. The unidimensional factor model had very good fit, but the bifactor model offered an overall improvement, though subfactors accounted for little item variance. The SCL-90s ability to identify those with and without a psychiatric disorder was good (AUC = 83 %, Glass's. = 1.4, Cohen's d = 1.1, diagnostic odds ratio 12.5). Scores were also fairly sensitive to change between admission and discharge (AUC 72 %, Cohen's d = 0.8). Conclusions: The SCL-90 proved mostly unidimensional and showed sufficient item measurement invariance, and is thus a useful tool for screening overall psychopathology in adolescents. It is also applicable as an outcome measure for adolescent psychiatric patients. SCL-90 revealed significant gender differences in subjective psychopathology among both inpatients and community youth.Peer reviewe

Identification of genetic markers with synergistic survival effect in cancer

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