Does Family Structure Play a Role in Depression in Adolescents Admitted to Psychiatric Inpatient Care?

We examined whether adolescents' family structure associate with depression in a clinical sample of 508 adolescents (age 13-17 years) treated in psychiatric hospital between April 2001 and March 2006. Psychiatric disorders of adolescents were based on the K-SADS-PL-interview. Adolescents with depression were characterized by a single parent family background (58 %), but less commonly by a child welfare placement (37 %). Depression in adolescents was significantly related to female gender and a single parent family background, but less significantly related to comorbid psychotic or conducts disorders. The association between family structure and depression presents a challenge to mental health services. Early screening for depression in adolescents admitted for psychiatric treatment from "at risk" family types is important to enhance their future wellbeing and coping strategies.Peer reviewe

Bullying involvement in relation to personality disorders : a prospective follow-up of 508 inpatient adolescents

We examined the association of bullying behavior in adolescence to personality disorder (PD) diagnosed in early adulthood. The study sample consisted of 508 adolescents (300 girls, 208 boys) who were admitted to psychiatric inpatient treatment between April 2001 and March 2006. Data were based on semi-structured K-SADSPL-interviews and hospital treatments extracted from the Care Register for Health Care (CRHC). At the end of 2013, details of psychiatric diagnoses recorded on hospital discharges and outpatient visits were extracted from the CRHC. This study showed that female victims of bullying have an almost fourfold likelihood of developing a PD later in life compared to adolescents with no involvement in bullying behavior. Most of the females had Borderline PD. Female adolescents diagnosed with anxiety disorder during adolescence had an over threefold risk of developing a PD during late adolescence or early adulthood. Conversely, we found no associations between bullying involvement among men in adolescence and subsequent PDs. Bullying victimization may influence the development of PDs among females. Adolescent services should pay particular attention to female victims of bullying and those displaying symptoms of anxiety disorders.Peer reviewe

Hanging suicides in northern Finland : A descriptive epidemiological study

The authors examined all hanging-suicides during 1988-2013 (N=851) in the province of Oulu, northern Finland. Using death-certificate data and ICD-diagnoses from the Finnish Hospital Discharge Register, we focused on gender differences in suicide, mental health, and somatic health. Male victims were more likely to have intoxication or problematic alcohol use; female victims were more likely to have somatic or mental hospitalization. Previous physical or mental hospitalization was related with absence of intoxication at the time of suicide. Suicide prevention should focus on acute alcohol abuse in the presence of acute stressors, suicidal thoughts and mental illness.Peer reviewe

Adolescent predictors of adult social and psychiatric adversities:a prospective follow-up study of the Northern Finland 1966 Birth Cohort

Abstract The aim of this study was to investigate, using a longitudinal design, the possible long-term effects of adolescent family background, school performance and substance use on educational performance, psychiatric disorders and substance use related problems during adulthood. A large, prospectively collected general population birth cohort (n = 11017), the Northern Finland 1966 Birth cohort, was used as study population. The database provided information on features of the primary family. The information on the cohort members' school performance, smoking, alcohol use and other substance use was obtained from a questionnaire mailed to the cohort members in 1980. Also information on school performance in various school subjects was obtained at the end of compulsory schooling at the age of 16. The level of education by the age of 31 was gathered from the national Registry of Educational Statistics in Finland. The relevant data for drunk driving offences were collected from the Ministry of Justice files. The Finnish Hospital Discharge Register was used to identify all hospital-treated psychiatric patients. Parental divorce increased the risk of adult educational underachievement. Other family background factors such as unwanted pregnancy, low maternal education and large family size were also associated with low adult educational performance. A history of drunk driving offences was associated both with impaired school performance in adolescence and with educational underachievement in early adulthood. Adolescent regular alcohol use, smoking and other substance use increased the risk for drunk driving offences and hospital-treated substance use disorders in adulthood. The smoking rate among psychiatric patients was about 1.5 times higher than among control subjects without psychiatric hospital treatment. The proportion of smokers was about 50% among subjects with schizophrenia. The initiation age of regular smoking was closely related to the age of onset of schizophrenia, but not to other mental disorders. Among schizophrenia patients the increased likelihood of smoking was associated with paternal smoking in the family environment, but not with any other background factors. Low overall mean scores and low combined mathematical and natural science scores at the end of compulsory school were associated with adult regular smoking among schizophrenia patients. This study gives new information on risk factors that affect educational attainment, substance use related problems and psychiatric morbidity within the developmental pathway from adolescence to adulthood

Itsetuhoisuuden ja itsensä vahingoittamisen eri muodot

Vertaisarvioitu. Teema : itsemurhien ehkäisySuomalainen Itsemurhien ehkäisyn ja itsemurhaa yrittäneen Käypä hoito -suositus määrittelee itsetuhoisuuden laajasti pyrkimykseksi tai käyttäytymiseksi, johon sisältyy itsensä vahingoittaminen tai tarkoituksellinen henkeä uhkaavan riskin ottaminen. Itsetuhoisuudella tarkoitetaan itsemurha-ajatuksia, itsemurhasta puhumista, keskeytynyttä itsemurhayritystä, itsemurhayritystä ja itsemurhaa. Vaikka itsetuhoiseen tekoon jollain hetkellä ei liittyisi lainkaan pyrkimystä kuolla, voi kuolemanpyrkimys ilmetä samalla henkilöllä myöhemmin.Peer reviewe

The impact of adverse childhood experiences on obesity and unhealthy weight control behaviors among adolescents

Background: Childhood abuse and other early-life stressors associate with being overweight or obese later in life. In addition to being overweight, unhealthy weight control behaviors (e.g., vomiting, using diet pills, fasting, and skipping meals) have been shown to be common among adolescents. To our knowledge, the association between these behaviors and adverse childhood experiences (ACEs) remains unexamined. Methods: We examined the association of ACEs to body mass index (BMI) and unhealthy weight control behaviors among 449 Finnish adolescents aged 12 to 17 years admitted to an acute psychiatric hospital unit between April 2001 and March 2006. We used the Schedule for AffeCtive Disorders and Schizophrenia for School-Age Children Present and Lifetime (K-SADS-PL) and the European Addiction Severity Index (EuropASI) to obtain information about ACEs, psychiatric diagnoses and weight control behaviors. BMI was calculated using the weight and height measured for each adolescent upon admission. Results: Girls who experienced sexual abuse were more likely to be obese (OR: 2.6; 95% CI: 1.1-6.4) and demonstrate extreme weight loss behaviors (EWLB) (OR: 2.2; 95% CI: 1.0-4.7). Among girls, parental unemployment is associated with an increased likelihood of obesity (OR: 3.5; 95% CI: 1.2-9.6) and of being underweight (OR: 3.6; 95% CI: 1.1-11.6). A proneness for excessively exercising was found among girls who had witnessed domestic violence (OR: 3.5; 95% CI: 1.4-9.2) and whose parent(s) had died (OR: 5.4; 95% CI: 1.1-27.7). Conclusion: This study showed that female adolescents with a history of traumatic experiences or difficult family circumstances exhibited an elevated likelihood of being obese and engaging in unhealthy weight control behaviors. (C) 2016 Elsevier Inc. All rights reserved.Peer reviewe

Borderline personality disorder associates with violent criminality in women : A population based follow-up study of adolescent psychiatric inpatients in Northern Finland

Various psychiatric problems in adolescence and early adulthood have been shown to associate with criminal behaviour. In this study the association of personality disorders (PDs) with criminal behaviour was examined in adolescents treated in psychiatric hospitals. The study sample consisted of 508 adolescents (age 13-17) admitted to acute psychiatric impatient care between April 2001 and March 2006. Crime data was obtained from the Finnish Legal Register Centre on September 2013. The Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime (K-SADS-PL) was used to assess psychiatric diagnoses in adolescence. The information on PDs in early adulthood was based on follow-up information on psychiatric treatments in either out-or inpatient settings until the end of 2012, and was extracted from the National Care Register for Health Care provided by the Finnish National Institute for Health and Welfare. A total of 22 (39%) of the 57 subjects with PD had committed a crime. In women, the likelihood for violent criminality was significantly increased in those with Borderline PD (OR 6.09, CI 1.24-29.84, p = 0.009) and was also associated with conduct disorder (OR 4.26, CI 1.38-13.19, p = 0.012), child welfare placement (OR 11.82, CI 3.61-38.76, p <0.001) and parent's substance use disorder (OR 7.74, CI 2.30-26.10, p = 0.001). In men, no association was observed between PD and any kind of criminal behaviour. Significant predictors for violent criminality in males were conduct disorder (OR 4.05, CI 1.75-9.38, p = 0.001), substance use disorder (OR 2.51, CI 1.22-5.17, p = 0.012) and special services at school (OR 2.58, CI 1.16-5.76, p = 0.021). Females with Borderline PD showed an increased risk for violent offending. This suggests Borderline PD as a potential explanatory factor for violent assaults by females and highlights the importance of recognizing the risk for violence in young women with a Borderline PD. (C) 2016 Elsevier Ireland Ltd. All rights reserved.Peer reviewe

Itsetuhoisuuden ja itsensä vahingoittamisen eri muodot

Tiivistelmä Suomalainen Itsemurhien ehkäisyn ja itsemurhaa yrittäneen Käypä hoito -suositus määrittelee itsetuhoisuuden laajasti pyrkimykseksi tai käyttäytymiseksi, johon sisältyy itsensä vahingoittaminen tai tarkoituksellinen henkeä uhkaavan riskin ottaminen. Itsetuhoisuudella tarkoitetaan itsemurha-ajatuksia, itsemurhasta puhumista, keskeytynyttä itsemurhayritystä, itsemurhayritystä ja itsemurhaa. Vaikka itsetuhoiseen tekoon jollain hetkellä ei liittyisi lainkaan pyrkimystä kuolla, voi kuolemanpyrkimys ilmetä samalla henkilöllä myöhemmin