Growing up unequal : Socioeconomic disparities in mental disorders throughout childhood in Finland

Problems in mental health and socioeconomic health inequalities during childhood and adolescence are receiving important scientific and political attention. This in mind, we study how current family income and parental education are associated with psychiatric disorders among children in a well-developed welfare state, Finland. To gain a deeper understanding of how these disparities develop through early life course, we study the differences between genders, age groups, types of mental disorders, and also take into account the role of parental mental disorders. We exploit high-quality Finnish register data containing the whole population aged 4–17 with information on their families and parents. Our results of linear probability models show that lower parental education is consistently associated with higher probability of mental disorders throughout childhood, although some gender and disorder-specific differences are also identified. Interestingly, household income is related to mental health in more complex ways, having both negative and positive associations with psychiatric disorders. Inequalities are stronger among boys than girls, and the strongest associations are found among boys aged 7–12 and girls aged 13–17. Parental mental disorders increase the risk of children's psychiatric disorders but do not explain socioeconomic disparities. Considering the negative effects of mental problems on socioeconomic outcomes, inequalities in childhood mental health can be expected to reinforce other social inequalities in later life and should therefore be a focus of interventions

Family structure and risk factors for schizophrenia: case-sibling study

BACKGROUND: Several family structure-related factors, such as birth order, family size, parental age, and age differences to siblings, have been suggested as risk factors for schizophrenia. We examined how family-structure-related variables modified the risk of schizophrenia in Finnish families with at least one child with schizophrenia born from 1950 to 1976. METHODS: We used case-sibling design, a variant of the matched case-control design in the analysis. Patients hospitalized for schizophrenia between 1969 and 1996 were identified from the Finnish Hospital Discharge Register, and their families from the Population Register Center. Only families with at least two children (7914 sibships and 21059 individuals) were included in the analysis. Conditional logistic regression with sex, birth cohort, maternal schizophrenia status, and several family-related variables as explanatory variables was used in the case-sibling design. The effect of variables with the same value in each sibship was analyzed using ordinary logistic regression. RESULTS: Having a sibling who was less than five years older (OR 1.46, 95% CI 1.29–1.66), or being the firstborn (first born vs. second born 1.62, 1.87–1.4) predicted an elevated risk, but having siblings who were more than ten years older predicted a lower risk (0.66, 0.56–0.79). CONCLUSIONS: Several family-structure-related variables were identified as risk factors for schizophrenia. The underlying causative mechanisms are likely to be variable

Daily functioning and symptom factors contributing to attitudes toward antipsychotic treatment and treatment adherence in outpatients with schizophrenia spectrum disorders

Background: Poor adherence and negative attitudes to treatment are common clinical problems when treating psychotic disorders. This study investigated how schizophrenia core symptoms and daily functioning affect treatment adherence and attitudes toward antipsychotic medication and to compare patients using clozapine or other antipsychotics. Method: A cross-sectional study with data from 275 patients diagnosed with schizophrenia spectrum disorder. Patients adherence, attitudes, insight and side-effects were evaluated using the Attitudes toward Neuroleptic Treatment scale. Overall symptomology was measured using the Brief Psychiatric Rating Scale (BPRS), the Health of the Nation Outcome Scale (HoNOS). The functioning was assessed using activities of daily living scale, instrumental activities of daily living scale and social functioning of daily living scale. Results: Self-reported treatment adherence was high. Of the patients, 83% reported using at least 75% of the prescribed medication. Having more symptoms was related with more negative attitude towards treatment. There was a modest association with functioning and treatment adherence and attitude toward antipsychotic treatment. Attitudes affected on adherence in non-clozapine but not in clozapine groups. Conclusion: Early detection of non-adherence is difficult. Systematic evaluation of attitudes toward the treatment could be one way to assess this problem, along with optimized medication, prompt evaluation of side effects and flexible use of psychosocial treatments.Peer reviewe

Vanhuus ja viisaus

Teema: vanhuuden vallankumous

Incidence and Risk Factors of Schizophrenia in Finland

Väitöskirja, liitteenä alkuperäisartikkelit

Ilmastoviestinnällä kohti ilmastotoimia ilmastonmuutoksen:kehystäminen Tiede-lehdessä vuosina 2020 ja 2021

Tiivistelmä. Ilmastonmuutos on maailmanlaajuinen ongelma, joka tulee aiheuttamaan vakavia seurauksia niin luonnolle kuin ihmisillekin, jos sen hillitsemiseksi ei tehdä mitään. Ilmastonmuutosta voidaan hillitä vähentämällä ihmisen toiminnasta aiheutuvia kasvihuonekaasupäästöjä. Ihmisiä on kuitenkin vaikea motivoida ilmastotoimiin, sillä niiden tiellä on useita esteitä ja haasteita. Esteet voivat olla esimerkiksi poliittisia, rakenteellisia, yhteiskunnallisia, kulttuurisia tai psykologisia. Ilmastotoimien edistämiseksi tehokas ilmastoviestintä on erityisen tärkeässä asemassa. Ilmastoviestinnällä levitetään tietoa ilmastonmuutoksesta sekä siihen liittyvistä teemoista, kuten sen hillinnästä ja siihen sopeutumisesta. Tämän pro gradu -tutkielman tavoitteena oli selvittää, millaista ilmastoviestintää esiintyy Tiede-lehdessä, joka on Suomen suurin tieteen aikakausjulkaisu ja samalla tärkeä yleistajuisen tiedeviestinnän kanava. Tarkastelussa otettiin huomioon viestinnän kehystäminen sekä se, noudattaako Tiede-lehden ilmastonmuutosaiheinen viestintä ilmastoviestinnän kansainvälisiä suosituksia. Tutkimusmenetelmänä käytettiin kehysanalyysia. Kehystäminen on olennainen osa ilmastoviestintää, ja kehykset vaikuttavat siihen, miten ilmastonmuutokseen suhtaudutaan. Ilmastoviestinnän tutkimus on Suomessa vähäistä, ja suomenkieliset kehysanalyysit painottuvat vahvasti uutisjournalismiin. Tämän tutkimuksen aineistona käytettiin Tiede-lehden vuosikertoja 2020 ja 2021. Ilmastoviestinnän artikkeleita oli tarkastelujaksolla yhteensä 55 kpl. Tutkimuksessa käytettyjä kehyksiä oli kolme: epämiellyttävä tulevaisuus, toivo ja teknologia. Eniten artikkeleita (27 kpl) oli epämiellyttävä tulevaisuus -kehyksessä. Teknologiakehykseen kuului 15 artikkelia ja toivon kehykseen 13 artikkelia. Tulosten perusteella ilmastonmuutosta käsitellään Tiede-lehdessä usein ja monipuolisesti. Vuoden 2021 lehdissä ilmastoviestintää esiintyi jokaisessa numerossa. Myös vuonna 2020 ilmastonmuutosta käsiteltiin lähes jokaisessa numerossa, vaikka elimme kriisiaikaa koronaviruspandemian takia. Pääosin Tiede-lehden ilmastoviestintä vastasi tutkimusalan suosituksia, mutta myös parantamisen varaa löytyy etenkin sen osalta, minkälaisissa kehyksissä ilmastonmuutos esitetään. Ilmastoviestinnän kotimaista tutkimusta tulisi lisätä, jotta voitaisiin laatia entistä tarkemmat raamit sille, miten ilmastonmuutos tulisi esittää mediassa

Is symptom connectivity really the most important issue in depression? : Depression as a dynamic system of interconnected symptoms revisited

According to the network theory strong associations between symptoms drive the disease process. We compared those with and without diagnosed depressive disorders (DD+/DD-) and analysed the effects of differences in (a) network connectivity, (b) symptom thresholds, and (c) autoregressive loops (i.e. how strongly specific symptoms predict themselves) on the potential activation of symptoms over time using simulations developed by Cramer and others (2016). The parameters for the simulation (symptom connectivity and symptom threshold) were obtained from Ising models and cross-lagged panel network analyses. Data were from the nationally representative samples (Health 2000-2011 Study) of 4190 participants measured in 2011 (cross-sectional analyses) and 3201 participants measured in 2000 and 2011 (longitudinal analyses). DD diagnosis was based on the Composite International Diagnostic Interview and depressive symptoms were self-reported using the 13-item version of the Beck Depression Inventory (BDI). Differences in symptom connectivity between participants with and without DD were not observed, but the mean probability (threshold) of symptom existence in the DD + group was higher than in the DD-group (0.41 vs. 0.12). Simulation showed that there are more active symptoms in the DD + group after 10 000 time points (means 1.2 vs. 4.6) than in the DD-group. This difference largely disappeared when we used longitudinal networks, including autoregressive loops, in the connectivity matrix. Our results suggest that the differences in symptom thresholds and autoregressive loops may be more important features than symptom connectivity in differentiating people with and without DD.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