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11-year follow-up of mortality in patients with schizophrenia: a population-based cohort study (FIN11 study).

https://arctichealth.org/en/permalink/ahliterature149701
Source
Lancet. 2009 Aug 22;374(9690):620-7
Publication Type
Article
Date
Aug-22-2009
Author
Jari Tiihonen
Jouko Lönnqvist
Kristian Wahlbeck
Timo Klaukka
Leo Niskanen
Antti Tanskanen
Jari Haukka
Author Affiliation
Department of Forensic Psychiatry, University of Kuopio and Niuvanniemi Hospital, Department of Clinical Physiology, Kuopio University Hospital, Kuopio, Finland. jari.tiihonen@niuva.fi
Source
Lancet. 2009 Aug 22;374(9690):620-7
Date
Aug-22-2009
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Antipsychotic Agents - adverse effects
Case-Control Studies
Cause of Death
Clozapine - adverse effects
Dibenzothiazepines - adverse effects
Drug Utilization - trends
Female
Finland - epidemiology
Follow-Up Studies
Health Status Disparities
Humans
Life expectancy
Male
Middle Aged
Patient Readmission - statistics & numerical data
Perphenazine - adverse effects
Proportional Hazards Models
Registries
Risk factors
Schizophrenia - drug therapy - mortality
Sex Distribution
Time Factors
Abstract
The introduction of second-generation antipsychotic drugs during the 1990s is widely believed to have adversely affected mortality of patients with schizophrenia. Our aim was to establish the long-term contribution of antipsychotic drugs to mortality in such patients.
Nationwide registers in Finland were used to compare the cause-specific mortality in 66 881 patients versus the total population (5.2 million) between 1996, and 2006, and to link these data with the use of antipsychotic drugs. We measured the all-cause mortality of patients with schizophrenia in outpatient care during current and cumulative exposure to any antipsychotic drug versus no use of these drugs, and exposure to the six most frequently used antipsychotic drugs compared with perphenazine use.
Although the proportional use of second-generation antipsychotic drugs rose from 13% to 64% during follow-up, the gap in life expectancy between patients with schizophrenia and the general population did not widen between 1996 (25 years), and 2006 (22.5 years). Compared with current use of perphenazine, the highest risk for overall mortality was recorded for quetiapine (adjusted hazard ratio [HR] 1.41, 95% CI 1.09-1.82), and the lowest risk for clozapine (0.74, 0.60-0.91; p=0.0045 for the difference between clozapine vs perphenazine, and p
Notes
Comment In: Lancet. 2009 Nov 7;374(9701):1591; author reply 1592-319897117
Comment In: Lancet. 2009 Nov 7;374(9701):1591; author reply 1592-319897118
Comment In: Lancet. 2009 Aug 22;374(9690):590-219595448
Comment In: Lancet. 2009 Nov 7;374(9701):1592; author reply 1592-319897121
Comment In: Lancet. 2009 Nov 7;374(9701):1592; author reply 1592-319897120
PubMed ID
19595447 View in PubMed
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A 15-year national follow-up: legislation is not enough to reduce the use of seclusion and restraint.

https://arctichealth.org/en/permalink/ahliterature162773
Source
Soc Psychiatry Psychiatr Epidemiol. 2007 Sep;42(9):747-52
Publication Type
Article
Date
Sep-2007
Author
Alice Keski-Valkama
Eila Sailas
Markku Eronen
Anna-Maija Koivisto
Jouko Lönnqvist
Riittakerttu Kaltiala-Heino
Author Affiliation
Vanha Vaasa Hospital, PO Box 13, Vaasa, 65381 Finland. alice.keski-valkama@vvs.fi
Source
Soc Psychiatry Psychiatr Epidemiol. 2007 Sep;42(9):747-52
Date
Sep-2007
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Coercion
Female
Finland - epidemiology
Follow-Up Studies
Humans
Male
Mental Disorders - epidemiology
Mental Health Services - legislation & jurisprudence - standards
Middle Aged
Patient Discharge - statistics & numerical data
Prevalence
Registries
Restraint, Physical - legislation & jurisprudence - utilization
Abstract
Seclusion and restraint are frequent but controversial coercive measures used in psychiatric treatment. Legislative efforts have started to emerge to control the use of these measures in many countries. In the present study, the nationwide trends in the use of seclusion and restraint were investigated in Finland over a 15-year span which was characterised by legislative changes aiming to clarify and restrict the use of these measures.
The data were collected during a predetermined week in 1990, 1991, 1994, 1998 and 2004, using a structured postal survey of Finnish psychiatric hospitals. The numbers of inpatients during the study weeks were obtained from the National Hospital Discharge Register.
The total number of the secluded and restrained patients declined as did the number of all inpatients during the study weeks, but the risk of being secluded or restrained remained the same over time when compared to the first study year. The duration of the restraint incidents did not change, but the duration of seclusion increased. A regional variation was found in the use of coercive measures.
Legislative changes solely cannot reduce the use of seclusion and restraint or change the prevailing treatment cultures connected with these measures. The use of seclusion and restraint should be vigilantly monitored and ethical questions should be under continuous scrutiny.
PubMed ID
17598058 View in PubMed
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Advanced paternal age and parental history of schizophrenia.

https://arctichealth.org/en/permalink/ahliterature131103
Source
Schizophr Res. 2011 Dec;133(1-3):125-32
Publication Type
Article
Date
Dec-2011
Author
Brian Miller
Jaana Suvisaari
Jouko Miettunen
Marjo-Riitta Järvelin
Jari Haukka
Antti Tanskanen
Jouko Lönnqvist
Matti Isohanni
Brian Kirkpatrick
Author Affiliation
Department of Psychiatry and Health Behavior, Medical College of Georgia Health Sciences University, Augusta, Georgia 30912, United States. brmiller@georgiahealth.edu
Source
Schizophr Res. 2011 Dec;133(1-3):125-32
Date
Dec-2011
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Cohort Studies
Family Health
Female
Finland
Humans
Logistic Models
Male
Maternal Age
Middle Aged
Odds Ratio
Paternal Age
Retrospective Studies
Risk factors
Schizophrenia - epidemiology - genetics
Young Adult
Abstract
Advanced paternal age (APA) is a risk factor for nonaffective psychosis (NAP) in the offspring, although the mechanism(s) of this association are not clear. The aim of this study was to examine whether later childbearing can be explained by parental schizophrenia, and in doing so, further evaluate the "de novo mutation" hypothesis for the association between APA and NAP.
Using binary logistic regression, the association between APA and parental history of schizophrenia in the offspring, considering maternal and paternal history separately, was examined in 1) all persons with NAP born in Finland between 1950 and 1969 (Finnish NAP Cohort, n = 13,712), and 2) members of the Northern Finland 1966 Birth Cohort (NFBC 1966, n = 10,224), a general population birth cohort.
In the Finnish NAP Cohort, having a mother with schizophrenia was associated with APA (Odds Ratio [OR] for linear trend = 1.20, 95% confidence interval 1.12-1.29, p
PubMed ID
21937198 View in PubMed
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Alcohol consumption, abstaining, health utility, and quality of life--a general population survey in Finland.

https://arctichealth.org/en/permalink/ahliterature159002
Source
Alcohol Alcohol. 2008 May-Jun;43(3):376-86
Publication Type
Article
Author
Samuli I Saarni
Kaisla Joutsenniemi
Seppo Koskinen
Jaana Suvisaari
Sami Pirkola
Harri Sintonen
Kari Poikolainen
Jouko Lönnqvist
Author Affiliation
National Public Health Institute, Department of Mental Health and Alcohol Research, Helsinki, Finland. samuli.saarni@helsinki.fi
Source
Alcohol Alcohol. 2008 May-Jun;43(3):376-86
Language
English
Publication Type
Article
Keywords
Adult
Alcohol Drinking - epidemiology - psychology
Female
Finland - epidemiology
Health Status Indicators
Health Surveys
Humans
Male
Middle Aged
Quality of Life - psychology
Temperance - psychology
Abstract
To examine the associations between alcohol consumption and utility-based health-related quality of life (HRQoL), subjective quality of life (QoL), self-rated health (SRH), and mental distress.
Representative general population survey in Finland, with 5871 persons aged 30-64 years. HRQoL was measured with two health utility instruments (15D and EQ-5D), QoL and SRH were measured with RATING scales, and mental distress with a General Health Questionnaire (GHQ-12). Past alcohol problems were diagnosed with a structured psychiatric interview known as the composite international diagnostic interview (CIDI). Alcohol consumption was examined with a self-report questionnaire.
Negative associations between alcohol and well-being were observed on several measures for women consuming more than 173 g and men more than 229 g per week. Former drinkers scored worst on most measures, even in comparison to the highest drinking decile. For men, all statistically significant associations between moderate drinking and well-being disappeared when sociodemographic factors and former drinkers were controlled for. For women, moderate alcohol use associated with better SRH and EQ-5D as compared to abstainers. However, the possible health utility benefits associated with moderate alcohol consumption were of clinically insignificant magnitude.
Failure to separate former drinkers and other abstainers produces a significant bias favoring moderate drinkers. As the possible health utility benefits of moderate alcohol use were clinically insignificant, it suffices to investigate mortality, when estimating the public health impact of moderate alcohol consumption using quality-adjusted life years.
PubMed ID
18245136 View in PubMed
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Alcohol dependence in relation to burnout among the Finnish working population.

https://arctichealth.org/en/permalink/ahliterature167531
Source
Addiction. 2006 Oct;101(10):1438-43
Publication Type
Article
Date
Oct-2006
Author
Kirsi Ahola
Teija Honkonen
Sami Pirkola
Erkki Isometsä
Raija Kalimo
Erkki Nykyri
Arpo Aromaa
Jouko Lönnqvist
Author Affiliation
Finnish Institute of Occupational Health, Helsinki, Finland. kirsi.ahola@occuphealth.fi
Source
Addiction. 2006 Oct;101(10):1438-43
Date
Oct-2006
Language
English
Publication Type
Article
Keywords
Adult
Alcohol Drinking - adverse effects - psychology
Burnout, Professional - etiology
Cross-Sectional Studies
Female
Finland - epidemiology
Health Surveys
Humans
Male
Middle Aged
Odds Ratio
Severity of Illness Index
Abstract
To investigate the relationship of burnout to alcohol dependence and high alcohol consumption.
A cross-sectional population-based multi-disciplinary 'Health 2000 Study'. The analyses were performed separately for the women and the men and adjusted for socio-demographic factors.
In Finland, 3276 active employees (1637 women and 1639 men), aged 30-64 years, from a representative population sample.
The diagnosis of Diagnostic and Statistical Manual of Mental Disorders version IV (DSM-IV) alcohol dependence was based on the standardized Munich Composite International Diagnostic Interview (M-CIDI). The assessment of high alcohol consumption was based on self-reported alcohol use. Burnout was assessed with the Maslach Burnout Inventory-General Survey (MBI-GS).
The 12-month prevalence of alcohol dependence was associated with burnout among both men and women. Each one-point increase in burnout score was associated with an 80% increase in the incidence for alcohol dependence among women and a 51% increase among men. These associations persisted when socio-demographic factors were adjusted. The associations between burnout and high alcohol consumption were not statistically significant.
There is an association between burnout and alcohol dependence among both genders. Among both women and men, attention to alcohol-related behaviour is warranted in the clinical context when burnout and other problems related to work are encountered. Interventions which include assessment of work conditions and management of work-related stress should be targeted at employees with alcohol dependence in addition to traditional treatment.
PubMed ID
16968345 View in PubMed
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Alcohol-induced psychotic disorder and delirium in the general population.

https://arctichealth.org/en/permalink/ahliterature141116
Source
Br J Psychiatry. 2010 Sep;197(3):200-6
Publication Type
Article
Date
Sep-2010
Author
Jonna Perälä
Kimmo Kuoppasalmi
Sami Pirkola
Tommi Härkänen
Samuli Saarni
Annamari Tuulio-Henriksson
Satu Viertiö
Antti Latvala
Seppo Koskinen
Jouko Lönnqvist
Jaana Suvisaari
Author Affiliation
National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Helsinki, Finland. jonna.perala@thl.fi
Source
Br J Psychiatry. 2010 Sep;197(3):200-6
Date
Sep-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Alcohol Withdrawal Delirium - epidemiology - therapy
Alcohol-Related Disorders - epidemiology - therapy
Ambulatory Care
Diagnosis, Dual (Psychiatry)
Epidemiologic Methods
Family Health
Fathers - psychology
Female
Finland - epidemiology
Hallucinations - epidemiology
Hospitalization - statistics & numerical data
Hospitals, Psychiatric
Humans
Interview, Psychological
Male
Middle Aged
Psychoses, Alcoholic - epidemiology - therapy
Socioeconomic Factors
Abstract
Epidemiological data on alcohol-induced psychotic disorder and delirium (alcohol-induced psychotic syndrome, AIPS) are scarce.
To investigate the epidemiology of AIPS, the risk factors for developing AIPS among people with alcohol dependence, and mortality associated with alcohol dependence with or without AIPS, in a sample drawn from the general population of Finland.
A general population sample of 8028 persons were interviewed with the Composite International Diagnostic Interview and screened for psychotic disorders using multiple sources. Best-estimate diagnoses of psychotic disorders were made using the Structured Clinical Interview for DSM-IV Axis I Disorders and case notes. Data on hospital reatments and deaths were collected from national registers.
The lifetime prevalence was 0.5% for AIPS and was highest (1.8%) among men of working age. Younger age at onset of alcohol dependence, low socioeconomic status, father's mental health or alcohol problems and multiple hospital treatments were associated with increased risk of AIPS. Participants with a history of AIPS had considerable medical comorbidity, and 37% of them died during the 8-year follow-up.
Alcohol-induced psychotic disorder is a severe mental disorder with poor outcome.
PubMed ID
20807964 View in PubMed
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Analysis of the seasonal pattern in suicide.

https://arctichealth.org/en/permalink/ahliterature178877
Source
J Affect Disord. 2004 Aug;81(2):133-9
Publication Type
Article
Date
Aug-2004
Author
Timo Partonen
Jari Haukka
Heikki Nevanlinna
Jouko Lönnqvist
Author Affiliation
Department of Mental Health and Alcohol Research, National Public Health Institute, Mannerheimintie 166, FIN-00300 Helsinki, Finland. timo.partonen@ktl.fi
Source
J Affect Disord. 2004 Aug;81(2):133-9
Date
Aug-2004
Language
English
Publication Type
Article
Keywords
Cosmic Radiation
Electromagnetic fields
Female
Finland - epidemiology
Humans
Male
Risk factors
Seasons
Solar Activity
Suicide - statistics & numerical data
Abstract
Suicide has been attributed to social and psychological factors but also to geophysical effects. Of the latter, changes in solar radiation and geomagnetic activities may contribute to the frequency and the seasonal pattern of suicides.
We studied with a population-based, nationwide analysis all the individuals who committed suicide (n=27,469) in Finland during the period of 1979 to 1999. The daily data on the number of suicides, and the mean and maximum levels of geomagnetic activity were compiled and modelled with Poisson regression using the number of inhabitants in each province as the denominator. Time series analysis of monthly numbers of suicides was carried out using a seasonal-trend decomposition procedure.
There was a strong seasonal effect on suicide occurrence (P
PubMed ID
15306138 View in PubMed
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An association between both low and high birth weight and increased disorganized and negative symptom severity in schizophrenia and other psychoses.

https://arctichealth.org/en/permalink/ahliterature120634
Source
Psychiatry Res. 2013 Jan 30;205(1-2):18-24
Publication Type
Article
Date
Jan-30-2013
Author
Asko Wegelius
Maiju Pankakoski
Ulriika Lehto
Jaana Suokas
Laura Häkkinen
Annamari Tuulio-Henriksson
Jouko Lönnqvist
Tiina Paunio
Jaana Suvisaari
Author Affiliation
National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Helsinki, Finland. asko.wegelius@thl.fi
Source
Psychiatry Res. 2013 Jan 30;205(1-2):18-24
Date
Jan-30-2013
Language
English
Publication Type
Article
Keywords
Adult
Birth weight
Cohort Studies
Disease Susceptibility
Female
Finland
Humans
Infant, Newborn
Male
Middle Aged
Psychotic Disorders - psychology
Schizophrenia
Schizophrenic Psychology
Severity of Illness Index
Abstract
Longitudinal cohort studies have implicated an association between both low and high birth weight and increased schizophrenia risk. In this study, we investigated the effect of birth weight on the symptom severity of psychotic disorders including schizophrenia in a Finnish schizophrenia family study sample. We used a multivariate GEE (General Estimating Equation) regression model to investigate the association of birth weight and symptom severity in 282 subjects with a primary psychotic disorder, 178 of whom had a diagnosis of schizophrenia. The Scales for the Assessment of Positive and Negative Symptoms (SAPS and SANS) were used as a measure of symptom severity. Sex, place of birth and year of birth were adjusted for in the model. Both low and high birth weight were associated with more severe symptoms with respect to bizarre behaviour, affective flattening and attentional impairment. In addition, low birth weight was associated with more severe symptoms with respect to positive formal thought. Our findings suggest that both low and high birth weight can influence the symptom severity of psychotic disorders. Our results implicate an association between both low and high birth weight and disorganized and negative symptoms.
PubMed ID
22985549 View in PubMed
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An association between high birth weight and schizophrenia in a Finnish schizophrenia family study sample.

https://arctichealth.org/en/permalink/ahliterature133792
Source
Psychiatry Res. 2011 Dec 30;190(2-3):181-6
Publication Type
Article
Date
Dec-30-2011
Author
Asko Wegelius
Annamari Tuulio-Henriksson
Maiju Pankakoski
Jari Haukka
Ulriika Lehto
Tiina Paunio
Jouko Lönnqvist
Jaana Suvisaari
Author Affiliation
National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Helsinki, Finland. asko.wegelius@hus.fi
Source
Psychiatry Res. 2011 Dec 30;190(2-3):181-6
Date
Dec-30-2011
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Birth Weight - genetics
Family Health
Female
Finland - epidemiology
Humans
Longitudinal Studies
Male
Middle Aged
Proportional Hazards Models
Psychiatric Status Rating Scales
Risk factors
Schizophrenia - epidemiology - genetics - mortality
Survival Analysis
Abstract
Longitudinal cohort studies have implicated an association between both low and high birth weight and schizophrenia. It has been suggested that schizophrenia associated genes could augment an individual's susceptibility to adverse prenatal and perinatal environmental events. We investigated the association between birth weight and schizophrenia in a large Finnish schizophrenia family study sample. We utilized the birth weight data of 1051 offspring from 315 Finnish families with at least one offspring with a diagnosis of schizophrenia. We used a multivariate COX frailty model to analyze the effect of birth weight on the risk of developing schizophrenia within the families. Using information from the Medication Reimbursement Register and patient interviews, we further investigated the association of maternal type 2 diabetes and schizophrenia risk among offspring. High birth weight (>4000g) was associated with a 1.68-fold increase in schizophrenia susceptibility. Maternal diabetes at the time of data collection, a proxy for gestational diabetes, was associated with a 1.66-fold increase in the risk of developing schizophrenia among offspring. Our results corroborate recent findings showing an association between high birth weight and schizophrenia. Our results also point to a potential birth-weight independent association between maternal type 2 diabetes and schizophrenia among offspring.
PubMed ID
21664700 View in PubMed
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An interaction between NDE1 and high birth weight increases schizophrenia susceptibility.

https://arctichealth.org/en/permalink/ahliterature273909
Source
Psychiatry Res. 2015 Dec 15;230(2):194-9
Publication Type
Article
Date
Dec-15-2015
Author
Asko Wegelius
Maiju Pankakoski
Liisa Tomppo
Ulriika Lehto
Jouko Lönnqvist
Jaana Suvisaari
Tiina Paunio
William Hennah
Source
Psychiatry Res. 2015 Dec 15;230(2):194-9
Date
Dec-15-2015
Language
English
Publication Type
Article
Keywords
Adult
Aged
Birth Weight - genetics
Cohort Studies
Disease Susceptibility
Female
Finland - epidemiology
Haplotypes - genetics
Humans
Male
Microtubule-Associated Proteins - genetics
Middle Aged
Nerve Tissue Proteins - genetics
Polymorphism, Single Nucleotide - genetics
Retrospective Studies
Schizophrenia - diagnosis - epidemiology - genetics
Abstract
Pre- and perinatal environmental factors have been shown to increase schizophrenia risk particularly when combined with genetic liability. The investigation of specific gene environment interactions in the etiology of psychiatric disorders has gained momentum. We used multivariate GEE regression modeling to investigate the interaction between genes of the DISC1 pathway and birth weight, in relation to schizophrenia susceptibility in a Finnish schizophrenia family cohort. The study sample consisted of 457 subjects with both genotype and birth weight information. Gender and place of birth were adjusted for in the models. We found a significant interaction between birth weight and two NDE1 markers in relation to increased schizophrenia risk: a four SNP haplotype spanning NDE1 (b=1.26, SE=0.5, p=0.012) and one of its constituent SNPs rs4781678 (b=1.33, SE=0.51, p=0.010). Specifically, high birth weight (>4000g) was associated with increased schizophrenia risk among subjects homozygous for the previously identified risk alleles. The study was based on a family study sample with high genetic loading for schizophrenia and thus our findings cannot directly be generalized as representing the general population. Our results suggest that the functions mediated by NDE1 during the early stages of neurodevelopment are susceptible to the additional disruptive effects of pre- and perinatal environmental factors associated with high birth weight, augmenting schizophrenia susceptibility.
PubMed ID
26350705 View in PubMed
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139 records – page 1 of 14.