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The ability of general practitioners to detect mental disorders in primary health care.

https://arctichealth.org/en/permalink/ahliterature216423
Source
Acta Psychiatr Scand. 1995 Jan;91(1):52-6
Publication Type
Article
Date
Jan-1995
Author
M. Joukamaa
V. Lehtinen
H. Karlsson
Author Affiliation
Department of Psychiatry, University of Turku, Finland.
Source
Acta Psychiatr Scand. 1995 Jan;91(1):52-6
Date
Jan-1995
Language
English
Publication Type
Article
Keywords
Adult
Clinical Competence
Curriculum
Education, Medical, Graduate
Family Practice - education
Female
Finland
Humans
Male
Mental Disorders - diagnosis - psychology - therapy
Patient care team
Primary Health Care
Psychiatry - education
Psychophysiologic Disorders - diagnosis - psychology - therapy
Sampling Studies
Somatoform Disorders - diagnosis - psychology - therapy
Abstract
The ability to detect mental disorders varies greatly among general practitioners in primary health care. The aim of this study was to determine the factors underlying the differences between general practitioners in the ability to recognize mental disorders in Finnish patient populations. The group studied consisted of 1000 randomly selected adult patients of primary care facilities in the city of Turku. The Symptom Checklist (SCL-25) was used as the reference method in the identification of psychiatric cases. According to the SCL-25, one fourth of the sample had mental disorders. A good recognition ability was associated with postgraduate psychiatric training and qualification as a specialist in general practice. Surprisingly, Balint group training, which is a method intended to improve the ability of general practitioners to manage their patients' mental health problems, was associated rather with poor than good detection ability.
Notes
Comment In: Acta Psychiatr Scand. 1995 Oct;92(4):3198848961
PubMed ID
7754788 View in PubMed
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Alexithymia and psychological distress among frequent attendance patients in health care.

https://arctichealth.org/en/permalink/ahliterature213347
Source
Psychother Psychosom. 1996;65(4):199-202
Publication Type
Article
Date
1996
Author
M. Joukamaa
H. Karlsson
B. Sholman
V. Lehtinen
Author Affiliation
Department of Psychiatry, University of Turku, Finland.
Source
Psychother Psychosom. 1996;65(4):199-202
Date
1996
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Affective Symptoms - epidemiology - psychology
Causality
Chi-Square Distribution
Comorbidity
Female
Finland - epidemiology
Humans
Logistic Models
Male
Middle Aged
Primary Health Care - statistics & numerical data
Sampling Studies
Stress, Psychological - epidemiology
Abstract
The aim of the present study was to find out whether alexithymia is common in frequently attending primary health care patients and whether alexithymia and psychological distress are associated in these patients.
Alexithymia was measured by the TAS-26 and psychological distress by the SCL-25 in a random sample of 394 working-age primary health care patients. Frequent attendance was defined as a minimum of 11 visits during 1 year to different kinds of outpatient health care services, excluding specialized psychiatric care.
Frequently attending patients with psychological distress were found to be alexithymic more commonly than other patients, but this was not the case with other frequently attending patients. In other words, frequent attendance and alexithymia had an association mediated by psychological distress.
There is a subgroup of frequently attending patients, who are alexithymic and have psychological distress, too. They usually visit health-care services because of a somatic complaint. We hypothesize that their expression of psychological distress was masked and somatized just because of alexithymia.
PubMed ID
8843500 View in PubMed
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Alexithymia, hypochondriacal beliefs, and psychological distress among frequent attenders in primary health care.

https://arctichealth.org/en/permalink/ahliterature52562
Source
Compr Psychiatry. 1999 Jul-Aug;40(4):292-8
Publication Type
Article
Author
S. Jyväsjärvi
M. Joukamaa
E. Väisänen
P. Larivaara
S L Kivelä
S. Keinänen-Kiukaanniemi
Author Affiliation
Department of Public Health Science and General Practice, University of Oulu, Oulu University Hospital, Finland.
Source
Compr Psychiatry. 1999 Jul-Aug;40(4):292-8
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Affective Symptoms - diagnosis - psychology
Comparative Study
Female
Finland
Humans
Hypochondriasis - psychology
Male
Mental Health Services - utilization
Patient Acceptance of Health Care - psychology
Primary Health Care
Psychiatric Status Rating Scales
Questionnaires
Research Support, Non-U.S. Gov't
Retrospective Studies
Severity of Illness Index
Abstract
Frequent use of health services has been associated with such concepts as alexithymia, hypochondriasis, and psychological distress. The aim of this case-control study was firstly to assess whether alexithymia, hypochondriasis, and psychological distress are associated with frequent attendance and secondly to assess the gender differences of these associations in a primary health care setting. A sample of 304 frequent attenders (eight or more visits during 1 year), including all of the frequent attenders during 1994, and 304 randomly selected age- and sex-matched controls were selected. Half of the sample (every second individual selected in date-of-birth order) was invited for an interview, 113 frequent attenders and 107 controls completed a questionnaire during the interview. Alexithymia was measured with the Toronto Alexithymia Scale-20 (TAS-20), hypochondriasis was screened with the Whiteley Index (WI), and Symptom Checklist-36 (SCL-36) was used to determine psychological distress. We found a distinct gender difference in the associations of these characteristics with frequent attending. Significant associations of alexithymia, hypochondriasis, and psychological distress with frequent attending were found among men, but not among women. Alexithymia, hypochondriasis, and psychological distress should be considered when treating frequent attenders, especially males.
PubMed ID
10428189 View in PubMed
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Alexithymia in a normal elderly population.

https://arctichealth.org/en/permalink/ahliterature212557
Source
Compr Psychiatry. 1996 Mar-Apr;37(2):144-7
Publication Type
Article
Author
M. Joukamaa
S. Saarijärvi
M L Muuriaisniemi
R K Salokangas
Author Affiliation
Department of Psychiatry, Turku University Central Hospital, Finland.
Source
Compr Psychiatry. 1996 Mar-Apr;37(2):144-7
Language
English
Publication Type
Article
Keywords
Affective Symptoms - diagnosis - epidemiology - psychology
Aged
Aging - psychology
Dementia - diagnosis - epidemiology - psychology
Female
Finland - epidemiology
Follow-Up Studies
Humans
Male
Middle Aged
Personality Assessment - statistics & numerical data
Prospective Studies
Psychometrics
Reference Values
Abstract
The aim of the study was to determine the prevalence of alexithymia in an elderly Finnish population sample. Associations between alexithymia and sociodemographic factors were investigated, together with the relationship between alexithymia and perceived somatic health and self-reported psychic health. The study forms a part of the Turun Vanhustutkimus (TUR-VA) project, which is a longitudinal, prospective follow-up study dealing with psychosocial adaptation to retirement and to old age. The study group consisted of a population sample of 72-year-old people (N = 190). Alexithymia was measured with the 26-item version of the Toronto Alexithymia Scale (TAS-26). The prevalence of alexithymia was 34%. Alexithymia was associated with poor perceived somatic health. Alexithymia was associated with having a psychiatric disturbance (measured by the 36-item General Health Questionnaire [GHQ-36]), but this relationship disappeared when the influence of perceived somatic health was controlled for. Alexithymia was not associated with gender, marital status, social status, or residential area.
PubMed ID
8654065 View in PubMed
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An evaluation of the absolute and relative stability of alexithymia over 11years in a Finnish general population.

https://arctichealth.org/en/permalink/ahliterature285523
Source
J Psychosom Res. 2017 Apr;95:81-87
Publication Type
Article
Date
Apr-2017
Author
A. Hiirola
S. Pirkola
M. Karukivi
N. Markkula
R M Bagby
M. Joukamaa
A. Jula
E. Kronholm
S. Saarijärvi
J K Salminen
J. Suvisaari
G. Taylor
A K Mattila
Source
J Psychosom Res. 2017 Apr;95:81-87
Date
Apr-2017
Language
English
Publication Type
Article
Keywords
Adult
Affective Symptoms - diagnosis - epidemiology - psychology
Female
Finland - epidemiology
Humans
Longitudinal Studies
Male
Middle Aged
Personality Inventory - statistics & numerical data
Population Surveillance - methods
Time Factors
Young Adult
Abstract
We investigated if alexithymia, a personality construct with difficulties in emotional processing, is stable in the general population.
Altogether 3083 unselected subjects aged 30 and older in Finland completed the 20-item Toronto Alexithymia Scale (TAS-20) in the longitudinal Health 2000 and Health 2011 general population surveys (BRIF8901). The stability of alexithymia at the 11-year follow-up was assessed with t-tests, correlations, and separate linear regression models with base-line and follow-up age, gender, marital status, education, and 12-month depressive and anxiety disorders as confounders.
The mean score (SD) of the TAS-20 for the whole sample was 44.2 (10.4) in 2000 and 44.2 (10.9) in 2011 (p=0.731). The mean score of the TAS-20 subscale Difficulty Identifying Feelings increased by 0.3 points, Difficulty Describing Feelings decreased by 0.6 points and Externally Oriented Thinking increased by 0.3 points. The effect sizes of the changes varied from negligible to small. Age had little effect except for the group of the oldest subjects (75-97years): the TAS-20 mean (SD) score was 49.1 (10.1) in 2000 and 53.1 (10.3) in 2011 (p
PubMed ID
28314554 View in PubMed
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Association between symptoms of temporomandibular disorders and depression: an epidemiological study of the Northern Finland 1966 Birth Cohort.

https://arctichealth.org/en/permalink/ahliterature46085
Source
Cranio. 2001 Jul;19(3):183-7
Publication Type
Article
Date
Jul-2001
Author
K. Sipilä
J. Veijola
J. Jokelainen
M R Järvelin
K S Oikarinen
A M Raustia
M. Joukamaa
Author Affiliation
Institute of Dentistry, University of Oulu, Dept of Prosthetic Dentistry and Stomatognathic Physiology, Finland. kirsir@cc.oulu.fi
Source
Cranio. 2001 Jul;19(3):183-7
Date
Jul-2001
Language
English
Publication Type
Article
Keywords
Adult
Cohort Studies
Comparative Study
Depression - diagnosis - epidemiology
Facial Pain - epidemiology - psychology
Female
Finland - epidemiology
Humans
Male
Population Surveillance
Prevalence
Research Support, Non-U.S. Gov't
Severity of Illness Index
Sex Distribution
Temporomandibular Joint Disorders - epidemiology - psychology
Abstract
Facial pain and other symptoms of temporomandibular disorders (TMD) are rather common in the adult population. According to clinical studies, psychological factors play an important role in the etiology and maintenance of these symptoms. On the other hand, chronic pain can cause depression. The aim of this study was to evaluate the association between symptoms of TMD and depression in a large population sample of young adults. The study was a part of the 31-year follow-up study of the Northern Finland Birth Cohort consisting of 12,058 live births from the year 1966. Questionnaire information concerning TMD symptoms was collected from a subsample of 5,696 subjects. Depression was measured with a question about reported depression (diagnosed by a doctor) and with the Symptom Checklist depression subscale (SCL-25 DS). Of the TMD symptoms, those related to pain had the most significant relations to indicators of depression. In both genders, the proportion of depression indicated with the SCL-25 DS was significantly higher in subjects with pain-related symptoms of TMD, i.e., facial pain and "pain at jaw rest", and in men with "pain on jaw movement", compared with non-pain subjects (p0.05), except "difficulties in mouth opening" among women. Among women, the prevalence of recognized depression was also significantly higher in subjects with pain-related symptoms of TMD, compared with subjects with no pain (p
PubMed ID
11482830 View in PubMed
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Association of symptoms of TMD and orofacial pain with alexithymia: an epidemiological study of the Northern Finland 1966 Birth Cohort.

https://arctichealth.org/en/permalink/ahliterature46063
Source
Cranio. 2001 Oct;19(4):246-51
Publication Type
Article
Date
Oct-2001
Author
K. Sipilä
J. Veijola
J. Jokelainen
M R Järvelin
K S Oikarinen
A M Raustia
M. Joukamaa
Author Affiliation
Dept. of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Oulu, Finland. kirsir@cc.oulu.fi
Source
Cranio. 2001 Oct;19(4):246-51
Date
Oct-2001
Language
English
Publication Type
Article
Keywords
Adult
Affective Symptoms - epidemiology
Attitude to Health
Chi-Square Distribution
Cohort Studies
Confidence Intervals
Confounding Factors (Epidemiology)
Depression - epidemiology
Epidemiologic Studies
Facial Pain - epidemiology
Female
Finland - epidemiology
Follow-Up Studies
Humans
Logistic Models
Male
Marital status
Odds Ratio
Prevalence
Questionnaires
Research Support, Non-U.S. Gov't
Self Concept
Sex Factors
Temporomandibular Joint Disorders - epidemiology
Tongue Diseases - epidemiology
Toothache - epidemiology
Abstract
Alexithymia is a term denoting a deficit in the ability to differentiate emotional from physical states and to identify and describe one's feelings, as well as a preference for external oriented thinking. Alexithymia has been linked with various somatic and psychosomatic diseases, especially with chronic pain. The aim of this study was to evaluate the association between alexithymia and symptoms of temporomandibular disorders (TMD) as well as oro-lingual and dental pain, in a large representative population sample of young adults. The study was a part of the 31-year follow-up study of the Northern Finland Birth Cohort originally consisting of 12058 live births in the year 1966. In 1997, 4893 subjects living in northern Finland or in the capital area, who participated in a field study of the project and later returned a postal questionnaire, made up the sample of this study. Information concerning symptoms of TMD and oro-lingual and dental pain was collected from the subjects. To assess alexithymia, the Toronto Alexithymia Scale-20 (TAS-20) was used. In addition, information about depression, marital status and self-rated health was collected. The proportion of alexithymics (TAS score over 60) was higher in subjects with the most orofacial symptoms than in asymptomatic subjects. In men, alexithymia associated significantly with facial pain, difficulties in mouth opening, oro-lingual pain and dental pain, and in women with pain on jaw movement and dental pain. After adjusting for depression, marital status, and self-rated health, a significant association remained between alexithymia and the symptoms mentioned, except for facial pain in men. It can be concluded that alexithymia is connected with orofacial symptoms. Clinicians treating these symptoms should be familiar with the concept of alexithymia.
PubMed ID
11725848 View in PubMed
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Cognitive impairment and the 10-year survival probability of a normal 62-year-old population.

https://arctichealth.org/en/permalink/ahliterature193334
Source
Scand J Psychol. 2001 Sep;42(4):359-66
Publication Type
Article
Date
Sep-2001
Author
R. Portin
M L Muuriaisniemi
M. Joukamaa
S. Saarijärvi
H. Helenius
R K Salokangas
Author Affiliation
Department of Neurology, University of Turku and Turku University Central Hospital, Finland. raija.portin@tyks.fi
Source
Scand J Psychol. 2001 Sep;42(4):359-66
Date
Sep-2001
Language
English
Publication Type
Article
Keywords
Aged
Aging - psychology
Cognition Disorders - diagnosis - mortality
Female
Finland - epidemiology
Health status
Humans
Male
Memory, Short-Term
Middle Aged
Neuropsychological Tests
Population Surveillance
Predictive value of tests
Sampling Studies
Severity of Illness Index
Survival Rate - trends
Abstract
The predictive value of cognitive impairment together with demographic and health factors on long-term survival was evaluated. The population sample comprised 389 subjects, all 62 years old. Cognitive performances were measured using verbal, visuomotor and memory tests. Cognitive impairment was determined by comparing performances with norms derived from healthy controls. Ten years after testing, the probability of survival was 89% for the cognitively preserved subjects, 80% for those with mild impairment, and 71% for those with moderate impairment (p = 0.009). Relative risk (RR) for shortened survival was 1.7 (95% CI 0.9-3.2) for the mildly, and 2.6 (95% CI 1.4-4.8) for the moderately impaired. Perceived health problems were, as expected, related to reduced survival (p
PubMed ID
11547911 View in PubMed
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Comorbidity of hospital-treated psychiatric and physical disorders with special reference to schizophrenia: a 28 year follow-up of the 1966 northern Finland general population birth cohort.

https://arctichealth.org/en/permalink/ahliterature72511
Source
Public Health. 1998 Jul;112(4):221-8
Publication Type
Article
Date
Jul-1998
Author
T. Mäkikyrö
J T Karvonen
H. Hakko
P. Nieminen
M. Joukamaa
M. Isohanni
P. Jones
M R Järvelin
Author Affiliation
Department of Psychiatry, University of Oulu, Finland.
Source
Public Health. 1998 Jul;112(4):221-8
Date
Jul-1998
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Cohort Studies
Comorbidity
Confidence Intervals
Female
Finland - epidemiology
Hospitalization
Humans
Male
Mental Disorders - epidemiology
Odds Ratio
Prospective Studies
Research Support, Non-U.S. Gov't
Schizophrenia - epidemiology
Sex Factors
Abstract
We studied the comorbidity of psychiatric and physical disorders in a sample (n = 11,017) from the unselected, general population, Northern Finland 1966 Birth Cohort. During the period 1982-1994, hospital-treated psychiatric patients were more likely than people without psychiatric diagnoses to have been treated for physical disease in hospital wards, 298 out of 387 (77%) vs 6687 out of 10,630 (62.9%) (OR = 2.0, 95% CI = 1.6-2.5). Injuries, poisonings and indefinite symptoms were a more common reason for hospital treatment in people with schizophrenia or other psychiatric disorder as compared with people without a psychiatric disorder. Men with psychiatric disorder had more than a 50-fold risk for poisoning by psychotropic drugs (OR = 52.6, 95% CI = 27.7-99.8), women with psychiatric disorder a 20-fold risk (OR = 19.0, 95% CI = 9.5-38.1) and schizophrenics more than a 30-fold (OR = 37.5, 95% CI = 19.1-73.8). Men with psychiatric disorders were more commonly hospitalised for a variety of gastrointestinal disorders and circulatory diseases (OR = 2.3, 95% CI = 1.2-4.4), as compared with men with no psychiatric disorder. Respiratory diseases (OR = 2.2, 95% CI = 1.2-4.2, vertebral column disorders (OR = 4.2, 95% CI = 1.8-9.9), gynaecological disorders (OR = 2.1, 95% CI = 1.2-3.6) and induced abortions (OR = 1.8, 95% CI = 1.2-2.7) were more prevalent in women with psychiatric disorder than in other women. Epilepsy was strongly associated with schizophrenia (OR = 11.1, 95% CI = 4.0-31.6). Nervous and sensory organ diseases in general (OR = 2.5, 95% CI = 1.1-5.8) and inflammatory diseases of the bowel (OR = 12.8, 95% CI = 3.8-42.7) were also overrepresented in schizophrenia when compared with people without a psychiatric disorder. Our results indicate that physicians must be alert for psychiatric disorder, and mental health professionals must be aware of the considerable morbidity in their patients.
PubMed ID
9724944 View in PubMed
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Depression and cardiovascular diseases.

https://arctichealth.org/en/permalink/ahliterature219289
Source
Acta Psychiatr Scand Suppl. 1994;377:77-82
Publication Type
Article
Date
1994
Author
A. Aromaa
R. Raitasalo
A. Reunanen
O. Impivaara
M. Heliövaara
P. Knekt
V. Lehtinen
M. Joukamaa
J. Maatela
Author Affiliation
Social Insurance Institution, Helsinki, Finland.
Source
Acta Psychiatr Scand Suppl. 1994;377:77-82
Date
1994
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cardiovascular Diseases - complications - mortality - psychology
Causality
Cause of Death
Comorbidity
Coronary Disease - mortality - psychology
Cross-Sectional Studies
Depressive Disorder - complications - mortality - psychology
Female
Finland - epidemiology
Follow-Up Studies
Humans
Longitudinal Studies
Male
Middle Aged
Risk factors
Survival Rate
Abstract
We first review the associations between depression and cardiovascular diseases (CVDs). Then we examine them in the nationally representative Mini-Finland Health Survey, which covers 8,000 persons. Chronic somatic diseases and mental disorders were diagnosed using standardized methods. Cross-sectionally, CVDs and neurotic depression were associated both before and after adjustment for covariates. The strongest associations were observed in the case of severe CVDs. During a 6.6 year follow-up, the risk of CVD death and coronary death was elevated in depressed persons both with and without CVDs at entry. Much of the cross-sectional association is probably due to depression caused by CVDs. The outcome of CVD may be poorer in depressed persons. The hypothesis that depression is a cause of CVDs requires further study.
PubMed ID
8053372 View in PubMed
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52 records – page 1 of 6.