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Antidepressant use and mortality in Finland: a register-linkage study from a nationwide cohort.

https://arctichealth.org/en/permalink/ahliterature152280
Source
Eur J Clin Pharmacol. 2009 Jul;65(7):715-20
Publication Type
Article
Date
Jul-2009
Author
Jari Haukka
Martti Arffman
Timo Partonen
Sinikka Sihvo
Marko Elovainio
Jari Tiihonen
Jouko Lönnqvist
Ilmo Keskimäki
Author Affiliation
National Institute for Health and Welfare, Helsinki, Finland. jari.haukka@thl.fi
Source
Eur J Clin Pharmacol. 2009 Jul;65(7):715-20
Date
Jul-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Antidepressive Agents - adverse effects - therapeutic use
Cause of Death
Cohort Studies
Data Collection
Female
Finland - epidemiology
Follow-Up Studies
Hospitalization
Humans
Male
Prescriptions
Registries
Risk assessment
Risk factors
Serotonin Uptake Inhibitors - adverse effects - therapeutic use
Suicide - psychology - statistics & numerical data
Young Adult
Abstract
It is generally acknowledged that depressed patients need specific attention during the first weeks after initiation of antidepressant (AD) treatment because of the increased risk of suicide.
The study population consisted of all individuals residing in Finland from 1999 to 2003 who had purchased a prescribed antidepressant at least once but had no preceding antidepressant prescription. Data sources were the National Prescription Register, the Causes of Death Register, Census Data of Statistics Finland, and the National Care Register. Follow-up started at the first purchase and ended at the end of 2003 or death. Data on prescriptions were used to construct contiguous treatment periods of follow-up time. Life-table analysis with Poisson regression was used to estimate risk ratios (RR) of antidepressant use with respect to all-cause mortality and to deaths from suicide.
Current AD use was associated with a lowered all-cause mortality (RR = 0.18, 95% CI = 0.18-0.19) compared with those who filled one previous prescription only. There was no difference in suicide mortality when any current antidepressant usage was compared to the one-prescription group. Current SSRI usage was associated with lower risk of suicide compared to the one-prescription or other antidepressant groups (RR 0.47, 0.38-0.59).
Current AD treatment is associated with decreased all-cause mortality rates in patients who have ever had AD treatment.
PubMed ID
19259654 View in PubMed
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Antipsychotic treatment and mortality in schizophrenia.

https://arctichealth.org/en/permalink/ahliterature269903
Source
Schizophr Bull. 2015 May;41(3):656-63
Publication Type
Article
Date
May-2015
Author
Minna Torniainen
Ellenor Mittendorfer-Rutz
Antti Tanskanen
Charlotte Björkenstam
Jaana Suvisaari
Kristina Alexanderson
Jari Tiihonen
Source
Schizophr Bull. 2015 May;41(3):656-63
Date
May-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Antipsychotic Agents - adverse effects - pharmacology
Cardiovascular Diseases - chemically induced - mortality
Cohort Studies
Female
Humans
Male
Middle Aged
Registries
Schizophrenia - drug therapy - mortality
Sweden - epidemiology
Young Adult
Abstract
It is generally believed that long-term use of antipsychotics increases mortality and, especially, the risk of cardiovascular death. However, there are no solid data to substantiate this view.
We identified all individuals in Sweden with schizophrenia diagnoses before year 2006 (N = 21 492), aged 17-65 years, and persons with first-episode schizophrenia during the follow-up 2006-2010 (N = 1230). Patient information was prospectively collected through nationwide registers. Total and cause-specific mortalities were calculated as a function of cumulative antipsychotic exposure from January 2006 to December 2010.
Compared with age- and gender-matched controls from the general population (N = 214920), the highest overall mortality was observed among patients with no antipsychotic exposure (hazard ratio [HR] = 6.3, 95% CI: 5.5-7.3), ie, 0.0 defined daily dose (DDD)/day, followed by high exposure (>1.5 DDD/day) group (HR = 5.7, 5.2-6.2), low exposure (
Notes
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PubMed ID
25422511 View in PubMed
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Association of socio-demographic factors, sick-leave and health care patterns with the risk of being granted a disability pension among psychiatric outpatients with depression.

https://arctichealth.org/en/permalink/ahliterature267619
Source
PLoS One. 2014;9(6):e99869
Publication Type
Article
Date
2014
Author
Ellenor Mittendorfer-Rutz
Tommi Härkänen
Jari Tiihonen
Jari Haukka
Source
PLoS One. 2014;9(6):e99869
Date
2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Cohort Studies
Depressive Disorder - epidemiology - psychology
Disabled Persons
Female
Follow-Up Studies
Health Services - utilization
Humans
Male
Mental Disorders - psychology
Middle Aged
Outpatients
Pensions - statistics & numerical data
Prognosis
Risk factors
Sick Leave - statistics & numerical data - trends
Socioeconomic Factors
Sweden - epidemiology
Young Adult
Abstract
Depression ranges among the leading causes of early exit from the labor market worldwide. We aimed to investigate the associations of socio-demographic factors, sickness absence, health care and prescription patterns with the risk of being granted a disability pension in psychiatric outpatients with depression.
All non-retired patients aged 18-60 years and living in Sweden 31.12.2005 with at least one psychiatric outpatient care visit due to a depressive episode during 2006 (N?=?18,034): were followed from 01.01.2007 to 31.12.2010 with regard to granting of all-cause and diagnosis-specific disability pension. Uni- and multivariate Rate Ratios (RR) and 95% Confidence Intervals (CI) were estimated for the various risk markers by Poisson Regression.
During the four years of follow-up, 3044 patients (16.8%) were granted a disability pension, the majority due to mental disorders (2558, 84%). In the multivariate analyses, being female, below 25 or above 45 years of age, with low educational level, living alone, residing outside big cities and being born outside Europe were predictive of a granted disability pension. Frequent in- and outpatient care due to mental disorders, prescription of antidepressants and long sickness absence spells were also associated with an increased risk of disability pension (range of RRs 1.10 to 5.26). Somatic health care was only predictive of disability pension due to somatic disorders. The risk of being granted a disability pension remained at the same level as at the start of follow-up for about 1.5 years, when it started to decrease and to level off at about 20% of the risk at the end of follow-up.
Identified risk markers should be considered when monitoring individuals with depression and when designing intervention programs.
Notes
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PubMed ID
24963812 View in PubMed
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Cause-specific mortality in Finnish forensic psychiatric patients.

https://arctichealth.org/en/permalink/ahliterature301165
Source
Nord J Psychiatry. 2018 Jul; 72(5):374-379
Publication Type
Journal Article
Date
Jul-2018
Author
Ilkka Ojansuu
Hanna Putkonen
Jari Tiihonen
Author Affiliation
a Kuopio University Hospital , Kuopio , Finland.
Source
Nord J Psychiatry. 2018 Jul; 72(5):374-379
Date
Jul-2018
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Cause of Death - trends
Female
Finland - epidemiology
Forensic Psychiatry - methods - trends
Homicide - psychology - trends
Hospitals, Psychiatric - trends
Humans
Male
Mental Disorders - diagnosis - mortality - psychology
Middle Aged
Suicide - psychology - trends
Young Adult
Abstract
To analyze the causes of mortality among patients committed to compulsory forensic psychiatric hospital treatment in Finland during 1980-2009 by categorizing the causes of mortality into somatic diseases, suicides and other unnatural deaths.
The causes of mortality were analyzed among 351 patients who died during the follow-up. Standardized mortality ratio (SMR) was calculated as the ratio of observed and expected number of deaths by using the subject-years methods with 95% confidence intervals, assuming a Poisson distribution. The expected number of deaths was calculated on the basis of sex-, age- and calendar-period-specific mortality rates for the Finnish population.
The vast majority (249/351) of deaths were due to a somatic disease with SMR of 2.6 (mean age at death 61 years). Fifty nine patients committed suicide with a SMR of 7.1 (mean age at death 40 years). Four patients were homicide victims (mean age at death 40 years) and 32 deaths were accidental (mean age at death 52 years). The combined homicides and accidental deaths resulted in a SMR of 1.7.
The results of this study point out that the high risk for suicide should receive attention when the hospital treatment and the outpatient care is being organized for forensic psychiatric patients. In addition, the risk of accidents should be evaluated and it should be assured that the patients receive proper somatic healthcare during the forensic psychiatric treatment and that it continues also in the outpatient setting.
PubMed ID
29720022 View in PubMed
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Characteristics of drug-abusing females with and without children seeking treatment in Helsinki, Finland.

https://arctichealth.org/en/permalink/ahliterature265030
Source
Scand J Public Health. 2015 May;43(3):221-8
Publication Type
Article
Date
May-2015
Author
Sushil Basnet
Ifeoma N Onyeka
Jari Tiihonen
Jaana Föhr
Jussi Kauhanen
Source
Scand J Public Health. 2015 May;43(3):221-8
Date
May-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Cross-Sectional Studies
Family Characteristics
Female
Finland
Humans
Middle Aged
Mothers - psychology - statistics & numerical data
Patient Acceptance of Health Care - statistics & numerical data
Risk-Taking
Street Drugs
Substance-Related Disorders - psychology - rehabilitation
Young Adult
Abstract
This study characterizes treatment-seeking female users of illicit drugs in Finland, and examines possible differences among women with or without children under 18.
The subjects were 2526 drug-using clients from the Helsinki metropolitan area, who sought treatment at Helsinki Deaconess Institute between 2001 and 2008. A total of 775 (30.6%) were females with complete information regarding their parental status. Of these, 225 (29%) had children under 18. The proportion of women with children varied between 20% and 30% annually, except in 2006, when it peaked at 40.5%.
Women with children were more likely to be somewhat older (p
PubMed ID
25652411 View in PubMed
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Comorbid opioid use is undertreated among forensic patients with schizophrenia.

https://arctichealth.org/en/permalink/ahliterature297569
Source
Subst Abuse Treat Prev Policy. 2018 11 06; 13(1):39
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
11-06-2018
Author
Kristiina Kivimies
Eila Repo-Tiihonen
Hannu Kautiainen
Jari Tiihonen
Author Affiliation
Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Niuvankuja 65, FI-70240, Kuopio, Finland. kristiina.kivimies@niuva.fi.
Source
Subst Abuse Treat Prev Policy. 2018 11 06; 13(1):39
Date
11-06-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Comorbidity
Diagnosis, Dual (Psychiatry) - statistics & numerical data
Female
Finland - epidemiology
Forensic Psychiatry - statistics & numerical data
Humans
Male
Opiate Substitution Treatment - statistics & numerical data
Opioid-Related Disorders - drug therapy - epidemiology
Registries
Retrospective Studies
Schizophrenia - epidemiology
Young Adult
Abstract
Substance use disorders are associated with poorer clinical outcomes in patients with schizophrenia. There is no specific treatment for amphetamine or cannabis use disorder, but methadone and buprenorphine are used as replacement therapy in the treatment of opioid dependence. Our aim was to study whether patients with schizophrenia have received opioid replacement therapy for their opioid use disorder.
The study sample consisted of 148 individuals diagnosed with schizophrenia who were in involuntary psychiatric treatment as forensic patients in Finland in 2012. The proportion of the study sample with comorbid opioid use disorder having received opioid replacement therapy prior to their forensic psychiatric treatment was compared to the available information of opioid dependent patients in general. The data were collected from forensic examination statements, patient files and other medical registers retrospectively.
Of the study sample, 15.6% (23/148) had a history of opioid use disorder, of whom 8.7% (2/23) had received opioid replacement treatment (95% confidence interval (Cl): 1.1-28.0), even though opioid use disorder had been diagnosed in the treatment system. According the available information the corresponding proportion among patients with opioid use disorder and using substance use disorder services was 30.4% (565/1860, 95% Cl: 28.3-32.5). The fraction of patients receiving opioid replacement therapy was significantly lower among patients with schizophrenia (p =?0.022).
Opioid replacement therapy was seldom used among schizophrenia patients who were later ordered to involuntary forensic psychiatric treatment. More attention should be paid to the possible use of opioids when planning treatment for patients with schizophrenia.
Our study is not a randomized controlled trial (but a register-based study); thus the trial registration is not applicable.
PubMed ID
30400965 View in PubMed
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The effects of a HTR2B stop codon and testosterone on energy metabolism and beta cell function among antisocial Finnish males.

https://arctichealth.org/en/permalink/ahliterature285571
Source
J Psychiatr Res. 2016 Oct;81:79-86
Publication Type
Article
Date
Oct-2016
Author
Roope Tikkanen
Tero Saukkonen
Malin Fex
Hedvig Bennet
Marja-Riitta Rautiainen
Tiina Paunio
Mika Koskinen
Rony Panarsky
Laura Bevilacqua
Rickard L Sjöberg
Jari Tiihonen
Matti Virkkunen
Source
J Psychiatr Res. 2016 Oct;81:79-86
Date
Oct-2016
Language
English
Publication Type
Article
Keywords
Adult
Antisocial Personality Disorder - genetics - metabolism - pathology
Area Under Curve
Blood glucose - genetics
Body mass index
Codon, Terminator - genetics
Cohort Studies
Energy Metabolism - genetics
Finland
Glucose Tolerance Test
Humans
Indoles - cerebrospinal fluid
Insulin - blood
Insulin-Secreting Cells - physiology
Male
Psychiatric Status Rating Scales
Receptor, Serotonin, 5-HT2B - genetics
Testosterone - blood
Young Adult
Abstract
Herein, we examined insulin resistance (IR), insulin sensitivity (IS), beta cell activity, and glucose metabolism in subjects with antisocial personality disorder (ASPD), and whether the serotonin 2B (5-HT2B) receptor and testosterone have a role in energy metabolism. A cohort of subjects belonging to a founder population that included 98 ASPD males, aged 25-30, was divided into groups based on the presence of a heterozygous 5-HT2B receptor loss-of-function gene mutation (HTR2B Q20*; n = 9) or not (n = 89). Serum glucose and insulin levels were measured in a 5 h oral glucose tolerance test (75 g) and indices describing IR, IS, and beta cell activity were calculated. Body mass index (BMI) was also determined. Concentrations of the serotonin metabolite 5-hydroxyindoleacetic acid were measured in cerebrospinal fluid, and testosterone levels from serum. An IR-like state comprising high IR, low IS, and high beta cell activity indices was observed among ASPD subjects without the HTR2B Q20* allele. By contrast, being an ASPD HTR2B Q20* carrier appeared to be preventive of these pathophysiologies. The HTR2B Q20* allele and testosterone predicted lower BMI independently, but an interaction between HTR2B Q20* and testosterone lead to increased insulin sensitivity among HTR2B Q20* carriers with low testosterone levels. The HTR2B Q20* allele also predicted reduced beta cell activity and enhanced glucose metabolism. Reduced 5-HT2B receptor function at low or normal testosterone levels may be protective of obesity. Results were observed among Finnish males having an antisocial personality disorder, which limits the generality.
PubMed ID
27420381 View in PubMed
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Factors associated with buprenorphine compared to amphetamine abuse among clients seeking treatment in Finland.

https://arctichealth.org/en/permalink/ahliterature263255
Source
J Subst Abuse Treat. 2014 May-Jun;46(5):561-6
Publication Type
Article
Author
Hanna Uosukainen
Jenni Ilomäki
Jussi Kauhanen
Ulrich Tacke
Jaana Föhr
Jari Tiihonen
J Simon Bell
Source
J Subst Abuse Treat. 2014 May-Jun;46(5):561-6
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Amphetamine-Related Disorders - epidemiology - rehabilitation
Buprenorphine - administration & dosage - adverse effects
Female
Finland - epidemiology
Humans
Interviews as Topic
Male
Multivariate Analysis
Opioid-Related Disorders - epidemiology - rehabilitation
Prescription Drug Misuse - statistics & numerical data
Sex Factors
Substance Abuse Treatment Centers
Young Adult
Abstract
Abuse of prescription opioids is becoming increasingly widespread. This study compared the social, health and treatment-related factors associated with buprenorphine and amphetamine abuse in Finland. Structured clinical interviews were conducted with clients seeking treatment for buprenorphine (n=670) or amphetamine (n=557) abuse in Helsinki from January 2001 to August 2008. Unadjusted and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were computed for factors associated with buprenorphine compared to amphetamine abuse. In multivariate analyses, buprenorphine abuse was associated with male gender (OR 1.57, 95% CI 1.17-2.09), daily abuse (OR 5.45, 95% CI 4.14-7.18), no drug free months during the last year (OR 1.68, 95%CI 1.23-2.29), and inversely associated with increasing age (OR 0.95, 95% CI 0.93-0.97 per year) and psychotic symptoms (OR 0.33, 95% CI 0.24-0.45). Despite more intense abuse patterns, clients seeking treatment for buprenorphine abuse shared similar characteristics to amphetamine clients. These characteristics were different to characteristics of those who abuse prescription opioids in North America. This is important for developing and targeting intervention programs.
PubMed ID
24560129 View in PubMed
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Factors associated with hospitalization for blood-borne viral infections among treatment-seeking illicit drug users.

https://arctichealth.org/en/permalink/ahliterature269593
Source
J Subst Abuse Treat. 2015 Jun;53:71-7
Publication Type
Article
Date
Jun-2015
Author
Ifeoma N Onyeka
Olubunmi Olubamwo
Caryl M Beynon
Kimmo Ronkainen
Jaana Föhr
Jari Tiihonen
Pekka Tuomola
Niko Tasa
Jussi Kauhanen
Source
J Subst Abuse Treat. 2015 Jun;53:71-7
Date
Jun-2015
Language
English
Publication Type
Article
Keywords
Adult
Cohort Studies
Female
Finland - epidemiology
HIV Infections - epidemiology - mortality
Hepatitis C - epidemiology - mortality
Humans
Length of Stay
Male
Patient Acceptance of Health Care
Patient Admission
Proportional Hazards Models
Retrospective Studies
Substance-Related Disorders
Surveys and Questionnaires
Survival Analysis
Young Adult
Abstract
Blood-borne viral infections (BBVIs) are important health consequences of illicit drug use. This study assessed predictors of inpatient hospital admissions for BBVIs in a cohort of 4817 clients seeking treatment for drug use in Finland. We examined clients' data on hospital admissions registered in the Finnish National Hospital Discharge Register from 1997 to 2010 with diagnoses of BBVIs. Cox proportional hazards regression analyses were separately conducted for each of the three BBVI groups to test for association between baseline variables and hospitalizations. Findings were reported as adjusted hazard ratios (aHRs). Based upon primary discharge diagnoses, 81 clients were hospitalized for HIV, 116 for hepatitis C, and 45 for other types of hepatitis. Compared to those admitted for hepatitis C and other hepatitis, drug users with HIV had higher total number of hospital admissions (294 versus 141 and 50 respectively), higher crude hospitalization rate (7.1 versus 3.4.and 1.2 per 1000 person-years respectively), and higher total length of hospital stay (2857 days versus 279 and 308 respectively). Trends in hospitalization for all BBVI groups declined at the end of follow-up. HIV positive status at baseline (aHR: 6.58) and longer duration of drug use (aHR: 1.11) were independently associated with increased risk for HIV hospitalization. Female gender (aHR: 3.05) and intravenous use of primary drug (aHR: 2.78) were significantly associated with HCV hospitalization. Having hepatitis B negative status at baseline (aHR: 0.25) reduced the risk of other hepatitis hospitalizations. Illicit drug use coexists with blood-borne viral infections. To address this problem, clinicians treating infectious diseases need to also identify drug use in their patients and provide drug treatment information and/or referral.
PubMed ID
25736625 View in PubMed
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Firesetting and general criminal recidivism among a consecutive sample of Finnish pretrial male firesetters: A register-based follow-up study.

https://arctichealth.org/en/permalink/ahliterature295740
Source
Psychiatry Res. 2018 01; 259:377-384
Publication Type
Journal Article
Date
01-2018
Author
Annika Thomson
Jari Tiihonen
Jouko Miettunen
Matti Virkkunen
Nina Lindberg
Author Affiliation
Psychiatry, Kellokoski Hospital, University of Helsinki and Helsinki University Hospital, Finland. Electronic address: annika.thomson@hus.fi.
Source
Psychiatry Res. 2018 01; 259:377-384
Date
01-2018
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Antisocial Personality Disorder - psychology
Checklist
Crime - psychology
Criminals - psychology
Finland
Firesetting Behavior - psychology
Follow-Up Studies
Humans
Male
Middle Aged
Recidivism - psychology
Registries
Schizophrenic Psychology
Young Adult
Abstract
The rate of criminal reoffending among firesetters varies greatly. Our aim was to investigate firesetting and general criminal recidivism in a consecutive sample of Finnish males who were sent for a forensic psychiatric examination (FPE)1 after committing firesetting offenses. We also wanted to evaluate the relationships between psychopathy and criminal recidivism, and between schizophrenia-spectrum disorders and criminal recidivism. The sample comprised 113 firesetters with a mean age of 32.8 years, and the average follow-up time was 16.9 years. The FPE statements of the firesetters were reviewed and psychiatric diagnoses were collected. The psychopathy assessments were based on the 20-item Hare Psychopathy Checklist-Revised (PCL-R). Information on reoffending was gathered from the Finnish National Police Register. During the follow-up 20 (18%) persons were registered for a new firesetting and 84 (74%) for any new offense. Firesetters with high traits (PCL-R = 25) of psychopathy were more likely than those with low traits (PCL-R
PubMed ID
29120846 View in PubMed
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32 records – page 1 of 4.