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Background: Previous research on health behavior and subjective well-being has mainly focused on interindividual differences or explored certain domains of health behavior. Good health behavior and subjective well-being at baseline can predict each other after a follow-up. In the present cohort study, we explored the outcomes of change for an individual i.e., how changed health behavior is reflected in subsequent subjective well-being and vice versa.Methods: Data (n = 10,855) originates from a population-based Health and Social Support (HeSSup) study on working-age Finns in 2003 and 2012. A composite measure of health behavior included physical activity, dietary habits, alcohol consumption, and smoking status (range 0-4, worst-best) and a composite measure of subjective well-being (with reversed scoring) included three life assessments, i.e., interest, happiness, and ease in life, and perceived loneliness (range 4-20, best-worst). Different multiple linear regression models were used to study how changes in health behavior predict subjective well-being and the opposite, how changes in subjective well-being predict health behavior.Results: A positive change in health behavior from 2003 to 2012 predicted better subjective well-being (i.e., on average 0.31 points lower subjective well-being sum score), whereas a negative change predicted poorer subjective well-being (i.e., 0.37 points higher subjective well-being sum score) (both: p < 0.001) compared to those study subjects who had no change in health behavior. Similarly, when a positive and negative change in subjective well-being was studied, these figures were 0.071 points better and 0.072 points worse (both: p < 0.001) health behavior sum score, respectively. When the magnitude of the effect of change was compared to the range of scale of the outcome the effect of health behavior change appeared stronger than that of subjective well-being.Conclusion: Changes in health behavior and subjective well-being have long-term effects on the level of the other, the effect of the first being slightly stronger than vice versa. These mutual long-term benefits can be used as a motivator in health promotion on individual and societal levels. [ABSTRACT FROM AUTHOR]

Background: Previous studies have shown positive association between health behavior and life satisfaction, but the studies have mostly been cross-sectional, had follow-up times up to 5 years or focused on only one health behavior domain. The aim of the study was to explore how principal health behavior domains predict life satisfaction as a composite score in a previously unexplored longitudinal setting.Methods: The present study tested whether a health behavior sum score (range 0-4) comprising of dietary habits, smoking, alcohol consumption, and physical activity predicted subsequent composite score of life satisfaction (range 4-20). Data included responses from 11,000 working-age Finns who participated in the Health and Social Support (HeSSup) prospective population-based postal survey.Results: Protective health behavior in 2003 predicted (p < .001) better life satisfaction 9 years later when sex, age, education, major diseases, and baseline life satisfaction were controlled for. The β in the linear regression model was - 0.24 (p < .001) corresponding to a difference of 0.96 points in life satisfaction between individuals having the best and worst health behavior.Conclusion: Good health behavior has a long-term beneficial impact on subsequent life satisfaction. This knowledge could strengthen the motivation for improvement of health behavior particularly on an individual level but also on a policy level. [ABSTRACT FROM AUTHOR]

Background: Separately, mental and musculoskeletal disorders (MSDs) are prevalent across the life course and are leading contributors to disability worldwide. While people with personality disorder (PD) have been shown to have an increased risk of certain physical health comorbidities—associations with MSDs have not been thoroughly explored. The proposed scoping review aims to explore the existing clinical- and population-based literature on the comorbidity of PD and MSDs among adults ≥ 18 years and the burden associated with their comorbidity, identify knowledge gaps on this topic, and propose recommendations for future research. Methods: This protocol describes the methodology to undertake the scoping review. It is guided by Arksey and O'Malley's framework and the extensions recommended by the Joanna Briggs Institute. A comprehensive search strategy will be used to identify relevant articles, which will be underpinned by Population, Concept, and Context (PCC) inclusion criteria. One author will perform the search and two authors will independently screen titles/abstracts followed by a full-text review for articles considered relevant. The supervising author will confirm the final selection of articles to be included. One author will extract relevant information from the articles using a predetermined charting form, while a second will perform validation of all information entered. Discussion: Information will be synthesised to inform a discussion of what is known regarding associations between PD and MSDs, and the burden associated with their comorbidity in different contexts, with future research directions proposed. Systematic review registration: This protocol is registered in Open Science Framework Registries (https://osf.io/mxbr2/). [ABSTRACT FROM AUTHOR]

Background: Previous follow-up studies have demonstrated the association between good health behavior and good sexual functioning for men, but the longitudinal relationship between multiple health behaviors and satisfaction with sex life remains understudied. Aim: The aim of the study was to explore whether good health behavior associates with improved satisfaction with sex life for men and women in a follow-up of 9 years. Methods: This cohort study utilized survey data from the population-based Health and Social Support study. It includes responses from 10 671 working-aged Finns. Using linear regression models, we examined a composite sum score representing 4 health behaviors (range, 0–4) in 2003 as a predictor of satisfaction with sex life in 2012. The analyses adjusted for various covariates in 2003, including satisfaction with sex life, living status, age, gender, education, number of diseases, and importance of sex life in 2012. Outcomes: The outcome in the study was satisfaction with sex life in the year 2012. Results: Participants who exhibited better health behavior at baseline demonstrated improved satisfaction with sex life when compared with those with poorer health behavior (β = −0.046, P = .009), even when controlling for the aforementioned covariates. The positive effect of reporting all beneficial health behaviors vs none of them was greater than having none vs 3 chronic conditions. Furthermore, this was almost half the effect of how satisfaction with sex life in 2003 predicted its level in 2012. These findings were supported by an analysis of the congruence of health behavior in the observation period from 2003 to 2012 predicting changes in satisfaction with sex life. Clinical Implications: The results could serve as a motivator for a healthy lifestyle. Strengths and Limitations: The current study used a longitudinal large sample and a consistent survey procedure, and it explored the personal experience of satisfaction instead of sexual function. However, the study is limited in representing today's diversity of gender, since the options for gender at the time of survey were only male and female. Conclusion: These findings indicate that engaging in healthy behaviors contributes to the maintenance and enhancement of satisfaction with sex life over time. [ABSTRACT FROM AUTHOR]

Background Online behavior-change programs may increase physical activity in adolescents, but their effects on subjective health and wellbeing are not well known. Purpose We investigated the effects of a mobile physical activity intervention on life satisfaction and self-rated health among young adolescent men. Methods In this population-based study, 496 men (17.8y, SD 0.6y) participated in a 6-month trial. They were randomized into an intervention (n = 250) and a control group (n = 246). Only the intervention group had access to a tailored mobile service. Life satisfaction and self-rated health were inquired about at baseline and at the end of the trial. Results Life satisfaction improved in the intervention (p < 0.001) and control group (p = 0.01). Life satisfaction was most likely to improve among men with low baseline satisfaction (OR 13.8; 95% CI 3.7–51.8) and mood-related exercise motive (2.5 (1.1–5.6)). There were no statistically significant changes in self-rated health, but those who reported poor health at baseline (OR 9.6; 95% CI 3.7–24.9) and improved self-rated fitness during the trial (4.2 (1.5–11.9)) were more likely to gain improvements in self-rated health. Conclusion In this mobile physical activity intervention, improvements in self-rated health and life satisfaction were associated with low life satisfaction and poor self-rated health at baseline within the intervention group. Trial registration This randomized controlled trial is registered to the clinical trials register NCT01376986 . [ABSTRACT FROM AUTHOR]

Objective: To compare life satisfaction between women with successful or unsuccessful outcome after assisted reproductive treatment (ART) by taking into account the time since the last ART. Design: Cohort study. Setting: Tertiary hospital. Patients: A total of 987 consecutive women who had undergone ART during 1996–2007 were invited and altogether 505 women participated in the study. Interventions: A postal enquiry with a life satisfaction scale. Main Outcome Measure: Self-reported life satisfaction in respect to the time since the last ART. Results: In general, women who achieved a live birth after ART had a significantly higher life satisfaction than those who had unsuccessful ART, especially when compared in the first three years. The difference disappeared in the time period of 6–9 years after ART. The unsuccessfully treated women who had a child by some other means before or after the unsuccessful ART had comparable life satisfaction with successfully treated women even earlier. Conclusions: Even if unsuccessful ART outcome is associated with subsequent lower level of life satisfaction, it does not seem to threaten the long-term wellbeing. [ABSTRACT FROM AUTHOR]

Abstract: Background: The majority of depressed individuals report insomnia. Self-reported symptoms of insomnia, in particular, more strongly predict adverse health effects than the actual measured sleep time. The physiological alterations in individuals with insomnia are complex, as both autonomic and endocrine dysfunctions are present. Plasminogen activator inhibitor (PAI)-1 is a stress-related acute-phase reactant that has also been suggested to regulate the circadian rhythm and sleep patterns. It has been suggested to contribute to both depressive symptoms and sleep disorders, although data on the relationships between these parameters are scarce. Objective: This study examined the role of self-reported sleep disturbance and its association with PAI-1 among individuals with a history of depressive symptoms. Methods: Differences in the serum levels of PAI-1 between two groups (group 1: moderate to very severe sleep disturbance, n =37; group 2: mild or no sleep disturbance, n =90) were examined in a population-based sample of individuals with a recorded history of depressive symptoms. Results: Multivariate analysis controlling for potential confounding factors (age, sex, body mass index, depression severity) showed that each 1-unit increase in PAI-1 (μg/mL) increased the likelihood for belonging to the group with moderate to very severe sleep disturbance by 23% (OR=1.23, C.I. 95%=1.04–1.45, p =0.016). This statistical significance remained after additional adjustments for regular smoking and the use of sleep or lipid-lowering medication. Conclusion: Our observations may further clarify the physiological alterations related to sleep disturbance in depressive individuals. In the present study, self-reported sleep disturbance in individuals with a recorded history of depressive symptoms was associated with an elevation of PAI-1. This finding may illustrate the association of subjective sleep disturbance with sympathetic activation. Our study highlights the importance of effects of perceived sleep disturbance on individual homeostasis, and may provide potential directions for research on treatment options. [Copyright &y& Elsevier]

Background: Self-report is commonly used as a source of information on the use of medicine. The aim of this study was to investigate the relationship between self-reported and register-based information on the use of psychoactive medication, especially in respect to antidepressants, and reasons of non-reporting. Methods: Study subjects (n = 11,031) originated from a population-based cohort of postmenopausal women born in 1932-41 from Eastern Finland who responded to a postal enquiry in 1999. Self-reported currently used prescribed medications were compared to the National prescription register data. Diuretics served as a reference for psychoactive medications. Results: Only 44% out of 1,638 women reported their use of psychoactive medication when compared to the prescription register within a 4-month time window preceding their response to enquiry. Altogether, 55% out of 777 women reported their use of antidepressants and 29% out of 861 reported their use of other psychoactive medications. In comparison 83% reported their use of diuretics. After excluding the occasional use, an increase in sensitivity by approximately 10 percentage points was seen regardless of the group of psychoactive medication. High use and history of work disability pension due to psychiatric cause were associated with a much higher likelihood of reporting psychoactive medication use (for antidepressants 70% and 81%, respectively). Conclusions: For research purposes, self-reported current use of psychoactive medication seems to be a sufficient indicator for regular use of antidepressants or in respect of use of any psychoactive medication, for subjects with severe psychiatric disease. [ABSTRACT FROM AUTHOR]

There is growing evidence of comorbidities between mental disorders and musculoskeletal diseases (MSDs). However, personality disorder (PD) is often overlooked as a common type of mental disorder, and there has been no broad-level exploration or synthesis of their comorbidity with MSDs. The objectives of this review are to explore and understand the extent and type of evidence on the comorbidity of PD and MSDs among people aged ≥15 years and the burden associated with their comorbidity in clinical and population-based settings. The conduct of this review is guided by Arksey and O'Malley's methodological framework for scoping studies and the guidance published by the Joanna Briggs Institute (JBI). Peer-reviewed published and unpublished grey literature are eligible. Eligible study designs include cross-sectional, case-control, and cohort studies as well as existing reviews. A comprehensive search strategy was developed for Medline, CINAHL, and PsycInfo via EbscoHost. Protocols for data extraction and the presentation of the data including the descriptive synthesis adheres to the JBI methodological approach. The main findings from this review will be presented including a discussion on what is known regarding the comorbidity of PD and MSDs and associated burden. In addition, we will highlight identified knowledge gaps and propose recommendations for future research. The findings from this review may highlight a need for routine psychiatric screening/assessment for PD in medical settings, to optimise treatment engagement, psychosocial recovery, and improve both mental and physical outcomes. [ABSTRACT FROM AUTHOR]

Introduction: The association of smoking and depression is established, but it remains unclear which depression dimensions are linked to smoking patterns. Methods: The associations between smoking and depression dimensions were investigated among 4,980 male and 5,997 female Finnish twins. Longitudinal cigarette smoking patterns in 1975–1981 included multiple categories describing consistency and change. Depression was measured with the Beck Depression Inventory (BDI) in 1990. Preexisting depressed mood was screened with the life satisfaction scale strongly correlated with BDI. The BDI dimensions were negative attitudes toward self (NATS), performance impairment (PI), and weight loss (WL). Multiple logistic regressions and conditional logistic regressions for discordant twin pairs were conducted. Results: Controlling for confounders, two smoking patterns predicted all later depression dimensions. The NATS dimension showed a significant Sex × Smoking interaction: the associations of persistent smoking (odds ratio = 1.6, 95% CI = 1.3–2.0; p < .001) and inconsistent former (current in 1975 and former in 1981) smoking (1.6, 1.2–2.2; p = .001) with NATS remained significant among men only. Independently of gender, inconsistent former smoking predicted PI (1.2, 1.0–1.5; p = .04) and persistent smoking predicted WL (1.5, 1.3–1.8; p < .001). Consistent former smokers (former smokers in 1975 and 1981) had no elevated risk for any dimensions. Controlling for familial confounding, the association of persistent smoking with later NATS was replicated among discordant twin pairs (1.6, 1.1–2.2; p = .006). Conclusions: Persistent smoking and inconsistent former smoking predict all depression dimensions, although such associations with the NATS dimension are independent among men only. Long-term abstinence (consistent former smoking) does not predict risk for any depression dimensions. [ABSTRACT FROM AUTHOR]

Purpose. We examined the significance of life dissatisfaction in pre-operative and early recovery phases with respect to functional ability, pain and coping on 2-year follow-up of patients with lumbar spinal stenosis (LSS). Methods. Patients ( n == 90, mean age, 62 years, men 40%%) with symptomatic LSS underwent decompressive surgery. Data collection took place with the same set of questionnaires before surgery and 3 months, 6 months and 2 years postoperatively. Life dissatisfaction was assessed with the four-item life satisfaction (LS) scale. In addition, a life dissatisfaction burden, comprising the sum of preoperative, 3-month and 6-month LS scores, was calculated. Physical functioning (Oswestry disability index), pain (VAS and pain drawing) and coping (sense of coherence, SOC) were assessed. Logistic regression analysis was used to examine life dissatisfaction as a predictor of the 2-year functional ability, pain and coping (SOC). Results. In these analyses, pain was not predicted by either pre-operative life dissatisfaction or life dissatisfaction burden. However, both disability and poor coping on 2-year follow-up were independently associated with both pre-operative and early recovery phase life dissatisfaction. Conclusions. Our results show the importance of both pre-operative and early post-operative well-being regarding subsequent functioning. Thus, monitoring of the subjective well-being throughout the pre-operative and post-operative period may indicate those patients at risk of poorer post-operative recovery. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Disagreements concerning the stability of alexithymia and its ability to predict subsequent psychiatric disorders prevail. The aim of this 7-year follow-up study was to examine whether alexithymia predicts subsequent major depression, personality disorder, or alcohol use disorders in a population-based sample. Methods: The four-phase Kuopio Depression Study (KUDEP) was conducted in the eastern part of Central Finland. The study population (aged 25–64, n=2050) was randomly selected from the National Population Register. Data were collected in 1998, 1999, and 2001. In 2005, a subsample (n=333, 43 were excluded) of the 3-year follow-up population (1998–2001) was gathered and their diagnoses of mental disorders were confirmed by the Structure Clinical Interview for DSM-IV Axis I (SCID-I). Alexithymia was measured using the Toronto Alexithymia Scale (TAS-20) and depressive symptoms using the Beck Depression Inventory (BDI-21). For both of these measures, two groups were formed based on the median of their sum score (summing the 1998, 1999, and 2001 scores). Logistic regression analyses were performed. Results: BDI sum scores, but not those of TAS, were associated with subsequent major depressive disorder, personality disorder, and alcohol use disorders in 2005. The BDI sum scores explained 35.7% of the variation in concurrent TAS sum scores. Conclusion: Alexithymia did not predict diagnoses of major depressive disorder, personality disorder, or alcohol use disorders. Alexithymia was closely linked to concurrent depressive symptoms. Thus, depressive symptoms may act as a mediator between alexithymia and psychiatric morbidity. [Copyright &y& Elsevier]

Adverse life events or the commencement of adverse lifestyles associate with suicidal ideation, but most associations only have been identified in cross-sectional studies. More information is needed about whether they are true risk factors and independently predict the development of suicidal ideation. A sample of the general population from Eastern Finland ( n = 1,339) was followed-up for three-years with baseline and two follow-up assessments using postal questionnaires. The main adverse life events and changes in lifestyles were screened at baseline and on one- and three-year follow-up. The Beck Depression Inventory was used to assess the level of depression and the presence of suicidal ideation. Suicidal ideation was common in the sample (annual incidence 4.3%). At baseline it associated with a cluster of adverse life events and lifestyles, as well as depression. Nevertheless, only the Beck Depression Inventory score on 3-year follow-up (OR 1.33, 95% CI 1.22–1.45) and the onset of daily smoking during the follow-up period (OR 5.38, 95% CI 1.41–20.62) independently predicted the presence of suicidal ideation on 3-year follow-up among those who had been non-suicidal at baseline and on 1-year follow-up. Depressive mood appears to be a necessary precondition for the occurrence of suicidal ideation even after adverse life events. [ABSTRACT FROM AUTHOR]

Psychiatric patients have the right to strive for well-being and not only be confined to symptom reduction. Studies are needed to assess global well-being during recovery from depression by comparing the assessments of patients and clinicians. A 6-year natural follow-up of 185 depressive out-patients was carried out with health questionnaires at baseline, 0.5, 1, 2 and 6 years, including scales on depression (BDI, HDRS), general psychopathology (SCL), functional capacity (GAF, SOFAS) and life satisfaction (LS). A structured diagnostic interview was carried out at baseline, 2 and 6 years. Complete follow-up data were obtained from 121 patients. In general, depressive patients mainly attained a normal mood, adequate functional capacity and life satisfaction. Those with a slow recovery improved with successive treatment contacts, eventually reaching levels of mental health not significantly different from the others. Throughout the follow-up, recovery was similarly shown with the self-reported BDI-21, SCL-90 and LS-4, while intercorrelations between clinician ratings were low at baseline. Adequate mental health and global well-being can be reached among depressive patients, but it may take time in treatment. Subjective assessments are reliable. The 4-item life satisfaction scale is a global well-being indicator and a valid treatment outcome measure. [ABSTRACT FROM AUTHOR]

Background: While physical health has improved considerably over recent decades in Finland, the disease burden of mental health, especially that of depression, has become increasingly demanding. However, we lack long-term data on the natural course of subjective well-being in the general population. The aim of this study was to investigate the long-term course of self-reported life satisfaction. Methods: This was a 15-year prospective cohort study on a nationwide sample of adult Finnish twins (N = 9679), aged 18-45 and healthy at baseline, who responded to postal questionnaires in 1975, 1981 and 1990 including a 4-item life satisfaction scale (happiness/easiness/interest in life and feelings of loneliness). Life satisfaction score (range: 4-20) was classified into three categories: satisfied (4-6), intermediate (7-11) and dissatisfied group (12-20). The associations between life satisfaction scores during the follow-up were studied with linear/logistic regression. Results: Moderate stability and only a slight effect of age or birth-cohort on mean life satisfaction score (LS) were detected. In 1990, 56% of all and 31% of the dissatisfied remained in the same LS category as at baseline. Only 5.9% of the study subjects changed from being satisfied to dissatisfied or vice versa. Correlations between continuous scores (1975, 1981 and 1990) were 0.3-0.4. Baseline dissatisfaction (compared to satisfaction) predicted dissatisfaction in 1981 (OR = 10.4; 95%CI 8.3-13.1) and 1990 (5.6; 4.6-6.8). Multiple adjustments decreased the risk only slightly. Conclusions: Life satisfaction in adult Finns was moderately stable during 15 years. Among an identifiable group (i.e. the dissatisfied) life dissatisfaction may become persistent, which places them at a greater risk of adverse health outcomes. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the cross-sectional and longitudinal relationship between life satisfaction and depressive symptoms in healthy adults.Method: This is a 15-year prospective cohort study with a nationwide sample of healthy Finnish adults (N = 9679), aged 18-45, who responded to postal questionnaires in 1975, 1981 and 1990 including a 4-item life satisfaction (LS) scale (range 4-20) and, in 1990, the 21-item Beck Depression Inventory (BDI).Results: A strong linear association was found between concurrent LS and BDI scales (r = 0.6). With an LS cut-off point of 11/12, moderate/severe depression (BDI > or = 19) was detected with 87% sensitivity, 88 % specificity and a 94% area under the ROC curve. Longitudinally, a strongly increased risk of moderate/severe depression in 1990 was observed among the dissatisfied (LS 12-20) compared with the satisfied (LS 4-6) in 1975 (OR = 6.7; 95 %CI 4.2-10.9) and in 1981 (OR = 10.4; 6.1-17.6).Conclusion: The 4-item LS scale can identify a group of healthy people from the general population with a high risk of having or developing depressive symptoms. Since low life satisfaction also indicates an elevated risk of other adverse health outcomes, the assessment of subjective well-being should be encouraged both in surveys and in clinical practice. [ABSTRACT FROM AUTHOR]

Investigates whether self-reported life satisfaction predicted suicide over a period of 20 years in adults. Association of dissatisfaction with higher risk of suicide; Long-term effect of life dissatisfaction on the risk of suicide; Role of life satisfaction as a composite health indicator.

Introduction: Several psychiatric disorders and medications used to treat them appear to be independently associated with skeletal deficits. As there is increasing evidence that lithium possesses skeletal protective properties, we aimed to investigate the association between lithium use and bone health in a group of women with bipolar disorder. Method: Women with bipolar disorder (n = 117, 20+ years) were recruited from south‐eastern Australia. Bipolar disorder was confirmed using a clinical interview (SCID‐I/NP). Bone mineral density (BMD; g/cm2) was measured at the spine, hip and total body using dual‐energy x‐ray absorptiometry and low bone mass determined by BMD T‐score of <−1.0. Weight and height were measured, socioeconomic status (SES) determined and information on medication use and lifestyle factors self‐reported. Linear and logistic regression were used to test associations between lithium and (i) BMD and (ii) low bone mass, respectively. Results: Thirty‐five (29.9%) women reported current lithium use. Lithium users and non‐users differed in regard to SES and BMD; otherwise, groups were similar. After adjustments, mean BMD among lithium users was 5.1% greater at the spine (1.275 [95% CI 1.229–1.321] vs. 1.214 [1.183–1.244] g/cm2, p = 0.03), 4.2% greater at the total hip (0.979 [0.942–1.016] vs. 0.938 [0.910–0.966] g/cm2, p = 0.03) and 2.2% greater at the total body (1.176 [1.148–1.205] vs. 1.150 [1.129–1.171] g/cm2, p = 0.08) compared to participants not receiving lithium. Lithium users were also less likely to have low bone mass (22.9% vs. 43.9%, p = 0.031). Associations persisted after adjustment for confounders. Conclusion: These data suggest lithium is associated with greater BMD and reduced risk of low bone mass in women with bipolar disorder. Research into the underlying mechanisms is warranted. [ABSTRACT FROM AUTHOR]

Background: The bidirectional relationship between health behavior and subjective well-being has previously been studied sparsely, and mainly for individual health behaviors and regression models. In the present study, we deepen this knowledge focusing on the four principal health behaviors and using structural equation modeling with selected covariates. Methods: The follow-up data (n = 11,804) was derived from a population-based random sample of working-age Finns from two waves (2003 and 2012) of the Health and Social Support (HeSSup) postal survey. Structural equation modeling was used to study the cross-sectional, cross-lagged, and longitudinal relationships between the four principal health behaviors and subjective well-being at baseline and after the nine-year follow-up adjusted for age, gender, education, and self-reported diseases. The included health behaviors were physical activity, dietary habits, alcohol consumption, and smoking status. Subjective well-being was measured through four items comprising happiness, interest, and ease in life, and perceived loneliness. Results: Bidirectionally, only health behavior in 2003 predicted subjective well-being in 2012, whereas subjective well-being in 2003 did not predict health behavior in 2012. In addition, the cross-sectional interactions in 2003 and in 2012 between health behavior and subjective well-being were statistically significant. The baseline levels predicted their respective follow-up levels, the effect being stronger in health behavior than in subjective well-being. Conclusion: The four principal health behaviors together predict subsequent subjective well-being after an extensive follow-up. Although not particularly strong, the results could still be used for motivation for health behavior change, because of the beneficial effects of health behavior on subjective well-being. [ABSTRACT FROM AUTHOR]

This study investigated the association between the 3-month postoperative sense of coherence and the 5-year postoperative outcome of decompressive surgery for lumbar spinal stenosis. The participants with a lower sense of coherence at the 3-month follow-up had a poorer functional ability and lower satisfaction with surgery, higher pain ratings, lower life satisfaction and more depressive symptoms 5 years postoperatively. A low 3-month sense of coherence associated with greater pain and a poorer functional ability 5 years postoperatively. Evaluating sense of coherence and depressive symptoms in patients who have had lumbar spinal stenosis surgery may help in identifying those in need of enhanced support for postoperative recovery. [ABSTRACT FROM AUTHOR]

One of the most important components of the developmental environment is the emotional atmosphere. Childhood experiences and perceptions of parental roles and behavior result in memory models and images, which may affect the children's relationships in adulthood. In the present study, the cross-sectional associations between childhood parental images and the quality of current intimate adult relationships were studied in a sub-study of a mother-child follow-up in northern Finland. The data were collected with a questionnaire mailed to 28-29-year-old adults, with a total of 337 replies. The present study included those respondents ( N = 253) who were married or cohabiting (153 women, 100 men). Since offspring can be affected by gender-specific parenting patterns, the analyses were made separately for both genders. In women, supportiveness in both maternal and paternal images was associated with a balanced intimate relationship, the latter also being associated with a loving relationship and providing protection against quarrelsome and repressive-submissive aspects of the relationship. In men, maternal supportiveness was linked with a balanced and loving intimate relationship and protected against a quarrelsome relationship. Paternal domination was associated with repressive-submissive relationships regardless of gender. In conclusion, the qualities of recalled childhood parenting are important to adult well-being in intimate relationships in a gender-specific manner. The specific importance of the father to the children's later life was also observed. This would indicate that supporting the relationship of the child with both parents is equally important for professionals working with children and families. [ABSTRACT FROM AUTHOR]

Objective: To ascertain whether the risk of falls of different types is related to morbidity (number of chronic medical conditions) among postmenopausal women.Study Design: This cohort study uses data from a population-based prospective cohort study (OSTPRE). The study population consisted of 10,594 women aged 47-56 years living in Kuopio Province, Eastern Finland, in 1989, who responded to postal enquiries at both baseline and 5-year follow-up, in 1994. Morbidity (i.e. number of diagnosed chronic medical conditions) was reported in 1989 and falls in 1994. Falls were categorized as slip or nonslip, and 'frequent falls' was defined as two or more in a 12-month period.Results: The risk (odds ratio (OR) with 95% CI) of a fall increased with the number of chronic medical conditions. The OR was 1.28 (1.17-1.40) for those with 1-2 conditions and 1.41 (1.24-1.60) for those with multimorbidity (≥3 conditions) compared with healthy respondents. Multimorbidity was associated with a greater risk of the woman experiencing frequent nonslip falls (OR=2.57; 2.01-3.29) than frequent slip falls (OR=1.46; 1.17-1.80). Adjusting with logistic regression for age, number of medications and smoking did not affect the risk estimates.Conclusion: Multimorbidity has a much smaller effect on slip than on nonslip falls in postmenopausal women. This should be taken into account when investigating the effects of multimorbidity on fall risk in varying weather conditions. [ABSTRACT FROM AUTHOR]

Background: Self-reports of diseases are used in research due to time and cost efficiency. Mental disorders (MDs) and musculoskeletal disorders (MSDs) are the leading causes of global disability.Aims: To investigate how self-reports detect physician-diagnosed severe MDs and MSDs in postmenopausal women.Methods: In the population-based OSTPRE cohort, 1466 women (aged 57-66) had received a permanent work disability pension (DP) due to 'MDs only' (n = 336), 'MSDs only' (n = 926) or 'MDs + MSDs' (n = 204) by the end of 1998 and responded to a postal enquiry in 1999. In 2009, 1029 women responded to a follow-up enquiry. Self-reports were cross-checked against register data on DPs.Results: In 1999, 47 % of the participants in the 'MDs only' and 21 % in the 'MDs + MSDs' reported DPs due to MDs, whereas 75 % in the 'MSDs only' and 67 % in the 'MDs + MSDs' reported DPs due to MSDs. By 2009, this discrepancy increased, with the respective figures being 34 % and 19 % for MDs and 75 % for both MSDs groups. In 1999, older age was related to non-reporting in the three groups (each: p ≤ 0.001).Conclusion: Self-reports grossly underestimate the prevalence of disabling MDs and considerably that of MSDs among ageing women. Thus, additional sources of information are needed. [ABSTRACT FROM AUTHOR]

Background: Falls are a common occurrence in psychiatric hospital settings, however population-based research among individuals with psychiatric disorders, in particular bipolar disorder (BD) is scant. Thus, we aimed to investigate falls risk in community-dwelling women diagnosed with BD. Methods: Women with BD (cases, n = 119) were recruited from health care settings located in southeast Victoria, Australia. Age-matched controls (n = 357, ratio 3:1) without BD were participants in the Geelong Osteoporosis Study drawn from the same geographical region. Lifetime history of BD was identified by semi-structured clinical interview (SCID-IV/NP). Previous 12-month falls data were obtained via questionnaire. Information on mobility, alcohol use, general health, medication use, blood pressure, body mass index, socioeconomic status and use of a walking aid was collected. Generalised Estimating Equations, binary and ordinal logistic regression were used to determine the odds ratio (OR) and 95% confidence interval (CI) for falls following adjustment for confounders. Results: During the 12-month period, 34 (28.6%, median age 48.4 yr) cases and 70 (19.6%, median age 49.1 yr) controls reported one fall; 22 (18.5%) cases and 18 (5.0%) controls reported ≥ two falls (p < 0.001). Cases had 2.5-fold increased odds of at least one fall and 2.9-fold increased likelihood of increasing falls categories (0 vs. 1 vs. 2 +), compared to controls [adjOR 2.5, 95%CI (1.8, 3.4), adjOR OR 2.9, 95%CI (2.0, 4.1)]. Conclusion: Risk of falls was greater among women with BD. Balance training could be a research and clinical focus for falls prevention programs among women with bipolar disorder to prevent the detrimental outcomes associated with falling. [ABSTRACT FROM AUTHOR]

Chronic conditions are common in childhood. We investigated the associations of childhood chronic conditions reported by parents with subsequent self-reported internalizing and externalizing problems in adolescence. A sample of 6290 children (3142 boys and 3148 girls) with data on chronic condition reported by parents both at 7 and at 16 years of age was obtained from the Northern Finland Birth Cohort 1986 (NFBC 1986), which is a longitudinal 1-year birth cohort (n = 9432) from an unselected, regionally defined population. Internalizing and externalizing problems were measured at 8 years of age with Rutter Children's Behavioral Questionnaire by teachers and at 16 years of age with Youth Self-Report by adolescents. When studying the effects of history of chronic conditions on these problems at 16 years of age, childhood internalizing and externalizing problems and social relations were adjusted. A history of chronic condition predicted subsequent somatic complaints among all adolescents. Early-onset chronic conditions were related to subsequent externalizing (OR 1.35; 1.02-1.79) and attention problems (OR 1.33; 1.01-1.75) and later onset of chronic conditions with internalizing (OR 1.49; 1.22-1.82) and thought problems (OR 1.50; 1.18-1.92). The effect was specific for sex and the type of chronic condition.Conclusion: Childhood chronic conditions predicted internalizing and externalizing problems in adolescence. To prevent poor mental health trajectories, children with chronic conditions during their growth to adolescence need early support and long-term monitoring.What Is Known: • Childhood adversities increase the risk of mental disorders. • Internalizing and externalizing problems have been suggested for measuring childhood and adolescent psychopathologies.What Is New: • Having a chronic condition (CC) before the age of 7 or later but before the age of 16 had different outcomes in adolescence. The early onset predicted externalizing problems, whereas the late onset predicted internalizing problems and thought problems in adolescence. The risk of somatic complaints was increased regardless of CC onset time. These findings can reflect more restricted ability to mental processing in the younger children. [ABSTRACT FROM AUTHOR]

Background: Bipolar disorder (BD) is associated with significant psychological and physical comorbidity. Yet little is known about the bone health of individuals with BD. Thus, we aimed to investigate the association between BD and bone health in a population-based sample of women.Methods: Women with a history of BD (cases; n = 117) were recruited from public and private health care settings and controls, without BD, were drawn from the Geelong Osteoporosis Study (n = 909). BD was identified using a semi-structured clinical interview (SCID-I/NP). Bone mineral density (BMD) was measured at the spine, femoral neck and total body using dual energy x-ray absorptiometry, and bone quality by quantitative heel ultrasound and included the following parameters: Speed of Sound (SOS), Broadband Ultrasound Attenuation (BUA) and Stiffness Index (SI). Weight and height were measured and information on medication use and lifestyle was obtained.Results: Adjusted mean BMD among the cases was 4.3% lower at the hip and 1.6% lower at the total body compared to controls. Age was an effect modifier at the spine. Among women <50 years, mean spine BMD for cases was 3.5% lower than controls. No differences in spine BMD for those ≥50 years were detected. Cases also had a 1.0%, 3.2% and 7.8% lower adjusted mean SOS, BUA and SI compared to controls, respectively.Limitations: Course, chronicity and recovery of BD were not explored in relation to bone health.Conclusion: These data suggest BD is associated with low bone quantity and quality in women. Replication and research into underlying mechanisms is warranted. [ABSTRACT FROM AUTHOR]

Background: Being overweight is an increasing problem among young people, among whom disordered eating behavior is linked with weight problems as well as unhealthy weight control. The aim of the present study was to investigate whether health factors and motives to exercise differ in young men by the type of disordered eating behavior.Methods: The population-based, cross-sectional MOPO study consisted of 2,096 young Finnish men (mean age 17.9, SD 0.7) attending compulsory call-ups for military service in the Oulu area in 2010, 2011, and 2013. They responded to a questionnaire that included two subscales of the Eating Disorder Inventory-3 indicating drive for thinness and bulimic behavior and questions on health, physical activity, and motives to exercise. The association between disordered eating behavior and related factors was analyzed by binary logistic regression.Results: Altogether, 6.9 % (n = 145) of the men had symptoms of disordered eating, i.e., 5.4 % had a drive for thinness (n = 114) and 3.7 % had bulimic behavior (n = 77). Drive for thinness was associated with a perception of being overweight (OR 3.7; 95 % CI 2.2-6.1), poor self-rated health (2.3; 1.2-4.4), more leisure sitting time (1.1; 1.0-1.2), and body-related exercise motives (body acceptance: 3.0; 1.7-5.2; weight loss: 2.5; 1.4-4.4). Bulimic behavior was positively associated with poor self-rated health (2.6; 1.1-5.8) and several motives to exercise, i.e., due to another person's suggestion (2.8; 1.6-4.8), competitive sports (2.1; 1.2-3.7), body acceptance (2.1; 1.1-3.9), and weight loss (1.9; 1.1-3.3), but inversely associated with health/fitness-related exercise motives (health promotion: 0.3; 0.1-0.5; muscular strength or physical performance: 0.5; 0.2-0.9).Conclusions: In young men, disordered eating behavior was associated with being overweight, having poor self-rated health, and having a greater amount of leisure sitting time as well as non-health-related motives to exercise. In order to recognize those at risk for disordered eating behavior, evaluating these factors could be beneficial. [ABSTRACT FROM AUTHOR]

Objective: The study examined the relationship of self-rated health and self-rated economic situation with depressed mood, and life satisfaction as mediator of this relationship among older adults in Costa Rica. Method: A longitudinal study was conducted with a subsample (N = 1,618) from the Costa Rican Longevity and Healthy Aging Study (CRELES). Self-rated health, self-rated economic situation, depressed mood, and life satisfaction were measured at baseline, and depressed mood was reassessed 18 months later. Putative mechanisms for changes in depressed mood were examined by means of conditional process analysis. Results: Self-rated health was negatively associated to depressed mood. This effect took place via life satisfaction. An interaction showed that better economic situation compensated the effect of a low self-rated health on life satisfaction. Discussion: This study suggests that subjective variables such as self-rated health, economic situation, and life satisfaction should be considered when addressing the onset of depressed mood. [ABSTRACT FROM AUTHOR]

Background: The C9ORF72 expansion is one of the most common genetic etiologies observed with behavioural variant frontotemporal dementia (bvFTD). Revised diagnostic criteria for bvFTD (FTDC) were recently introduced but only a few studies have evaluated the accuracy of these criteria. Objective: The objective of the study was to evaluate the applicability of the FTDC criteria and assess the psychiatric history of these patients. Methods: The study examined 36 patients carrying the C9ORF72 expansion and suffering from bvFTD (N = 32) or from bvFTD with motor neuron disease (bvFTD-MND, N = 4). Neuropsychological, neuropsychiatric, structural brain imaging and PET/SPECT data were evaluated. Results: We found 0.75 sensitivity (SD 0.44, 95%CI 0.57–0.87) for possible bvFTD and 0.64 (SD 0.44, 95%CI 0.57–0.87) for probable bvFTD. The sensitivity was even higher in bvFTD patients without MND, i.e., 0.81 for possible bvFTD and 0.69 for probable bvFTD. PET/SPECT was normal in 17.6% of scanned patients with bvFTD. A history of psychiatric symptoms (psychotic and/or mood symptoms) was detected in 61% of cases. Conclusions: The FTDC possible and probable bvFTD criteria seem to identify the majority of the C9ORF72 expansion carriers with bvFTD, even though they exhibit only a limited number of behavioral criteria but a significant amount of psychiatric symptoms. The presence of a normal PET/SPECT does not exclude the possibility the C9ORF72 associated bvFTD. [ABSTRACT FROM AUTHOR]

Background: Mental health problems of children are commonly treated by psychotherapy and other psychosocial treatments. Studies comparing different treatments in naturalistic clinical settings are few, however. Aims: We assessed the differences: 1) in symptoms and diagnoses; 2) in treatment outcome between psychotherapy and other psychosocial treatments; and 3) evaluated the effect of family background and life circumstances on the outcome. Methods: The data were collected from the psychiatric hospital records of Oulu University Hospital, Finland. All 118 children (aged < 16 years) referred to psychotherapy from the Department of Child Psychiatry in 1996-2005 and 118 age- and sex-matched children undergoing other psychosocial treatments were included. A lack of later recorded psychiatric problems was used as an indicator of good treatment outcome. Results: On referral, functional ability was severely impaired in almost half of the children (Children's Global Assessment Scale score < 55). Internalizing symptoms were more common in the psychotherapy group, while no difference was found in externalizing symptoms between the groups. In both groups, later psychiatric problems were associated with a child's low functional ability and poor parental coping with their responsibilities. Children with internalizing problems had impaired prognosis if they had psychosocial treatments other than psychotherapy. Conclusions: Individual psychotherapy should especially be considered for children with internalizing symptoms, but the outcome of psychiatric treatment depends not only on children's own functional abilities, but also on parental abilities. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Our aim was to assess the impact of the most commonly used typical and atypical antipsychotics on mortality of patients with first-onset schizophrenia. Method: We conducted a nationwide, register-based, five-year follow-up study of all patients presenting with first-onset of schizophrenia between 1998 and 2003. Details of reimbursed medicines were obtained from the register of Social Insurance Institution. Results: After adjusting for age, gender, comorbid physical diseases and patient group, the use of second generation antipsychotics (SGAs), especially clozapine, olanzapine and quetiapine, was associated with reduced risk of all-cause mortality in patients with schizophrenia, while clozapine associated with lower suicide risk. First generation antipsychotics (FGAs), specifically levomepromazine, thioridazine or clorprothixene, were associated with increased risk of all-cause mortality. The FGAs, particularly clorprothixene, were associated with decreased suicide mortality. An increased likelihood for cardiovascular deaths was found among users of levomepromazine. In antidepressants, the use of mirtazapine associated with increased risk of suicide. Conclusions: Differences exist between FGAs' and SGAs' use in relation to mortality. These differences remain even when the patient's physical illness are taken into account when prescribing antipsychotic medication. [Copyright &y& Elsevier]

Background: Altered immune responses are seen in depression, and recent data suggest that similar changes could also be observable in alexithymia. We examined whether the inflammatory markers high-sensitivity C-reactive protein (hs-CRP) and interleukin (IL)-6 are independently related to alexithymia or its factors in a population-based sample. Methods: This study formed a clinical part of the Kuopio Depression (KUDEP) general population study focusing on the mental health of a general population of adults aged 25-64 years (n = 308). Alexithymia was measured using the Toronto Alexithymia Scale (TAS-20), and depressive symptoms were assessed using the Beck Depression Inventory (BDI-21). Results: The levels of IL-6 (in picograms per milliliter) and hs-CRP (in milligrams per liter) were significantly higher in alexithymic than in nonalexithymic subjects (IL-6 effect size, ES: 0.50; hs-CRP ES: 0.27). The BDI scores, hs-CRP and IL-6 explained 33.5% of the variation in TAS scores in the whole study population. According to logistic regression analysis, hs-CRP but not IL-6 increased the likelihood of belonging to the alexithymic group. This observation remained unaltered after additional adjustments for chronic inflammation-related disorders, the use of inflammation-modulating medications and depressive symptoms. Conclusions: Our findings suggest that the association between hs-CRP and alexithymia resembles that observed in depressed patients. It is, however, independent of depressive symptoms. These findings widen our view on the stress-alexithymia concept. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the life satisfaction of lumbar spinal stenosis (LSS) patients up to the 2-year postoperative phase. Patients ( N = 102, mean age, 62 years) with symptomatic LSS underwent decompressive surgery. Data collection took place with the same set of questionnaires before surgery and 3 months, 6 months, 1 year and 2 years postoperatively. Life satisfaction was assessed with the four-item Life Satisfaction scale and depression symptoms with the 21-item Beck Depression Inventory (BDI). In addition, a depression burden variable was included, comprising the sum of preoperative, 3- and 6-month BDI scores. Physical functioning and pain were assessed with the Oswestry disability index, Stucki questionnaire, self-reported walking ability, visual analogy scale and pain drawing. Two years postoperatively, 18% of the LSS patients was dissatisfied with their lives. As a whole, the life satisfaction of the LSS patients improved during the postoperative follow-up, reaching the level of the healthy adult Finnish population. However, 2 years postoperatively, dissatisfied patients reported significantly more pain, a poorer functional ability and more depressive symptoms and depression than the patients who were satisfied with life. This difference was seen throughout the postoperative follow up. In regression analyses, the only significant associations were between the depression burden and postoperative life dissatisfaction. Thus, subjective well-being as well as depression among LSS patients should be assessed pre- and postoperatively in order to enable early intervention for those at risk of poorer life satisfaction. [ABSTRACT FROM AUTHOR]

Introduction. In middle-aged men, the associations between long-term depressive symptoms and circulating testosterone levels are poorly known, although it is known that testosterone levels decrease with age. Methods. A health questionnaire was mailed to a population-based sample from the National Population Register in 1998, 1999, and 2001. Based on their self-reported mental symptoms, a total of 116 men were selected for clinical examination in 2005. Half of them had high and the others low levels of adverse mental symptoms in all three previous follow-ups. A structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders-IV was performed. Depressive symptoms were assessed with the Beck Depression Inventory (BDI) and the Hamilton Depression Rating Scale (HDRS). The Aging Males’ Symptoms scale was also compiled and testosterone levels were determined. Results. In the entire study sample, serum free testosterone levels correlated negatively with both BDI and HDRS scores. In the hypogonadism group (based on free testosterone, 19.8% of the sample), clinically significant depression (BDI score ≥ 13) was more than three times as frequent as in the other men (34.8% vs. 10.4%), the odds ratio after multiple adjustments being 4.98 (95% confidence interval 1.66–14.95). A decrease in sexual desire was common in hypogonadism (36%). Nevertheless, it also associated with clinically significant depression, irrespective of free testosterone levels. Discussion. Long-term and current depressive symptoms, a decreased sexual desire, and low serum free testosterone levels are associated in middle-aged men. Hypogonadism per se and as a cause of decreased sexual desire may be a contributory and possibly treatable factor underlying male depression. Conclusions. The findings highlight the need for hormonal status assessment in middle-aged depressive men. Hintikka J, Niskanen L, Koivumaa-Honkanen H, Tolmunen T, Honkalampi K, Lehto SM, and Viinamäki H. Hypogonadism, decreased sexual desire, and long-term depression in middle-aged men. J Sex Med 2009;6:2049–2057. [ABSTRACT FROM AUTHOR]

The present study examined the relationship between smoking and depression among patients with different psychiatric diagnoses according to DSM-III-R criteria. The study sample of 1217 consecutive in- and outpatients, treated at the Department of Psychiatry, Kuopio University Hospital, in eastern Finland, was interviewed with two sets of questions during May 1993. The prevalence of smoking was higher among severely depressive than among mildly or moderately depressive patients in all diagnostic categories, except in male schizophrenics. However, this difference in rate of smoking was statistically significant only among men with major depression and women with personality disorder. The best determinants of severe depression in a multiple logistic model were diagnosis of major depression, personality disorder, and dysthymia. According to the model, current smokers had a 40% higher risk of severe depression than nonsmokers. Because both smoking and depression are major public health problems, the observed association deserves more thorough research, especially by psychiatric specialists. [ABSTRACT FROM AUTHOR]

Background: Personality disorder (PD) may affect the efficacy of pharmacological interventions for mood disorders, but the extent to which this occurs is uncertain. We aimed to examine the available published evidence concerning the role of PD in pharmacological treatment outcomes of randomised controlled trials (RCTs) for adults with mood disorders (i.e. depressive and bipolar spectrum disorders).Methods: A systematic search of Cochrane Central Register of Controlled Clinical Trials, PubMed, EMBASE, PsycINFO, CINAHL Complete, and Google Scholar databases was undertaken to identify studies of interest. Data were independently extracted by two reviewers. The Cochrane Risk of Bias tool was used to assess methodological quality and risk of bias. A random effects model was utilised and statistical heterogeneity was assessed using the I2 statistic. This systematic review was registered with PROSPERO (CRD42018089279) and the protocol is published.Results: The search yielded 11,640 studies. Subsequent to removing duplicates, 9657 studies were screened at title and abstract stage and 1456 were assessed at full-text stage. Eighteen studies met criteria for inclusion in this review. Meta-analysis did not reveal a significant difference between groups for treatment outcome (standardised mean difference 0.22 [-0.09, 0.54]; I2: 69%, p=0.17) and remission (risk ratio 0.84 [0.64, 1.11]; I2: 51%, p=0.22).Limitations: This review was limited by lack of studies on bipolar disorder.Conclusion: PD comorbidity does not appear to affect treatment efficacy of pharmacological interventions for adults with mood disorders. [ABSTRACT FROM AUTHOR]

The purpose of the article: Adverse childhood experiences (ACEs) have been postulated to negatively affect the development of emotional regulation. However, little is known about specific associations between ACEs, depressive symptoms, and alexithymia or its components [i.e. difficulty in identifying feelings (DIF), difficulty in describing feelings to others (DDF) and externally–oriented thinking (EOT)] in patients with major depressive disorder (MDD). The aims of the present cross-sectional study were to (1) compare ACEs (emotional neglect, emotional abuse, physical neglect, physical abuse, sexual abuse) between alexithymic and non-alexithymic patients with MDD; (2) explore whether specific ACEs, depressive symptoms or the interaction between sex and depressive symptoms predicted TAS-20 or its components. Materials and Methods: The study sample consisted of 186 psychiatric outpatients with MDD (aged 21–61 years, mean 33.87 years, SD 10.88) recruited from the Department of Psychiatry, Kuopio University Hospital between 2016–2019. Alexithymia and its components were assessed using the 20-item Toronto Alexithymia Scale (TAS-20). ACEs were assessed with the Trauma and Distress Scale (TADS). Results: Almost all patients with alexithymia and 80% of non-alexithymic patients reported that they had experienced emotional abuse or neglect, at least sometimes. Approximately 60% of MDD patients reported having experienced physical neglect and 30% described physical abuse. Emotional and physical abuse and neglect predicted DDF score. Conclusions: These findings suggest that among MDD patients, early experiences of emotional and physical abuse and neglect is associated with difficulties in describing feelings in adulthood. [ABSTRACT FROM AUTHOR]

Due to the significant clinical overlap between frontotemporal lobar degeneration (FTLD) spectrum disorders and late-onset primary psychiatric disorders (PPD), diagnostic biomarkers reflecting the different underlying pathophysiologies are urgently needed. Thus far, elevated cerebrospinal fluid (CSF) levels of neurofilament light chain (NfL) have been reported in various neurological conditions. Furthermore, recent advancements in ultrasensitive analytical methods (e.g., single molecule array, Simoa) have enabled sensitive and less invasive NfL detection also from blood samples. In this study, we evaluated the potential of serum NfL (sNfL) as a diagnostic tool between FTLD and PPD. We analyzed sNfL levels with Simoa from 125 participants including patients from FTLD (n = 91) and PPD (n = 34) spectra. Our results show that sNfL levels are higher in the FTLD group compared to the PPD group as well as in separate clinical subtypes of FTLD compared to different psychiatric manifestations (i.e., mood or psychotic disorders). At single-subject level, discrimination between FTLD and PPD was possible with 80% sensitivity and 85% specificity (AUC = 0.850, 95% CI 0.776–0.923), and between behavioral variant frontotemporal dementia (bvFTD) and PPD with 79% sensitivity and 85% specificity (AUC = 0.830, 95% CI 0.732–0.908). These findings highlight the potential of sNfL as a discriminating biomarker for FTLD over PPD in patients with wide-ranging behavioral, psychiatric and cognitive symptoms. [ABSTRACT FROM AUTHOR]

Globally, musculoskeletal diseases (MSDs) and mental disorders are the leading causes of disability, but their mutual relationships have been little studied. The objective of the current review is to summarize the evidence on the relationships between depressive and anxiety disorders, subjective mental health and common MSDs in adults aged 45 years and over. A review of studies published in English, identified using MEDLINE, was conducted. Search terms included spinal stenosis, intervertebral disc displacement, osteoarthritis, osteoporosis, depressive disorder, anxiety disorders, mental health, subjective well-being, subjective quality of life, life satisfaction and personal satisfaction. A total of 287 records were initially identified, and an additional 190 records were identified from their reference lists. Eight studies were considered eligible and were, thus, included in the current review. The included studies reported that: 1) major depressive disorder is associated with chronic back pain; 2) anxiety disorders are associated with cervical or lumbar disc herniation; 3) mood and anxiety disorders are associated with lower bone mineral density in men; 4) life satisfaction and its improvement prevent bone loss in postmenopausal women; and 5) quality of life reduces progressively as the number of osteoporotic fractures increases. In conclusion, common MSDs are associated with mental disorders and subjective mental health in adults aged 45 years or more, but longitudinal research is needed. [ABSTRACT FROM AUTHOR]

Background: Schema therapy has been proposed as a potentially effective treatment for chronic depression. However, little is known about early maladaptive schemas (EMSs), a key concept in schema therapy, in relation to chronic depression or chronic depression with comorbid personality pathology. The aim of the present study was to compare EMSs between currently chronically depressed patients with comorbid cluster C personality disorder (CDCPD), currently chronically depressed patients (CD), and patients remitted from chronic depression (CDR). Methods: Based on data from a naturalistic follow‐up study on psychiatric outpatients with major depressive disorder, three groups were formed according to Diagnostic and Statistical Manual of Mental Disorders‐IV: CDCPD (n = 15), CD (n = 23), and CDR (n = 13). Groups were compared in terms of background information and measurements for depression (Beck Depression Inventory) and EMSs (Young Schema Questionnaire). Results: Patients with CDCPD and CD did not differ in terms of background variables or the severity of depressive symptoms, but patients with CDCPD were more maladaptive with respect to the majority of EMSs. Patients with CDR were less depressed than CDCPD or CD patients, but did not differ in terms of EMSs compared with CD patients. Conclusions: Comorbid cluster C personality disorder appears to be associated with more severe EMS endorsement in chronically depressed patients. Remitted patients show similar cognitive vulnerability factors in terms of EMSs compared to those currently chronically depressed. The findings suggest that EMSs may contribute to vulnerability to chronic depression. Focusing on EMSs may be beneficial in the treatment of chronic depression. [ABSTRACT FROM AUTHOR]

Highlights • Lowered total cholesterol levels among MDD patients with childhood physical violence. • Findings remained significant after comprehensive adjustments for several factors. • Total cholesterol correlated with the chronicity of depression. Abstract Associations between adverse childhood experiences (ACEs) and cholesterol in depressed patients are unclear. Therefore, we compared 78 adult outpatients with major depressive disorder (MDD) with (n = 24) or without (n = 54) experiences of physical violence in childhood. Background data were collected with questionnaires, and total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were measured from fasting blood samples. Patients with a history of childhood physical violence had lower levels of TC than the control group. No differences were observed in HDL-C, LDL-C, or low-grade inflammation levels between the two groups. In multivariate models, decreased levels of TC were associated with childhood physical violence, and these associations remained significant after adjustments for age, gender, lifestyle, metabolic condition, socioeconomic situation, psychiatric status, suicidality, low-grade inflammation, the chronicity of depression, medications used and somatic diseases. At the 8-month follow-up, the results were essentially the same when the Trauma and Distress Scale (TADS) was used as the measure of ACEs. The specific mechanisms underlying cholesterol alterations associated with ACEs are a topic for future studies. Better understanding of these mechanisms might lead to possible new interventions in the prevention of adverse health effects resulting from ACEs. [ABSTRACT FROM AUTHOR]

Background and aim: Prevention of the recurrence of major depression and its residual symptoms requires effective treatment. Our aim was to study the effects of bifrontal active rTMS controlled by sham rTMS in treatment-resistant unipolar major depressive disorder (MDD). Methods: Thirty-seven patients with treatment-resistant MDD were randomized into two groups. One group received a total of 30 sessions of active bifrontal rTMS (10 Hz rTMS on left dorsolateral prefrontal cortex (DLPFC) and 1Hz rTMS on right DLPFC) and the other group received bilateral sham rTMS on five days a week for six weeks. Results: Depressive symptoms significantly improved in both the groups, but without a significant group difference. Furthermore, patients with psychotic depression improved similarly to those with moderate or severe depression. Conclusions: The results of present study indicate a large sham effect of stimulation treatment. The intensive structured treatment protocol may explain the positive outcome in both the groups. It is important to recognize, appreciate, and utilize placebo effects as a significant means of rehabilitation in psychiatric care. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To find factors that are associated with not having psychotic illness in a prospective general population sample, with a special interest in individuals with parental psychosis. Methods: Data from the Northern Finland Birth Cohort 1966 (n = 10 458) and several registers were used to detect individuals with and without parental psychosis. Altogether, 594 persons had parent(s) with psychosis and 48 of them also had psychosis subsequently. Variables related to pregnancy and birth, family and childhood, health and habits in adolescence, school performance and physical activity were studied to identify determinants of unaffected status among individuals with and without parental psychosis. Results: In the parental psychosis group, the unaffected persons had more likely a mother who was non‐depressed during pregnancy, and who worked outside the home or studied than among those who developed psychosis. Conclusions: Protective factors for psychosis were surprisingly few in this sample. These factors were related to the mother's non‐depressed mood and the mother's work outside the home or studies. This could relate to better health and functioning of a mother. This work highlights the need for more research on protective factors for psychosis in order to identify methods for prevention of psychosis. [ABSTRACT FROM AUTHOR]

Background: Major depressive disorder (MDD) is characterized by increased oxidative and nitrosative stress. We compared nitric oxide metabolism, i.e., the global arginine bioavailability ratio (GABR) and related serum amino acids, between MDD patients and non-depressed controls, and between remitted and non-remitted MDD patients.Methods: Ninety-nine MDD patients and 253 non-depressed controls, aged 20-71 years, provided background data via questionnaires. Fasting serum samples were analyzed using ultra-performance liquid chromatography coupled to mass spectrometry to determine the serum levels of ornithine, arginine, citrulline, and symmetric and asymmetric dimethylarginine. GABR was calculated as arginine divided by the sum of ornithine plus citrulline. We compared the above measures between: 1) MDD patients and controls, 2) remitted (n=33) and non-remitted (n = 45) MDD patients, and 3) baseline and follow-up within the remitted and non-remitted groups.Results: Lower arginine levels (OR 0.98, 95% CI 0.97-0.99) and lower GABR (OR 0.13, 95% CI 0.03-0.50) were associated with the MDD vs. the non-depressed group after adjustments for potential confounders. The remitted group showed a decrease in GABR, arginine, and symmetric dimethylarginine, and an increase in ornithine after the follow-up compared with within-group baseline values. The non-remitted group displayed an increase in arginine and ornithine levels and a decrease in GABR. No significant differences were recorded between the remitted and non-remitted groups.Limitations: The MDD group was not medication-free.Conclusions: Arginine bioavailability may be decreased in MDD. This could impair the production of nitric oxide, and thus add to oxidative stress in the central nervous system. [ABSTRACT FROM AUTHOR]

Background: Physical inactivity is a global problem that increases the risk of many chronic diseases and shortens life expectancy. The built environment contributes to physical inactivity through accessibility of amenities and transportation patterns. With better urban planning, cities could be designed to enhance active transportation and population health on a permanent basis.Purpose: We conducted a systematic review to identify determinants of the built environment associated with physical activity and to evaluate how changes in the built environment are associated with changes in physical activity.Methods: We searched six databases, from the inception of each until December 2015, for studies that were written in English, used longitudinal before-and-after design and assessed changes in both the built environment and physical activity. A total of 21 prospective cohort studies and 30 natural experiments were included in the review.Results: The review showed that changes in the built environment and in physical activity were related. A higher objective accessibility and new infrastructure for walking, cycling and public transportation were associated with increased overall and transportation-related physical activity. Some evidence was found for perceived aesthetics and safety as determinants of physical activity.Conclusions: Improved objectively measured accessibility of different type of destinations and public transportation and land use mix were associated with increased physical activity. Creating new infrastructure for walking, cycling and public transportation could induce demand for walking and cycling. The results support the creation of compact and diverse residential areas and investments into infrastructure that encourage active modes of transportation. [ABSTRACT FROM AUTHOR]

We examined whether mental state disorders (lifetime mood, anxiety, eating, substance misuse) with comorbid personality disorder are associated with physical multimorbidity in a population-based sample of women. Mental state and personality disorders were assessed using semi-structured diagnostic interviews. Clinical measures were performed and medical conditions, medication use and lifestyle factors were documented by questionnaire. Mental state disorders were associated with higher odds of physical multimorbidity; risk was especially high for those with comorbid personality disorder. These findings suggest that mental state and physical comorbidity might be worsened by the additional comorbidity of personality disorder. [ABSTRACT FROM AUTHOR]

Recent evidence supports the association between healthy dietary patterns and a reduced risk of depression. The objective was: (1) to examine the associations between dietary patterns and alexithymic features; and (2) investigate whether these possible associations are explained by depressive symptoms in a cross-sectional study among the Finnish general population aged 25-65 years. The study population was a part of the population-based Kuopio Depression Study ( KUDEP) conducted in central-eastern Finland (n = 1747). Dietary data were collected using a food frequency questionnaire and dietary patterns from 22 predefined food groups, which were extracted by factor analysis. Alexithymia was assessed using the 20-item Toronto Alexithymia Scale ( TAS-20) and depression using the 21-item Beck Depression Inventory ( BDI-21). Altogether, 173 of the study subjects (9.9%) were alexithymic. Three dietary patterns were identified: 'prudent,' 'Western' and 'traditional.' Lower scores for a healthy prudent dietary pattern and higher scores for an unhealthy Western dietary pattern were associated with an increased likelihood of belonging to the alexithymic group among subjects with elevated depressive symptoms. Among subjects without depressive symptoms, alexithymia was associated with lower scores in the prudent dietary pattern, but also with higher scores in the traditional dietary pattern. General population subjects with alexithymic features may have unhealthier dietary patterns than non-alexithymic subjects. [ABSTRACT FROM AUTHOR]

Family history of psychiatric disorders has been associated with impaired outcome in schizophrenia, but very few studies have investigated its long-term social and occupational outcome. We investigated the association of family history of psychiatric disorders, especially psychosis, with long-term social, occupational, clinical and global outcome in schizophrenia. The study sample comprises of the Northern Finland Birth Cohort 1966. Cohort members with psychosis were detected by Finnish national registers. Altogether 69 individuals with schizophrenia spectrum diagnosis participated, mean age 43, after on average 17 years since onset of illness. The information regarding family history of psychiatric disorders were gathered from registers and interviews. A Strauss-Carpenter Outcome Scale, PANSS and SOFAS were conducted to assess the outcome. Results showed that the family history of any psychiatric disorder was associated with more severe positive and emotional symptoms in PANSS. The family history of psychosis was not associated with outcomes. These findings suggest that family history of psychiatric disorders has a small association with outcome in schizophrenia. Despite family history of psychosis being a strong risk factor for schizophrenia, after years of illness it does not seem to affect outcome. [ABSTRACT FROM AUTHOR]

Objective: We aimed to describe the prevalence and age distribution of personality disorders and their comorbidity with other psychiatric disorders in an age-stratified sample of Australian women aged ⩾25 years. Methods: Individual personality disorders (paranoid, schizoid, schizotypal, histrionic, narcissistic, borderline, antisocial, avoidant, dependent, obsessive-compulsive), lifetime mood, anxiety, eating and substance misuse disorders were diagnosed utilising validated semi-structured clinical interviews (Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-patient Edition and Structured Clinical Interview for DSM-IV Axis II Personality Disorders). The prevalence of personality disorders and Clusters were determined from the study population (n = 768), and standardised to the Australian population using the 2011 Australian Bureau of Statistics census data. Prevalence by age and the association with mood, anxiety, eating and substance misuse disorders was also examined. Results: The overall prevalence of personality disorders in women was 21.8% (95% confidence interval [CI]: 18.7, 24.9). Cluster C personality disorders (17.5%, 95% CI: 16.0, 18.9) were more common than Cluster A (5.3%, 95% CI: 3.5, 7.0) and Cluster B personality disorders (3.2%, 95% CI: 1.8, 4.6). Of the individual personality disorders, obsessive-compulsive (10.3%, 95% CI: 8.0, 12.6), avoidant (9.3%, 95% CI: 7.1, 11.5), paranoid (3.9%, 95% CI: 3.1, 4.7) and borderline (2.7%, 95% CI: 1.4, 4.0) were among the most prevalent. The prevalence of other personality disorders was low (⩽1.7%). Being younger (25–34 years) was predictive of having any personality disorder (odds ratio: 2.36, 95% CI: 1.18, 4.74), as was being middle-aged (odds ratio: 2.41, 95% CI: 1.23, 4.72). Among the strongest predictors of having any personality disorder was having a lifetime history of psychiatric disorders (odds ratio: 4.29, 95% CI: 2.90, 6.33). Mood and anxiety disorders were the most common comorbid lifetime psychiatric disorders. Conclusions: Approximately one in five women was identified with a personality disorder, emphasising that personality disorders are relatively common in the population. A more thorough understanding of the distribution of personality disorders and psychiatric comorbidity in the general population is crucial to assist allocation of health care resources to individuals living with these disorders. [ABSTRACT FROM AUTHOR]