Browsing by study line "ingen studieinriktning"

Physical and social anhedonia have shown some promise as possible indicators of later mental illness, especially of depression and schizophrenia. However, previous studies have focused on college students and clinical populations, limiting their generalizability into the whole population. Most previous studies have also been cross-sectional. The aim of this longitudinal study with a general population sample is to examine whether high social or physical anhedonia in young adulthood precedes later psychiatric diagnoses. In addition, cross-sectional connections between demographic factors (sex, age, marital status, education) and social and physical anhedonia were examined. The study sample (n=453) of young adults was recruited through the Health 2000 study, which is a representative sample of the adult Finnish population. In the beginning of the study, participants filled in the self-report Chapman Revised Anhedonia Scales, and their demographic factors were clarified using a questionnaire (marital status, education level) and health records (age, sex). After this there was a follow-up period of 9 to 12 years. The psychiatric diagnoses of the participants from the follow-up period were retrieved from the Finnish Hospital Discharge Register, which includes both inpatient and outpatient specialized psychiatric care. Two sets of analyses were done: analyses of variance (ANOVA) examining the cross-sectional associations between anhedonia and demographic factors (age, sex, marital status, education) and Cox regression analyses examining longitudinal associations between aforementioned variables and later psychiatric diagnoses. Male sex was associated with both higher physical and higher social anhedonia. 63 participants (13%) received at least one psychiatric diagnosis during the follow-up period. Three diagnostic groups were examined; one for receiving a depression diagnosis, one for receiving any anxiety diagnosis and one for receiving any psychiatric diagnosis. Physical or social anhedonia during young adulthood was not found to be associated with later psychiatric diagnoses. Instead, lack of marriage/cohabitation and female sex were found to be possible risk factors for receiving a diagnosis. Contrary to the hypotheses of this study, no association between anhedonia and later psychiatric diagnoses were found. However, the relatively small amount of diagnoses during the follow-up period restricted the statistical strength of the results. The results of this study suggest that anhedonia is not a major predictor of for receiving a later depression diagnosis, any anxiety diagnosis or any psychiatric diagnosis in the general young adult population.

Aims: The transdiagnostic cognitive-behavioral model of eating disorders (ED) views EDs as a single disorder with different clinical manifestations, but the CBT effectiveness research thus far has mostly only pooled results within individual ED categories. A panoramic meta-analysis (PMA) synthesizes evidence across indications, and here the aim is to explore whether a PMA in the context of CBT for EDs provides an unbiased and precise effect estimate when pooling across the ED diagnoses. Methods: Reviews that synthesize RCTs of CBT for EDs were searched, and reviews that met inclusion criteria and included meta-analytic data or valid data from a single RCT were included in the PMA. Two PMAs (CBT vs active controls, CBT vs inactive controls) were performed. The outcome most commonly employed in the meta-analyses identified in the search was chosen as the outcome of interest. Findings: Of the n=24 meta-analyses, only n=7 were eligible for the PMA. The analysis provided support for the effectiveness of CBT vs inactive controls ((SMD: 0.32, 95% CI: 0.05 to 0.59, I2= 38.1%) but results were inconclusive when CBT was compared to active controls (SMD: 0.01, 95% CI: -0.35 to 0.36, I2=75.2%). Conclusions: Due to the methodological limitations of this thesis, several central comprehensive meta-analyses had to be excluded from the PMA. Thus, this PMA failed to provide a precise and unbiased synthesis of existing data of the effectiveness of CBT for EDs across the diagnoses.

Objectives. Different biases induced by stimulus and response history have been identified in the field of perceptual psychology. Serial dependence is a bias in the perception of objects caused by previous stimuli. Perception can also be biased towards the average of previous stimuli. This is called central tendency bias. The interdependence of responses in a serial task is serial response bias. These history biases have mostly been studied separately despite their effects being similar. This thesis aims to unravel the independent effects of the biases on observers’ responses in a perceptual task and the effect of working memory delay on their magnitude. Methods. The biases were studied with two experiments. Eleven subjects took part in the first experiment which used colored patches with different hues as stimuli. The second experiment had 7 subjects and used grating patches differing in orientation. Subjects were presented with a continuous stream of reference and comparison stimuli. In each trial, they had to respond if the comparison stimulus, presented second, was bluer or greener or was oriented more to the left or the right than the reference stimulus, presented first. Inter-stimulus interval was either short or long in two blocked conditions. The independent effects of the history biases on responses were tested using a generalized linear mixed model with a probit link function. Results and conclusions. In the hue experiment, independent effects were found for all history biases. Previous stimuli attracted the perception of subsequent stimuli and this effect lasted for 12-16 seconds. Independently of this, the percept was also biased towards the average of previous stimuli. In addition, subjects tended to change their response between trials. Working memory delay had no observable effect on the magnitude of the biases. In the orientation experiment, results on serial dependence were mixed, likely due to more noise in the data. Central tendency bias was not observed. Response bias was dependent on the inter-stimulus interval in such a way that with a short delay, subjects were more likely to repeat their choices and with a long, delay they were more likely to alternate between choices. The results clarify the relationships between previously reported history biases. Neither central tendency bias nor serial response bias can explain serial dependence. Furthermore, the results suggest that serial dependence cannot originate solely from the inertia of responses.

Objectives: Associations between family socioeconomic status and child and adolescent mental health have garnered increasing research interest in the last few decades. Parental mental health has also been shown to affect these associations. The aim of this study was to investigate whether changes in household income are associated with changes in adolescent mental health, and whether parental psychological distress affects these possible associations. Methods: The sample of this study was derived from the UK Household Longitudinal Study, and consisted of 9233 British adolescents aged 10 to 15 years and their biological mothers, stepmothers, or adopted mothers. The data of this study was gathered in four separate study waves. Adolescent mental health was measured with the self-completed Strengths and Difficulties Questionnaire total difficulties score. Parental psychological distress was measured with the 12-item version of the General Health Questionnaire. Household income was equivalised to account for family size and composition. The data was analysed using fixed effects and random effects panel models. Adolescent sex, adolescent age, and parent age were included in the models as potential confounding variables. Results and conclusions: Greater household income was associated with less self-reported mental health symptoms in adolescents, but changes in household income were not associated with changes in adolescent mental health. Increases in parental psychological distress were associated with increases in adolescent mental health symptoms. The sex of the adolescent was not associated with adolescent mental health, while results regarding adolescent and parent age were mixed. The findings of this study suggest that there is an association between household income and adolescent mental health, but this association may not be causal in nature. The results also corroborate the status of parental mental health as an important determinant of adolescent mental health.

Objective. Depression is associated with increased risk of chronic disease, which may be at least partly due to poor health behaviors. Growing body of evidence has associated depression with unhealthy diet. However, the association of depression with diet quality in the long run is not well known. Furthermore, it is unclear if dietary interventions could mitigate the harmful association of depression with diet. This study examined the association of depression with diet both cross-sectionally and longitudinally in a population-based prospective cohort. The effectiveness of an early-onset dietary intervention in modifying these associations was investigated. Methods. The sample (n = 457) was from The Special Turku Coronary Risk Factor Intervention Project (STRIP). The intervention group (n = 209) had undergone a dietary intervention lasting from age of 7 months until age of 20 years. Depression was measured at age 20 using Beck Depression Inventory II (BDI-II). Diet quality was assessed at ages 20 and 26 using a diet score calculated based on food diaries. Missing values were replaced using multiple imputation by chained equations. Linear regression analyses were used to analyze the association of depression at age 20 with diet at ages 20 and 26, as well as the modifying effect of intervention group on these associations. Results. No cross-sectional association was found for depression and diet at age 20. Depression at age 20 was longitudinally associated with worse diet quality at age 26. The associations did not differ between intervention and control groups at either of the time points. Conclusions. Contrary to previous research, this study did not find cross-sectional association for depression with diet. However, this study offers novel information on longitudinal associations, suggesting that depression may have effects on diet quality that can manifest after several years. Dietary intervention was not found effective in modifying these associations. Since long-term effects on diet may be an important factor explaining the association of depression with chronic diseases, ways to mitigate the adverse consequences of depression for diet should be explored further.

Objectives. Autism spectrum disorder (ASD) has been assoaciated with anomalies in pain sensitivity, although the results of the studies have not been concordant. Since sensory atypicalities are a frequent feature in ASD, it has led to the hypothesis of sensory dysfunction which affects the whole sensory system, including the pain system. ASD has also been associated with increased pain disturbance in previous studies. This Master`s thesis investigated the relationship between ASD traits and pain intensity, pain interference, and pain sensitivity. Moreover, the aim was to study if sensory atypicalities have a different impact on pain intensity, pain interference, and pain sensitivity, when accompanied with ASD traits. Methods. The sample consisted of 947 adults aged between 18 and 60 years. The data were collected using an online questionnaire, which contained items about ASD traits, pain intensity and pain interference from the past week, pain sensitivity in different situations, and sensory hyper- and hyposensitivies. In addition, there were items on backround information relevant for the study in the questionnaire. The subjects were divided into two groups based on the score obtained from the ASD trait questionnaire: the ASD trait group and the reference group. Results and conclusions. There was a significant negative association between ASD traits and pain intensity, such that the estimates of pain intensity were significantly lower in the ASD trait group than in the reference group, despite there being more self-reported comorbidities and chronic pain presented in the ASD trait group. There were no significant associations between ASD traits and pain interference or pain sensitivity. Furthermore, there was a significant interaction between ASD traits and sensory atypicalities in pain intensity, pain interference, and pain sensitivity; as the number of sensory atypicalities increased, pain intensity, pain interference, and pain sensitivity increased significantly in the reference group. Instead, the impact of sensory atypicalities on pain was significantly weaker in individuals with ASD traits. The results imply that individuals with ASD traits may have lower pain sensitivity in everyday life, but regular pain sensitivity in specific pain situations. The impact of sensory atypicalities on pain seems to be stronger in individuals without ASD traits, which does not provide support for the hypothesis of sensory dysfunction as an underlying mechanism of pain sensitivity in ASD.

Introduktion: Insättning av en ventrikulär dränage kateter är en mycket vanlig neurokirurgisk procedur som används för att bland annat sänka på det intrakraniella trycket och behandla akut hydrokefalus. Insättningen av katetern i operationsalen är vanligt (ibland guidat med bilder eller stereotaktiskt). Det finns ett behov att undersöka ifall insättningen av katetern vid "bedside" är ett säkert alternativ till insättning i operationssalen, eftersom operationssalstid är begränsad i många länder. Målsättning: Det primära målet är att visa att insättningen av en ventrikulär dränage kateter vid "bedside" med bolt-fixering (i en allmän neurokirurg population) inte ökar på risken för ventrikulär dränage kateter relaterade infektioner jämfört med den internationella literaturen. Ett sekundärt mål är undersöka riskfaktorer för ventrikulär dränage kateter relaterade infektioner i denna population. Material och metoder: operationsloggböcker från januari 2021 till juni 2022 granskades för ventrikulär dränage kateter insättning vid vår institution. Initiellt identifierades 96 patienter, varav 12 exkluderades. 2 exkluderas på grund av otillräcklig data medan den kvarvarande 10 exkluderades eftersom de presenterade med intrakraniell infektion eller de inte hade möjlighet att ventrikulär dränage kateter relaterad infektion. Bivariat och multivariat korrelationsanalys för riskfaktorer att utveckla ventrikulär dränage kateter relaterad infektion utfördes på 84 patienter. Resultat: Bakteriell tillväxt i CSF eller kateter odling kunde ses i 3 utav 12 patienter (3,2%). Tillsammans 12 patienter behandlas för ventrikulär dränage kateter relaterad infektion. När en mer strikt definition för infektion användes var antalet ännu lägre. "Bedside" insättning och bolt-fixation påvisades inte vara riskfaktorer för ventrikulär dränage kateter relaterad infektion i den bivariata korrelationsanalysen. Inga självständiga riskfaktorer för ventrikulär dränage kateter relaterad infektion kunde identifieras i den multivariata analysen. Slutsats: "Bedside" insättning av ventrikulär dränage kateter är säkert och mer effektivt än insättning av kateter i operationssalen. Användningen av bolt-fixering ökar inte risken för ventrikulär dränage kateter relaterad infektion.

Det har föreslagits att fortsätta screening för livmoderhalscancer hos kvinnor som tidigare haft avvikande testresultat eller som tidigare deltagit oregelbundet i screeningen. Vi har undersökt täckningen och faktorer som möjligen påverkar det opportunistiska testandet för livmoderhalscancer hos äldre kvinnor, som inte mera är inom åldern för det organiserade screeningprogrammet i Finland. Det nationella screeningprogrammet bjuder in alla kvinnor vart femte år, minst upp till 60 års ålder. Därefter är endast opportunistiskt testande tillgängligt. Data om testandet för livmoderhalscancer samlades från Massundersökningsregistret och från erbjudare av opportunistisk Pap/HPV-testning och kopplades ihop med information gällande socioekonomiska variabler. Studien omfattade 373 353 kvinnor som hade fått minst en inbjudan till det nationella screeningprogrammet mellan 50-60 års ålder, och som var 65-74 år gamla under uppföljningsperioden åren 2006-2016. Multivariabla binomialregressionsmodeller genomfördes för att undesöka möjliga samband. Sammanlagt 33% av forskningspopulationen hade blivit åtminstone en gång testade under åldern 65-74 år. Tidigare deltagande i screening och tidigare avvikande testreslutat var klart associerade med högre testningsaktivitet vid högre ålder. Andra faktorer som hade samband till högre testningsaktivitet var urban bostadsmiljö, inhemskt modersmål, hög utbildning och hög socioekonomisk status.

Objective: Both stress-related exhaustion and depression have previously been associated with a decline in cognitive performance, but there is a lack of evidence on whether these conditions have different associations with different cognitive domains and whether they have additive effects on cognitive performance. Furthermore, very little is known about the cognitive effects of chronic stress-related exhaustion. Consequently, the aims of this study were to 1) examine the associations between current stress-related exhaustion and cognitive performance, 2) investigate whether different developmental trajectories of stress-related exhaustion are differently associated with cognitive performance, 3) compare the association between stress-related exhaustion and cognitive performance to the relationship between depressive symptoms and cognitive performance, 4) examine if individuals with comorbid stress-related exhaustion and depression have lower cognitive performance than individuals with at most one of these conditions (i.e., whether clinical stress-related exhaustion and clinical depression might have additive effects on cognitive performance). Methods: The data used in the study was a Finnish population-based sample of six cohorts born between 1962 and 1977 from the Cardiovascular Risk in Young Finns Study. Stress-related exhaustion was assessed using the Maastricht Questionnaire, depressive symptoms with the Beck Depression Inventory, and cognitive performance with four subtests of the Cambridge Neuropsychological Test Automated Battery, measuring visuospatial associative learning, reaction time, sustained attention, and executive functions. Cognitive performance and depressive symptoms were assessed in 2012, and stress-related exhaustion in 2001, 2007, and 2012. Participants were 35 to 50 years old in 2012. Linear associations between stress-related exhaustion and cognitive performance (N = 905) and depressive symptoms and cognitive performance (N = 904) were examined by conducting multivariate regression analyses. Age, sex, socioeconomic status, and parents’ socioeconomic status were controlled in the regression models. Additionally, multivariate analyses of variance were performed to investigate the different developmental trajectories of stress-related exhaustion and their relation to cognitive performance (N = 541) and the associations of comorbid stress-related exhaustion and depression with cognitive performance (N = 1273). Results and conclusion: The main finding was that high stress-related exhaustion is associated with slower reaction times, but not with performance in spatial working memory, visuospatial associative learning, or executive functions. Ongoing, chronic stress-related exhaustion was more strongly associated with slower reaction times than short-term exhaustion experienced years ago. Compared to depressive symptoms, high stress-related exhaustion was associated with slower reaction times also when subclinical cases were included, whereas only clinical levels of depressive symptoms had an association with slower reaction times. There were no differences in cognitive performance between individuals with only stress-related exhaustion or depression and those with comorbid stress-related exhaustion and depression, which supports the notion that these conditions do not have additive effects on cognitive performance. These findings add to the existing evidence of the cognitive effects of stress-related exhaustion in the general population and have several practical implications. Further research is needed on the topic, preferably with longitudinal designs, more comprehensive cognitive measures, and clinical assessment of the psychiatric symptoms.

Objective: Anxiety has been studied in COVID-19 patients, but there are few studies comparing the level of anxiousness in patient groups requiring different levels of treatment. The aim of this study was to investigate anxiety symptoms in COVID-19 patients six months after the acute phase of the disease. The study also compared the amount of anxiety symptoms between patients in intensive care unit, those treated in a hospital ward, those who stayed at home during the illness, and a healthy control group. Moreover, the study aimed at investigating the associations of need for support (physical, mental, practical life and obtaining disease-related information) during the recovery phase of the disease with anxiety symptoms at six months. Methods: This study was a part of the RECOVID-20 research project, which is a collaborative project between the University of Helsinki and the Hospital District of Helsinki and Uusimaa (HUS). The project investigates the physical and mental symptoms of COVID-19 patients three and six months after hospitalization. In the present study, 135 COVID-19 patients (58 in the intensive care unit, 41 in the regular hospital care, and 36 patients who stayed at home during the illness) and 50 healthy controls were included. The data were collected during the first and second wave of the pandemic in years 2020 and 2021, three and six months after the acute phase of the illness. At three months, participants were interviewed by phone. The interview included questions about their need for support, as well as questions of physical and psychological well-being. At six months, a questionnaire was sent to them including a questionnaire (GAD-7, The Generalized Anxiety Disorder Assessment) on symptoms of anxiety. The differences in anxiety between different groups and the associations between need for support and later anxiety symptoms were analyzed using general linear models (GLM). Results and conclusions: COVID-19 patients had more symptoms of anxiety six months after the acute phase when compared to the healthy control group, but the patient groups did not differ. In addition, 25 % of the COVID-19 patients and 12 % of the healthy control group had at least mild anxiety symptoms. While recovering from the COVID-19 infection, most support was needed for information about the COVID-19 disease, and the least support for practical life. Furthermore, the need for mental support associated with greater post-disease anxiety symptoms. The study provides new evidence that COVID-19 patients need more support, especially for their mental symptoms which might be associated with anxiety. Further research should focus on the need for support and its association with mental health in COVID-19 patients.