Therapeutic alliance in guided internet therapy programs for depression and anxiety disorders - A systematic review.

Objective: The role of internet therapy programs for mental disorders is growing. Those programs employing human support yield better outcomes than do those with no such support. Therapeutic alliance may be a critical element in this support.

Multiple physical healthcare needs among outpatients with schizophrenia: findings from a health examination study.

Background: Despite the abundant literature on physical comorbidity, the full range of the concurrent somatic healthcare needs among individuals with schizophrenia has rarely been studied.

Aims: This observational study aimed to assess the distressing somatic symptoms and needs for physical health interventions in outpatients with schizophrenia, and factors predicting those needs.

Methods: A structured, comprehensive health examination was carried out, including a visit to a nurse and a general practitioner on 275 outpatients with schizophrenia.

A longitudinal study of educational differences in antidepressant use before and after hospital care for depression.

Background: Despite social inequalities in depression various studies report small or even reversed social gradients for antidepressant treatment, suggesting unmet need for treatment among those with low social position. However, few studies assess need for treatment or compare longitudinal antidepressant use patterns between socioeconomic groups.

Methods: We used a nationally representative register cohort of Finnish adults with hospital care for depression in 1998-2007 (n = 7249).

The effectiveness of email-based exercises in promoting psychological wellbeing and healthy lifestyle: a two-year follow-up study.

Background: Web-based interventions provide a possibility to enhance well-being in large groups of people. Only a few studies have studied the effectiveness of the interventions and there is no information on the sustainability of the effects. Study aims were to investigate both the short (2-month) and long-term (2-year) effects of email-based training for mental health and lifestyle.

[Online therapies - what is known about their functionality].

Online therapies are partly automated therapies, in which psychotherapeutic contents have been complemented with computer-aided presentational and educational contents, with a therapist giving support to the progress of the patient. As methods, these therapeutic programs incorporate therapeutic methods that have proven effective, such as remodeling of thoughts, activation of behavior and exposure, empathy, strengthening of cooperative relationship and motivation, and general support for self-reflection. For instance, online therapies already constitute part of the Finnish treatment guidelines on depression.

Clozapine use and sedentary lifestyle as determinants of metabolic syndrome in outpatients with schizophrenia.

Background: Schizophrenia patients are in danger of developing metabolic syndrome (MetS) and its outcomes type 2 diabetes and cardiovascular disease. Antipsychotic treatment and adverse lifestyle increase the burden of metabolic problems in schizophrenia, but little is known about the role of patients' current psychiatric problems and living arrangements in MetS.

Aims: This study aims to evaluate correlations between MetS, severity of psychiatric symptoms, living arrangements, health behaviour and antipsychotic medication in outpatients with schizophrenia spectrum disorders.

Association of stigma resistance with emotion regulation - functional magnetic resonance imaging and neuropsychological findings.

Background: [corrected] Personal characteristics contribute to whether negative attitudes in society are internalized as deteriorating self-stigma. Studies in healthy subjects suggest that resilience is associated with the regulation of amygdala activation by the medial prefrontal cortex (mPFC), but little is known about the factors that contribute to individual stigma resistance in psychiatric patients.

Methods: We assessed stigma (by measuring association strengths between social inferiority and schizophrenia by an implicit association test) in 20 patients with schizophrenia and in 16 age- and sex-matched healthy control subjects.

Confidence in the future, health-related behaviour and psychological distress: results from a web-based cross-sectional study of 101 257 Finns.

Objectives: To investigate the role of socioeconomic status and psychological stress to potential associations between confidence in the future and a wide range of health-related behaviours.

Design: Web-based cross-sectional study including an 'Electronic Health Check' at the Finnish Happiness-Flourishing Study website linked to a TV programme on happiness and depression.

Setting: The Finnish population with access to the internet.

Does hospital admission risk for depression vary across social groups? A population-based register study of 231,629 middle-aged Finns.

Purpose: Evidence on social differentials in depression outcomes remains inconsistent. We assess social predictors of psychiatric admission for depression in a community setting.

Methods: A register-based 14% sample of community-dwelling Finns aged 40-64 at the end of 1997 was assessed for depression and psychiatric comorbidity, using register data on psychiatric hospital care and medication purchases in 1996-1997.

Parental use of antidepressant medication and family type in the risk for incident psychiatric morbidity in offspring.

Background: Maternal depression increases the risk for psychiatric morbidity in offspring but the effects of paternal depression and family type are less studied.

Methods: We assessed the effects of parental antidepressant use on offspring psychiatric morbidity in various family settings.

Results: Our register-based study followed 132637 children for incident psychiatric morbidity in 1998-2003.

Cerumen impaction in patients with schizophrenia.

Cerumen impaction may cause hearing loss and pain. We investigated the prevalence of cerumen impaction in a population of outpatients with schizophrenia spectrum psychoses and studied factors contributing to it. As a part of our study--"The Living Conditions and Physical Health of Outpatients with Schizophrenia"--we performed a thorough medical examination including otoscopy of the ear canal for patients treated in the community mental health center of one Finnish municipality.

Alcohol-related deaths and social factors in depression mortality: a register-based follow-up of depressed in-patients and antidepressant users in Finland.

Background: Excess mortality of depression is established for various causes of death, but evidence is scarce on alcohol-related causes. It also remains unclear whether the magnitude of the excess varies by social factors. This study aimed to quantify the contribution of alcohol-related causes of death and to assess modifying effects of socioeconomic position, employment status, and living arrangements in the excess mortality of depression.

Depressive symptoms, major depressive episodes and cognitive test performance-what is the role of physical activity?

Background: Positive associations between physical activity and cognitive test performance in depressed subjects have been proposed in clinical studies. The contribution of severity and recency of depressive symptoms at the population level is not known.

Aims: This study aims to examine whether regular physical activity associates with better verbal fluency and psychomotor speed in depressed subjects using a large population-based sample.

Living alone and antidepressant medication use: a prospective study in a working-age population.

Background: An increasing proportion of the population lives in one-person households. The authors examined whether living alone predicts the use of antidepressant medication and whether socioeconomic, psychosocial, or behavioral factors explain this association.

Methods: The participants were a nationally representative sample of working-age Finns from the Health 2000 Study, totaling 1695 men and 1776 women with a mean age of 44.

Psychiatric comorbidity in couples: a longitudinal study of 202,959 married and cohabiting individuals.

Purpose: To examine whether partner's psychiatric and somatic disorders are risk factors for incidence of psychiatric disorders among non-psychiatric individuals at baseline.

Methods: Register-based 6-year follow-up on Finns (106,935 men and 96,024 women aged 40 and over), living with a married or cohabiting partner at the end of 1997. The outcome measures included non-psychotic major depressive disorder (MDD), substance use disorder (SUD), and severe psychiatric disorder, evaluated using information on reimbursement for drug costs, purchases of prescription medication, and principal causes of hospitalization.

Childhood and current determinants of heavy drinking in early adulthood.

Aims: To explore the association of parental education, childhood living conditions and several adversities with heavy drinking in early adulthood, and to analyze the effect of the respondent's current circumstances on these associations.

Method: The analyses were conducted in a sample of 1234 adults aged 18-29 years participating in the Finnish Health 2000 Survey (65% of the original representative two-stage cluster sample, N = 1894). The outcome measure was heavy drinking measured by g/week for pure alcohol (for men >or=280 g/week and for women >or=140 g/week).

Alcohol consumption, abstaining, health utility, and quality of life--a general population survey in Finland.

Aims: To examine the associations between alcohol consumption and utility-based health-related quality of life (HRQoL), subjective quality of life (QoL), self-rated health (SRH), and mental distress.

Methods: Representative general population survey in Finland, with 5871 persons aged 30-64 years. HRQoL was measured with two health utility instruments (15D and EQ-5D), QoL and SRH were measured with RATING scales, and mental distress with a General Health Questionnaire (GHQ-12).

Mortality differences according to living arrangements.

Background: Research has revealed mortality differences between marital status groups in different societies and different periods of time. Due to the increase in consensual unions, living alone and other changes in living arrangements, it is necessary to apply a more detailed classification of living arrangements that incorporates partnership situation and household composition.

Methods: We analyse mortality by cause-of-death in the total Finnish population aged 30 or over in 1996-2000.

Living arrangements, heavy drinking and alcohol dependence.

Aims: To assess the variation in heavy drinking and alcohol dependence by living arrangements, and the contribution of social and behavioural factors to this variation.

Design: The Health 2000 survey is a nationally representative cross-sectional survey conducted in Finland in 2000-2001 (N = 4589 in the age-range of 30-54 years, response rate 81%).

Measurements: Living arrangements; married, cohabiting, living with other(s) than a partner, and living alone.

Living arrangements and mental health in Finland.

Background: Non-married persons are known to have poor mental health compared with married persons. Health differences between marital status groups may largely arise from corresponding differences in interpersonal social bonds. However, official marital status mirrors the social reality of persons to a decreasing extent, and living arrangements may be a better measure of social bonds.

Official marital status, cohabiting, and self-rated health-time trends in Finland, 1978-2001.

Background: Married persons are healthier and live longer than single, divorced, and widowed persons. Time trends in self-rated health (SRH) by marital status and cohabitation have remained largely unstudied. We aim to assess the levels and trends of SRH by official marital status and cohabitation, and to study the causes of these differences.