The Delphic nature of the language of psychiatry.

In this perspective piece, the language used in psychiatric classification is considered from a linguistic and anthropological perspective. It is important for psychiatrists to consider how ambiguous language can impact on their view of clinical presentations and the delivery of treatments. Ultimately, delivering care using an empathic and humane approach should always be a primary consideration when treating mental illness.

Maternal smoking during pregnancy and offspring psychiatric disorder: a longitudinal birth cohort study.

Background: There is evidence that prenatal stress and smoking during pregnancy both independently increase the risk of offspring psychopathology. Here we examine whether increased levels of self-reported stress is associated with increased smoking in a population of pregnant women, and whether prenatal smoking is associated with offspring psychiatric diagnoses independent of prenatal stress exposure.

Method: Using a longitudinal birth cohort, we used ordered logistic regressions to examine associations between maternal stress and smoking during pregnancy.

Childhood temperament and its association with adult psychiatric disorders in a prospective cohort study.

Background: Childhood temperament and its component factors have previously been shown to be associated with depression and anxiety disorders in later life. Studies have also suggested possible links between childhood temperament and later psychosis.

Aims: To investigate the association between childhood temperament and its individual component factors, measured at age 5, and later psychiatric disorders.

The role of prenatal stress as a pathway to personality disorder: longitudinal birth cohort study.

Background: Many studies have reported associations between prenatal stress and the development of psychotic, anxiety and depressive disorders; however, to date no studies have investigated potential associations with personality disorders.

Aims: This study investigated potential associations between exposure to prenatal stress and personality disorder in offspring.

Method: In a subsample (N = 3626) of a large Finnish birth cohort, we used logistic regression models to examine associations between self-reported maternal stress during pregnancy, collected monthly during antenatal clinic appointments, and personality disorder in offspring.

Psychotherapy effectiveness for major depression: a randomized trial in a Finnish community.

Background: The purpose of this study is to assess the relative effectiveness of Interpersonal Psychotherapy (IPT), Psychoeducative Group Therapy (PeGT), and treatment as usual (TAU) for patients with Major Depressive Disorder (MDD) in municipal psychiatric secondary care in one Finnish region.

Methods: All adult patients (N = 1515) with MDD symptoms referred to secondary care in 2004-2006 were screened. Eligible, consenting patients were assigned randomly to 10-week IPT (N = 46), PeGT (N = 42), or TAU (N = 46) treatment arms.

[Pitfalls in psychopharmacological drug use].

Psychiatric drug therapy is based on diagnoses and controlled examinations Psychiatric illnesses or disorders are, however, heterogenous conditions in their nature and treatment response. It is not possible to know beforehand whether a drug is beneficial or actually harmful for an individual patient. In practice, the use of psychopharmacological drugs is actually experimental, and success will require critical monitoring of the response, flexibility and good pharmacotherapeutic rapport.

Evaluation of verbal list learning as a predictor of psychosis.

Aim: We explored whether cognitive performance, and verbal learning in particular, predicts psychosis or psychiatric hospitalizations among unselected first-admission adolescent patients in general psychiatric care.

Methods: Up to 152 adolescents aged 15-18 were interviewed with the SIPS, tested with a cognitive test battery in the beginning of their psychiatric treatment, and followed for a maximum of 9 years (median 4.5 years).

[Hoarding].

Hoarding is a mental disorder having its onset at young age and often worsening with age, manifested as a need of storing up goods to an extent that significantly hampers everyday life. In the light of conducted studies, at least 1 to 2% of the adult population suffers from hoarding. Upon increased compulsive hoarding with aging, problems arise especially for those living alone.

Predicting psychosis and psychiatric hospital care among adolescent psychiatric patients with the Prodromal Questionnaire.

The Prodromal Questionnaire (PQ) identifies psychiatric help-seekers in need of clinical interviews to diagnose psychosis risk. However, some providers use the PQ alone to identify risk. Therefore, we tested its predictive utility among 731 adolescent psychiatric help-seekers, with a 3-9-year register-based follow-up.

Predicting psychosis in a general adolescent psychiatric sample.

Introduction: Current psychosis risk criteria have often been studied on a pre-selected population at specialized clinics. We investigated whether the Structured Interview for Prodromal Syndromes (SIPS) is a useful tool for psychosis risk screening among adolescents in general psychiatric care.

Methods: 161 adolescents aged 15-18 with first admission to adolescent psychiatric services in Helsinki were interviewed with the SIPS to ascertain Clinical High-Risk (CHR) state.

Clinical high-risk state does not predict later psychosis in a delinquent adolescent population.

Aim: Adolescents with severe disruptive behaviour have an elevated risk for adult psychosis. We investigated whether the Structured Interview for Prodromal Syndromes (SIPS) is a useful psychosis risk-screening tool for adolescents with disruptive behaviour.

Method: Fifty-three adolescents residing in a reform school due to severe behavioural problems were interviewed with SIPS to ascertain clinical high-risk (CHR) state.

Sudden death of father or sibling in early childhood increases risk for psychotic disorder.

Objective: To determine if exposure to a severe, acute stressor during early development is associated with an increased incidence of schizophrenia and bipolar disorder compared to exposure to a chronic stressor.

Design: We identified all those born in Helsinki between 1960 and 1990 whose father or sibling died between their conception and 5-years-of-age through linking two national registers: the Finnish Population Register and the Cause of Death Register. The reason for the death was also extracted from the Cause of Death Register.

Low verbal ability predicts later violence in adolescent boys with serious conduct problems.

Background: Delinquent adolescents are a known high-risk group for later criminality. Cognitive deficits correlate with adult criminality, and specific cognitive deficits might predict later criminality in the high-risk adolescents.

Aims: This study aimed to explore the neuropsychological performance and predictors of adult criminal offending in adolescents with severe behavioural problems.

Genetic risk for schizophrenia, obstetric complications, and adolescent school outcome: evidence for gene-environment interaction.

Low birth weight (LBW) and hypoxia are among the environmental factors most reliably associated with schizophrenia; however, the nature of this relationship is unclear and both gene-environment interaction and gene-environment covariation models have been proposed as explanations. High-risk (HR) designs that explore whether obstetric complications differentially predict outcomes in offspring at low risk (LR) vs HR for schizophrenia, while accounting for differences in rates of maternal risk factors, may shed light on this question. This study used prospectively obtained data to examine relationships between LBW and hypoxia on school outcome at age 15-16 years in a Finnish sample of 1070 offspring at LR for schizophrenia and 373 offspring at HR for schizophrenia, based on parental psychiatric history.

Two founder mutations in the alpha-tropomyosin and the cardiac myosin-binding protein C genes are common causes of hypertrophic cardiomyopathy in the Finnish population.

Background: Hypertrophic cardiomyopathy (HCM) is predominantly caused by a large number of various mutations in the genes encoding sarcomeric proteins. However, two prevalent founder mutations for HCM in the alpha-tropomyosin (TPM1-D175N) and myosin-binding protein C (MYBPC3-Q1061X) genes have previously been identified in eastern Finland.

Objective: To assess the prevalence of these founder mutations in a large population of patients with HCM from all over Finland.

Evidence for shared susceptibility to epilepsy and psychosis: a population-based family study.

Background: There is emerging evidence of an etiological overlap between a range of neurodevelopmental disorders, including schizophrenia and epilepsy. Here we investigate shared familial vulnerability to psychotic illness and epilepsy in a family-based study.

Methods: The study population consisted of parents and their children born in Helsinki between 1947 and 1990.

The genetic and environmental determinants of the association between brain abnormalities and schizophrenia: the schizophrenia twins and relatives consortium.

Background: Structural brain abnormalities are consistently found in schizophrenia (Sz) and have been associated with the familial risk for the disorder. We aim to define the relative contributions of genetic and nongenetic factors to the association between structural brain abnormalities and Sz in a uniquely powered cohort (Schizophrenia Twins and Relatives consortium).

Methods: An international multicenter magnetic resonance imaging collaboration was set up to pool magnetic resonance imaging scans from twin pairs in Utrecht (The Netherlands), Helsinki (Finland), London (United Kingdom), and Jena (Germany).

Phospholipids and insulin resistance in psychosis: a lipidomics study of twin pairs discordant for schizophrenia.

Background: Several theories have been proposed to conceptualize the pathological processes inherent to schizophrenia. The 'prostaglandin deficiency' hypothesis postulates that defective enzyme systems converting essential fatty acids to prostaglandins lead to diminished levels of prostaglandins, which in turn affect synaptic transmission.

Methods: Here we sought to determine the lipidomic profiles associated with schizophrenia in twin pairs discordant for schizophrenia as well as unaffected twin pairs.

Increased risk of schizophrenia from additive interaction between infant motor developmental delay and obstetric complications: evidence from a population-based longitudinal study.

Objective: Obstetric complications and developmental delay are well-established risk factors for schizophrenia. The authors investigated whether these risk factors interact in an additive manner to further increase risk for schizophrenia.

Method: The study population encompassed all individuals born in Helsinki between 1962 and 1969 who had developmental records archived in the Helsinki City Archives.

Prodromal psychosis screening in adolescent psychiatry clinics.

Background: Research has identified a syndrome conferring ultra-high risk (UHR) for psychosis, although UHR interviews require intensive staff training, time and patient burden. Previously, we developed the Prodromal Questionnaire (PQ) to screen more efficiently for UHR syndromes.

Aims: This study examined the concurrent validity of the PQ against UHR status and preliminary predictive validity for later psychotic disorder.

Alexithymia is common among adolescents with severe disruptive behavior.

This study aimed to examine alexithymic features and associations between alexithymia and psychiatric symptoms among adolescents living in a closed institution because of severe behavioral problems. Forty-seven adolescents (29 boys and 18 girls) aged 15 to 18 years completed the 20-item Toronto Alexithymia Scale (TAS-20) Questionnaire and the Youth Self-Report, whereas their foster parents completed the Child Behavior Checklist. The TAS-20 scores of the participants were compared with those of an extensive population sample (N = 6000) matched by age and birth year.

Hippocampal morphology in lithium and non-lithium-treated bipolar I disorder patients, non-bipolar co-twins, and control twins.

Background: Bipolar I disorder is a highly heritable psychiatric illness with undetermined predisposing genetic and environmental risk factors. We examined familial contributions to hippocampal morphology in bipolar disorder, using a population-based twin cohort design.

Methods: We acquired high-resolution brain MRI scans from 18 adult patients with bipolar I disorder [BPI; mean age 45.

Mapping corpus callosum morphology in twin pairs discordant for bipolar disorder.

Callosal volume reduction has been observed in patients with bipolar disorder, but whether these deficits reflect genetic vulnerability to the illness remains unresolved. Here, we used computational methods to map corpus callosum abnormalities in a population-based sample of twin pairs discordant for bipolar disorder. Twenty-one probands with bipolar I disorder (mean age 44.