Abstract A miscarriage may have a sustained negative effect on mental health. Our aim was to analyze the association of the history and, if any, the number of miscarriages with mental health. The ...participants were women from two population-based studies, the Finnish Health 2000 survey and the National FINRISK 2002 Survey. Data were collected with a set of self-reported questionnaires, a clinical health examination and/or a home interview. A modified Beck Depression Inventory (BDI), the 12-item General Health Questionnaire (GHQ-12), the Munich-Composite International Diagnostic Interview (M-CIDI) and other non-structured interviews were used for the assessment of mental health. A diagnosis of depressive disorder and the presence of depressive symptoms were more prevalent among women with a history of miscarriage. In both datasets the higher the number of miscarriages was, the worse the current state of mood was and the higher the frequency of a psychiatric diagnosis was. These results suggest that a miscarriage, and in particular the number of miscarriages, contributes to mental health in a negative way for long.
ObjectivesSociodemographic and mental health characteristics are associated with contraceptive choices. We aimed to describe the sociodemographic, reproductive and mental health characteristics of ...all fertile-aged women in Finland who used hormonal contraception (HC) in 2017.DesignA nationwide, register-based study.SettingAll women living in Finland in 2017; data from the Care Register of Health Care, Medical Birth Register, Population Register Centre, Prescription Centre, Register of Induced Abortions.ParticipantsAll women aged 15–49 with one redeemed HC prescription in 2017 (n=294 356), and a same-sized, age-matched and residence-matched, control group of non-users.OutcomesRates of HC use; associations between HC use and mental disorders, sociodemographic and reproductive characteristics.Results25.8% of women aged 15–49 years used HC. Women with the lowest socioeconomic levels had lower odds of using HC than women with upper-level statuses (OR, 95% CI students: 0.97, 0.94 to 0.99; entitled to pension: 0.66, 0.63 to 0.69; other: 0.87, 0.85 to 0.89; unknown: 0.90, 0.85 to 0.90). Women with the highest education (secondary: 1.46, 1.43 to 1.48; tertiary: 1.64, 1.58 to 1.70; academic: 1.60, 1.56 to 1.63) and income (second quarter: 1.57, 1.54 to 1.60; third quarter: 1.85, 1.82 to 1.89; fourth quarter: 2.01, 1.97 to 2.06), and unmarried women had higher odds of using HC than women with the lowest education and income levels, and married (0.61, 0.60 to 0.62), divorced (0.86, 0.84 to 0.88), widowed (0.73, 0.65 to 0.83) or other marital status women (0.26, 0.22 to 0.30).Parous women (0.70, 0.69 to 0.71), those with previous induced abortion(s) (0.91, 0.89 to 0.92) or recent eating (0.68, 0.62 to 0.75) or personality (0.89, 0.79 to 0.97) disorders had lower odds of HC use. Absolute risk differences between women with and without mental disorders ranged from 3.1% (anxiety disorders) to 10.1% (eating disorders).ConclusionsA quarter of the fertile-aged women use HC in Finland. Sociodemographic disparities persist in relation to HC use, although of small effect size. HC use is less common among women suffering from severe to moderate psychiatric disorders, especially eating disorders.
Monitoring factors related to hormonal contraception (HC) use is essential to evaluating public health strategies and promoting access to contraception. We aimed to examine municipal social and ...health indicators of HC use at the population level, and to identify patterns of inequality across Finnish municipalities.
We identified all women (15-49 years) with a redeemed HC prescription in Finland in 2017 (n = 294,445), and a control group of non-users. Municipal social and health indicators at the population level were retrieved from the nationwide Statistics and Indicator Bank. Differences between the groups across 309 municipalities were calculated, and associations of municipal-specific proportions of HC users with municipal-specific indicators were studied using LASSO (Least Absolute Shrinkage and Selection Operator) models.
Sociodemographic differences between HC users and non-users were non-homogenous across municipalities. Indicators positively associated with HC use included: larger population and higher proportions of population aged 16-24 years, of household-dwelling units with one person, of persons with higher education, and of divorces among those aged 25-64. Lower HC use was associated with higher proportions of Swedish-speaking population, of those aged 7-15 years, of young people not in education/training, and of household-dwelling units in overcrowded conditions. Lower HC use was also associated with indicators of outpatient and inpatient healthcare, and of municipal finances in welfare and healthcare.
Sociodemographic differences in relation to HC use exist across Finnish municipalities. Municipal indicators of social structure, health and welfare, and investment in and use of healthcare services are related to HC use.
ObjectivesThe relationship between the use of contraception and of psychiatric medications is understudied. We examined whether the current and past use of psychotropic medications is associated with ...the use and type of hormonal contraception (HC).DesignNationwide register-based matched case–control study.SettingsAll fertile-aged (15–49 years) girls and women living in Finland in 2017; data from several national registers.Participants294 356 girls and women with a redeemed prescription of HC in 2017, and their same-sized control group of non-users (n=294 356) identified through the Prescription Centre.Main outcome measuresAssociations between the use of psychotropic medications and the use of HC, and the type of HC tested in logistic regression models.ResultsAltogether 19.5% of the HC users, and 18% of the HC non-users received at least one prescription for a psychotropic medication in 2017. Among HC users, the proportions of occasional and regular users of psychotropic medications in 2013–2016 were 4.5% and 14.8%, while among HC non-users the respective figures were 4.3% and 14.6%, respectively. In multivariable logistic regression models both the use of psychotropic medications in 2017, and their occasional or regular use between 2013–2016 were associated with higher odds of HC use, although with small to very small effect sizes (ORs between 1.37 and 1.06 and 95% CIs 1.22 to 1.53, and 1.03 to 1.09, respectively). After adjustment for covariates, when fixed combinations of progestogens and oestrogens for systemic use was the reference category, women using almost any class of psychotropic medications had higher odds of using other types of HC.ConclusionsFertile-aged girls and women with current and past use of psychotropic medications have higher odds of using HC, with a specific pattern in the type of contraceptives used. Further research is warranted to examine whether our observations indicate a reduction of unwanted pregnancies in women with psychiatric disorders.
Reproductive events have a significant impact on women’s lives. The aim of this study was to analyze the effects of age at menarche and current menstrual irregularity on psychological well-being and ...psychopathology. Data were collected in the context of the Finnish population-based Health 2000 study with self-administered questionnaires, a home interview, and a clinical health examination. The Beck Depression Inventory (BDI-21), the General Health Questionnaire-12 (GHQ-12), and the Composite International Diagnostic Interview (M-CIDI) were used to assess psychopathology. The relationships between age at menarche and current menstrual flow irregularity vs. BDI-21 and GHQ-12 scores and M-CIDI diagnoses were studied among 4,391 women aged 30 years and over. Negative, nonsignificant associations were found between age at menarche and BDI-21 and GHQ-12 scores. Young age at menarche was associated with increased risks of any recent mental disorder (OR = 0.894,
p
< 0.01), major depressive episode (OR = 0.900,
p
< 0.05), major depressive disorder (OR = 0.888;
p
< 0.05), and anxiety disorder (OR = 0.892;
p
< 0.05). Menstrual irregularity was associated with BDI-21 (
p
< 0.001) and GHQ-12 (
p
< 0.05) scores, but not with any recent psychiatric diagnosis. Age at menarche and menstrual irregularity have an influence on mental health, particularly on mood and anxiety symptoms. Reproductive features (age at menarche and menstrual irregularity) should be paid attention to during psychiatric evaluations.
•Plasma levels of hs-CRP are higher in subjects who had recently attempted suicide compared to age- and sex-matched healthy subjects.•The lack of correlations between hs-CRP levels measured shortly ...after the attempted suicide vs. depression severity and other psychological symptoms suggests that inflammation may be specifically related to suicidal behavior.
We found significantly higher levels of hs-CRP in 27 subjects who had recently attempted suicide compared to 27 age- and sex-matched healthy subjects. Moreover, the levels of hs-CRP in suicide attempters were not related to background or psychopathological characteristics, nor to the methods of suicide attempt. Our matched case-control study confirms previous observations of high levels of the inflammation marker hs-CRP in patients who have attempted suicide, irrespective of their underlying type and levels of psychopathology.
Whether infant regulatory behavior problems already in the first month of life indicate an increased risk of childhood neurobehavioral problems, and whether maternal depression in the postpartum and ...early childhood underpins these associations remain unclear. Altogether, 2049–2364 mothers from the Prediction and Prevention of Pre-eclampsia and Intrauterine Growth Restriction (PREDO) study completed the Neonatal Perception Inventory on regulatory behavior problems at the infant’s age of 15.6 days (SD 3.2, range 1–30), the Infant Behavior Questionnaire-Revised on temperament at 6.5 months (SD 0.9, range 4.2–12.4), and the Ages and Stages Questionnaire-3 on developmental milestones and the Child Behavior Checklist on behavioral problems at 3.5 years (SD 0.7, range 1.9–6.0). Maternal depressive symptoms were measured by the Center for Epidemiological Studies Depression Scale (infancy follow-ups) and Beck Depression Inventory-II (childhood follow-up). Father-rated infant temperament and paternal depressive symptoms were also available (
n
= 1474). Higher levels of infant regulatory behavior problems predicted higher levels of mother- and father-rated negative affectivity temperament (0.13 SD units per SD unit, 95% confidence interval 0.09–0.17; and 0.09, 0.04–0.14, respectively), lower levels of mother-rated orienting/regulation temperament (− 0.09, − 0.13 to − 0.05) and problem-solving skills (− 0.12, − 0.21 to − 0.04), and higher levels of Externalizing (0.07, 0.03–0.11) and Total behavioral problems (0.07, 0.03–0.11). Regulatory behaviors partially mediated the effect of maternal depressive symptoms. Regulatory behavior problems already during the first month of life predict neurobehavioral outcomes, and partially mediate the effect of maternal depressive symptoms. Our study may inform design of interventions aimed at timely prevention in children at risk.
•The influence of empathy on auto-aggressive suicidal behaviors is not known.•Suicide attempters scored higher on empathy Personal Distress and Fantasy scales.•Empathic profiles are associated to ...suicidal behavior in a gender specific pattern.
High levels of empathy may inhibit hetero-aggressive behaviors; however, the role of empathy on suicide behaviors is still unknown. This study aimed to compare the Interpersonal Reactivity Index (IRI) empathic profiles of 56 patients hospitalized after a suicide attempt with those of 138 people who had never attempted suicide.
Differences were tested with t-test and Chi-square test. The associations between attempted suicide and empathy scores were tested with linear regression models, controlling for sex and age. Latent Class Regression Analysis was applied to investigate the relationship between multivariate categorical empathy response items and suicide attempts, controlling for sex and age.
Suicide attempters scored significantly higher on the ‘Personal Distress’ and ‘Fantasy’ IRI subscales. Women in the control group had similar probabilities of belonging to the class of high or low Personal Distress and Fantasy levels, while women who had attempted suicide were more likely to have high scores at the same scales. Men in the control group had higher probabilities of scoring low at the Personal Distress and Fantasy subscales, while men who had attempted suicide had similar probabilities of belonging to the class with high or low scores.
The use of a self-administered tool may have introduced a gender-role stereotype bias in empathy assessment. Additionally, it was not possible to test the role of psychopathology.
Our results suggest that distinct empathic profiles are associated with suicidal behavior, with a gender specific pattern. Addressing empathy constructs may help identifying suicidal individuals.
Background
Completed suicide is more frequent among older adults than any other age group. Data on suicide in nursing homes and other residential facilities are inconsistent. This work aims to ...describe the characteristics of elderly suicide victims in different residential settings compared to young suicide victims.
Methods
Data on people who died by suicide in the South Tyrol (Alto Adige) region of Italy between 2000 and 2009 were gathered from the local Provincial Mortality Register. Further detailed information was collected via questionnaires to mental health departments and psychological services, family physicians and relatives of the deceased.
Results
A total of 525 cases of suicide were recorded, with a linearly decreasing trend during the study period. About one‐third of the suicides occurred in those aged 60 years and over. Suicide in the elderly was associated with low education level (odds ratio (OR) = 7.1, P < 0.001), living in a one‐person household (OR = 2.4, P < 0.01), not having economic troubles (OR = 6.1, P < 0.01), having seen a doctor in the past month (OR = 2.4, P < 0.01) and living in a residential facility (OR = 2.6, P < 0.05). Twenty‐four (17.9%) suicide victims aged 60 years and over were in a residential facility/hospital at the time of the death. They were more likely to be women, not married, and to die by jumping from a height.
Conclusions
The suicide risk should be carefully assessed in the elderly who live alone or are institutionalized or hospitalized. Efforts are warranted to reduce seniors' access to high places in hospitals and facilities.
There is evidence for the reciprocal interaction between circadian oscillation and reproduction, and disruption of circadian rhythms has been associated with impaired menstrual functions and reduced ...fertility in women. However, only little information is available on the relationship between reproduction and chronotype. The aim of the present study is to better assess this relationship. The participants (aged 25 to 74 yrs) were selected randomly from the Finnish Population Information System. The data from 2672 female participants of the National FINRISK Survey 2007 were analyzed to test the associations between chronotype (morning, intermediate, or evening) and reproductive features. Of the participants, 139 (5.6%) were evening, 1217 (48.7%) intermediate, and 1145 (45.8%) morning chronotypes. Among the participants aged 25 to 54 yrs, the duration of menstrual cycle was longer among evening chronotypes (28.8 ± 4.4 d) than among morning (27.7 ± 2.6 d; p < 0.01) and intermediate (27.8 ± 3.3 d; p = 0.05) chronotypes. Significant correlations were found between the higher morningness-eveningness scores (the more of morning chronotype) and the shorter durations of menstrual bleeding, both in the whole sample (p < 0.001) and after limiting the analyses to women younger than 55 yrs (p < 0.05). In multivariable analyses on the whole sample, as compared with morning chronotypes, intermediate chronotypes had a significantly longer duration of menstrual bleeding (B = 0.160, 95% confidence interval CI = 0.044 to 0.276; p < 0.01) as well as a higher odds for difficulties in getting pregnant (odds ratio OR = 1.464, 95% CI = 1.118 to 1.917; p < 0.01). Our findings suggest that chronotype is related to the reproductive function in women.
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