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Somero A, Suominen A, Pohjola V, Ogawa M, Sipilä K, Kakko N, Tulppo M, Lahti S. Autonomic Nervous System Activity and Dental Anxiety in the Northern Finland Birth Cohort (NFBC1966) Population. Dent J (Basel) 2024; 12:81. [PMID: 38534305 DOI: 10.3390/dj12030081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/07/2024] [Accepted: 03/18/2024] [Indexed: 03/28/2024] Open
Abstract
Autonomic nervous system (ANS) activity may be associated with dental anxiety; however, no studies exist on the topic. The aim of this study was to assess if ANS activity and dental anxiety are associated. Data were collected as part of a Northern Finland Birth Cohort Study, NFBC1966, at the age of 46 years with eligible data on 1905 participants. Dental anxiety was measured using the Modified Dental Anxiety Scale (MDAS) categorized as follows: 19-25 = high, 10-18 = moderate, 5-9 = no to low dental anxiety. Heart rate variability (HRV) data were collected using an HR monitor and a standard lead-II electrocardiogram (ECG). Baroreflex sensitivity (BRS) was calculated from continuous ECG and blood pressure signals. Participants were categorized into three groups as follows: Low = the lowest 20th percentile, Mid = medium 21-79th percentile, and High = the highest 20th percentile according to their ANS variables. The associations between the MDAS and ANS activity parameters were evaluated using unordered multinomial logit models adjusted for comorbidities, β-blockers, BMI, smoking, and education. High heart rate, reduced HRV, low cardiac vagal modulation, and poor BRS were associated with moderate dental anxiety, and high cardiac vagal modulation and good BRS were associated with no to low dental anxiety. Poorer ANS activity might predispose some to dental anxiety, and better ANS activity might protect from dental anxiety.
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Affiliation(s)
- Atte Somero
- Department of Community Dentistry, University of Turku, 20014 Turku, Finland
| | - Auli Suominen
- Department of Community Dentistry, University of Turku, 20014 Turku, Finland
| | - Vesa Pohjola
- Department of Community Dentistry, University of Turku, 20014 Turku, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, 90014 Oulu, Finland
| | - Mika Ogawa
- Department of Community Dentistry, University of Turku, 20014 Turku, Finland
| | - Kirsi Sipilä
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, 90014 Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, 90014 Oulu, Finland
| | - Niklas Kakko
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, 90014 Oulu, Finland
| | - Mikko Tulppo
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, 90014 Oulu, Finland
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, 90014 Oulu, Finland
| | - Satu Lahti
- Department of Community Dentistry, University of Turku, 20014 Turku, Finland
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Lahti S, Kataja EL, Suominen A, Palo K, Ogawa M, Kallio A, Räikkönen O, Pohjola V, Rantavuori K, Karlsson L, Karlsson H. Two-Year Trajectories of Dental Anxiety in Parents and Their Association with Parents' and Children's Oral Healthcare Procedures in FinnBrain Birth Cohort Study. Dent J (Basel) 2024; 12:72. [PMID: 38534296 DOI: 10.3390/dj12030072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/16/2024] [Accepted: 03/05/2024] [Indexed: 03/28/2024] Open
Abstract
We aimed to identify parents' dental anxiety trajectories and the association of the trajectories with the number of parents' and their children's oral healthcare procedures in the FinnBrain Birth Cohort Study. Dental anxiety was measured with the Modified Dental Anxiety Scale at gestational weeks (gw) 14 and 34, as well as 3 and 24 months (mo) after childbirth. Oral healthcare procedures from gw14 to 24 mo were obtained from the national patient data register and categorized as preventive and treatment. Trajectories were identified with latent growth mixture modelling for 2068 fathers and 3201 mothers. Associations between trajectories and procedures adjusted for education were analyzed using unordered multinomial logit models. Fathers' trajectories were stable low (80.1%), stable high (3.4%), stable moderate (11.0%), moderate increasing (3.9%) and high decreasing (1.6%). Mothers' trajectories were stable low (80.7%), stable high (11.2%), moderate increasing (5.3%) and high decreasing (2.8%). Mothers with decreasing dental anxiety had a higher number of preventive and treatment procedures. Fathers with decreasing dental anxiety had a higher number of preventive and treatment procedures, while fathers with increasing dental anxiety had fewer procedures. Children of mothers with stable low dental anxiety had higher number of preventive procedures. There seems to be a two-way association between dental anxiety trajectories and oral healthcare procedures.
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Affiliation(s)
- Satu Lahti
- Department of Community Dentistry, University of Turku, 20014 Turku, Finland
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, 20014 Turku, Finland
- Centre for Population Health Research, University of Turku, Turku University Hospital, 20521 Turku, Finland
| | - Eeva-Leena Kataja
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, 20014 Turku, Finland
- Centre for Population Health Research, University of Turku, Turku University Hospital, 20521 Turku, Finland
| | - Auli Suominen
- Department of Community Dentistry, University of Turku, 20014 Turku, Finland
| | - Katri Palo
- Department of Community Dentistry, University of Turku, 20014 Turku, Finland
| | - Mika Ogawa
- Department of Community Dentistry, University of Turku, 20014 Turku, Finland
| | - Anu Kallio
- Department of Community Dentistry, University of Turku, 20014 Turku, Finland
- Oral Health Services, Wellbeing Services County of Southwest Finland, 20521 Turku, Finland
| | - Outi Räikkönen
- Department of Community Dentistry, University of Turku, 20014 Turku, Finland
- Oral Health Services, Wellbeing Services County of Southwest Finland, 20521 Turku, Finland
| | - Vesa Pohjola
- Department of Community Dentistry, University of Turku, 20014 Turku, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, 90014 Oulu, Finland
| | - Kari Rantavuori
- Department of Oral Development and Orthodontics, University of Turku, 20014 Turku, Finland
- Cleft Palate and Craniofacial Center, Department of Plastic Surgery Helsinki University, Helsinki University Hospital, 00014 Helsinki, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, 20014 Turku, Finland
- Centre for Population Health Research, University of Turku, Turku University Hospital, 20521 Turku, Finland
- Unit of Public Health, Department of Clinical Medicine, University of Turku, 20014 Turku, Finland
- Department of Clinical Medicine, Paediatrics and Adolescent Medicine, University of Turku, Turku University Hospital, 20521 Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, 20014 Turku, Finland
- Centre for Population Health Research, University of Turku, Turku University Hospital, 20521 Turku, Finland
- Department of Psychiatry, University of Turku, Turku University Hospital, 20521 Turku, Finland
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Seppänen S, Vuorenmaa K, Suominen A, Ogawa M, Pohjola V, Rantavuori K, Karlsson H, Karlsson L, Lahti S. Concordance of Fathers and Mothers in the Assessment of Their 5-Year-Old Child's Dental Fear. Dent J (Basel) 2024; 12:53. [PMID: 38534277 DOI: 10.3390/dj12030053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/01/2024] [Accepted: 02/23/2024] [Indexed: 03/28/2024] Open
Abstract
The aim of this study was to evaluate the concordance of parents' assessments of their child's dental fear. Cross-sectional secondary analysis used data from the multidisciplinary FinnBrain Birth Cohort Study. Child dental fear was assessed at age 5 with the Finnish translation of the modified Children's Fear Survey Schedule Dental Subscale (CFSS-M) by both fathers (n = 588) and mothers (n = 1100). Reply alternatives were from 1 = not afraid to 5 = very afraid and 6 = no experience coded as missing and 1. In total, 514 mother-father pairs were eligible for the analyses. Descriptive statistics, percentage agreement and Cohen's Kappa coefficients were used in the analyses. The concordance of parents' assessments was poor (Kappa range 0.072-0.258). The majority of parents replied "No Experience" to items related to invasive treatment or being unable to breathe. Thus, coding of this reply alternative had a significant impact on the mean values of the child's fear. When assessing the fear of a five-year-old child, it might not be safe to rely only on one parent's assessment, and whether or not the child has experience with the question asked should also be considered.
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Affiliation(s)
- Sanna Seppänen
- Department of Community Dentistry, University of Turku, 20014 Turku, Finland
| | - Kukka Vuorenmaa
- Department of Community Dentistry, University of Turku, 20014 Turku, Finland
| | - Auli Suominen
- Department of Community Dentistry, University of Turku, 20014 Turku, Finland
| | - Mika Ogawa
- Department of Community Dentistry, University of Turku, 20014 Turku, Finland
| | - Vesa Pohjola
- Department of Community Dentistry, University of Turku, 20014 Turku, Finland
| | - Kari Rantavuori
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, 20014 Turku, Finland
- Department of Pediatric Dentistry and Orthodontics, University of Turku, 20014 Turku, Finland
- Cleft Palate and Craniofacial Center, Department of Plastic Surgery, Helsinki University Hospital and Helsinki University, 00029 Helsinki, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, 20014 Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, 20014 Turku, Finland
- Department of Psychiatry, University of Turku and Turku University Hospital, 20014 Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, 20014 Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, 20014 Turku, Finland
- Department of Clinical Medicine, Unit of Public Health, University of Turku, 20014 Turku, Finland
- Department of Clinical Medicine, Paediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, 20014 Turku, Finland
| | - Satu Lahti
- Department of Community Dentistry, University of Turku, 20014 Turku, Finland
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, 20014 Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, 20014 Turku, Finland
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Koskela M, Jokiranta-Olkoniemi E, Luntamo T, Suominen A, Sourander A, Steinhausen HC. Selective mutism and the risk of mental and neurodevelopmental disorders among siblings. Eur Child Adolesc Psychiatry 2024; 33:291-302. [PMID: 36422730 PMCID: PMC10805856 DOI: 10.1007/s00787-022-02114-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 11/16/2022] [Indexed: 11/25/2022]
Abstract
The siblings of children with mental disorders are more likely to experience mental health issues themselves, but there has been a lack of sibling studies on selective mutism (SM). The aim of this population-based study was to use national registers to examine associations between children with SM and diagnoses of various mental disorder in their siblings. All singleton children born in Finland from 1987 to 2009, and diagnosed with SM from 1998 to 2012, were identified from national health registers and matched with four controls by age and sex. Their biological siblings and parents were identified using national registries and the diagnostic information on the siblings of the subjects and controls was obtained. The final analyses comprised 658 children with SM and their 1661 siblings and 2092 controls with 4120 siblings. The analyses were conducted using generalized estimating equations. Mental disorders were more common among the siblings of the children with SM than among the siblings of the controls. The strongest associations were observed for childhood emotional disorders and autism spectrum disorders after the data were adjusted for covariates and comorbid diagnoses among SM subjects. The final model showed associations between SM and a wide range of disorders in siblings, with strongest associations with disorders that usually have their onset during childhood. Our finding showed that SM clustered with other mental disorders in siblings and this requires further research, especially the association between SM and autism spectrum disorders. Strong associations with childhood onset disorders may indicate shared etiologies.
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Affiliation(s)
- Miina Koskela
- Department of Child Psychiatry, University of Turku, Turku, Finland.
- Department of Child Psychiatry, Turku University Hospital, Turku, Finland.
- INVEST Research Flagship Center, University of Turku, Turku, Finland.
- Research Centre for Child Psychiatry, Faculty of Medicine, University of Turku, Turku, Finland.
| | - Elina Jokiranta-Olkoniemi
- Department of Child Psychiatry, University of Turku, Turku, Finland
- Department of Child Psychiatry, Turku University Hospital, Turku, Finland
- INVEST Research Flagship Center, University of Turku, Turku, Finland
- Unit of Psychology, Faculty of Education, University of Oulu, Oulu, Finland
| | - Terhi Luntamo
- Department of Child Psychiatry, University of Turku, Turku, Finland
- Department of Child Psychiatry, Turku University Hospital, Turku, Finland
| | - Auli Suominen
- Department of Child Psychiatry, University of Turku, Turku, Finland
- Department of Child Psychiatry, Turku University Hospital, Turku, Finland
- INVEST Research Flagship Center, University of Turku, Turku, Finland
| | - Andre Sourander
- Department of Child Psychiatry, University of Turku, Turku, Finland
- Department of Child Psychiatry, Turku University Hospital, Turku, Finland
- INVEST Research Flagship Center, University of Turku, Turku, Finland
| | - Hans-Christoph Steinhausen
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinic, Zurich, Switzerland
- Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
- Department of Child and Adolescent Psychiatry, University of Southern Denmark, Odense, Denmark
- Child and Adolescent Mental Health Centre, Capital Region Psychiatry, Copenhagen, Denmark
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Riekkinen R, Suominen A, Svedström-Oristo AL. Effects of the COVID-19 pandemic on orthodontic care in Finland. Acta Odontol Scand 2023; 81:578-585. [PMID: 37319410 DOI: 10.1080/00016357.2023.2223635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 05/31/2023] [Accepted: 06/07/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVES To investigate the measures that were taken to limit the risk of COVID-19 contagion, how the risk of adverse effects on patient treatment outcomes was mitigated in orthodontic practices in Finland during the COVID-19 pandemic, and how these measures affected the course of orthodontic treatment. MATERIALS AND METHODS In January 2021, an online questionnaire was sent by email to the members of the Orthodontic Division of the Finnish Dental Association Apollonia (n = 361). An additional inquiry was sent to the chief dental officers of 15 health centers. RESULTS A total of 99 clinically active members (39.8%) responded to the questionnaire. Of them, 97.0% had made changes in their practices, e.g. using additional protective gear such as visors (82.8%), incorporating preoperative mouthwashes (70.7%), and limiting the use of turbines (68.7%) and ultrasonics (47.5%). Two in three respondents reported temporary lockdowns (mean 1.9 months, range 0.3-5.0 months), during which some occlusions slightly regressed (30.2%) and some relapsed to a previous stage of treatment (9.5%). During this study, 59.6% of respondents reported that some treatments were still behind schedule. One in three respondents had used teleorthodontics because of the pandemic. CONCLUSIONS Preventive measures and changes in treatment procedures were implemented according to the local COVID-19 situation. Some treatments were prolonged, e.g. because of lockdowns or patient's fear of contracting COVID-19 whilst receiving treatment. New methods like teleorthodontics were introduced for coping with the increased workload.
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Affiliation(s)
| | - Auli Suominen
- Department of Community Dentistry, Institute of Dentistry, University of Turku, Turku, Finland
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Pylkkö J, Willberg J, Suominen A, Laine HK, Rautava J. Appearance and recurrence of odontogenic keratocysts. Clin Exp Dent Res 2023; 9:894-898. [PMID: 37794837 PMCID: PMC10582210 DOI: 10.1002/cre2.796] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 09/20/2023] [Accepted: 09/23/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the appearance, histopathological features, and recurrence of odontogenic keratocysts (OKCs) from a large single institute registry over a 36-year period. MATERIALS AND METHODS A total of 226 cases of OKC were identified in 174 patients over a 36-year period in a single institute in Southwestern Finland. Histological specimens were re-evaluated. The patient's age, sex, location, recurrence, and histopathological features of the OKC were the study variables. RESULTS OKCs occurred more frequently in men, the mean age was 46 years, and the most frequent site was the lower jaw. Recurrence rate was 21%. Histopathologically, inflammation was present in 95% and satellite cysts in 10% of cases. In patients diagnosed with satellite cysts, OKC recurred in 50% of cases, while the corresponding figure for patients without satellite cysts was 17%. CONCLUSIONS Compared with the literature, patients were older and inflamed cysts were found more frequently. Satellite cysts occurred only in association with chronic inflammation. Based on the results, regular radiographic evaluation is important among patients aged 10-29 years to detect OKCs and to treat them before enlargement, infection, and inflammation. Satellite cysts should be reported and may be a sign of increased risk of OKC recurrence.
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Affiliation(s)
- Jaakko Pylkkö
- Department of Oral Pathology and Oral Radiology, Institute of Dentistry, Faculty of MedicineUniversity of TurkuTurkuFinland
| | - Jaana Willberg
- Department of Oral Pathology and Oral Radiology, Institute of Dentistry, Faculty of MedicineUniversity of TurkuTurkuFinland
- Department of PathologyTurku University Central HospitalTurkuFinland
| | - Auli Suominen
- Department of Community DentistryUniversity of TurkuTurkuFinland
| | - Hanna K. Laine
- Department of Oral Pathology and Oral Radiology, Institute of Dentistry, Faculty of MedicineUniversity of TurkuTurkuFinland
- Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
| | - Jaana Rautava
- Department of Oral Pathology and Oral Radiology, Institute of Dentistry, Faculty of MedicineUniversity of TurkuTurkuFinland
- Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Department of Pathology, HUS Diagnostic Center, HUSLABHelsinki University HospitalHelsinkiFinland
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Salmi R, Närhi T, Suominen A, Suominen AL, Lahti S. Oral health-related quality of life among home-dwelling older people with and without domiciliary care. Gerodontology 2023; 40:340-347. [PMID: 36178113 DOI: 10.1111/ger.12659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 03/21/2022] [Accepted: 03/28/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim was to compare oral health-related quality of life (OHRQoL) between home-dwelling older people with and without domiciliary care when adjusted for gender, education, use of dental services and removable dental prostheses. BACKGROUND OHRQoL of home-dwelling older people with and without domiciliary care is a neglected area of research, with few studies having been conducted. MATERIALS AND METHODS A secondary analysis was conducted on the Finnish Health 2011 interview data. Home-dwelling participants (age ≥ 70) with or without domiciliary care were included (n = 758). OHRQoL was measured with the Oral Health Impact Profile questionnaire (OHIP-14) calculating three outcomes: prevalence of at least one impact reported: "occasionally," "fairly often" or "very often" (OFoVo), severity as mean sum score and mean of the seven OHIP-14 dimensions. These were evaluated by use of domiciliary care using logistic and negative binomial regression analyses. RESULTS Domiciliary care clients tended to have poorer OHRQoL than non-clients (severity mean 4.33 vs 4.11, P = .057), especially men (6.71 vs 4.15, P = .027), and reported more psychological discomfort than non-clients (mean 1.10 vs 0.82, P = .039). The use of removable dental prostheses was the strongest predictor (OR 2.84, P < .001) of poor OHRQoL. CONCLUSION Domiciliary care clients tended to report poorer OHRQoL, especially with regard to psychological discomfort dimension than non-clients. Thus, support of oral hygiene and regular utilisation of oral health services should be part of domiciliary care among older people to enhance OHRQoL.
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Affiliation(s)
- Riikka Salmi
- Department of Prosthetic Dentistry and Stomatognathic Physiology, University of Turku, Turku, Finland
| | - Timo Närhi
- Department of Prosthetic Dentistry and Stomatognathic Physiology, University of Turku, Turku, Finland
- City of Turku, Welfare Division, Turku, Finland
| | - Auli Suominen
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
- Public Health Evaluation and Projection Unit, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Satu Lahti
- Department of Community Dentistry, University of Turku, Turku, Finland
- Centre for Population Health, University of Turku and Turku University Hospital, Turku, Finland
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Kirvelä A, Snäll J, Suominen A, Puolakkainen T, Thorén H. Characteristics of Associated Injuries in Children and Teenagers With Craniofacial Fractures. J Craniofac Surg 2023; 34:1625-1628. [PMID: 37202848 PMCID: PMC10445634 DOI: 10.1097/scs.0000000000009343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 03/08/2023] [Indexed: 05/20/2023] Open
Abstract
The incidence of pediatric craniofacial fractures and heterogeneity of fractures is known to increase with age. This study aimed to determine the occurrence of associated injuries (AIs) to craniofacial fractures and identify differences in patterns of and predictors for AIs in children and teenagers. A 6-year retrospective cross-sectional cohort study was designed and implemented. The study population included 397 patients aged 19 years or less diagnosed with craniofacial fracture at Helsinki University Hospital from 2013 to 2018. Boys (71.0%) and teenagers (64.7%) were predominated. Associated injuries were more common in teenagers than children. Teenagers had more often AI in 2 or more organ systems. Assault and intoxication by alcohol were observed only in teenagers and predominantly boys. A total of 27.0% of all patients sustained AIs. In 18.1%, brain injury was reported. In children, motor vehicle accident (MVA) was an independent predictor for AI. In teenagers, independent predictors for AI were female sex, isolated cranial fracture, combined cranial fracture, and high-energy trauma mechanism. Injury patterns and AI related to craniofacial fractures in the pediatric population are age-specific, requiring multidisciplinary collaboration in the diagnosis, treatment, and follow-up of such trauma. Predictors for AIs increase in complexity with age, and the role of sex as a predictor is evident in teenagers.
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Affiliation(s)
- Aura Kirvelä
- Department of Oral and Maxillofacial Surgery, Institute of Dentistry, University of Turku, Turku, Finland
- Department of Oral and Maxillofacial Diseases, Turku University Hospital, Turku, Finland
| | - Johanna Snäll
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Auli Suominen
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Tero Puolakkainen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hanna Thorén
- Department of Oral and Maxillofacial Surgery, Institute of Dentistry, University of Turku, Turku, Finland
- Department of Oral and Maxillofacial Diseases, Turku University Hospital, Turku, Finland
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Rantavuori K, Silvola AS, Suominen A, Masood M, Suominen AL, Lahti S. Gender differences in the association between malocclusion traits and oral health-related quality of life in Finnish adults. Eur J Oral Sci 2023; 131:e12927. [PMID: 36855237 DOI: 10.1111/eos.12927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 01/29/2023] [Indexed: 03/02/2023]
Abstract
We aimed to evaluate the gender-specific associations of malocclusion traits with oral health-related quality of life (OHRQoL) among Finnish adults. Data were obtained from the Health 2000 Survey, Finland. Included participants (n = 3993) were ≥30 years old with OHRQoL and occlusion data. OHRQoL was measured using the 14-item Oral Health Impact Profile (OHIP-14). OHIP-14 severity mean score, prevalence of impacts, and means of seven dimensions were outcomes. Explanatory variables were any malocclusion trait, increased overjet, negative overjet, open bite, deep bite, and crossbite/scissor bite. Logistic (prevalence) and cumulative (severity) regression models were adjusted for age, decayed teeth, deep periodontal pocket, occluding pairs, orthodontic treatment, and self-perceived health. Gender modified the association between any malocclusion trait and OHRQoL, with the association being stronger in females. Females without any malocclusion trait (OR = 1.62, 95% CI = 1.14-2.28) or without crossbite/scissor bite (OR = 1.68, 95% CI = 1.16-2.43) had better OHRQoL (lower prevalence) than those with malocclusions. Males without increased overjet (OR 1.50, 95% CI = 1.04-2.17) had lower mean OHIP-14 severity score than males with increased overjet, after adjustments. The association between psychological and physical disability and malocclusion traits was different between males and females. Gender differences in the impact of malocclusion traits should be considered when assessing orthodontic treatment need.
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Affiliation(s)
- Kari Rantavuori
- Department of Pediatric Dentistry and Orthodontics, Institute of Dentistry, Faculty of Medicine, University of Turku, Finland
- Cleft Palate and Craniofacial Center, Department of Plastic Surgery, Helsinki University Hospital and Helsinki University, Finland
| | - Anna-Sofia Silvola
- Research Unit of Population Health, Faculty of Medicine, University of Oulu and Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, Finland
| | - Auli Suominen
- Department of Community Dentistry, Institute of Dentistry, Faculty of Medicine, University of Turku, Finland
| | - Mohd Masood
- Department of Dentistry and Oral Health, La Trobe Rural Health School, La Trobe University, Australia
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland, Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland and Public Health Evaluation and Projection Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Satu Lahti
- Department of Community Dentistry, Institute of Dentistry, Faculty of Medicine, University of Turku, Finland
- Centre for Population Health Research, University of Turku, Turku University Hospital, Finland
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Kuusisto N, Hirvonen J, Suominen A, Syrjänen S, Huumonen S, Vallittu P, Kinnunen I. Retrospective Analysis of Artifacts in Cone Beam Computed Tomography Images Used to Diagnose Chronic Rhinosinusitis. Diagnostics (Basel) 2023; 13:diagnostics13091511. [PMID: 37174903 PMCID: PMC10177128 DOI: 10.3390/diagnostics13091511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/18/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Cone beam computed tomography (CBCT) is frequently used to corroborate the signs and symptoms of chronic rhinosinusitis (CRS). However, artifacts induced by dental restorations might complicate the diagnosis of CRS. Here, we assessed the frequency and location of artifacts in CBCT images taken to confirm the CRS. METHODS All CBCT images of the patients referred to the Emergency Radiology unit, Turku University Hospital, with an indication of CRS in 2017 were re-examined. The prevalence of the artifacts was analyzed in three cross-sectional views and three horizontal levels delimited by anatomical landmarks. RESULTS In total, 214 CBCT images of patients with CRS were evaluated. The diagnosis of apical periodontitis (AP) was impaired by artifacts present in 150/214 images (70%). The diagnosis of CRS was impaired in 5 of the 214 images (2.3%). The main origins of the artifacts were large dental fillings or crowns, and endodontic fillings were present in 95% (203/214) and 52% (111/214) of the images, respectively. CONCLUSIONS AP as an etiology of CRS is possible to miss because of artifacts originating from dental and endodontic fillings in the CBCT images of the paranasal sinuses.
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Affiliation(s)
- Niina Kuusisto
- Department of Oral Pathology and Radiology, Institute of Dentistry, University of Turku, 20520 Turku, Finland
- Department of Radiology, Päijät-Häme Central Hospital, 15850 Lahti, Finland
| | - Jussi Hirvonen
- Department of Radiology, University of Turku and Turku University Hospital, 20520 Turku, Finland
- Medical Imaging Center, Department of Radiology, Tampere University and Tampere University Hospital, 33521 Tampere, Finland
| | - Auli Suominen
- Department of Community Dentistry, Institute of Dentistry, University of Turku, 20520 Turku, Finland
| | - Stina Syrjänen
- Department of Oral Pathology and Radiology, Institute of Dentistry, University of Turku, 20520 Turku, Finland
| | - Sisko Huumonen
- Institute of Dentistry, University of Eastern Finland, 70210 Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, 70029 Kuopio, Finland
- Research Unit of Oral Health Sciences, University of Oulu, 90570 Oulu, Finland
| | - Pekka Vallittu
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku, 20520 Turku, Finland
- Welfare Division, City of Turku, 20520 Turku, Finland
| | - Ilpo Kinnunen
- Department of Otorhinolaryngology-Head and Neck Surgery, Turku University and Turku University Hospital, 20520 Turku, Finland
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11
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Yilmaz M, Sorsa T, Demir E, Gürsoy M, Suominen A, Tervahartiala T, Räisänen IT, Gürsoy UK. Accuracy of aMMP-8 point-of-care test in indicating periodontal treatment outcomes in stage III/IV periodontitis: A 24-week follow-up study. J Periodontal Res 2023; 58:325-335. [PMID: 36618000 DOI: 10.1111/jre.13093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/20/2022] [Accepted: 12/27/2022] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To analyse the correspondence between aMMP-8 PoC test results and the clinical endpoints of non-surgical periodontal treatment in stage III/IV periodontitis. BACKGROUND The diagnostic success of the active-matrix metalloproteinase-8 (aMMP-8) point-of-care (PoC) test has been demonstrated in various studies, but the evidence of its accuracy following periodontal treatment is limited. MATERIALS AND METHODS Altogether 42 stage III/IV grade C periodontitis patients were included in this prospective diagnostic study. Clinical periodontal indices were recorded, aMMP-8 PoC test was applied and mouthrinse was collected before and at 6, 12 and 24 weeks after non-surgical periodontal treatment. Quantitative aMMP-8 levels were determined with immunofluorometric assay (IFMA) for the verification of the PoC test results. The accuracy of the aMMP-8 PoC test was assessed using previously established clinical endpoints as references. RESULTS Sensitivity and specificity of aMMP-8 PoC test to indicate clinical endpoints were ranged as follows: Sensitivity 71.4% at baseline, 39.3%-42.4% at week 6, 28.6%-32.4% at week 12 and 35.3%-42.9% at week 24; specificity 64.3%-80% at week 6, 40%-57.1% at week 12 and 56%-64.3% at week 24. CONCLUSIONS The accuracy of aMMP-8 PoC test in identifying clinical endpoints after non-surgical periodontal treatment is reduced in relation to baseline. Individual healing patterns of each diseased pocket eventually limit the accuracy of the dichotomous aMMP-8 oral rinse test during the post-treatment period.
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Affiliation(s)
- Mustafa Yilmaz
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland.,Department of Periodontology, Faculty of Dentistry, Biruni University, Istanbul, Turkey
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Esra Demir
- Department of Periodontology, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey
| | - Mervi Gürsoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
| | - Auli Suominen
- Department of Community Dentistry, Institute of Dentistry, University of Turku, Turku, Finland
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ismo T Räisänen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ulvi K Gürsoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
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12
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Suokko H, Tolvanen M, Virtanen J, Suominen A, Karlsson L, Karlsson H, Lahti S. Parent's self-reported tooth brushing and use of fluoridated toothpaste: Associations with their one-year-old child's preventive oral health behaviour. Community Dent Oral Epidemiol 2023; 51:311-317. [PMID: 35312099 DOI: 10.1111/cdoe.12742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 02/22/2022] [Accepted: 03/09/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of the study was to examine if the tooth brushing frequency and use of fluoridated toothpaste of the mother and father were associated with the tooth brushing frequency and use of fluoridated toothpaste for their 1-year-old child. METHODS This cross-sectional study is part of the FinnBrain Birth Cohort Study. Questionnaire data were obtained from 1672 mothers and 867 fathers on tooth brushing and use of fluoridated toothpaste, age, education, number of siblings and parity (when the child was 1-year-old). For 763 families (mother and father), data from both parents were available. Tooth brushing was dichotomized to at least twice daily (2× day) and less than 2× day, and use of fluoridated toothpaste for child to at least once daily and less than once daily. The association between brushing of child's teeth (both parents less than 2× day) and use of fluoridated toothpaste for the child (both parents less than once daily) with parent's own tooth brushing was modelled with logistic regression analyses adjusted for family-related variables (parents' age and education, number of older siblings) using odds ratios (OR) and 95% confidence intervals (CI). RESULTS Families in which both parents brushed their own teeth less than 2× day were more likely to brush their child's teeth less than 2× day than families in which both parents brushed their own teeth 2× day (OR = 9.23; 95%CI = 5.42-15.69). The likelihood of not brushing the child's teeth 2× day was less strong when at least one of the parents brushed his/her own teeth 2× day (mother 2× day: OR = 1.97; 95%CI = 1.25-3.10; father 2× day: OR = 2.85; 95%CI = 1.51-5.40). CONCLUSIONS Less frequent tooth brushing of both mothers and fathers was strongly associated with less frequent tooth brushing of their child. When educating parents on child oral home care, parents' own home care and inclusion of fathers also need more attention.
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Affiliation(s)
- Hanna Suokko
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Mimmi Tolvanen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Jorma Virtanen
- Department of Community Dentistry, University of Turku, Turku, Finland
- Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Auli Suominen
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Linnea Karlsson
- Centre for Population Health Research, University of Turku, Turku, Finland
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Hasse Karlsson
- Centre for Population Health Research, University of Turku, Turku, Finland
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Satu Lahti
- Department of Community Dentistry, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku, Turku, Finland
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland
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13
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Kallio A, Suominen A, Tolvanen M, Rantavuori K, Jussila H, Karlsson L, Karlsson H, Lahti S. Concurrent changes in dental anxiety and smoking in parents of the FinnBrain Birth Cohort Study. Eur J Oral Sci 2023; 131:e12912. [PMID: 36599651 PMCID: PMC10107302 DOI: 10.1111/eos.12912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 12/15/2022] [Indexed: 01/06/2023]
Abstract
We evaluated associations between changes in dental anxiety and tobacco use, adjusted for general anxiety and depressive symptoms. The FinnBrain Birth Cohort Study data, collected at gestational weeks 14 and 34 and at 3 months postpartum, were used. Questionnaires included the Modified Dental Anxiety Scale (MDAS), the Edinburgh Postnatal Depression Scale (EPDS), and the anxiety subscale of the Symptom Checklist-90 (SCL). Smoking was categorized as "stable non-smoking", "started smoking", "quit smoking", and "stable smoking". Changes in smoking and dental anxiety were evaluated "during pregnancy" (i.e., from gestational week 14 to gestational week 34) in 2442 women and 1346 men and "after pregnancy" (i.e., from gestational week 34 to 3 months postpartum) in 2008 women and 1095 men. Changes were evaluated in three smoking categories (stable non-smoking, fluctuating, and stable smoking), using data from all three time-points (1979 women and 1049 men). Modeling used repeated measures analysis of covariance. Stable smoking mothers had statistically significantly higher levels of dental anxiety (mean MDAS 12.3-12.6) than non-smoking mothers (mean MDAS 10.1-10.7) or mothers who smoked at some point during pregnancy (mean MDAS 10.8-11.5). A similar tendency was observed in fathers. However, no systematic change in dental anxiety by changes in smoking habits was observed. Those smoking during pregnancy and with high dental anxiety may need special support for smoking cessation.
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Affiliation(s)
- Anu Kallio
- Department of Community Dentistry, University of Turku, Turku, Finland.,City of Turku, Welfare Services Division, Oral and Dental Health Care, Turku, Finland
| | - Auli Suominen
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Mimmi Tolvanen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Kari Rantavuori
- Department of Oral Development and Orthodontics, University of Turku, Turku, Finland.,Cleft Palate and Craniofacial Center, Department of Plastic Surgery, Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | - Heidi Jussila
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Brain and Mind Center, University of Turku, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Brain and Mind Center, University of Turku, Turku, Finland.,Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Brain and Mind Center, University of Turku, Turku, Finland.,Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland
| | - Satu Lahti
- Department of Community Dentistry, University of Turku, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Brain and Mind Center, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland
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14
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Kuu-Karkku L, Suominen A, Svedström-Oristo AL. Craniofacial microsomia - more than a structural malformation. Orthod Craniofac Res 2023; 26:117-122. [PMID: 35689427 PMCID: PMC10084096 DOI: 10.1111/ocr.12592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/25/2022] [Accepted: 06/03/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To analyse the prevalence and distribution of craniofacial microsomia (CFM) cases in Finland and their most frequent comorbidities. The second aim was to analyse the patients' need for specialized healthcare services. MATERIALS AND METHODS Data were gathered from two complementary registers: The Register of Congenital Malformations and the Care Register for Social Welfare and Health Care (Hilmo) of the Finnish Institute for Health and Welfare (THL). RESULTS The prevalence of CFM patients in Finland was 1:10 057. They were evenly distributed across the five university hospital districts. Their most frequently used ICD-10 diagnosis codes were F40-48 (Neurotic, stress-related and somatoform disorders), 60% of patients in adolescent and adult psychiatry; Q67.0 (Facial asymmetry), 43% in plastic surgery; Z00.4 (General psychiatric examination, not elsewhere classified), 31% in child psychiatry; Z31.5 (Genetic counselling), 28% in clinical genetics and Q67.40 (Other congenital deformities of the skull, face and jaw, Hemifacial atrophy), 18% in dental, oral and maxillofacial diseases. Of the patients, 70% had had visits in clinical genetics, 60% in plastic surgery, 41% in dental, oral and maxillofacial diseases, 28% in adolescent/adult psychiatry and 21% in child psychiatry. The majority of the patients' plastic surgery visits were concentrated in one university hospital. Other services were mainly provided by patients' own hospital districts. CONCLUSIONS Even though the majority of CFM patients' visits in specialized healthcare services are related to correction of facial asymmetry and ear malformations, the obvious need for psychiatric care was apparent in all age groups.
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Affiliation(s)
- Louhi Kuu-Karkku
- Pediatric Dentistry and Orthodontics, Institute of Dentistry, University of Turku, Turku, Finland
| | - Auli Suominen
- Department of Community Dentistry, Institute of Dentistry, University of Turku, Turku, Finland
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15
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Raittio E, Torppa‐Saarinen E, Sokka T, Lahti S, Suominen A, Suominen AL, Heikkinen AM. Association of service use with subjective oral health indicators in a freedom of choice pilot. Clin Exp Dent Res 2023; 9:134-141. [PMID: 36263738 PMCID: PMC9932228 DOI: 10.1002/cre2.680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/23/2022] [Accepted: 10/01/2022] [Indexed: 02/17/2023] Open
Abstract
OBJECTIVES A freedom of choice pilot provided access to private oral health care services without queuing and with fixed public service-fees for participants in Tampere region, Finland in 2018-2019. The aim of this study was to investigate how use of oral health care services differed by demographics, socioeconomic status, dental fear, and self-reported oral health in this pilot. MATERIAL AND METHODS SMS-messages including a link to online questionnaire were sent to participants who had booked an appointment, and to those who had not booked an appointment despite registering to pilot. We categorized participants to (1) those who had booked their first appointment before receiving SMS (visitors), (2) those who booked an appointment after receiving the SMS-message (late-visitors), and (3) those who had not booked an appointment during pilot (nonvisitors). We used regression analysis to estimate the association of age, gender, dental fear, economic situation, Oral Health Impact Profile-14-severity (oral health-related quality of life [OHRQoL]), self-reported oral health and need for oral health care (exposures) with oral health care service use during the pilot (outcome). RESULTS Out of 2300 participants, 636 (28%) responded. Late-visitors were more likely older and reported more likely need for oral health care, poorer oral health and OHRQoL than visitors or nonvisitors. Nonvisitors were younger and had better OHRQoL than the others. The differences in the service use by gender, economic situation, and dental fear were small. CONCLUSIONS Service use during the pilot depended on the subjective oral health. Our findings highlight the potential of reminders in increasing care use among those with perceived need for services.
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Affiliation(s)
- Eero Raittio
- Oral Health Care ServicesTampereFinland
- Institute of DentistryUniversity of Eastern FinlandKuopioFinland
- Department of Dentistry and Oral HealthAarhus UniversityAarhusDenmark
| | | | - Taru Sokka
- The Council of Tampere RegionTampereFinland
| | - Satu Lahti
- Department of Community DentistryUniversity of TurkuTurkuFinland
| | - Auli Suominen
- Department of Community DentistryUniversity of TurkuTurkuFinland
| | - Anna Liisa Suominen
- Institute of DentistryUniversity of Eastern FinlandKuopioFinland
- Oral Health Teaching Clinic, Kuopio University HospitalKuopioFinland
| | - Anna Maria Heikkinen
- Oral Health Care ServicesTampereFinland
- Faculty of Medicine and Health TechnologyTampere UniversityTampereFinland
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16
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Thorén H, Mäyränpää MK, Mäkitie A, Niemensivu R, Suominen A, Snäll J. Otologic injuries are frequent in pediatric patients with temporal bone fractures. J Craniomaxillofac Surg 2023; 51:24-30. [PMID: 36740516 DOI: 10.1016/j.jcms.2023.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 10/25/2022] [Accepted: 01/22/2023] [Indexed: 01/26/2023] Open
Abstract
This retrospective study aimed to clarify the occurrence and types of otologic injuries in children and adolescents with skull fractures. Files of all patients under 18 years of age who had been diagnosed with skull fractures at a tertiary trauma centre were included. The primary outcome variable was the presence of any otologic symptom or finding. Secondary outcome variables were clinically detected and radiologically detected otologic injuries. The primary predictor variable was a temporal bone fracture. Other study variables were sex, age, mechanism of injury, traumatic brain injury, and mortality. A total of 97 patients were identified for the study. Otologic symptoms and findings were frequent (33.9%). The most common clinical findings were bleeding from the external auditory canal (18.6%) and hemotympanum (13.4%). The prevailing radiological finding was blood and/or cerebrospinal fluid in the middle ear (30.9%). Patients with fractures of temporal bone had a 29-fold risk for otologic symptoms or findings (RR 28.9, 95% CI 4.1-202.9, p < 0.001) relative to those who did not have a temporal bone fracture. Severe otologic complications, such as permanent hearing loss (6.2%), cerebrospinal fluid leak (5.2%), or facial nerve palsy (1%), were infrequent. Within the limitations of the study it seems that there is the necessity of otoscopy in all pediatric patients with blunt head trauma. In case of positive otologic findings, the patient should undergo imaging and ENT consultation.
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Affiliation(s)
- Hanna Thorén
- Department of Oral and Maxillofacial Surgery, University of Turku and Department of Oral and Maxillofacial Diseases, Turku University Hospital, Turku, Finland.
| | - Mervi K Mäyränpää
- Department of Radiology, HUS Diagnostic Center, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Antti Mäkitie
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Riina Niemensivu
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Auli Suominen
- Department of Community Dentistry, University of Turku, Turku, Finland.
| | - Johanna Snäll
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
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17
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Ellonen R, Suominen A, Kelppe J, Willberg J, Rautava J, Laine H. Histopathological findings of oral epithelial dysplasias and their relation to malignant transformation. Cancer Treat Res Commun 2023; 34:100664. [PMID: 36481601 DOI: 10.1016/j.ctarc.2022.100664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/16/2022] [Accepted: 11/18/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Oral squamous cell carcinomas (OSCCs) are often diagnosed late. This study aimed to determine how frequently oral epithelial dysplasia (OED) transforms to OSCC and to identify histological features that could influence the rate of malignant transformation. MATERIALS AND METHODS The study was a retrospective analysis of OED over 29 years at the Institute of Dentistry, University of Turku, Finland. OEDs with co-existing carcinomas were excluded from the data (5.8%). OED patients who developed carcinoma were identified from the Finnish Cancer Registry database. RESULTS Altogether 681 OED patients had a mean age of 59.0 years, and the male:female ratio was 0.67. Of all OED samples, 21.8% were on the tongue, followed by lining mucosa (21.3%), lip (5.3%), and masticatory mucosa (4.85%). In addition, 46.7% had no location cited. The prevalence of mild dysplasia was 62.4%, moderate dysplasia 29.1%, and severe dysplasia 3.2%. Of the patients, 94.7% had an additional histological diagnosis alongside OED. Candidiasis, lichenoid inflammation, and ulcer were found in 18.2%, 0.0%, and 22.7% of severe dysplasias, in 12.1%, 12.2%, and 22.7% of moderate dysplasias, and in 6.6%, 12.2%, and 15.8% of mild dysplasias, respectively. An additional histopathological diagnosis did not increase the risk for OED to transform to OSCC. In a mean time of 5.2 (range 0.7-29.0) years, 7.5% of OED patients developed OSCC. CONCLUSIONS Location on the tongue and the more severe OED grades increased the risk of malignant transformation of OED. These patients may benefit from an intensified follow-up schedule to ensure early diagnosis of OSCC.
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Affiliation(s)
- Riikka Ellonen
- Department of Oral Pathology and Radiology, University of Turku and Turku University Hospital, Turku, Finland.
| | - Auli Suominen
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Jetta Kelppe
- Department of Pathology, HUSLAB, Helsinki, Finland
| | - Jaana Willberg
- Department of Oral Pathology and Radiology, University of Turku and Turku University Hospital, Turku, Finland
| | - Jaana Rautava
- Department of Oral Pathology and Radiology, University of Turku and Turku University Hospital, Turku, Finland; Department of Oral and Maxillofacial Diseases, Clinicum, University of Helsinki, Helsinki, Finland; Department of Pathology, HUSLAB, Helsinki, Finland
| | - Hanna Laine
- Department of Oral Pathology and Radiology, University of Turku and Turku University Hospital, Turku, Finland; Department of Oral and Maxillofacial Diseases, Clinicum, University of Helsinki, Helsinki, Finland
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18
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Arkkila J, Suominen A, Nolvi S, Rantavuori K, Karlsson H, Karlsson L, Lahti S. Associations between temperament dimensions and dental anxiety in parents of the FinnBrain Birth Cohort Study. Eur J Oral Sci 2022; 130:e12897. [PMID: 36302720 PMCID: PMC10092261 DOI: 10.1111/eos.12897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/18/2022] [Indexed: 12/13/2022]
Abstract
We evaluated associations between dental anxiety and four temperament dimensions: effortful control, extraversion/surgency, negative affect and orienting sensitivity among 2558 parents in the FinnBrain Birth Cohort Study. Dental anxiety was measured with the Modified Dental Anxiety Scale, and temperament with the Adult Temperament Questionnaire. Associations between dental anxiety and temperament dimensions were modelled using linear and logistic (cut-off ≥ 19 for high dental anxiety) regression analyses adjusting for general anxiety and depressive symptoms, age and education. In women and men, dental anxiety was positively associated with negative affect (women β = 1.10; 95%CI 1.06-1.15; men β = 1.11; 95%CI 1.05-1.18) and negatively associated with effortful control (women β = 0.95; 95% CI0.92-0.99, men β = 0.90; 95% CI 0.85-0.95). In women, extraversion/surgency was also positively associated with dental anxiety (β = 1.04; 95%CI 1.00-1.08). For high dental anxiety, negative affect in women (OR = 2.00; 95%CI 1.31-3.06) and men (OR = 5.21; 95%CI 1.72-15.83) and for extraversion/surgency in women (OR = 1.50; 95%CI 1.01-1.47) associated positively with dental anxiety, but for effortful control, the association was not statistically significant. Dentists should understand that temperament dimensions affect the risk for dental anxiety more strongly than general anxiety or depressive symptoms. Dimensions negative affect and extraversion/surgency may increase and effortful control decrease the risk.
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Affiliation(s)
- Juuso Arkkila
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Auli Suominen
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Saara Nolvi
- Turku Institute for Advanced Studies, Department of Psychology and Speech-Language Pathology, University of Turku and Turku University Hospital, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Kari Rantavuori
- Department of Pediatric Dentistry and Orthodontics, University of Turku, Turku, Finland.,Cleft Palate and Craniofacial Center, Department of Plastic Surgery, Helsinki University Hospital and Helsinki University Finland, Helsinki, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland.,Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland.,Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Satu Lahti
- Department of Community Dentistry, University of Turku, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland
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19
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Khanal P, Ståhlberg T, Luntamo T, Gyllenberg D, Kronström K, Suominen A, Sourander A. Time trends in treated incidence, sociodemographic risk factors and comorbidities: a Finnish nationwide study on anxiety disorders. Eur Psychiatry 2022. [PMCID: PMC9565546 DOI: 10.1192/j.eurpsy.2022.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction Anxiety disorders (ADs) are common in childhood and adolescence and global estimates suggest they affect 6.5% of individuals under 19 years of age.Yet, there has been a lack of research on time trends and socio-demographic risks for children and adolescents who receive treatment for ADs. Objectives We aim to fill gaps in our knowledge by examining a nationwide sample of Finnish children and adolescents diagnosed in specialized healthcare settings. Methods We used register data of all singleton children born in Finland from 1992-2006 and diagnosed with ADs from 1998-2012. Changes in time trends in incidence were studied by dividing the study sample into three cohorts by birth years: 1992-1996, 1997-2001 and 2002-2006. The 22,388 individuals with ADs were matched with 76,139 controls. Nested case-control design was used to study the socio-demographic risk factors. Results Comparing the 1992-1996 and 2002-2006 cohorts showed the cumulative incidence of treated ADs at the age of 10 increased from 0.3% to 1.2% (females) and 0.46% to 1.9% (males). Subjects had higher odds of being diagnosed with an AD if mothers had low SES (OR 1.49, 95% CI 1.42-1.58) and were single parents (OR 1.99, 95% CI 1.84-2.15) at birth. Unipolar depression was the most common psychiatric comorbidity (31.2%). Conclusions
ADs diagnosed by specialized services increased from 1998-2012 in both genders. This could indicate real increase in overall ADs, an increase in seeking treatment or both phenomena. The findings on maternal socioeconomic status and single parenting help improve understanding of environmental risk for anxiety disorders among children and adolescents. Disclosure No significant relationships.
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20
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Kokko L, Puolakkainen T, Suominen A, Snäll J, Thorén H. Are The Elderly With Maxillofacial Injuries at Increased Risk of Associated Injuries? J Oral Maxillofac Surg 2022; 80:1354-1360. [DOI: 10.1016/j.joms.2022.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 10/18/2022]
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21
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Ståhlberg T, Upadhyaya S, Khanal P, Sucksdorff M, Luntamo T, Suominen A, Sourander A. Preterm birth, poor foetal growth and anxiety disorders in a Finnish nationwide register sample. Acta Paediatr 2022; 111:1556-1565. [PMID: 35488484 PMCID: PMC9545468 DOI: 10.1111/apa.16377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/20/2022] [Accepted: 04/27/2022] [Indexed: 11/28/2022]
Abstract
Aim We examined the associations between preterm birth, poor foetal growth and anxiety disorders among children and adolescents. Additionally, we examined the impact of common comorbidities and specific anxiety disorders separately. Methods Three Finnish registers provided data on a nationwide birth cohort of 22,181 cases with anxiety disorders and 74,726 controls. Conditional logistic regression was used to examine the associations. Results Extremely very preterm birth and moderate‐late preterm birth were associated with increased adjusted odds ratios (aOR) for anxiety disorders (aOR 1.39, 95% CI 1.11–1.75 and aOR 1.13, 95% CI 1.03–1.23, respectively). Weight for gestational age of less than −2SD (aOR 1.29, 95% CI 1.17–1.42) and −2SD to −1SD (aOR 1.08, 95% CI 1.03–1.14) were associated with increased odds ratios for anxiety disorders. When comorbidities were considered, the associations became statistically insignificant for pure anxiety disorders, but remained significant in the groups with comorbid depressive or neurodevelopmental disorders. Conclusion Preterm birth and poor foetal growth increased the odds for anxiety disorders. However, the associations seem to be explained by the conditions of comorbid depressive and neurodevelopmental disorders. Comorbidities should be considered when examining and treating child and adolescent anxiety disorders.
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Affiliation(s)
- Tiia Ståhlberg
- University of Turku Turku Finland
- INVEST Research Flagship Center University of Turku Turku Finland
| | - Subina Upadhyaya
- University of Turku Turku Finland
- INVEST Research Flagship Center University of Turku Turku Finland
| | - Prakash Khanal
- University of Turku Turku Finland
- INVEST Research Flagship Center University of Turku Turku Finland
| | - Minna Sucksdorff
- University of Turku Turku Finland
- INVEST Research Flagship Center University of Turku Turku Finland
- Department of Pediatrics Turku University Hospital Turku Finland
| | - Terhi Luntamo
- University of Turku Turku Finland
- INVEST Research Flagship Center University of Turku Turku Finland
- Department of Child Psychiatry Turku University Hospital Turku Finland
| | - Auli Suominen
- University of Turku Turku Finland
- INVEST Research Flagship Center University of Turku Turku Finland
| | - Andre Sourander
- University of Turku Turku Finland
- INVEST Research Flagship Center University of Turku Turku Finland
- Department of Child Psychiatry Turku University Hospital Turku Finland
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Alanko OME, Svedström-Oristo AL, Suominen A, Soukka T, Peltomäki T, Tuomisto MT. Does orthognathic treatment improve patients' psychosocial well-being? Acta Odontol Scand 2022; 80:177-181. [PMID: 34550844 DOI: 10.1080/00016357.2021.1977384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To analyse changes in patients' psychosocial well-being from before treatment until post-surgical orthodontic treatment (including retention) is completed. MATERIALS AND METHODS Data was collected six times: before treatment (T0), 6-8 weeks after the placement of orthodontic appliances (T2), 3-4 weeks before surgery (T3), six weeks after surgery (T4), one year after surgery (T5) and after completing orthodontic treatment (T6; 20-57 months after surgery). At T0, 60 patients participated while at T6, data was available for 15 patients. All patients completed the Orthognathic Quality of Life Questionnaire (OQLQ), Rosenberg Self-Esteem Questionnaire (RSES), Acceptance and Action Questionnaire II (AAQ-II) and the Symptom Checklist 90 (SCL-90). All pairwise comparisons between variables were conducted with the Wilcoxon signed-rank test. RESULTS OQLQ function, RSES, AAQ-II and SCL GSI worsened from T0 to T2. At T5, improvements compared to T0 were found in all aspects of OQLQ and SCL GSI. When comparing results at T6 to T0, improvements where only found in OQLQ sum, OQLQ facial aesthetics and OQLQ function. CONCLUSIONS Although well-being of orthognathic patients seems to improve during treatment, many improvements cannot be verified anymore at the completion of the retention period. Most stable changes are found in the oral function component and in the facial aesthetics component of the OQLQ.
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Affiliation(s)
- Outi Marja Elina Alanko
- Pediatric Dentistry and Orthodontics, University of Turku, Turku, Finland
- Faculty of Social Sciences (Psychology), Tampere University, Tampere, Finland
| | - Anna-Liisa Svedström-Oristo
- Pediatric Dentistry and Orthodontics, University of Turku, Turku, Finland
- Department of Oral Diseases, Turku University Hospital, Turku, Finland
| | - Auli Suominen
- Community Dentistry, University of Turku, Turku, Finland
| | - Tero Soukka
- Department of Oral Diseases, Turku University Hospital, Turku, Finland
| | - Timo Peltomäki
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Institute of Dentistry, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
- Department of Ear and Oral Diseases, Tampere University Hospital, Tampere, Finland
| | - Martti T. Tuomisto
- Faculty of Social Sciences (Psychology), Tampere University, Tampere, Finland
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23
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Arponen H, Suominen A, Svedström-Oristo AL. Longitudinal analysis of the quality of orthodontic treatment outcome and stability of occlusal traits. Acta Odontol Scand 2022; 80:234-240. [PMID: 34818138 DOI: 10.1080/00016357.2021.2005137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To assess the quality and stability of orthodontic treatment outcome relative to the initial malocclusion. MATERIAL AND METHODS The study was performed in one public health care clinic in Finland. Study subjects comprised 51 orthodontic patients (age range 12.7-18.7 years). Pre-treatment medical records and lateral skull radiographs were analysed for malocclusion type. The main reasons for orthodontic treatment were mandibular retrognathia, Class II distal bite, deep bite and crowding. At the end of a retention phase (Examination 1), the quality of treatment outcome was assessed using the occlusal morphology and function index (OMFI) and patients were asked about treatment satisfaction. Stability of occlusal traits and patient satisfaction were re-evaluated after a two-year follow-up (Examination 2). Occlusal characteristics descriptive statistics were performed. RESULTS At Examination 1, all six morphological criteria for acceptability were fulfilled by 76% and all functional criteria by 82% of the patients. All OMFI criteria were met by 67% of the patients. At Examination 2, 68% of the patients fulfilled all morphological and 82% all functional criteria of acceptability. At Examination 2, all the OMFI criteria were still met by 64% of the patients and 92% expressed satisfaction with own occlusion. The main reasons for unacceptability were deficiencies in canine relationship and overbite, in addition to functional protrusion interferences. CONCLUSIONS In the evaluated health care clinic, patient satisfaction and the quality of treatment outcome were high. However, deep bite showed a tendency for relapse.
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Affiliation(s)
- Heidi Arponen
- Espoo Social and Health Services, City of Espoo, Finland
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Auli Suominen
- Department of Community Dentistry, Institute of Dentistry, University of Turku, Turku, Finland
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24
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Khanal P, Ståhlberg T, Luntamo T, Gyllenberg D, Kronström K, Suominen A, Sourander A. Time trends in treated incidence, sociodemographic risk factors and comorbidities: a Finnish nationwide study on anxiety disorders. BMC Psychiatry 2022; 22:144. [PMID: 35193518 PMCID: PMC8864838 DOI: 10.1186/s12888-022-03743-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 01/27/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND There has been a lack of research about the time trends and socio-demographic risk factors for children and adolescents who receive treatment for anxiety disorders. This study aimed to fill these gaps in our knowledge by examining a nationwide sample of Finnish children and adolescents diagnosed in specialized healthcare settings. METHODS This study comprised national register data of all singleton children born in Finland from 1992-2006 who were diagnosed with anxiety disorders from 1998-2012. The changes in time trends in incidence were studied by dividing the study sample into three cohorts by birth years: 1992-1996, 1997-2001 and 2002-2006, who were followed up until the age of 20, 15 and 10 years, respectively. The 22,388 individuals with anxiety disorders were age and gender matched with 76,139 controls from the general population. Logistic regression was used to examine the socio-demographic risk factors and anxiety disorders in the entire sample. Comorbid disorders were examined in the oldest birth cohort (1992-1996 born). RESULTS Comparing the 1992-1996 and 2002-2006 cohorts showed that the cumulative incidence of treated anxiety disorders at the age of 10 increased from 0.3 to 1.2% among females and 0.46 to 1.9% among males. Subjects had higher likelihood for being diagnosed with an anxiety disorder if their mothers had low maternal socio-economic status class at birth (OR 1.53, 95% CI 1.45-1.61) compared to higher SES class, and marital status was single at the time of birth (OR 2.02, 95% CI 1.87-2.17) compared to married or in a relationship. They had lower risk of anxiety disorders diagnosis if born in rural (OR 0.82, 95% CI 0.79-0.86) or semi-urban areas (OR 0.79, 95% CI 0.76-0.82) when compared to urban residence. There was a wide range of psychiatric comorbidities, and unipolar depression was the most common (31.2%). CONCLUSION Anxiety disorders diagnosed by specialized Finnish services increased from 1998-2012 in both genders. This could indicate a real increase in overall anxiety disorders or an increase in treatment seeking. The findings on maternal socioeconomic status and single parenting improve the recognition of the environmental risk factors for anxiety disorders among children and adolescents.
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Affiliation(s)
- Prakash Khanal
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland. .,INVEST Research Flagship Center, University of Turku, Turku, Finland.
| | - Tiia Ståhlberg
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, University of Turku, Turku, Finland ,grid.1374.10000 0001 2097 1371INVEST Research Flagship Center, University of Turku, Turku, Finland ,grid.410552.70000 0004 0628 215XDepartment of Adolescent Psychiatry, Turku University Hospital, Turku, Finland
| | - Terhi Luntamo
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, University of Turku, Turku, Finland ,grid.1374.10000 0001 2097 1371INVEST Research Flagship Center, University of Turku, Turku, Finland ,grid.410552.70000 0004 0628 215XDepartment of Child Psychiatry, Turku University Hospital, Turku, Finland
| | - David Gyllenberg
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, University of Turku, Turku, Finland ,grid.1374.10000 0001 2097 1371INVEST Research Flagship Center, University of Turku, Turku, Finland ,grid.14758.3f0000 0001 1013 0499National Institute of Health and Welfare, Helsinki, Finland ,grid.15485.3d0000 0000 9950 5666Department of Adolescent Psychiatry, Helsinki University and Helsinki University Central Hospital, Helsinki, Finland
| | - Kim Kronström
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, University of Turku, Turku, Finland ,grid.410552.70000 0004 0628 215XDepartment of Adolescent Psychiatry, Turku University Hospital, Turku, Finland
| | - Auli Suominen
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, University of Turku, Turku, Finland ,grid.1374.10000 0001 2097 1371INVEST Research Flagship Center, University of Turku, Turku, Finland
| | - Andre Sourander
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, University of Turku, Turku, Finland ,grid.1374.10000 0001 2097 1371INVEST Research Flagship Center, University of Turku, Turku, Finland ,grid.410552.70000 0004 0628 215XDepartment of Child Psychiatry, Turku University Hospital, Turku, Finland
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25
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Arrhenius B, Sariaslan A, Suominen A, Sourander A, Gyllenberg D. Familial confounding affected the associations between maternal smoking during pregnancy and offspring speech and language, scholastic and coordination disorders. Acta Paediatr 2021; 110:3275-3283. [PMID: 34363238 DOI: 10.1111/apa.16062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/05/2021] [Accepted: 08/05/2021] [Indexed: 01/16/2023]
Abstract
AIM This study examined the associations between prenatal smoking and speech and language, scholastic, coordination and mixed developmental disorders in offspring, using sibling and population controls. METHODS National Finnish registers were used to identify all 690 654 singletons born between 1996 and 2007 and any cases diagnosed with speech and language, scholastic, coordination and mixed developmental disorders by the end of 2012. Cases were compared to population controls, biological full-siblings and maternal half-siblings born during the same period. Conditional logistic regression was used to assess any associations between smoking during pregnancy and the selected developmental disorders. RESULTS Prenatal smoking was higher in the mothers of the 27 297 cases (21.7%) than the 99 876 population controls (14.5%). The adjusted odds ratio for smoking throughout pregnancy, and any diagnosis of speech and language, scholastic, coordination or mixed developmental disorders, was 1.29 (95% confidence interval 1.24-1.34). However, when we compared a subsample of 15 406 cases and their 20 657 siblings, the association was no longer statistically significant (odds ratio 1.09, 95% confidence interval 0.98-1.21). CONCLUSION The sibling comparisons suggested that the associations between prenatal smoking and speech and language, scholastic, coordination and mixed developmental disorders were confounded by familial factors shared by differentially exposed siblings.
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Affiliation(s)
- Bianca Arrhenius
- Department of Child Psychiatry University of Turku Turku Finland
- INVEST Research Flagship Center University of Turku Turku Finland
- Child and Youth Health Services City of Helsinki Finland
| | - Amir Sariaslan
- Department of Child Psychiatry University of Turku Turku Finland
- Social and Public Policy Unit Faculty of Social Sciences University of Helsinki Helsinki Finland
| | - Auli Suominen
- Department of Child Psychiatry University of Turku Turku Finland
- INVEST Research Flagship Center University of Turku Turku Finland
| | - Andre Sourander
- Department of Child Psychiatry University of Turku Turku Finland
- INVEST Research Flagship Center University of Turku Turku Finland
- Department of Child Psychiatry Turku University Hospital Turku Finland
| | - David Gyllenberg
- Department of Child Psychiatry University of Turku Turku Finland
- INVEST Research Flagship Center University of Turku Turku Finland
- National Institute for Health and Welfare Helsinki Finland
- Department of Adolescent Psychiatry Helsinki University Central Hospital Helsinki Finland
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26
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Karukivi M, Suominen A, Scheinin NM, Li R, Ahrnberg H, Rantavuori K, Karlsson H, Karlsson L, Lahti S. Gender-specific associations between the dimensions of alexithymia personality trait and dental anxiety in parents of the FinnBrain Birth Cohort Study. Eur J Oral Sci 2021; 130:e12830. [PMID: 34761432 DOI: 10.1111/eos.12830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 09/05/2021] [Indexed: 12/30/2022]
Abstract
We evaluated gender-specific associations of two dimensions of dental anxiety (anticipatory and treatment-related dental anxiety) with three dimensions of alexithymia: difficulty in identifying feelings, difficulty in describing feelings, and externally oriented thinking. The sample comprised 2558 parents from the general population participating in the FinnBrain Birth Cohort Study. Dental anxiety was measured with the Modified Dental Anxiety Scale and alexithymia with the 20-item Toronto Alexithymia Scale. Associations between dental anxiety and alexithymia dimensions were modelled using linear regression analysis adjusting for general anxiety and depressive symptoms, age, and education. Structural equation modeling assessed their interrelationships. In women, anticipatory dental anxiety was associated only with difficulty in identifying feelings, but treatment-related dental anxiety was associated with difficulty in identifying feelings, difficulty in describing feelings, and externally oriented thinking. In men, anticipatory dental anxiety was associated with only externally oriented thinking, whereas treatment-related dental anxiety was associated with difficulty in describing feelings, and with externally oriented thinking. Structural equation modelling showed that difficulty in identifying feelings was associated with anticipatory and treatment-related dental anxiety in women, whereas in men, only difficulty in describing feelings was associated with both types of dental anxiety. Anticipatory and treatment-related dental anxiety have different associations with alexithymia dimensions.
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Affiliation(s)
- Max Karukivi
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Auli Suominen
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Noora M Scheinin
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Ru Li
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Hanna Ahrnberg
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Kari Rantavuori
- Department of Oral Development and Orthodontics, University of Turku, Turku, Finland
| | - Hasse Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Linnea Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Satu Lahti
- Centre for Population Health Research, University of Turku, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Turku Brain and Mind Center, University of Turku, Turku, Finland.,Department of Community Dentistry, University of Turku, Turku, Finland
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27
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Jokiranta-Olkoniemi E, Gyllenberg D, Sucksdorff D, Suominen A, Kronström K, Chudal R, Sourander A. Risk for Premature Mortality and Intentional Self-harm in Autism Spectrum Disorders. J Autism Dev Disord 2021; 51:3098-3108. [PMID: 33140146 PMCID: PMC8349316 DOI: 10.1007/s10803-020-04768-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2020] [Indexed: 11/25/2022]
Abstract
To examine the risk for premature mortality and intentional self-harm in autism spectrum disorders (ASD). Based on a national birth cohort. Children born in 1987-2005, diagnosed with ASD by 2007 (n = 4695) were matched with four non-ASD subjects (n = 18,450) and followed until 2015 for mortality and intentional self-harm. The risk among ASD subjects was elevated only for natural cause of death. The risk for intentional self-harm was increased in the unadjusted analyses, but decreased to non-significant after adjusting for comorbid psychiatric disorders. ASD subjects are at increased risk for premature mortality due to natural causes of death. While ASD subjects die of suicide and present with more self-harm, the association is explained by comorbid psychiatric disorders.
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Affiliation(s)
- Elina Jokiranta-Olkoniemi
- Department of Child Psychiatry, University of Turku and Turku University Hospital, Lemminkäisenkatu 3/Teutori (3rd floor), 20014, Turku, Finland.
- INVEST Research Flagship Center, University of Turku, Turku, Finland.
| | - David Gyllenberg
- Department of Child Psychiatry, University of Turku and Turku University Hospital, Lemminkäisenkatu 3/Teutori (3rd floor), 20014, Turku, Finland
- Department of Adolescent Psychiatry, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- National Institute of Health and Welfare, Helsinki, Finland
- INVEST Research Flagship Center, University of Turku, Turku, Finland
| | - Dan Sucksdorff
- Department of Child Psychiatry, University of Turku and Turku University Hospital, Lemminkäisenkatu 3/Teutori (3rd floor), 20014, Turku, Finland
- INVEST Research Flagship Center, University of Turku, Turku, Finland
| | - Auli Suominen
- Department of Child Psychiatry, University of Turku and Turku University Hospital, Lemminkäisenkatu 3/Teutori (3rd floor), 20014, Turku, Finland
- INVEST Research Flagship Center, University of Turku, Turku, Finland
| | - Kim Kronström
- Department of Child Psychiatry, University of Turku and Turku University Hospital, Lemminkäisenkatu 3/Teutori (3rd floor), 20014, Turku, Finland
- Department of Adolescent Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
- INVEST Research Flagship Center, University of Turku, Turku, Finland
| | - Roshan Chudal
- Department of Child Psychiatry, University of Turku and Turku University Hospital, Lemminkäisenkatu 3/Teutori (3rd floor), 20014, Turku, Finland
- INVEST Research Flagship Center, University of Turku, Turku, Finland
| | - Andre Sourander
- Department of Child Psychiatry, University of Turku and Turku University Hospital, Lemminkäisenkatu 3/Teutori (3rd floor), 20014, Turku, Finland
- INVEST Research Flagship Center, University of Turku, Turku, Finland
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28
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Pereira G, Francis RW, Gissler M, Hansen SN, Kodesh A, Leonard H, Levine SZ, Mitter VR, Parner ET, Regan AK, Reichenberg A, Sandin S, Suominen A, Schendel D. Optimal interpregnancy interval in autism spectrum disorder: A multi-national study of a modifiable risk factor. Autism Res 2021; 14:2432-2443. [PMID: 34423916 DOI: 10.1002/aur.2599] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 07/09/2021] [Accepted: 08/06/2021] [Indexed: 11/10/2022]
Abstract
It is biologically plausible that risk of autism spectrum disorder (ASD) is elevated by both short and long interpregnancy intervals (IPI). We conducted a retrospective cohort study of singleton, non-nulliparous live births, 1998-2007 in Denmark, Finland, and Sweden (N = 925,523 births). Optimal IPI was defined as the IPI at which minimum risk was observed. Generalized additive models were used to estimate relative risks (RR) of ASD and 95% Confidence Intervals (CI). Population impact fractions (PIF) for ASD were estimated under scenarios for shifts in the IPI distribution. We observed that the association between ASD (N = 9302) and IPI was U-shaped for all countries. ASD risk was lowest (optimal IPI) at 35 months for all countries combined, and at 30, 33, and 39 months in Denmark, Finland, and Sweden, respectively. Fully adjusted RRs at IPIs of 6, 12, and 60 months were 1.41 (95% CI: 1.08, 1.85), 1.26 (95% CI: 1.02, 1.56), and 1.24 (95% CI: 0.98, 1.58) compared to an IPI of 35 months. Under the most conservative scenario PIFs ranged from 5% (95% CI: 1%-8%) in Denmark to 9% (95% CI: 6%-12%) in Sweden. The minimum ASD risk followed IPIs of 30-39 months across three countries. These results reflect both direct IPI effects and other, closely related social and biological pathways. If our results reflect biologically causal effects, increasing optimal IPIs and reducing their indications, such as unintended pregnancy and delayed age at first pregnancy has the potential to prevent a salient proportion of ASD cases. LAY SUMMARY: Waiting 35 months to conceive again after giving birth resulted in the least risk of autism. Shorter and longer intervals resulted in risks that were up to 50% and 85% higher, respectively. About 5% to 9% of autism cases might be avoided by optimizing birth spacing.
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Affiliation(s)
- Gavin Pereira
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia.,enAble Institute, Curtin University, Perth, Western Australia, Australia.,Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, Oslo, Norway
| | - Richard W Francis
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Mika Gissler
- Information Services Department, THL Finnish Institute for Health and Welfare, Helsinki, Finland.,Research Centre for Child Psychiatry, University of Turku, Turku, Finland.,Department of Neurobiology, Care Sciences and Society & Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Stefan N Hansen
- Research Unit for Biostatistics, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Arad Kodesh
- Department of Community Mental Health, University of Haifa, Haifa, Israel.,Meuhedet Health Services, Mental Health, Tel Aviv, Israel
| | - Helen Leonard
- enAble Institute, Curtin University, Perth, Western Australia, Australia
| | - Stephen Z Levine
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Vera R Mitter
- Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, Oslo, Norway
| | - Eric T Parner
- Research Unit for Biostatistics, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Annette K Regan
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia.,School of Nursing and Health Professions, University of San Francisco, San Francisco, California, USA.,Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA
| | - Abraham Reichenberg
- Departments of Psychiatry and Environmental Medicine and Public Health; Mindich Child Health and Development Institute; Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Sven Sandin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Seaver Autism Center for Research and Treatment at Mount Sinai, New York, New York, USA
| | - Auli Suominen
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
| | - Diana Schendel
- National Centre for Register-based Research, Department of Economics and Business, Aarhus University, Aarhus, Denmark.,Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit for Epidemiology; Department of Public Health, Aarhus University, Aarhus, Denmark.,AJ Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
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Cheslack-Postava K, Sourander A, Suominen A, Jokiranta-Olkoniemi E, McKeague IW, Brown AS. Increased Risk of ADHD at Short and Long Interpregnancy Intervals in a National Birth Cohort. Paediatr Perinat Epidemiol 2021; 35:392-400. [PMID: 32162359 PMCID: PMC10339818 DOI: 10.1111/ppe.12657] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 12/27/2019] [Accepted: 01/07/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Short or long interpregnancy interval (IPI) may adversely impact conditions for foetal development. Whether attention deficit hyperactivity disorder (ADHD) is related to IPI has been largely unexplored. OBJECTIVES To examine the association between IPI and ADHD in a large, population-based Finnish study. METHODS All children born in Finland between 1991 and 2005 and diagnosed with ADHD (ICD-9 314x or ICD-10 F90.x) from 1995 to 2011 were identified using data from linked national registers. Each subject with ADHD was matched to 4 controls based on sex, date of birth, and place of birth. A total of 9564 subjects with ADHD and 34,479 matched controls were included in analyses. IPI was calculated as the time interval between sibling birth dates minus the gestational age of the second sibling. The association between IPI and ADHD was determined using conditional logistic regression and adjusted for potential confounders. RESULTS Relative to births with an IPI of 24 to 59 months, those with the shortest IPI (<6 months) had an increased risk of ADHD (odds ratio [OR] 1.30, 95% confidence interval (CI) 1.12, 1.51) and the ORs for the longer IPI births (60-119 months and ≥120 months) were 1.12 (95% CI 1.02, 1.24) and 1.25 (95% CI 1.08, 1.45), respectively. The association of longer IPI with ADHD was attenuated by adjustment for maternal age at the preceding birth, and comorbid autism spectrum disorders did not explain the associations with ADHD. CONCLUSIONS The risk of ADHD is higher among children born following short or long IPIs although further studies are needed to explain this association.
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Affiliation(s)
- Keely Cheslack-Postava
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY
| | - Andre Sourander
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY
- Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Auli Suominen
- Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | | | - Ian W. McKeague
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY
| | - Alan S. Brown
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY
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30
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Salmi R, Närhi T, Suominen A, Suominen AL, Lahti S. Perceived oral health and oral health behaviours among home-dwelling older people with and without domiciliary care. Gerodontology 2021; 39:121-130. [PMID: 33565677 DOI: 10.1111/ger.12542] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 01/14/2021] [Accepted: 01/17/2021] [Indexed: 01/11/2023]
Abstract
OBJECTIVES The aim was to compare the perceived oral health and oral health behaviours of home-dwelling older people with and without domiciliary care. BACKGROUND Oral health is poor in long-term care, but less is known about perceived oral health of home-dwelling older people receiving domiciliary care. MATERIALS AND METHODS Data from the Health 2000 and Health 2011 surveys (BRIF8901) were used. Interview participants were at least 70 years old and living at home with or without domiciliary care (n = 1298 in 2000 and n = 1027 in 2011). Differences in perceived oral health (subjective oral health, pain, eating difficulties) and oral health behaviours (hygiene, use of services) were compared based on the use of domiciliary care and stratified by gender. Differences between groups were compared with the chi-square test. RESULTS In 2011, compared to non-clients, domiciliary care clients more often had poor subjective oral health (40.3% vs. 28.9%, P = .045). In both surveys, they also used oral health services less recently (2000, 76.4% vs. 60.9%; and 2011, 61.1% vs. 46.6%) and more often had difficulties chewing hard food (2000, 50.6% vs. 34%, P < .001; and 2011, 38.4% vs. 20.7%, P < .001) than non-clients. In 2000, clients had more difficulty eating dry food without drinking (39.5% vs. 21.6%, P < .001) and cleaning their teeth and mouth (14.3% vs. 1.1%, P < .001) than non-clients. Women clients in 2011 brushed their teeth less often than non-clients (43.5% vs. 23.7%, respectively, P = .001). CONCLUSION Domiciliary care clients have poorer perceived oral health, and greater difficulties with eating and oral hygiene maintenance than non-clients.
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Affiliation(s)
- Riikka Salmi
- Department of Prosthetic Dentistry and Stomatognathic Physiology, University of Turku, Turku, Finland
| | - Timo Närhi
- Department of Prosthetic Dentistry and Stomatognathic Physiology, University of Turku, Turku, Finland.,Welfare Division, Turku, Finland
| | - Auli Suominen
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland.,Public Health Evaluation and Projection Unit, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Satu Lahti
- Department of Community Dentistry, University of Turku, Turku, Finland.,Turku Clinical Research Centre, Turku University Hospital, Turku, Finland
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31
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Alander P, Perea-Lowery L, Vesterinen K, Suominen A, SÄilynoja E, Vallittu PK. Layer structure and load-bearing properties of fibre reinforced composite beam used in cantilever fixed dental prostheses. Dent Mater J 2020; 40:165-172. [PMID: 33028792 DOI: 10.4012/dmj.2019-428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study evaluates the effect of fiber reinforcement quantity and position on fracture load of fixed dental prostheses specimens with different fibre reinforced composite (FRC)/ particulate filler composite (PFC) ratio in a cantilever beam test. Three types of specimen structures where made: Specimens with FRC, PFC, or with a combination of both. Specimen's size was 2.0×2.0×25 mm3 and the thicknesses of the FRC layers were 0, 0.5, 1.0, 1.5 and 2.0 mm. The layers of FRC were placed at the top or at the bottom. Eight groups of specimens were evaluated (n=15/group). The test specimens were statically-loaded until fracture. The fracture loads were linearly dependent on the quantity of the FRC reinforcement when placed at the top (R2=0.941) and bottom (R2=0.896) of the specimens. ANOVA revealed that reinforcement position on the tension side and higher FRC reinforcement volume in the test specimens had positive effect to load bearing capacity (p<0.001).
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Affiliation(s)
- Pasi Alander
- Degree Programme in Dental Technology, Faculty of Health and Well-being, Turku University of Applied Science.,Department of Biomaterials Science, Institute of Dentistry, University of Turku
| | - Leila Perea-Lowery
- Department of Biomaterials Science, Institute of Dentistry, University of Turku
| | - Kalevi Vesterinen
- Technology Industry, Faculty of Engineering and Business, Turku University of Applied Sciences
| | - Auli Suominen
- Department of Community Dentistry, Institute of Dentistry, University of Turku
| | - Eija SÄilynoja
- Department of Biomaterials Science, Institute of Dentistry, University of Turku.,Scientific Affairs and Administration, Stick Tech Ltd. -a member of GC Group
| | - Pekka Kalevi Vallittu
- Department of Biomaterials Science, Institute of Dentistry, University of Turku.,City of Turku, Welfare Division
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Koskela M, Chudal R, Luntamo T, Suominen A, Steinhausen HC, Sourander A. The impact of parental psychopathology and sociodemographic factors in selective mutism - a nationwide population-based study. BMC Psychiatry 2020; 20:221. [PMID: 32398046 PMCID: PMC7216734 DOI: 10.1186/s12888-020-02637-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 04/30/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Selective mutism (SM) is nowadays considered a relatively rare anxiety disorder characterized by children failing to speak in certain situations. Research on risk factors for SM are limited in comparison to other psychiatric disorders. The aim of this study was to examine several potential risk factors for SM in a large nationwide cohort, namely parental psychopathology, parental age, maternal SES, urbanicity, maternal marital status and parental immigration status. METHODS This nested case-control study comprised 860 cases with SM, identified from the Finnish Hospital Discharge Register and 3250 controls matched for sex and age from the Finnish Central Population Register. Conditional logistic regression was used to examine the association between the risk factors and SM. RESULTS If both parents had any psychiatric disorder, this almost tripled their odds of having a child with SM (OR 2.8, 95% CI 2.0-4.0). There were increased rates of all types of psychiatric disorders in the parents of the children with SM, with a wider range of diagnoses among the mothers than fathers. Fathers over 35 years (OR 1.4, 95% CI 1.1-1.8) were significantly more likely to have children with SM. Offspring of a single mother had a 2-fold (OR = 2.0, 95% CI 1.4-3.0) increased odds of SM than mothers who were married or in a relationship. CONCLUSIONS Several parental psychiatric disorders were associated with offspring SM. This points towards a shared aetiology of psychiatric disorders. Findings on paternal age and single motherhood help to improve our understanding of risk factors for SM.
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Affiliation(s)
- Miina Koskela
- Research Centre for Child Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, University of Turku, Lemminkäisenkatu 3 / Teutori (3rd floor), 20014, Turku, Finland.
| | - Roshan Chudal
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, University of Turku, Lemminkäisenkatu 3 / Teutori (3rd floor), 20014 Turku, Finland
| | - Terhi Luntamo
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, University of Turku, Lemminkäisenkatu 3 / Teutori (3rd floor), 20014 Turku, Finland
| | - Auli Suominen
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, University of Turku, Lemminkäisenkatu 3 / Teutori (3rd floor), 20014 Turku, Finland ,grid.410552.70000 0004 0628 215XTurku University Central Hospital, Turku, Finland
| | - Hans-Christoph Steinhausen
- grid.412556.10000 0004 0479 0775Department of Child and Adolescent Psychiatry, Psychiatric University Clinic, Zurich, Switzerland ,grid.6612.30000 0004 1937 0642Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland ,grid.10825.3e0000 0001 0728 0170Department of Child and Adolescent Psychiatry, University of Southern Denmark, Odense, Denmark ,Child and Adolescent Mental Health Centre, Capital Region Psychiatry, Copenhagen, Denmark
| | - Andre Sourander
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, University of Turku, Lemminkäisenkatu 3 / Teutori (3rd floor), 20014 Turku, Finland ,grid.410552.70000 0004 0628 215XDepartment of Child Psychiatry, Turku University Hospital, Turku, Finland ,grid.1374.10000 0001 2097 1371INVEST Research Flagship, University of Turku, Turku, Finland
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Juslin J, Jääsaari P, Teerijoki-Oksa T, Suominen A, Thorén H. Survival of Autotransplanted Teeth With Open Apices: A Retrospective Cohort Study. J Oral Maxillofac Surg 2020; 78:902.e1-902.e9. [PMID: 32184086 DOI: 10.1016/j.joms.2020.02.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 02/09/2020] [Accepted: 02/09/2020] [Indexed: 01/28/2023]
Abstract
PURPOSE Autotransplantation of teeth is an alternative treatment method in growing patients with hypodontia or impacted teeth. The purpose of the present study was to investigate the occurrence of, and predictors for, the loss of transplanted teeth in children and young adults. PATIENTS AND METHODS All patients who had undergone tooth transplantation at the Department of Oral and Maxillofacial Surgery, Turku University Hospital, from October 1, 2009 to January 5, 2017, were identified from the hospital's database. The outcome variable was survival of the transplanted tooth. The predictor variables were the transplantation type, donor tooth, maturity of the donor tooth, number of roots of the donor tooth, recipient's jaw, the need for extraoral storage of the donor tooth during surgery, continuation of root development during follow-up, and institution experience. One tooth was randomly selected from each subject. The Kaplan-Meier method for survival analysis, and the Cox proportional hazards regression analysis results were used to assess the association between survival and the risk factors. RESULTS The sample included 36 subjects with a mean age of 14.3 years; 33.3% were male, 45 teeth were transplanted, and the median follow-up time was 1.3 years. The 1-year survival rate was 87% (95% confidence interval [CI], 75 to 99%). A significant predictor for tooth survival was the continuation of root development (hazard ratio, 21.3; 95% CI, 2.1 to 215.0; P = .009). Although not statistically significantly, more favorable prognoses were found for distant than for transalveolar transplantations, 1-rooted than multirooted teeth, premolars than molars, teeth not stored in an extraoral media, and teeth that had been transplanted later during the study period. CONCLUSIONS The experience of the professional team, use of open apex premolars, and postoperative continuation of root development of the transplant were the factors associated with favorable outcomes. Transplants could benefit from the use of 3-dimensional models during surgery.
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Affiliation(s)
- Jessica Juslin
- Registered Specialist in Orthodontics, Department of Oral and Maxillofacial Surgery, Institute of Dentistry, University of Turku, Turku, Finland.
| | - Päivi Jääsaari
- Registered Specialist in Orthodontics, Department of Oral and Maxillofacial Diseases, Turku University Hospital, Turku, Finland
| | - Tuija Teerijoki-Oksa
- Registered Specialist in Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Diseases, Turku University Hospital, Turku, Finland
| | - Auli Suominen
- Biostatistician, Department of Community Dentistry, Institute of Dentistry, University of Turku, Turku, Finland
| | - Hanna Thorén
- Professor and Department Head, Department of Oral and Maxillofacial Surgery, Institute of Dentistry, University of Turku; and Registered Specialist in Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Diseases, Turku University Hospital, Turku, Finland
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Abstract
Introduction: Dental anxiety is common and causes symptomatic use of oral health services. Objectives: The aim was to study if a short-term virtual reality intervention reduced preoperative dental anxiety. Methods: A randomized controlled single-center trial was conducted with 2 parallel arms in a public oral health care unit: virtual reality relaxation (VRR) and treatment as usual (TAU). The VRR group received a 1- to 3.5-min 360° immersion video of a peaceful virtual landscape with audio features and sound supporting the experience. TAU groups remained seated for 3 min. Of the powered sample of 280 participants, 255 consented and had complete data. Total and secondary sex-specific mixed effects linear regression models were completed for posttest dental anxiety (Modified Dental Anxiety Scale [MDAS] total score) and its 2 factors (anticipatory and treatment-related dental anxiety) adjusted for baseline (pretest) MDAS total and factor scores and age, taking into account the effect of blocking. Results: Total and anticipatory dental anxiety decreased more in the VRR group than the TAU group (β = −0.75, P < .001, for MDAS total score; β = −0.43, P < .001, for anticipatory anxiety score) in patients of a primary dental care clinic. In women, dental anxiety decreased more in VRR than TAU for total MDAS score (β = −1.08, P < .001) and treatment-related dental anxiety (β = −0.597, P = .011). Anticipatory dental anxiety decreased more in VRR than TAU in both men (β = −0.217, P < .026) and women (β = −0.498, P < .001). Conclusion: Short application of VRR is both feasible and effective to reduce preoperative dental anxiety in public dental care settings (ClinicalTrials.gov NCT03993080). Knowledge Transfer Statement: Dental anxiety, which is a common problem, can be reduced with short application of virtual reality relaxation applied preoperatively in the waiting room. Findings of this study indicate that it is a feasible and effective procedure to help patients with dental anxiety in normal public dental care settings.
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Affiliation(s)
- S. Lahti
- Department of Community Dentistry, University of Turku, Turku, Finland
- Turku Clinical Research Centre, Turku University Hospital, Turku, Finland
- S. Lahti, Department of Community Dentistry, University of Turku, Turku, FI-20014, Finland.
| | - A. Suominen
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - R. Freeman
- Dental Health Services Research Unit, School of Dentistry, University of Dundee, Dundee, UK
| | - T. Lähteenoja
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - G. Humphris
- Division of Populations and Behavioural Science, School of Medicine, University of St Andrews, St Andrews, UK
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Korpela I, Vaununmaa K, Tolvanen M, Suominen A, Freeman R, Lahti S. Dental students' and patients' perceived importance and knowledge of dental anxiety. Eur J Dent Educ 2019; 23:515-521. [PMID: 31429501 DOI: 10.1111/eje.12460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 07/03/2019] [Accepted: 08/15/2019] [Indexed: 06/10/2023]
Abstract
AIM To examine the perceived importance and knowledge of the dental students' in their treatment of dental anxiety according to their year of study and to find out patients' perceived importance of the dental students' knowledge of dental anxiety according to their level on dental fear. METHODS Dental students (N = 219) at the University of Turku and non-probability convenience sample of 100 of patients attending the Dental Teaching Clinic were given questionnaires with multiple choice and open-ended questions. Students were categorised into three groups according to the year of study (1-3, 4, 5). Patients were categorised into three groups using the established cut points for Modified Dental Anxiety Scale (no fear = 5-9, low fear = 10-18, high fear = 19-25). The differences between groups were evaluated using cross-tabulations, chi squared and Fisher's exact tests. The open-ended questions were subjected to content analysis. RESULTS Students' perceived importance of dental anxiety did not differ between three groups. Students with greater undergraduate education and clinical experience were more likely to have excellent or quite good knowledge (P < .001). Patients' perceived importance of dental students' knowledge of dental anxiety was greater in patients with high level of fear. The overlapping category that emerged from the open-ended question analysis was communication skills. This appeared to be important for patients with dental anxiety and for dental students in their management of dental anxiety. CONCLUSION Clinical communication skills should be part of dental anxiety management teaching. Dental students should be able to gain sufficient knowledge and skills in treating dental anxiety before graduating.
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Affiliation(s)
- Ilona Korpela
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Katri Vaununmaa
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Mimmi Tolvanen
- Department of Community Dentistry, University of Turku, Turku, Finland
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Auli Suominen
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Ruth Freeman
- Dental Health Services Research Unit, University of Dundee, Dundee, Scotland
| | - Satu Lahti
- Department of Community Dentistry, University of Turku, Turku, Finland
- Turku Clinical Research Centre, Turku University Hospital, Turku, Finland
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Filatova S, Upadhyaya S, Kronström K, Suominen A, Chudal R, Luntamo T, Sourander A, Gyllenberg D. Time trends in the incidence of diagnosed depression among people aged 5-25 years living in Finland 1995-2012. Nord J Psychiatry 2019; 73:475-481. [PMID: 31443615 DOI: 10.1080/08039488.2019.1652342] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Knowledge of time trends for depression is important for disease prevention and healthcare planning. Only a few studies have addressed these questions regarding the incidence and cumulative incidence of diagnosed depression from childhood to early adulthood and findings have been inconclusive. Aim: The aim of this national register-based Finnish study was to report the time trends of the age-specific and gender-specific incidence and cumulative incidence of diagnosed depression. Methods: The study sample included all 1,245,502 singletons born in Finland between 1 January 1987 and 31 December 2007 and still living in Finland at the end of 2012. The participants were divided into three cohorts by birth year: 1987-1993, 1994-2000 and 2001-2007. Depression diagnoses (ICD-9: 2961; ICD-10: F32, F33) given in 1995-2012 were available and identified from the Care Register for Health Care. Results: Ten percent of the females and five percent of the males were diagnosed with depression in specialized services by age 25 years. The cumulative incidence of depression by age 15 years rose from 1.8% (95% CI 1.8-1.9) to 2.9% (95% CI 2.8-3.0) in females and from 1.0% (95% CI 1.1-1.2) to 1.6% (95% CI 1.6-1.7) in males when the cohorts born 1987-1993 and 1994-2000 were compared. Conclusions: A larger proportion of young people in Finland are diagnosed with depression in specialized services than before. This can be due to better identification, more positive attitudes to mental health problems and increased availability of the services.
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Affiliation(s)
- Svetlana Filatova
- Research Centre for Child Psychiatry, University of Turku , Turku , Finland
| | - Subina Upadhyaya
- Research Centre for Child Psychiatry, University of Turku , Turku , Finland
| | - Kim Kronström
- Research Centre for Child Psychiatry, University of Turku , Turku , Finland.,Department of Adolescent Psychiatry, Turku University Hospital , Turku , Finland
| | - Auli Suominen
- Research Centre for Child Psychiatry, University of Turku , Turku , Finland.,Turku University Hospital , Turku , Finland
| | - Roshan Chudal
- Research Centre for Child Psychiatry, University of Turku , Turku , Finland
| | - Terhi Luntamo
- Research Centre for Child Psychiatry, University of Turku , Turku , Finland
| | - Andre Sourander
- Research Centre for Child Psychiatry, University of Turku , Turku , Finland.,Turku University Hospital , Turku , Finland.,INVEST Research Flagship, University of Turku , Turku , Finland
| | - David Gyllenberg
- Research Centre for Child Psychiatry, University of Turku , Turku , Finland.,National Institute of Health and Welfare , Helsinki , Finland.,Department of Adolescent Psychiatry, Helsinki University Central Hospital, University of Helsinki , Helsinki , Finland
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Bai D, Yip BHK, Windham GC, Sourander A, Francis R, Yoffe R, Glasson E, Mahjani B, Suominen A, Leonard H, Gissler M, Buxbaum JD, Wong K, Schendel D, Kodesh A, Breshnahan M, Levine SZ, Parner ET, Hansen SN, Hultman C, Reichenberg A, Sandin S. Association of Genetic and Environmental Factors With Autism in a 5-Country Cohort. JAMA Psychiatry 2019; 76:1035-1043. [PMID: 31314057 PMCID: PMC6646998 DOI: 10.1001/jamapsychiatry.2019.1411] [Citation(s) in RCA: 261] [Impact Index Per Article: 52.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
IMPORTANCE The origins and development of autism spectrum disorder (ASD) remain unresolved. No individual-level study has provided estimates of additive genetic, maternal, and environmental effects in ASD across several countries. OBJECTIVE To estimate the additive genetic, maternal, and environmental effects in ASD. DESIGN, SETTING, AND PARTICIPANTS Population-based, multinational cohort study including full birth cohorts of children from Denmark, Finland, Sweden, Israel, and Western Australia born between January 1, 1998, and December 31, 2011, and followed up to age 16 years. Data were analyzed from September 23, 2016 through February 4, 2018. MAIN OUTCOMES AND MEASURES Across 5 countries, models were fitted to estimate variance components describing the total variance in risk for ASD occurrence owing to additive genetics, maternal, and shared and nonshared environmental effects. RESULTS The analytic sample included 2 001 631 individuals, of whom 1 027 546 (51.3%) were male. Among the entire sample, 22 156 were diagnosed with ASD. The median (95% CI) ASD heritability was 80.8% (73.2%-85.5%) for country-specific point estimates, ranging from 50.9% (25.1%-75.6%) (Finland) to 86.8% (69.8%-100.0%) (Israel). For the Nordic countries combined, heritability estimates ranged from 81.2% (73.9%-85.3%) to 82.7% (79.1%-86.0%). Maternal effect was estimated to range from 0.4% to 1.6%. Estimates of genetic, maternal, and environmental effects for autistic disorder were similar with ASD. CONCLUSIONS AND RELEVANCE Based on population data from 5 countries, the heritability of ASD was estimated to be approximately 80%, indicating that the variation in ASD occurrence in the population is mostly owing to inherited genetic influences, with no support for contribution from maternal effects. The results suggest possible modest differences in the sources of ASD risk between countries.
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Affiliation(s)
- Dan Bai
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR
| | - Benjamin Hon Kei Yip
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Gayle C. Windham
- Center for Health Communities, Environmental Health Investigations Branch, California Department of Public Health, Richmond
| | - Andre Sourander
- Department of Child Psychiatry, Turku University, Turku University Hospital, Turku, Finland
| | - Richard Francis
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia
| | | | - Emma Glasson
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia
| | - Behrang Mahjani
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York,Seaver Autism Center for Research and Treatment at Mount Sinai, New York, New York
| | - Auli Suominen
- Department of Child Psychiatry, Turku University, Turku University Hospital, Turku, Finland
| | - Helen Leonard
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia
| | - Mika Gissler
- Department of Child Psychiatry, Turku University, Turku University Hospital, Turku, Finland,Information Services Department, National Institute for Health and Welfare, Helsinki, Finland,Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Joseph D. Buxbaum
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York,Seaver Autism Center for Research and Treatment at Mount Sinai, New York, New York,Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York,The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Kingsley Wong
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia
| | - Diana Schendel
- Department of Public Health, Aarhus University, Aarhus, Denmark,Department of Economics and Business, National Centre for Register-based Research, Aarhus University, Aarhus, Denmark,iPSYCH, Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus University, Aarhus, Denmark
| | - Arad Kodesh
- Department of Community Mental Health, University of Haifa, Haifa, Israel,Meuhedet Health Services, Israel
| | - Michaeline Breshnahan
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York,New York State Psychiatric Institute, New York
| | - Stephen Z. Levine
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Erik T. Parner
- Section for Biostatistics, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Stefan N. Hansen
- Section for Biostatistics, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Christina Hultman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York,Seaver Autism Center for Research and Treatment at Mount Sinai, New York, New York,Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York,The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Sven Sandin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York,Seaver Autism Center for Research and Treatment at Mount Sinai, New York, New York
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Filatova S, Gyllenberg D, Sillanmäki L, Suominen A, Hinkka-Yli-Salomäki S, Kaljonen A, Kerkelä M, Keski-Säntti M, Ristikari T, Lagström H, Hurtig T, Miettunen J, Surcel HM, Veijola J, Gissler M, Sourander A. The Finnish psychiatric birth cohort consortium (PSYCOHORTS) - content, plans and perspectives. Nord J Psychiatry 2019; 73:357-364. [PMID: 31271336 DOI: 10.1080/08039488.2019.1636135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background: Psychiatric disorders tend to be developmental, and longitudinal settings are required to examine predictors of psychiatric phenomena. Replicating and combining data and results from different birth cohorts, which are a source of reliable data, can make research even more valuable. The Finnish Psychiatric Birth Cohort Consortium (PSYCOHORTS) project combines birth cohorts in Finland. Aim: The aim of this paper is to introduce content, plans and perspectives of the PSYCOHORTS project that brings together researchers from Finland. In addition, we illustrate an example of data harmonization using available data on causes of death. Content: PSYCOHORTS includes eight Finnish birth cohorts. The project has several plans: to harmonize different data from birth cohorts, to incorporate biobanks into psychiatric birth cohort research, to apply multigenerational perspectives, to integrate longitudinal patterns of marginalization and inequality in mental health, and to utilize data in health economics research. Data on causes of death, originally obtained from Finnish Cause of Death register, were harmonized across the six birth cohorts using SAS macro facility. Results: Harmonization of the cause of death data resulted in a total of 21,993 observations from 1965 to 2015. For example, the percentage of deaths due to suicide and the sequelae of intentional self-harm was 14% and alcohol-related diseases, including accidental poisoning by alcohol, was 13%. Conclusions: PSYCOHORTS lays the foundation for complex examinations of psychiatric disorders that is based on compatible datasets, use of biobanks and multigenerational approach to risk factors, and extensive data on marginalization and inequality.
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Affiliation(s)
- S Filatova
- a Centre for Child Psychiatry, University of Turku , Turku , Finland
| | - D Gyllenberg
- a Centre for Child Psychiatry, University of Turku , Turku , Finland.,b National Institute of Health and Welfare , Helsinki , Finland.,c Department of Adolescent Psychiatry, University of Helsinki and Helsinki University Central Hospital , Helsinki , Finland
| | - L Sillanmäki
- a Centre for Child Psychiatry, University of Turku , Turku , Finland
| | - A Suominen
- a Centre for Child Psychiatry, University of Turku , Turku , Finland.,d Turku University Central Hospital , Turku , Finland
| | | | - A Kaljonen
- e Department of Biostatistics, Faculty of Medicine, University of Turku , Finland
| | - M Kerkelä
- b National Institute of Health and Welfare , Helsinki , Finland.,f Medical Research Center, University of Oulu and University Hospital of Oulu , Finland
| | - M Keski-Säntti
- b National Institute of Health and Welfare , Helsinki , Finland
| | - T Ristikari
- b National Institute of Health and Welfare , Helsinki , Finland
| | - H Lagström
- g Department of Public Health, University of Turku and Turku University Hospital , Turku , Finland
| | - T Hurtig
- h Research Unit of Clinical Neuroscience, Psychiatry University of Oulu , Finland.,i PEDEGO Research Unit, Child Psychiatry, University of Oulu , Finland.,j Clinic of Child Psychiatry, University Hospital of Oulu , Finland
| | - J Miettunen
- k Centre for Life Course Health Research, University of Oulu , Finland
| | - H-M Surcel
- l Biobank Borealis, University of Oulu , Finland.,m Faculty of Medicine, University of Oulu , Finland
| | - J Veijola
- f Medical Research Center, University of Oulu and University Hospital of Oulu , Finland.,n University Hospital of Oulu , Finland
| | - M Gissler
- a Centre for Child Psychiatry, University of Turku , Turku , Finland.,b National Institute of Health and Welfare , Helsinki , Finland.,o Department of Neurobiology, Care Sciences and Society, Karolinska Institute , Stockholm , Sweden
| | - A Sourander
- a Centre for Child Psychiatry, University of Turku , Turku , Finland.,p INVEST Research Flagship, University of Turku , Finland.,q Turku University Hospital , Turku , Finland
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Spann MN, Timonen-Soivio L, Suominen A, Cheslack-Postava K, McKeague IW, Sourander A, Brown AS. Proband and Familial Autoimmune Diseases Are Associated With Proband Diagnosis of Autism Spectrum Disorders. J Am Acad Child Adolesc Psychiatry 2019; 58:496-505. [PMID: 30975444 PMCID: PMC6631342 DOI: 10.1016/j.jaac.2018.09.444] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 08/27/2018] [Accepted: 09/13/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE There is evidence that parental autoimmune diseases (ADs) are associated with autism spectrum disorders (ASD) in offspring. The association between offspring ASD and ADs diagnosed in siblings and probands remains less clear. We examined whether proband and familial diagnoses of ADs were associated with increased odds of ASD in probands. METHOD The study is based on a nested case-control design that used data from a large national birth cohort (N = 1.2 million) in Finland. There were 4,600 cases of ASD and controls matched 1:4 on date of birth, sex, and residence. Data were accessed from national medical, birth, and central registries. RESULTS Probands had a statistically significant increase in odds of ASD when they (adjusted odds ratio [OR] = 1.2), their mother (adjusted OR = 1.1), or their sibling (adjusted OR = 1.2) were diagnosed with an AD. With regard to specific ADs, we found a statistically significant increase in odds of ASD in probands diagnosed with autoimmune thyroiditis (adjusted OR = 2.7). Further analyses considering ADs by body system yielded a statistically significant increase in odds of ASD in probands with ADs associated with the central/peripheral nervous (adjusted OR = 4.8) and skin/mucous membrane (adjusted OR = 1.3) systems. Probands of mothers diagnosed with ear/eye (adjusted OR = 1.6) or respiratory (adjusted OR = 1.4) ADs, or siblings diagnosed with skin/mucous membrane ADs (adjusted OR = 1.3) also had increased odds of ASD. CONCLUSION The findings suggest that there may be common pathogenic, developmental mechanisms related to autoimmunity that are associated with the etiology of ASD.
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Affiliation(s)
- Marisa N Spann
- Columbia University Irving Medical Center, New York, NY.
| | - Laura Timonen-Soivio
- University of Turku and Turku University Central Hospital, Turku, Finland; Helsinki University Central Hospital, Finland
| | - Auli Suominen
- University of Turku and Turku University Central Hospital, Turku, Finland
| | | | - Ian W McKeague
- Columbia University Mailman School of Public Health, New York, NY
| | - Andre Sourander
- Columbia University Irving Medical Center, New York, NY; University of Turku and Turku University Central Hospital, Turku, Finland; Helsinki University Central Hospital, Finland
| | - Alan S Brown
- Columbia University Irving Medical Center, New York, NY; New York State Psychiatric Institute, New York, NY
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40
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Silwal S, Lehti V, Chudal R, Suominen A, Lien L, Sourander A. Parental immigration and offspring post-traumatic stress disorder: A nationwide population-based register study. J Affect Disord 2019; 249:294-300. [PMID: 30797121 DOI: 10.1016/j.jad.2019.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 01/23/2019] [Accepted: 02/05/2019] [Indexed: 01/23/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the association between parental immigration status and a diagnosis of post-traumatic stress disorder (PTSD) in their offspring. METHODS This nested matched case-control study was based on a Finnish national birth cohort for 1987-2010 and cases were diagnosed with PTSD by 2012 from the Care Register for Health Care. We identified 3639 cases and 14,434 controls individually matched for gender, place and date of birth (±30 days). Conditional logistic regression analyses were conducted to examine the association between parental immigration status, parents' region of birth and time since paternal immigration, and PTSD after controlling for confounding factors. RESULTS The likelihood of being diagnosed with PTSD was significantly increased among children with an immigrant father (OR 1.8, 95% CI 1.3 - 2.4) than those with two Finnish parents and one immigrant mother. There was no significant association between having an immigrant mother or two immigrant parents and receiving a diagnosis of PTSD. The likelihood of being diagnosed with PTSD was increased if the children's fathers had migrated less than five years before their birth (OR 1.4, 95% CI 1.03 - 1.9) and if their immigrant fathers had been born in North Africa or the Middle East (OR 2.1, 95% CI 1.4 - 3.3). LIMITATIONS The sample included a heterogeneous migrant group without information on the reason for migration. The cases were identified from hospital diagnosis that may have only included severe cases. CONCLUSION The increased likelihood of a diagnosis of PTSD underlines the need for psychosocial services among second-generation immigrants.
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Affiliation(s)
- Sanju Silwal
- Deparment of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku, Lemminkäisenkatu 3 / Teutori (3. floor), 20014 Turku, Finland.
| | - Venla Lehti
- Deparment of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku, Lemminkäisenkatu 3 / Teutori (3. floor), 20014 Turku, Finland; Department of Psychiatry, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Roshan Chudal
- Deparment of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku, Lemminkäisenkatu 3 / Teutori (3. floor), 20014 Turku, Finland
| | - Auli Suominen
- Deparment of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku, Lemminkäisenkatu 3 / Teutori (3. floor), 20014 Turku, Finland
| | - Lars Lien
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway; Department of Public Health, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Andre Sourander
- Deparment of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku, Lemminkäisenkatu 3 / Teutori (3. floor), 20014 Turku, Finland; Department of Child Psychiatry, Turku University Hospital, Turku, Finland
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41
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Ristkari T, Kurki M, Suominen A, Gilbert S, Sinokki A, Kinnunen M, Huttunen J, McGrath P, Sourander A. Web-Based Parent Training Intervention With Telephone Coaching for Disruptive Behavior in 4-Year-Old Children in Real-World Practice: Implementation Study. J Med Internet Res 2019; 21:e11446. [PMID: 30973337 PMCID: PMC6482405 DOI: 10.2196/11446] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 11/09/2018] [Accepted: 12/31/2018] [Indexed: 11/26/2022] Open
Abstract
Background Parent training is the most effective approach to the psychosocial treatment of disruptive behavioral problems in childhood. However, no studies exist on how well Web-based training programs work when they make the transition from the research setting to implementation in primary health care. Objective The study aimed to examine how the randomized controlled trial (RCT) and implementation study groups of the Strongest Families Smart Website (SFSW) intervention differed in child psychopathology, family demographics and treatment-related factors, such as therapeutic alliance and parents’ satisfaction rates. The intervention was conducted in the pediatric primary health care in Finland. Methods The study focused on 232 parents who had taken part in the SFSW intervention, which formed part of a 2-arm RCT study, and 882 families that would participate in the subsequent SFSW implementation study group. Both groups comprised parents whose children displayed high levels of parent-reported disruptive behavioral problems when they were screened in child health clinics at 4 years of age. Parents in both groups were provided with the SFSW intervention, which consisted of a Web-based training program with 11 weekly themes and associated telephone sessions. Results Demographic factors or duration of behavioral problems did not differ statistically or clinically between the RCT and implementation groups. Overall, 42.0% (362/862) of children in the implementation group and 35.4% (80/226) in the RCT intervention group had suffered from behavioral difficulties more than 1 year before the screening phase (χ12=3.2; P=.07). The mean duration of telephone coaching calls was very similar in the implementation and RCT intervention groups, that is, 38 and 37 min per call, respectively (t279.5=0.26; P=.79). The total time spent on the website of the program was 451 min in the implementation group and 431 min in the RCT intervention group (t318.8=1.38; P=.17). In the RCT intervention group, 52 of the 232 participants (22.4%) discontinued the program before the tenth week, whereas in the implementation group, 109 of the 882 participants (12.4%; odds ratio 2.05, 95% CI 1.4-3.0; P<.001) discontinued. Parents in both the implementation (77.1% to 98.5%, 498/742 to 731/742, respectively) and the RCT (64.8% to 98.2%, N=105/162- to 159/162, respectively) groups reported qualitatively similar and high level of posttreatment satisfaction rates in improved parenting skills, expectations, and stress relief. Parents in both groups reported a high level of satisfaction in skills and professionalism of the telephone coaches. Conclusions The implementation of population-based screening of Web-based parent training intervention with telephone coaching resulted in good feasibility, fidelity, accessibility, and similar satisfaction level post treatment when compared with intervention in RCT research setting. The discontinuation of treatment in the implementation group was exceptionally low.
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Affiliation(s)
- Terja Ristkari
- Department of Child Psychiatry, Turku University Central Hospital, University of Turku, Turku, Finland
| | - Marjo Kurki
- Department of Child Psychiatry, Turku University Central Hospital, University of Turku, Turku, Finland
| | - Auli Suominen
- Department of Child Psychiatry, Turku University Central Hospital, University of Turku, Turku, Finland
| | - Sonja Gilbert
- Department of Child Psychiatry, Turku University Central Hospital, University of Turku, Turku, Finland
| | - Atte Sinokki
- Department of Child Psychiatry, Turku University Central Hospital, University of Turku, Turku, Finland
| | - Malin Kinnunen
- Department of Child Psychiatry, Turku University Central Hospital, University of Turku, Turku, Finland
| | - Jukka Huttunen
- Department of Child Psychiatry, Turku University Central Hospital, University of Turku, Turku, Finland
| | - Patrick McGrath
- Centre for Research in Family Health, Izaak Walton Killam Health Centre, Halifax, NS, Canada.,Strongest Families Institute, Halifax, NS, Canada.,Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Andre Sourander
- Department of Child Psychiatry, Turku University Central Hospital, University of Turku, Turku, Finland
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Jokiranta-Olkoniemi E, Cheslack-Postava K, Joelsson P, Suominen A, Brown AS, Sourander A. Attention-deficit/hyperactivity disorder and risk for psychiatric and neurodevelopmental disorders in siblings. Psychol Med 2019; 49:84-91. [PMID: 29607791 PMCID: PMC6316367 DOI: 10.1017/s0033291718000521] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 02/05/2018] [Accepted: 02/08/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND Probands with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for several psychiatric and neurodevelopmental disorders. The risk of these disorders among the siblings of probands has not been thoroughly assessed in a population-based cohort. METHODS Every child born in Finland in 1991-2005 and diagnosed with ADHD in 1995-2011 were identified from national registers. Each case was matched with four controls on sex, place, and date of birth. The full siblings of the cases and controls were born in 1981-2007 and diagnosed in 1981-2013. In total, 7369 cases with 12 565 siblings and 23 181 controls with 42 753 siblings were included in the analyses conducted using generalized estimating equations. RESULTS 44.2% of the cases and 22.2% of the controls had at least one sibling diagnosed with any psychiatric or neurodevelopmental disorder (risk ratio, RR = 2.1; 95% CI 2.0-2.2). The strongest associations were demonstrated for childhood-onset disorders including ADHD (RR = 5.7; 95% CI 5.1-6.3), conduct and oppositional disorders (RR = 4.0; 95% CI 3.5-4.5), autism spectrum disorders (RR = 3.9; 95% CI 3.3-4.6), other emotional and social interaction disorders (RR = 2.7; 95% CI 2.4-3.1), learning and coordination disorders (RR = 2.6; 95% CI 2.4-2.8), and intellectual disability (RR = 2.4; 95% CI 2.0-2.8). Also, bipolar disorder, unipolar mood disorders, schizophrenia spectrum disorders, other neurotic and personality disorders, substance abuse disorders, and anxiety disorders occurred at increased frequency among the siblings of cases. CONCLUSIONS The results offer potential utility for early identification of neurodevelopmental and psychiatric disorders in at-risk siblings of ADHD probands and also argue for more studies on common etiologies.
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Affiliation(s)
| | - Keely Cheslack-Postava
- Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, New York
| | - Petteri Joelsson
- Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Auli Suominen
- Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Alan S. Brown
- Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, New York
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Andre Sourander
- Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
- Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, New York
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Sucksdorff M, Lehtonen L, Chudal R, Suominen A, Gissler M, Sourander A. Lower Apgar scores and Caesarean sections are related to attention-deficit/hyperactivity disorder. Acta Paediatr 2018; 107:1750-1758. [PMID: 29604108 DOI: 10.1111/apa.14349] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 02/15/2018] [Accepted: 03/26/2018] [Indexed: 12/31/2022]
Abstract
AIM We examined the associations between prenatal, birth-related and newborn risk factors and attention-deficit/hyperactivity disorder (ADHD). METHODS In this population-based study, 10 409 subjects diagnosed with ADHD by 31 December 2011 and 39 124 controls, born between 1 January 1991 and 31 December 2005, were identified from Finnish nationwide registers. Perinatal data were obtained from the Birth Register. Conditional logistic regression was used to examine the associations after controlling for confounders. RESULTS Lower Apgar scores were associated with a higher risk of ADHD, with odds ratios of 1.12 (95% confidence intervals 1.06-1.19) for one-minute Apgar scores of 7-8, 1.17 (95% CI 1.02-1.35) for scores of 5-6 and 1.41 (95% CI 1.18-1.68) for scores of 0-4, compared to Apgar scores of 9-10. Elective Caesarean sections were associated with an increased risk of ADHD with an adjusted odds ratio of 1.15 (95% CI 1.05-1.26). Other identified risk factors were breech presentation, induced labour and admission to a neonatal intensive care unit. Low umbilical artery pH did not increase the risk of ADHD. CONCLUSION Elective Caesareans and perinatal adversities leading to lower Apgar scores increased the risk of ADHD. Future research to identify the mechanisms behind these findings is warranted.
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Affiliation(s)
- Minna Sucksdorff
- Department of Child Psychiatry; University of Turku; Turku Finland
- Department of Pediatrics; Turku University Hospital; Turku Finland
| | - Liisa Lehtonen
- Department of Pediatrics; Turku University Hospital; Turku Finland
- Department of Pediatrics; University of Turku; Turku Finland
| | - Roshan Chudal
- Department of Child Psychiatry; University of Turku; Turku Finland
| | - Auli Suominen
- Department of Child Psychiatry; University of Turku; Turku Finland
| | - Mika Gissler
- Department of Child Psychiatry; Turku University Hospital; Turku Finland
- National Institute for Health and Welfare; Helsinki Finland
- Karolinska Institute; Stockholm Sweden
| | - Andre Sourander
- Department of Child Psychiatry; University of Turku; Turku Finland
- Department of Child Psychiatry; Turku University Hospital; Turku Finland
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Lehti V, Gyllenberg D, Suominen A, Sourander A. Finnish-born children of immigrants are more likely to be diagnosed with developmental disorders related to speech and language, academic skills and coordination. Acta Paediatr 2018; 107:1409-1417. [PMID: 29505120 DOI: 10.1111/apa.14308] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 01/24/2018] [Accepted: 02/28/2018] [Indexed: 01/22/2023]
Abstract
AIM We examined the association between having at least one parent born abroad and being diagnosed with a developmental disorder related to speech and language, academic skills or coordination. METHODS This nested case-control study was based on Finnish population records for 1996-2007. Cases from the Finnish Hospital Discharge Register were diagnosed with developmental disorders of speech and language, academic skills and coordination by the end of 2012. We identified 28 192 cases and 106 616 matched controls. RESULTS Children were more likely to be diagnosed with developmental disorders if they had an immigrant mother than children with two Finnish-born parents, with an adjusted odds ratio (aOR) of 1.3 and 95% confidence interval (95% CI) of 1.2-1.4, an immigrant father (aOR 1.2, 95% CI 1.1-1.3) or two immigrant parents (aOR 1.5, 95% CI 1.3-1.6). The level of development of the parental country of origin was not associated with receiving a diagnosis. CONCLUSION Children of immigrant parents were more likely to be diagnosed with developmental disorders and the association was strongest with regard to speech and language disorders. There were similar adjusted odds ratios for mothers, fathers and both parents. The development level of the country of origin was irrelevant.
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Affiliation(s)
- Venla Lehti
- Research Center for Child Psychiatry; University of Turku; Turku Finland
- Department of Psychiatry; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - David Gyllenberg
- Research Center for Child Psychiatry; University of Turku; Turku Finland
- Children, Adolescents and Family Unit; National Institute for Health and Welfare; Helsinki Finland
| | - Auli Suominen
- Research Center for Child Psychiatry; University of Turku; Turku Finland
| | - Andre Sourander
- Research Center for Child Psychiatry; University of Turku; Turku Finland
- Department of Child Psychiatry; University of Turku and Turku University Hospital; Turku Finland
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45
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Fossum S, Ristkari T, Cunningham C, McGrath PJ, Suominen A, Huttunen J, Lingley-Pottie P, Sourander A. Parental and child factors associated with participation in a randomised control trial of an Internet-assisted parent training programme. Child Adolesc Ment Health 2018; 23:71-77. [PMID: 32677336 DOI: 10.1111/camh.12193] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/31/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Parental training is an effective way to treat and prevent children's conduct problems, but knowledge of who participates in such initiatives is limited. METHOD This study examined child and family factors associated with participation in an Internet-assisted parent training programme. The parents of 4-year-old children with high levels of disruptive behaviour in a region of Finland were offered the opportunity to participate in a randomised controlled trial of the Strongest Families Smart Website intervention (SFSW). The participants and nonparticipants were compared using the Strengths and Difficulties Questionnaire (SDQ), duration of child problems and information about family demographics, which were routinely collected prior to randomisation to the SFSW and control group. RESULTS We found that 464 (64.5%) of the 709 parents of children fulfilling the screening criteria, participated. In the multivariable analysis, nonparticipation was most strongly associated with a child only having minor difficulties [odds ratio (OR): 2.1; 95% confidence interval (CI): 1.5-3.0] and a shorter duration of problems, for less than 12 months (OR: 1.7, 95% CI: 1.2-2.5), after controlling for other child factors. Nonparticipation was significantly associated with mothers spending a shorter time in the education system (OR: 1.6, 95% CI: 1.2-2.3) after controlling for other parental factors. CONCLUSIONS A larger percentage of parents of children with longer lasting and more severe problems seemed to be motivated to participate in this remote parent training programme. Future studies on how to encourage parents with shorter duration of education to participate in early intervention programmes are warranted.
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Affiliation(s)
- Sturla Fossum
- UiT The Artic University of Norway, Faculty of Health Sciences, The Regional Centre for Child and Youth Mental Health and Child Welfare - North, Tromsø, Norway
| | - Terja Ristkari
- Department of Child Psychiatry, Clinical Sciences, Medical Faculty, University of Turku and Turku University Hospital, Lemminkäisenkatu 3/ Teutori 3. krs, 20014, Turku, Finland
| | - Charles Cunningham
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Science, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Patrick J McGrath
- Centre for Research in Family Health, IWK Health Centre, Halifax, NS, Canada.,Faculty of Science, Dalhousie University, Halifax, NS, Canada.,Strongest Families Institute, Lower Sackville, NS, Canada.,Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Auli Suominen
- Department of Child Psychiatry, Clinical Sciences, Medical Faculty, University of Turku and Turku University Hospital, Lemminkäisenkatu 3/ Teutori 3. krs, 20014, Turku, Finland
| | - Jukka Huttunen
- Department of Child Psychiatry, Clinical Sciences, Medical Faculty, University of Turku and Turku University Hospital, Lemminkäisenkatu 3/ Teutori 3. krs, 20014, Turku, Finland
| | - Patricia Lingley-Pottie
- Centre for Research in Family Health, IWK Health Centre, Halifax, NS, Canada.,Strongest Families Institute, Lower Sackville, NS, Canada.,Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Andre Sourander
- Department of Child Psychiatry, Clinical Sciences, Medical Faculty, University of Turku and Turku University Hospital, Lemminkäisenkatu 3/ Teutori 3. krs, 20014, Turku, Finland
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Leivonen S, Scharf JM, Mathews CA, Chudal R, Gyllenberg D, Sucksdorff D, Suominen A, Voutilainen A, Brown AS, Sourander A. Parental Psychopathology and Tourette Syndrome/Chronic Tic Disorder in Offspring: A Nationwide Case-Control Study. J Am Acad Child Adolesc Psychiatry 2017; 56:297-303.e4. [PMID: 28335873 DOI: 10.1016/j.jaac.2017.01.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 01/19/2017] [Accepted: 01/26/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To determine the associations between maternal and paternal psychiatric diagnoses and Tourette syndrome (TS)/chronic tic disorder (CT) in a nationwide study. METHOD This nested case-control study linked data derived from three national registers. All singletons born and diagnosed with TS/CT in Finland between January 1991 and December 2010 were identified (n = 1,120) and matched to four controls (n = 4,299). Conditional logistic regression was used to examine the associations between parental psychopathology and TS/CT. RESULTS Altogether, 24.9% of patients with TS/CT and 12.0% of controls had a mother with a psychiatric diagnosis. Similarly, 17.9% and 12.9% had a father with a psychiatric diagnosis. Any maternal and any paternal psychiatric diagnosis was associated with offspring TS/CT (odds ratio [OR] 2.3; 95% CI 1.9-2.7 and OR 1.2; 95% CI 1.01-1.5, respectively). The association between maternal psychiatric diagnosis and TS/CT was stronger than that between paternal psychiatric diagnosis and TS/CT (p < .001). Maternal personality disorders (OR 3.1, 95% CI 1.9-5.1), anxiety disorders (OR 2.6, 95% CI 1.9-3.5), affective disorders (OR 2.3, 95% CI 1.8-2.9), psychotic disorders (OR 2.0, 95% CI 1.2-3.3), and addiction disorders (OR 1.8, 95% CI 1.1-2.8) were associated with TS/CT. Paternal OCD (OR 6.5, 95% CI 1.1-39.5) and anxiety disorders (OR 1.5, 95% CI 1.1-2.3) were associated with TS/CT. CONCLUSION Parental psychiatric diagnoses (especially in the mother) are associated with diagnosed offspring TS/CT. Further studies are required before the results can be generalized to all children with TS/CT. The associations between maternal psychiatric disorders and TS may reflect both maternal specific environmental and/or genetic influences.
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Affiliation(s)
- Susanna Leivonen
- University of Turku and Turku University Hospital, Turku, Finland; Child Neurology, Helsinki University Hospital and University of Helsinki, Finland
| | - Jeremiah M Scharf
- Center for Human Genetics Research, Massachusetts General Hospital, and Harvard Medical School, Boston
| | | | - Roshan Chudal
- University of Turku and Turku University Hospital, Turku, Finland
| | - David Gyllenberg
- University of Turku and Turku University Hospital, Turku, Finland
| | - Dan Sucksdorff
- University of Turku and Turku University Hospital, Turku, Finland
| | - Auli Suominen
- University of Turku and Turku University Hospital, Turku, Finland
| | - Arja Voutilainen
- Child Neurology, Helsinki University Hospital and University of Helsinki, Finland
| | - Alan S Brown
- Columbia University Medical Center and New York State Psychiatric Institute, New York City
| | - Andre Sourander
- University of Turku and Turku University Hospital, Turku, Finland.
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47
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Sucksdorff D, Brown AS, Chudal R, Heinimaa M, Suominen A, Sourander A. Parental and comorbid migraine in individuals with bipolar disorder: A nationwide register study. J Affect Disord 2016; 206:109-114. [PMID: 27472412 PMCID: PMC5077692 DOI: 10.1016/j.jad.2016.07.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 06/09/2016] [Accepted: 07/18/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Genetic studies imply a shared genetic etiology between bipolar disorder (BD) and migraine. Epidemiological studies have demonstrated elevated comorbidity between these disorders, but haven't controlled for parental psychopathology. No previous nationally representative studies exist on familial clustering of BD and migraine. This study examines the association between parental and comorbid migraine and BD, controlling for potential confounders. METHODS We identified 1861 cases aged ≤25 years, 3643 matched controls, and their parents from Finnish national registers. Conditional logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) and two-sided significance limits of p<0.05. RESULTS Parental migraine, controlling for parental BD, was associated with offspring BD diagnosed at age ≥18 years (OR 1.52, 95%CI: 1.08-2.14). Associations between BD and comorbid migraine persisted following adjustment for parental BD and parental migraine in all subjects (OR=2.46, 95% CI: 1.76-3.42), both age groups of BD-diagnosis (<18 years,≥18 years) and both sexes. LIMITATIONS The diagnoses were register-based, not directly ascertained. CONCLUSIONS This study indicates that parental migraine, even in the absence of parental BD, is a risk factor for offspring BD. Thus, a genetic link between BD and migraine could potentially explain some of the elevated comorbidity between these disorders. However, BD shows a stronger association with comorbid migraine than with parental migraine, suggesting that much of the elevated comorbidity is related to non-genetic factors. Increased understanding of mechanisms underlying the comorbidity of BD and migraine is important since it is associated with poorer health-related outcomes compared with BD alone.
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Affiliation(s)
- Dan Sucksdorff
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland.
| | - Alan S Brown
- Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, USA; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, USA
| | - Roshan Chudal
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
| | - Markus Heinimaa
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Auli Suominen
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
| | - Andre Sourander
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland; Department of Child Psychiatry, University of Turku, Turku, Finland
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48
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Joelsson P, Chudal R, Talati A, Suominen A, Brown AS, Sourander A. Prenatal smoking exposure and neuropsychiatric comorbidity of ADHD: a finnish nationwide population-based cohort study. BMC Psychiatry 2016; 16:306. [PMID: 27581195 PMCID: PMC5006583 DOI: 10.1186/s12888-016-1007-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 08/18/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prenatal smoking exposure has been associated with attention-deficit/hyperactivity disorder (ADHD). ADHD is commonly associated with a wide spectrum of psychiatric comorbidity. The association between smoking and neuropsychiatric comorbidity of ADHD has remained understudied. The aim of this study is to examine the association between prenatal exposure to maternal smoking and offspring ADHD, and test whether the smoking-ADHD associations are stronger when ADHD is accompanied by other lifetime neuropsychiatric comorbidities. METHODS The study is based on a nested case-control design and includes all Finnish singletons born between 1991 and 2005 and diagnosed with ADHD by 2011 (n = 10,132), matched with four controls (n = 38,811) on date of birth, sex and residence in Finland. RESULTS The risk for ADHD with or without comorbidity was significantly increased among offspring exposed to maternal smoking on adjusting for potential confounders (OR = 1.75, CI 95 % = 1.65-1.86). Compared to the only ADHD cases, subjects with comorbid conduct disorder or oppositional defiant disorder had a significantly stronger association with smoking exposure (OR = 1.80, CI 95 % = 1.55-2.11). CONCLUSIONS Prenatal smoking represents an important risk factor for the ADHD comorbid with CD/ODD. Further research on the association between prenatal smoking exposure and neuropsychiatric comorbidity of ADHD is needed considering the increased risk among these subjects of an overall poor health outcome as compared to only ADHD. In particular, studies utilizing biomarkers or including subjects with neuropsychiatric conditions with and without comorbid ADHD are needed.
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Affiliation(s)
- Petteri Joelsson
- Department of Child Psychiatry, University of Turku, Lemminkäisenkatu 3, Lastenpsykiatrian tutkimuskeskus, 20014, Turku, Finland.
| | - Roshan Chudal
- Department of Child Psychiatry, University of Turku, Lemminkäisenkatu 3, Lastenpsykiatrian tutkimuskeskus, 20014 Turku, Finland
| | - Ardesheer Talati
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY USA ,Division of Epidemiology, New York State Psychiatric Institute, New York, NY USA
| | - Auli Suominen
- Department of Child Psychiatry, University of Turku, Lemminkäisenkatu 3, Lastenpsykiatrian tutkimuskeskus, 20014 Turku, Finland
| | - Alan S. Brown
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY USA ,Division of Epidemiology, New York State Psychiatric Institute, New York, NY USA ,Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY USA
| | - Andre Sourander
- Department of Child Psychiatry, University of Turku, Lemminkäisenkatu 3, Lastenpsykiatrian tutkimuskeskus, 20014 Turku, Finland ,Department of Child Psychiatry, Turku University Hospital, Turku, Finland
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49
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Lehti V, Chudal R, Suominen A, Gissler M, Sourander A. Association between immigrant background and ADHD: a nationwide population-based case-control study. J Child Psychol Psychiatry 2016; 57:967-75. [PMID: 27133554 DOI: 10.1111/jcpp.12570] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/29/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND Information about psychiatric disorders among those with immigrant parents is important for early detection and service development. The aim of this study is to examine the association between parental immigration and the diagnosis of attention-deficit hyperactivity disorder (ADHD) in offspring in Finland. METHODS This matched case-control study was based on a national birth cohort. The sample included all singletons who were born in Finland in 1991-2005 and diagnosed with ADHD by the year 2011 (n = 10,409) and their matched controls (n = 39,124). Nationwide registers were used to identify participants and to gather information on the parents' country of birth and native language. Conditional logistic regression analyses were conducted using maternal and paternal migration status and region of birth as well as time since maternal migration as exposure factors. RESULTS The likelihood of being diagnosed with ADHD was significantly increased among children of two immigrant parents [adjusted odds ratio (aOR) 4.7, 95% CI 3.4-6.6] and children of an immigrant father (aOR 1.9, 95% CI 1.6-2.2). The likelihood of receiving an ADHD diagnosis was equal among children whose mother was a recent immigrant when she gave birth and those whose mother had stayed in Finland at least for a year before birth. The association between parental migration and ADHD diagnosis was strongest among fathers born in sub-Saharan Africa or Latin America and among mothers born in sub-Saharan Africa or North Africa and Middle East. Children, whose parents were born in countries with low Human Development Index (HDI), were more often diagnosed with ADHD. CONCLUSIONS The increased likelihood of ADHD diagnosis among children of immigrants indicates increased exposure to environmental risk factors, differences in the use of health services, or challenges in diagnosing immigrants' children.
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Affiliation(s)
- Venla Lehti
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland.,Department of Psychiatry, Helsinki University Hospital, Helsinki, Finland
| | - Roshan Chudal
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
| | - Auli Suominen
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
| | - Mika Gissler
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland.,National Institute for Health and Welfare, Helsinki, Finland
| | - Andre Sourander
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland.,Department of Child Psychiatry, Turku University Hospital, Turku, Finland
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50
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Jokiranta-Olkoniemi E, Cheslack-Postava K, Sucksdorff D, Suominen A, Gyllenberg D, Chudal R, Leivonen S, Gissler M, Brown AS, Sourander A. Risk of Psychiatric and Neurodevelopmental Disorders Among Siblings of Probands With Autism Spectrum Disorders. JAMA Psychiatry 2016; 73:622-9. [PMID: 27145529 DOI: 10.1001/jamapsychiatry.2016.0495] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Previous research has focused on examining the familial clustering of schizophrenia, bipolar disorder, and autism spectrum disorders (ASD). Little is known about the clustering of other psychiatric and neurodevelopmental disorders among siblings of persons with ASD. OBJECTIVE To examine the risk for psychiatric and neurodevelopmental disorders among full siblings of probands with ASD. DESIGN, SETTING, AND PARTICIPANTS The Finnish Prenatal Study of Autism and Autism Spectrum Disorders used a population-based cohort that included children born from January 1, 1987, to December 31, 2005, who received a diagnosis of ASD by December 31, 2007. Each case was individually matched to 4 control participants by sex and date and place of birth. The siblings of the cases and controls were born from January 1, 1977, to December 31, 2005, and received a diagnosis from January 1, 1987, to December 31, 2009. This nested case-control study included 3578 cases with ASD with 6022 full siblings and 11 775 controls with 22 127 siblings from Finnish national registers. Data were analyzed from March 6, 2014, to February 12, 2016. MAIN OUTCOMES AND MEASURES The adjusted risk ratio (RR) for psychiatric and neurodevelopmental disorders among siblings of probands with ASD vs siblings of matched controls. Additional analyses were conducted separately for ASD subgroups, including childhood autism, Asperger syndrome, and pervasive developmental disorders not otherwise specified. Analyses were further stratified by sex and intellectual disability among the probands. RESULTS Among the 3578 cases with ASD (2841 boys [79.4%]) and 11 775 controls (9345 boys [79.4%]), 1319 cases (36.9%) and 2052 controls (17.4%) had at least 1 sibling diagnosed with any psychiatric or neurodevelopmental disorder (adjusted RR, 2.5; 95% CI, 2.3-2.6). The largest associations were observed for childhood-onset disorders (1061 cases [29.7%] vs 1362 controls [11.6%]; adjusted RR, 3.0; 95% CI, 2.8-3.3), including ASD (374 cases [10.5%] vs 125 controls [1.1%]; adjusted RR, 11.8; 95% CI, 9.4-14.7), tic disorders (28 cases [0.8%] vs 24 controls [0.2%]; adjusted RR, 4.3; 95% CI, 2.3-8.2), attention-deficit/hyperactivity disorder (189 cases [5.3%] vs 180 controls [1.5%]; adjusted RR, 3.7; 95% CI, 2.9-4.7), learning and coordination disorders (563 cases [15.7%] vs 697 controls [5.9%]; adjusted RR, 3.2; 95% CI, 2.8-3.6), intellectual disability (104 cases [2.9%] vs 137 controls [1.2%]; adjusted RR, 3.1; 95% CI, 2.3-4.2), conduct and oppositional disorders (180 cases [5.0%] vs 221 controls [1.9%]; adjusted RR, 2.8; 95% CI, 2.2-3.5), and emotional disorders with onset specific to childhood (126 cases [3.5%] vs 157 controls [1.3%]; adjusted RR, 2.6; 95% CI, 1.9-3.4). Autism spectrum disorders were also associated with schizophrenia spectrum disorders, affective disorders, anxiety disorders, and other neurotic and personality disorders among siblings. CONCLUSIONS AND RELEVANCE Psychiatric and neurodevelopmental disorders cluster among siblings of probands with ASD. For etiologic research, these findings provide further evidence that several psychiatric and neurodevelopmental disorders have common risk factors.
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Affiliation(s)
| | - Keely Cheslack-Postava
- Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, New York
| | - Dan Sucksdorff
- Department of Child Psychiatry, University of Turku, Turku University Hospital, Turku, Finland
| | - Auli Suominen
- Department of Child Psychiatry, University of Turku, Turku University Hospital, Turku, Finland
| | - David Gyllenberg
- Department of Child Psychiatry, University of Turku, Turku University Hospital, Turku, Finland
| | - Roshan Chudal
- Department of Child Psychiatry, University of Turku, Turku University Hospital, Turku, Finland
| | - Susanna Leivonen
- Department of Child Psychiatry, University of Turku, Turku University Hospital, Turku, Finland
| | - Mika Gissler
- Department of Child Psychiatry, University of Turku, Turku University Hospital, Turku, Finland3National Institute for Health and Welfare, Helsinki, Finland
| | - Alan S Brown
- Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, New York4Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | - Andre Sourander
- Department of Child Psychiatry, University of Turku, Turku University Hospital, Turku, Finland2Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, New York
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