Anu-Katriina Pesonen

Early determinants of mental health

Environmental adversities in pre- and early postnatal life may have life-long consequences. Based upon a series of epidemiological and clinical studies and natural experiments, this review describes how the early life environment may affect psychological functions and mental disorders later in life. We focus on studies that have examined the associations of small body size at birth and prematurity as proxies of prenatal environmental adversity. We also review literature on materno-fetal malnutrition, maternal prenatal glycyrrhizin in licorice consumption and hypertension-spectrum pregnancy disorders as factors that may compromise the fetal developmental milieu and hence provide insight into some of the mechanisms that may underlie prenatal programming. While effects of programming mostly take place during the first 1000 days after conception, we finally present evidence from prospective studies suggesting that programming can occur also during later critical periods of development or windows of plasticity. The studies may bear relevance for future prevention and intervention programs targeting the potentially modifiable environmental factors that will aid at promoting mental well-being and health of an individual.

Childhood socioeconomic status modifies the association between intellectual abilities at age 20 and mortality in later life

Background People who score poorly in intellectual ability tests have shorter life expectancy. A study was undertaken to determine whether this association is different in people from different socioeconomic backgrounds. Methods The mortality of 2786 men born in Helsinki, Finland during 1934–1944 who, as military conscripts, underwent a standardised intellectual ability test comprising verbal, visuospatial and arithmetic reasoning subtests was studied. Mortality data came from the Finnish Death Register. Results Comparing men in the lowest and highest test score quartiles, HRs for all-cause mortality were 1.9 (95% CI 1.4 to 2.5) for verbal reasoning, 2.2 (95% CI 1.6 to 3.0) for visuospatial reasoning and 1.9 (95% CI 1.4 to 2.5) for arithmetic reasoning, corresponding to 2.6, 3.4 and 2.6 excess years of life lost, respectively. Associations were similar for cardiovascular and non-cardiovascular mortality. Intellectual ability scores were stronger predictors in men who grew up in middle-class families. Compared with middle-class men in the highest quartile of the visuospatial reasoning score, middle-class men in the lowest quartile lost 6.5u2005years of life while men from families of manual workers in the highest quartile lost 2.8u2005years and men in the lowest quartile lost 5.6u2005years. Conclusions High intellectual ability in men aged 20 protects them from mortality in later life. This effect is stronger in men who grew up in middle-class families than in those who grew up in manual worker families. This finding suggests that early life conditions that are unfavourable to the development of cognitive abilities negate the life expectancy benefits of being born into a more affluent family.

Inter-generational social mobility following early life stress.

Abstract Introduction. Socio-economic position (SEP) is a powerful source of health inequality. Less is known of early life conditions that may determine the course of adult SEP. We tested if early life stress (ELS) due to a separation from the parents during World War II predicts adult SEP, trajectories of incomes across the entire working career, and inter-generational social mobility. Materials and methods. Participants (n = 10,702) were from the Helsinki Birth Cohort Study 1934–44. Compared to the non-separated, the separated individuals attained a lower SEP in adulthood. The separated whose fathers were manual workers were less likely to be upwardly mobile from paternal occupation category to higher categories of own occupation, education, and incomes. The separated whose fathers had junior and senior clerical occupations were more likely to be downwardly mobile. Comparison of trajectories of incomes across adulthood showed that the difference between the separated and the non-separated grew larger across time, such that among the separated the incomes decreased. Conclusions. This life-course study shows that severe ELS due to a separation from parents in childhood is associated with socio-economic disadvantage in adult life. Even high initial SEP in childhood may not protect from the negative effects of ELS.