Georgios Nikolakaros

Child Mental Health Problems and Obesity in Early Adulthood

OBJECTIVE To examine whether mental health problems in childhood increase the likelihood of overweight or obesity during early adulthood among male subjects. STUDY DESIGN In a national prospective population-based study conducted in Finland, child mental health, including depression, emotional problems, conduct problems, and hyperactivity (determined on the basis of child, parent, and teacher information), was assessed at age 8 years. Body mass index (BMI) was obtained from military examination records (n = 2209) conducted in early adulthood (age range, 18-23 years). RESULTS Both moderate (50th-90th percentile) and high (>90th percentile) levels of conduct problems at age 8 years were prospectively associated with a young adult being obese (BMI > or = 30; odds ratio [OR], 2.0; 95% CI, 1.2-3.2; and OR, 2.9; 95% Confidence interval [CI], 1.5-5.9; respectively). Conduct problems were also prospectively associated with a young adult being overweight (25 < or = BMI < 30; OR, 1.5; 95% CI, 1.1-1.9 for moderate levels of conduct problems, and OR, 1.9; 95% CI, 1.2-2.8 for high levels), after controlling for hyperactive problems and sociodemographic factors. CONCLUSIONS Conduct problems in childhood are prospectively associated with overweight and obese in young adulthood. Future studies should address the potential for interventions to reduce obesity risk in young adulthood for boys who manifest conduct problems early in life.

Sense of coherence among Finnish young men--a cross-sectional study at military call-up.

The aim of this study was to study associations between sense of coherence (based on Antonovskys theory), and mental health problems, the use of mental health services, substance use, predisposition to suicide and possible psychiatric diagnosis among Finnish young men. The study included 2314 18-year-old young men who attended military call-up in autumn 1999 and completed the 13-item Orientation to Life Questionnaire (SOC-13) questionnaire (89.1% of the study sample attending military call-up). Furthermore, all young men had a medical examination at military call-up, including evaluation of possible psychiatric disorder. Suicidality, perceived mental health problems, psychiatric diagnosis at military call-up medical examination, use of mental health services, excessive alcohol consumption and use of illicit drugs were identified as independent factors associated with sense of coherence. Sense of coherence is a valuable construction in psychiatric evaluation of adolescents. SOC-13 can be used both in clinical practice and in epidemiological research to evaluate the adolescents health resources. Future research on its applications in clinical practice is warranted.

Military fitness class of Finnish 18-year-old men--prediction of military fitness class at call-up with the YASR and sociodemographic factors.

ObjectiveThe aim of this study was to examine psychosocial factors associated with military fitness class, classified as capability of service, vs. temporary or permanent exemption from service.MethodParticipants were 2,340 (80% of the original sample) Finnish 18-year-old men at call-up for obligatory military service who filled in the Young Adult Self-Report (YASR) questionnaire.ResultsTemporary exemption from military service was independently associated with the YASR total problem score, externalizing and internalizing problems, excessive alcohol use, drug use, problems with peers and family, and mental health service use.Permanent exemption was independently associated with problems with peers and family.ConclusionThe YASR is a potential selection tool to be used at call-up. Temporary exemption was more strongly associated with psychosocial problems than permanent exemption. Because of the high level of psychological problems among those temporarily exempted, the call-up situation offers a unique opportunity to identify those with problem behaviour and risk of marginalization.

Life events, self-reported psychopathology and sense of coherence among young men*A population-based study

The aim is to study the associations between sense of coherence (SOC), and psychopathology and major life events among adolescent boys. The study population consisted of 2314 Finnish boys born during 1981 who attended military call-up (79% of the original sample). At military call-up in 1999, the boys filled in the Young Adult Self-Report (YASR) and Antonovskys Orientation to Life Questionnaire (SOC-13), which measure SOC. In univariate analysis, low parental education level, death and serious illness of parent, parental divorce and high symptom level in all YASR scales were associated with poor SOC. In multivariate analysis, most YASR syndrome scales and fathers education level were independently associated with SOC. The study demonstrates the sensitivity of the SOC-13 scale to a wide range of mental health problems. The results offer additional support to the argument that SOC may be an important global measure for use in both clinical and research purposes in adolescent psychiatry.

Factors associated with reported childhood depressive symptoms at age 8 and later self-reported depressive symptoms among boys at age 18.

AimsThis study aimed to study conditions associated with depressive symptoms at ages 8 and 18 in a representative birth cohort of Finnish males.MethodsThe participants in this community-based 10-year follow-up study consisted of 2,348 boys born in 1981. At age 8, three informant sources were used: parents, teachers, and the children themselves. Depressive symptoms were established using the Children’s Depression Inventory (CDI). At age 18, self-report questionnaires were used to study the boys’ family factors, life events, adaptive functioning, and substance use. Depressive symptoms at age 18 were established using Beck’s Depression Inventory (BDI).ResultsPoor adaptive functioning at age 18 was independently associated with both child and late adolescent depressive symptoms. Use of illicit drugs and somatic health problems were independently associated with later depressive symptoms. Parental divorce in early childhood independently predicted depressive symptoms both in childhood and in late adolescence. Teacher reports of child’s total problems at age 8 independently predicted depressive symptoms at age 18.ConclusionsDepression in males at ages 8 and 18 is particularly associated with stressful life events in childhood, whereas late depression is associated with somatic health problems and substance use. Further population-based studies comparing conditions associated with childhood and adolescent depression are needed.

Childhood Predictors of Military Fitness: A Prospective, Community-Based, Follow-up Study from Age 8 to Age 18

Knowledge of the impact of childhood psychosocial problems on success in military service is scarce. The purpose of the study was to assess whether childhood psychosocial problems are associated with suitability for military service. The subjects were 2,622 Finnish boys born in 1981. They were first assessed with the Rutter parent and teacher questionnaires and self-reports (Childrens Depression Inventory) at age 8. Their suitability for military service was assessed at age 18. A wide range of childhood problems, especially internalizing disorders, predicted release from military service. All informants had predictive association with later suitability for military service. The majority of children with psychiatric problems were later estimated to be fit for military service. The results show a predictive association between childhood psychiatric problems and early adult psychosocial impairment, as estimated by the ability to serve in the military forces.

Obesity, Underweight, and Smoking Are Associated with Worse Cardiorespiratory Fitness in Finnish Healthy Young Men: A Population-Based Study

Background Obesity and smoking are strongly associated with worse cardiorespiratory fitness (CRF). Most previous studies that have examined the association of body composition with CRF have neither assessed non-linearity nor separately examined the effects of underweight. Thus, very little is known on how underweight affects CRF. Possible joint effects of obesity and smoking on CRF have not been adequately explored. Aims We examined the association between body mass index (BMI) and smoking with CRF in 1,629 Finnish army conscripts. We focused on non-linear effects of BMI in order to assess the importance of underweight. We also examined whether the cooccurrence of obesity and smoking potentiates their deleterious effects on CRF. Methods We used the Cooper’s 12-minute run test (12MR) to measure CRF. The 12MR score was analyzed as continuous (linear, polynomial, and restricted cubic spline regression) and categorical. In categorical analyses, we used binary logistic regression with the 12MR score in two groups (low = lowest quintile vs. intermediate/high = quintiles 2–5) and multinomial logistic regression with the 12MR score in three groups (low = lowest quintile, intermediate = quintiles 2 and 3, and high = quintiles 4 and 5). Results Non-linearity in the spline model was statistically significant (p < 0.001). In addition, the non-linear models had a clearly better fit than the linear one in terms of Akaike Information Criterion and R-squared values. There was a statistically significant interaction between smoking and BMI (p < 0.01). In the categorical analysis, overweight/obese regular smokers were at a particularly high risk of not achieving high CRF. Conclusion In healthy young men, not only overweight/obesity but also underweight may be associated with worse CRF. This provides a potential mechanism for the previously reported association between underweight and increased mortality. The cooccurrence of overweight/obesity and regular smoking may have a deleterious effect on CRF.