Ilka Kangas

Making Sense of Depression: Perceptions of Melancholia in Lay Narratives

In the field of lay health knowledge research, little attention has been paid to mental health problems. Drawing on in-depth interviews with depressed people, this article analyses lay theories of depression, focusing on narrative accounts of depression. These narratives were guided and shaped by a core explanation of the individual etiology of depression. Three narrative types were distinguishable: one storyline was based on shortcomings of childhood and adolescence development. A second storyline focused on excessive demands and role-conflicts, presented as causes of work-related burn-out, which developed into or already contained traits of depression. A third storyline was formed along symptom-provoking factors, outlining a story of hardships and severe life events during adulthood, which were reacted to with depression. Apart from the core explanation, the accounts reflected upon other explanations of depression. In revealing individual and social circumstances that create discomfort, depression accounts act as powerful describers of society.

Experience and opinions of climacterium by Finnish women

OBJECTIVE Literature on womens experiences with climacterium is mostly based on patients or on North American women. In this study, the experiences and opinions of Finnish women were investigated. STUDY DESIGN In 1989, a questionnaire was sent to a representative sample of 45-64-year-old Finnish women (n = 2000); 1713 (86%) responded, of which 1308 were postmenopausal. RESULTS Most women (87%) reported their health to be good or rather good. Symptoms were commonly experienced, but each symptom usually by a minority of women. Most subjective health problems were not related to climacterium as such, but were problems also encountered otherwise or related to aging. Some symptoms decreased with increased age, others increased or stayed the same. Comparing the symptoms reported in the past two weeks and womens own judgements suggests that hot flashes and irritability were specific to climacterium. Most women had a neutral or positive opinion of climacterium in general. CONCLUSION Our study challenges the view that climacterium is a time of big subjective health problems.

Hysterectomy among Finnish women: prevalence and women's own opinions

Hysterectomy among furnish women: Prevalence and Womens own Opinions. Luoto R., Hemminki E., Topo P., Uutela A. and Kangas I. University of Helsinki, Department of Public Health Helsinki, Finland This article describes the prevalence of hysterectomy, womens own opinions of it, and socioeconomic characteristics of hysterectomized women compared to non-hysterectomized ones. The questionnaire was sent in spring 1989 to 2000 45 to 64-year-old Finnish women picked randomly from the Population Census. After two reminders, 1713 (86%) had responded. One fifth of the women had had a hysterectomy and 5% had also had both ovaries removed. Among the highest educated there were less hysterectomized women than among the less educated. The largest differences in the prevalence of hysterectomy were between counties, not between socioeconomic groups. Fourtyone percent of the hysterectomized women had themselves wished hysterectomy, 25% did not have any specific opinion about the operation. Results raise further questions about clinical decision making and regional variation of hysterectomy.

Alternative drug use for the climacteric in Finland

OBJECTIVES To investigate the use of alternative drugs for the climacteric in Finland, which products are used, and who are the women using them. METHODS The study was based on a population-based survey conducted in 1989 among 2000 Finnish women aged 45-64 (response rate 86%). RESULTS 11% of the women reported the use of alternative drugs for the climacteric. Food supplements and bee products were the most common types of alternative drugs used. Some of them may have allergic or other side effects. Users differ little from other women judging by health habits and the utilization of health care services. The best predictors for alternative drug use were urban residence, more than 9 years of general education, and among 50 54-year olds, the use of prescription or OTC drugs for menopause. Over half of the users of alternative drugs had also used hormone therapy. CONCLUSIONS Women using alternative drugs during and after the climacteric represent a large group. More information is needed about the clinical effects of alternative drugs, and the characteristics of alternative drug users.