Juha Veijola

Obesity and depression: results from the longitudinal Northern Finland 1966 Birth Cohort Study

Objective:To examine the association between body size and depression in a longitudinal setting and to explore the connection between obesity and depression in young adults at the age of 31 years.Design:This study forms part of the longitudinal Northern Finland 1966 Birth Cohort Study (N=12u2009058). The follow-up studies were performed at 14 and 31 years. Data were collected by postal inquiry at 14 years and by postal inquiry and clinical examination at 31 years.Subjects:A total of 8451 subjects (4029 men and 4422 women) who gave a written informed consent and information on depression by three depression indicators at 31 years.Measurements:Body size at 14 (body mass index (BMI) and 31 (BMI and waist-to-hip ratio (WHR)) years and depression at 31 years by three different ways: depressive symptoms by the HSCL-25-depression questionnaire (HSCL-25), the use of antidepressants and self-reported physician-diagnosed depression.Results:Obesity at 14 years associated with depressive symptoms at 31 years; among male subjects using the cutoff point 2.01 in the HSCL-25 (adjusted odds ratio (OR) 1.97, 95% CI 1.06–3.68), among female subjects using the cutoff point 1.75 (adjusted OR 1.64, 95% CI 1.16–2.32). Female subjects who were obese both at baseline and follow-up had depressive symptoms relatively commonly (adjusted OR 1.40, 95% CI 1.06–1.85 at cutoff point 1.75); a similar association was not found among male subjects. The proportion of those who used antidepressants was 2.17-fold higher among female subjects who had gained weight compared to female subjects who had stayed normal-weighted (adjusted OR 2.17, 95% CI 1.28–3.68). In the cross-sectional analyses male subjects with abdominal obesity (WHR ⩾85th percentile) had a 1.76-fold risk of depressive symptoms using the cutoff 2.01 in the HSCL-25 (adjusted OR 1.76, 95% CI 1.08–2.88). Abdominally obese male subjects had a 2.07-fold risk for physician-diagnosed depression (adjusted OR 2.07, 95% CI 1.23–3.47) and the proportion of those who used antidepressants was 2.63-fold higher among obese male subjects than among male subjects without abdominal obesity (adjusted OR 2.63, 95% CI 1.33–5.21). Abdominal obesity did not associate with depression in female subjects.Conclusion:Obesity in adolescence may be associated with later depression in young adulthood, abdominal obesity among male subjects may be closely related to concomitant depression, and being overweight/obese both in adolescence and adulthood may be a risk for depression among female subjects.

Birth measures and depression at age 31 years: The Northern Finland 1966 Birth Cohort Study

The aim of the study was to explore whether there is an association between body size at birth measured by birth weight and ponderal index and later depression at the age of 31 years. The analyses were based on 4,007 males and 4,332 females born in 1966 in the two northernmost provinces of Finland with data on current depression measured by the Hopkins Symptom Checklist-25 questionnaire (HSCL-25) and self-reported physician-diagnosed lifetime depression at 31 years and childhood characteristics. The associations between birth measures and later depression were analysed with several confounding factors including maternal depression during pregnancy. Low birth measures did not associate with adult depression in men or women. Women with high birth weight (>or=4,500 g) had a higher risk for current depression compared to women with birth weight 3,000 g-3,499 g. Women with high ponderal index (the highest 90-95 percentiles and >or=95 percentiles) had a 1.53-1.55 higher likelihood for current depression compared with women with normal ponderal index. Based on this study, large body size at birth may be a risk factor for later depression.

Inter-correlations between Cloninger's temperament dimensions-- a meta-analysis.

The Temperament and Character Inventory (TCI) was developed to measure the following temperament dimensions: novelty seeking (NS), harm avoidance (HA), reward dependence (RD) and persistence (P). These four dimensions of temperament were originally proposed to be independent of one another. In this study the inter-relationships between the dimensions were studied with meta-analytic techniques. We also studied the effects of sociodemographic factors (location of the study, mean age and gender distribution) on correlations between temperament dimensions. We searched studies on healthy (non-clinical) populations that used the TCI (version 9), and that had a required sample size of at least 100. The search resulted in 16 articles. The resulted pooled correlation coefficient was medium level between NS and HA (-0.27). Correlations were small for HA-P (-0.20), NS-P (-0.14), NS-RD (0.10), RD-P (0.05) and HA-RD (0.04). In meta-regression, the correlation NS-P was significantly affected by the location of the study (Asian/other) and by the gender distribution of the sample. In the HA-P correlation, the mean age of the sample affected the correlation. In conclusion, we found a medium level negative correlation between NS and HA; other correlations between the dimensions were small. These findings mainly support Cloningers theory of independent dimensions.

Impact of temperament on depression and anxiety symptoms and depressive disorder in a population-based birth cohort

BACKGROUNDnThe aim of this study was to characterize at the population level how innate features of temperament relate to experience of depressive mood and anxiety, and whether these symptoms have separable temperamental backgrounds.nnnMETHODSnThe study subjects were 4773 members of the population-based Northern Finland Birth Cohort 1966, a culturally and genetically homogeneous study sample. Temperament was measured at age 31 using the temperament items of the Temperament and Character Inventory and a separate Pessimism score. Depressive mood was assessed based on a previous diagnosis of depressive disorder or symptoms of depression according to the Hopkins Symptom Check List - 25. Anxiety was assessed analogously.nnnRESULTSnHigh levels of Harm avoidance and Pessimism were related to both depressive mood (effect sizes; d=0.84 and d=1.25, respectively) and depressive disorder (d=0.68 and d=0.68, respectively). Of the dimensions of Harm avoidance, Anticipatory worry and Fatigability had the strongest effects. Symptoms of depression and anxiety showed very similar underlying temperament patterns.nnnLIMITATIONSnAlthough Harm avoidance and Pessimism appear to be important endophenotype candidates for depression and anxiety, their potential usefulness as endophenotypes, and whether they meet all the suggested criteria for endophenotypes will remain to be confirmed in future studies.nnnCONCLUSIONSnPersonality characteristics of Pessimism and Harm avoidance, in particular its dimensions Anticipatory worry and Fatigability, are strongly related to symptoms of depression and anxiety as well as to depressive disorder in this population. These temperamental features may be used as dimensional susceptibility factors in etiological studies of depression, which may aid in the development of improved clinical practice.

Early Environment and Neurobehavioral Development Predict Adult Temperament Clusters

Background Investigation of the environmental influences on human behavioral phenotypes is important for our understanding of the causation of psychiatric disorders. However, there are complexities associated with the assessment of environmental influences on behavior. Methods/Principal Findings We conducted a series of analyses using a prospective, longitudinal study of a nationally representative birth cohort from Finland (the Northern Finland 1966 Birth Cohort). Participants included a total of 3,761 male and female cohort members who were living in Finland at the age of 16 years and who had complete temperament scores. Our initial analyses (Wessman et al., in press) provide evidence in support of four stable and robust temperament clusters. Using these temperament clusters, as well as independent temperament dimensions for comparison, we conducted a data-driven analysis to assess the influence of a broad set of life course measures, assessed pre-natally, in infancy, and during adolescence, on adult temperament. Results Measures of early environment, neurobehavioral development, and adolescent behavior significantly predict adult temperament, classified by both cluster membership and temperament dimensions. Specifically, our results suggest that a relatively consistent set of life course measures are associated with adult temperament profiles, including maternal education, characteristics of the family’s location and residence, adolescent academic performance, and adolescent smoking. Conclusions Our finding that a consistent set of life course measures predict temperament clusters indicate that these clusters represent distinct developmental temperament trajectories and that information about a subset of life course measures has implications for adult health outcomes.

Data on schizotypy and affective scales are gender and education dependent - Study in the Northern Finland 1966 Birth Cohort

We present psychometric properties and normative data by gender and educational level in scales related to schizotypy and affective disorders in a large population-based adult sample. As part of the 31-year follow-up survey of the Northern Finland 1966 Birth Cohort; Bipolar II scale (BIP2), Hypomanic Personality Scale (HPS), Physical Anhedonia Scale (PAS), Social Anhedonia Scale (SAS), Perceptual Aberration Scale (PER) and Schizoidia Scale (SCHD) were filled in by 4928 subjects. In total sample mean scores were: BIP2 10.59 (3.80), HPS 11.26 (7.03), PAS 14.99 (S.D. 7.03), SAS 9.44 (5.52), PER 2.35 (3.26) and SCHD 2.56 (1.42). Men scored higher (had more psychopathological symptoms) in PAS and SAS (P<0.001), and in BIP2 (P=0.02). Women had higher scores in SCHD, HPS and PER (P<0.001). Participants with a lower level of education scored higher in all scales; differences were largest in BIP2, PAS and SAS (ES>0.5,P<0.001). The gender and education differences were moderate or large in all the included scales. These differences should be taken into account when considering normal values in these scales. The findings indicate that commonly used student samples are likely to be biased when compared to community based samples.

Parental separation at birth and depression in adulthood: a long-term follow-up of the Finnish Christmas Seal Home Children

BACKGROUNDnEarly separation of a child from the mother has been considered a risk factor for later depression. We investigated the association between very early separation and depression in adulthood in a unique dataset.nnnMETHODnThe index cohort consisted of 3020 subjects born in 1945-1965 in Finland, isolated from their family due to tuberculosis in the family and placed in special nurseries, immediately after birth, for an average time of 7 months. Those subjects alive at 1 January, 1971 were identified. For every index subject two reference subjects were chosen, the matching criteria being sex, year of birth and place of birth. Data on depression were obtained from the Finnish Hospital Discharge Register by the end of year 1998.nnnRESULTSnIn males, 4.2% of the index subjects and 2.6% (Adjusted Rate Ratio RR 1.7, 95% CI 1.3-2.3) of the reference subjects had been treated in hospital due to a depressive episode. In females the respective figures were 3.9% for index subjects and 3.6% (RR 1.1, 95% CI 0.8-1.5) for reference subjects.nnnCONCLUSIONSnThe index subjects had an elevated risk for hospital treated depression in adulthood. One explanation may be that the very early temporal separation from the mother at birth may have unfavourable effects on later psychological development. On the other hand, separation from the parents at birth was not found to be strongly associated with severe adulthood depression.

Impact of the dopamine receptor gene family on temperament traits in a population-based birth cohort.

Although the genetic determinants of personality have been intensively investigated especially since Cloninger proposed his psychobiological model of temperament and character, findings to date remain inconclusive and very few studies have addressed the topic in large population cohorts. In the current study we investigated one gene family in its entirety by addressing the role of all known dopamine receptor genes, DRD1–DRD5, on Cloningers temperament traits in a Finnish population‐based birth cohort. The study sample (nu2009=u20091,434) was ascertained from the Northern Finland Birth Cohort 1966 with over 5,000 study individuals tested at the age of 31 years. We utilized the genetic homogeneity and genealogical structure of this population to uncover putative effects of these genes on temperament traits at the population level. Our strategy utilizing a large birth cohort and its well established genealogical structure represents an optimal design for studying normally distributed traits. We also wished to provide a comprehensive view to one biologically relevant gene family instead of testing single candidate genes. We report evidence of association of several SNPs at the 5′ end of dopamine receptor D2 (DRD2) with Novelty seeking (low) and Harm avoidance (high), and at the 3′ end of DRD2 with Persistence. The strongest evidence of association emerged from females. Our study supports the involvement of the dopamine pathway in temperament traits, in particular underlining the role of DRD2 in Novelty seeking, Harm avoidance and Persistence.

Temporary parental separation at birth and substance use disorder in adulthood

BackgroundAdversities in the early mother-infant relation pose a hypothetical risk for addiction. We studied the association between very early separation and later development of substance use disorder.MethodA follow-up study was performed of subjects temporarily isolated from their family immediately after birth to adequate nursing homes in order to protect them against morbidity and mortality for tuberculosis. The average separation time was 7 months. The index cohort consisted of 3,020 subjects born in 1945–1965. For every index subject, two reference subjects were matched for sex, year of birth and place of birth. We were able to obtain the SES of the family of origin as recorded in 1971 from Statistics Finland. Finnish Hospital Discharge Register was used to identify subjects with substance use disorder arising from childhood to middle age, between January 1,1971 and December 31, 1998.ResultsThe 28-year cumulative incidence of alcohol use disorders was 4.2% in the index cohort and 3.1% in the reference cohort (rate ratio, RR 1.4, 95% CI 1.1–1.8). The incidences of hospital-treated drug abuse or dependence were 0.6% and 0.2% (RR 2.5, 95% CI 1.2–5.1), respectively. The differences in socioeconomic status of the family of origin did not explain the differences found.ConclusionsSubstance use disorders were more prevalent among subjects temporarily separated at birth from their mothers because of tuberculosis in the family than in the reference cohort. While risks experienced during pregnancy, delivery and childhood are alternative explanations, this result suggests that very early temporal separation from the mother at birth may have had unfavourable but modest effects on later psychological development, including vulnerability to addiction.

The influence of temperament on symptoms and functional outcome in people with psychosis in the Northern Finland 1966 Birth Cohort

OBJECTIVEnTo describe symptom expression and functional outcome in psychotic disorders in relation with temperament traits assessed with the Temperament and Character Inventory (TCI) in a population-based sample.nnnMETHODnAs part of the 31-year follow-up survey of the Northern Finland 1966 Birth Cohort, TCI temperament items were filled in by 4349 members of the cohort. In individuals with psychotic disorders, also positive and negative symptoms and outcome variables were assessed in a 35-year follow-up. Information of TCI and outcomes were available for altogether 41 individuals with psychosis.nnnRESULTnReward dependence (RD) (rho=-0.45) and Persistence (P) (rho=-0.52) were significantly correlated with Positive and Negative Syndrome Scale (PANSS) negative symptoms. Higher P scores predicted higher social and occupational functioning (as measured by Social and Occupational Functioning Assessment Scale [SOFAS]), and higher Harm avoidance (HA) predicted a higher likelihood of being on a disability pension.nnnCONCLUSIONnResults indicate that understanding of personality dimensions support better understanding of outcome and symptom expressions in psychotic disorders.