Kaisa Haatainen

Is the Beck Depression Inventory suitable for screening major depression in different phases of the disease

This prospective study aimed to assess the suitability of the 21-item Beck Depression Inventory (BDI-21) as a screening method for current episodes of major depressive disorder in different phases of the disease. In a sample of treatment-seeking outpatients (n=125), a structured interview method (SCID) was used twice with a 2-year interval to screen whether the patient had a current episode of major depressive disorder. The validity of the BDI-21 was also analysed by means of receiver operating characteristic (ROC) curves. The results showed that with a cut-off point of 14/15 the BDI-21 can be used to indicate the presence of a major depressive episode regardless of the phase of the major depressive disorder. The sensitivity and specificity were quite satisfactory with this cut-off point. The areas under the ROC curves were large (0.81 at baseline and 0.93 at follow-up). The same BDI-21 cut-off point is suitable for screening major depression among outpatients in any phase of the disease.

Impact of multiple traumatic experiences on the persistence of depressive symptoms--a population-based study.

The objective of this population-based study was to determine whether traumatic experiences in general, and multiple traumatic experiences in particular, are associated with persistent self-rated depressive symptoms in adult Finnish subjects over 2 years of follow-up. The study sample included 1405 subjects aged 25–64 years. Subjects (n=217) who were depressed both at baseline in 1999 and on follow-up 2 years later in 2001 (having persistent depressive symptoms) were compared with subjects (n=987) having no depressive symptoms either at baseline or on follow-up. All six categories of traumatic experiences (wartime experience, natural disaster, life-threatening accident, victim of violent crime, domestic violence and childhood sexual abuse) pertained to the respondents’ whole life span. Odds ratios, adjusted for significant covariates, were obtained from multiple logistic regression models that estimated the likelihood of persistent depressive symptoms in different trauma categories. Persistent depressive symptoms had a significant positive graded relationship with the number of traumatic experiences. The adjusted odds of persistent depression was 6.05 (95% CI 1.76–20.7) for men and 6.99 (95% CI 2.69–18.2) for women in those with three or more traumatic experiences compared with those with no such experiences at all. Multiple traumatic experiences substantially increase the likelihood of persistent depressive symptoms. Mental health intervention, as early as possible, may serve to prevent the chronicity of depressive reactions among victims of multiple traumas.

Association of depressive symptoms and metabolic syndrome in men

Objective:  To explore the relationship between several indicators of depression and metabolic syndrome (MetS).

Is alexithymia a risk factor for major depression, personality disorder, or alcohol use disorders? A prospective population-based study

OBJECTIVE Disagreements concerning the stability of alexithymia and its ability to predict subsequent psychiatric disorders prevail. The aim of this 7-year follow-up study was to examine whether alexithymia predicts subsequent major depression, personality disorder, or alcohol use disorders in a population-based sample. METHODS The four-phase Kuopio Depression Study (KUDEP) was conducted in the eastern part of Central Finland. The study population (aged 25-64, n=2050) was randomly selected from the National Population Register. Data were collected in 1998, 1999, and 2001. In 2005, a subsample (n=333, 43 were excluded) of the 3-year follow-up population (1998-2001) was gathered and their diagnoses of mental disorders were confirmed by the Structure Clinical Interview for DSM-IV Axis I (SCID-I). Alexithymia was measured using the Toronto Alexithymia Scale (TAS-20) and depressive symptoms using the Beck Depression Inventory (BDI-21). For both of these measures, two groups were formed based on the median of their sum score (summing the 1998, 1999, and 2001 scores). Logistic regression analyses were performed. RESULTS BDI sum scores, but not those of TAS, were associated with subsequent major depressive disorder, personality disorder, and alcohol use disorders in 2005. The BDI sum scores explained 35.7% of the variation in concurrent TAS sum scores. CONCLUSION Alexithymia did not predict diagnoses of major depressive disorder, personality disorder, or alcohol use disorders. Alexithymia was closely linked to concurrent depressive symptoms. Thus, depressive symptoms may act as a mediator between alexithymia and psychiatric morbidity.

Daily tea drinking is associated with a low level of depressive symptoms in the Finnish general population

Tea drinking has been suggested to be beneficial in neurodegenerative diseases where depressive mood is a common symptom. Nevertheless, it is not known whether there are any associations between tea drinking and depression in general populations. In this study we investigated these associations in a sample of the Finnish general population (n = 2011) using a postal questionnaire and the Beck Depression Inventory (BDI). Those who reported drinking tea daily were less depressed than the others. They had a lower mean BDI score and also a lower prevalence of depression. None of those whose daily tea intake was five cups or more had depression. Several potential confounding factors were included in the final sex- and age-adjusted multivariate logistic regression model which suggested that those who drink tea daily may have a significantly reduced risk of being depressed (adjusted odds ratio 0.47, 95 confidence interval 0.27–0.83). In conclusion, an inverse relationship between daily tea drinking and the risk of being depressed was found in a relatively large general population sample. Nevertheless, the underlying mechanisms are unresolved and further studies are needed.

Somatoform Dissociation and Adverse Childhood Experiences in the General Population

Childhood trauma has been associated with psychological dissociation, but there is evidence that trauma may also result in somatoform dissociation. We performed a general population study with 1739 subjects, using the Somatoform Dissociation Questionnaire, measures of adverse childhood experiences, and sociodemographic background. The prevalence of high somatoform dissociation (Somatoform Dissociation Questionnaire ≥30) was 9.4% in the Finnish general population. Unemployment, a reduced working ability, and a poor financial situation were associated with high somatoform dissociation. Of the adverse childhood experiences, high somatoform dissociation was strongly linked to physical punishment but not associated with domestic violence, including sexual and physical abuse. The odds of high somatoform dissociation were also increased among men by a poor relationship between their parents, and among women by alcohol abuse in their childhood home. We found a strong, graded relationship between an increasing number of adverse childhood experiences and high somatoform dissociation.

Ftors Associated with Hopelessness: A Population Study

Background: Hopelessness is associated with depression and suicidality in clinical as well as in non-clinical populations. However, data on the prevalence of hopelessness and the associated factors in general population are exiguous. Aims: To assess the prevalence and the associated factors of hopelessness in a general population sample. Methods: The random population sample consisted of 1722 subjects. The study questionnaires included the Beck Hopelessness Scale (HS), Beck Depression Inventory (BDI), Toronto Alexithymia Scale (TAS-20) and Life Satisfaction Scale (LS). Results: Eleven percent of the subjects reported at least moderate hopelessness. A poor financial situation (OR 3.64), poor subjective health (OR 2.87) and reduced working ability (OR 2.67) independently associated with hopelessness. Moreover, the likelihood of moderate or severe hopelessness was significantly increased in subjects dissatisfied with life (OR 5.99), with depression (OR 4.86), with alexithymia (OR 2.37) and with suicidal ideation (OR 1.85). Conclusions: This study demonstrated a moderately high prevalence of hopelessness at the population level. Hopelessness appears to be an important indicator of low subjective well-being in the general population that health care personnel should pay attention to.

Advanced nursing roles: A systematic review

In this systematic literature review, we analyzed and synthesized the literature on one specialized advance practice nursing role in three countries for the purpose of describing and comparing these roles, as well as discussing whether an international consensus of the advance practice nursing definition is possible. A systematic search on CINAHL and PubMed Medline was conducted in 2011 to search the literature on the nurse consultant in the UK, the clinical nurse specialist in the USA, and the clinical nurse consultant in Australia. The studies (n = 42) were analyzed and combined using qualitative content analysis method. The roles of the nurse consultant, clinical nurse specialist, and clinical nurse consultant were similar. The variation in the roles appears to derive from organizational or individual choices, not the country in question. The study process comprised a synthesized representation of one specialized advance practice nursing role. More work is needed to further define the concept of the advance practice nursing, as well as its implementation on other cultures beyond this review. Based on this review, an international consensus regarding the definition of advance practice nursing and its subroles is possible.

Gender differences in the association of adult hopelessness with adverse childhood experiences

Abstract.Background: The impact of childhood traumatic events on long-term psychological development has been widely studied. Nevertheless, little research has been carried out on possible associations between adverse childhood experiences (ACEs) and hopelessness in adulthood, and whether any gender differences exist. Aim: The aim of this study was to examine the association between ACEs (poor relationship between parents, unhappiness of childhood home, hard parenting, physical punishment, domestic violence, alcohol abuse in primary family) and current hopelessness without any mental disorder in a general population sample. Method: 1598 adults (43 % were men), aged 25–64 years, completed self-report measures to assess ACEs and hopelessness by means of the Beck Hopelessness Scale (HS). Logistic regression was used to adjust for the effects of sociodemographic factors on the association between the cumulative number of ACEs and hopelessness. Results: Whereas several bivariate associations were found between ACEs and hopelessness, none of them remained significant in multivariate analysis. However, men who reported three or more ACEs were 2.79 times (95 % CI 1.17–6.63) and women 2.19 times (95 % CI 1.04–4.65) more likely to be hopeless compared with those without any ACEs. In women (OR 2.25, 95 % CI 1.01–5.00), but not in men, this relationship remained significant after adjusting for several current covariates. Conclusion: Clustering of ACEs may have long-lasting effects by increasing the risk of hopelessness in adulthood, especially in women. Increased awareness of the frequency of ACEs and their subsequent consequences, such as hopelessness, may encourage health care professionals to undertake preventive work in primary and mental health care.

Adverse childhood experiences, stressful life events or demographic factors : which are important in women's depression? A 2-year follow-up population study

OBJECTIVE The aim of this study was to simultaneously test adverse background factors, namely adverse childhood experiences (ACEs), stressful life events and prior depressive symptoms, for their ability to predict recovery and non-recovery from depression in women among the general population. METHOD A stratified random sample of women (n = 835) from the general population was collected at baseline in 1999. Depression (Beck Depression Inventory, BDI-21), ACEs and background factors were assessed by postal questionnaire at baseline. Two years later, stressful life events during the study phase, social support, use of health services and current depression (BDI > or = 13) were similarly assessed. RESULTS Adverse childhood experiences were common among depressed women and these past experiences together with the use of health services were associated with recovery from depression. Financial difficulties and a poor subjective health status associated with non-recovery and current stressful life events increased the likelihood of depression on follow-up. Furthermore, the important variables explaining depression on follow-up were the quality of social support and the existence of prior depressive symptoms at baseline. CONCLUSIONS Our results suggest that womens current depression especially associates with stressful life events, insufficient social support, poor subjective health and financial difficulties. It seems possible that past adverse experiences predispose women to depression, but current stressful events actualize these symptoms. In addition, use of health services are associated with recovery in women who had ACEs.