Kalle Romanov

Self-reported hostility and suicidal acts, accidents, and accidental deaths: a prospective study of 21,443 adults aged 25 to 59.

&NA; The association of self‐reported hostility with morbidity and mortality due to external causes, including suicidal acts, was analyzed in 10,586 Finnish men and 10,857 Finnish women aged 24 to 59 years. Hostility was assessed from self‐ratings on irritability, ease of anger‐arousal, and argumentativeness. Three groups, low (33.6% of subjects), intermediate (50.6%), and extreme (15.9%), were formed from the self‐reported hostility scores. A 6‐year mortality follow‐up yielded 76 violent deaths among men and 11 among women. A 4‐year morbidity follow‐up found 399 hospitalizations due to external causes among men and 169 among women. Among men, the risk ratio between the highest and lowest hostility groups was 1.51 (95% confidence interval, 1.16–1.96) for all events due to external causes and 3.6 (95% confidence interval, 1.63–7.89) for suicidal behavior, when effects of age, marital status, social status, and self‐reported alcohol use were controlled in a multivariate model. No association was observed between traffic‐related injuries and hostility. Hostility did not predict accidents or accidental deaths or suicidal behavior among women.

Familial association between allergic disorders and depression in adult Finnish twins

Clinical studies have shown a relationship between allergic disorders and depression, panic disorder, attention deficit/hyperactivity disorder, and social anxiety for a significant subset of patients with these disorders. The nature of the relationship, whether due to shared environmental or biologic vulnerabilities or as a result of the stress of chronic illness, has been less clear. By examining the covariance of atopic disorders and depressive symptoms in a community sample of monozygotic (MZ) and dizygotic (DZ) twins, the contribution of genetic and/or shared environmental etiological factors can be established. A Finnish sample of 1337 MZ and 2506 DZ twin pairs, ages 33-60 years, was sent questionnaires inquiring about history of asthma, eczema, and atopic rhinitis, as well as the Beck Depression Inventory (BDI). The nature of the covariation between twins of these symptoms was investigated by fitting competing genetic and environmental models. Within-person correlation between atopic symptoms and BDI was 0.103 (P < 0.001) for the total sample. Using the Mx statistical modeling program to fit the data to competing quantitative genetic models, the best fitting model estimated that 64% of the association between atopy and BDI was due to shared familial vulnerability, primarily additive genetic influences. Although the measures for allergic disorders and depression are crude, this study supports the hypothesis that there is a small shared genetic risk for atopic and depressive symptoms, and if replicated, may open research for common mechanisms between allergic and depressive disorders. Am. J. Med. Genet. (Neuropsychiatr. Genet.) 96:146-153, 2000.

Smoking behaviour as a predictor of depression among Finnish men and women: a prospective cohort study of adult twins

BACKGROUND Depression is associated with smoking, but the causality of the relationship is debated. The authors examine smoking behaviour as a predictor of depression among the Finnish adult twin population. METHOD Based on responses to surveys in 1975 and 1981, the authors characterized the subjects as never smokers, persistent former smokers, quitters, recurrent smokers and persistent smokers. The Beck Depression Inventory (BDI) was applied in 1990 to measure depression (BDI score >9). Although the population consisted of twins, the authors first considered the subjects as individuals. Logistic regression models were computed for 4164 men and 4934 women. In order to control for family and genetic background, conditional logistic regression analyses were conducted among twin pairs discordant for depression. Bivariate genetic modelling was used to examine genetic and environmental components of the correlation between smoking and depression. RESULTS Among the men, persistent smoking (OR 1 x 42, 95% CI 1 x 07-1 x 89) and smoking in 1975 but quitting by 1981 (OR 1 x 68, 95% CI 1 x 17-2 x 42) was associated with a higher risk of depression, while among the women only the quitters had an elevated risk (OR 1 x 38, 96% CI 1 x 01-1 x 87). The gender x smoking interaction showed persistent smoking to be a stronger risk for men. When family and genetic background were controlled, smoking remained a predictor of depression. Genetic modelling among the men suggested a modest correlation (rg=0 x 25) between genetic components of smoking and depression. CONCLUSIONS Smoking behaviour may be a gender-sensitive predictor of depression, the stronger association in men being partly accounted for by having underlying genes in common.

Interpersonal conflict as a predictor of work disability: A follow-up study of 15,348 finnish employees

This 6-year follow-up study investigates the impact of interpersonal conflict at work on work disability among 8,021 male and 7,327 female employees aged 24 to 65 years at baseline. Marital status, marital conflict, monotonous work, hectic work pace, hostility, neuroticism, life dissatisfaction, and experienced stress of daily activities were included in survival analyses, which were adjusted for age, social status, and general health status. Interpersonal conflict at work predicted work disability only among women (RR 1.56, CL 1.01-2.39). This risk was confined to women who reported simultaneous marital conflicts (RR 2.54, CL 1.03-6.22). When included in further analyses, life dissatisfaction was a significant risk factor among both genders, but monotonous work, neuroticism, and experienced stress of daily activities were risk factors only among men. These data suggest that interpersonal conflict could be a determinant of work disability, and this indicates the importance of gender and marital factors.

Interpersonal conflicts at work and psychosocial characteristics of employees.

Associations of psychosocial factors with interpersonal conflicts at work were studied in a sample drawn from the Finnish population using a mailed questionnaire. The sample consisted of 14,578 employees aged 24-64 years. The frequency of interpersonal conflicts at work was equal among both sexes. Our results suggest that occupational factors such as hectically paced work, monotonous work and white collar status are associated with interpersonal conflicts at work; and more conflicts are found in the younger age-groups. In the multivariate analyses, dissatisfaction with life, daily stress, neuroticism and hostility were found to be the significant risk factors for interpersonal conflicts at work for both sexes, whereas a higher educational level was a considerable risk factor only for men, and low self-assurance only for women. Among men the combination of hectically paced and monotonous work was also found to be a significant risk factor. The results indicate complexity of the concept of human relationships at work, and the importance of both occupational factors and psychological characteristics.

Recent interpersonal conflict at work and psychiatric morbidity: A prospective study of 15,530 employees aged 24–64

Relationships between psychiatric morbidity and interpersonal conflict at work among 15,530 Finnish employees aged 24 to 64 years were studied in a prospective follow-up: 4 years for all psychiatric hospitalizations, 5 years for suicide, and 6 years for long-term medication due to chronic psychosis. The association between interpersonal conflict at work and physician-diagnosed psychiatric morbidity was significant (RR 2.18, 95% CI 1.34-3.54) when results were adjusted for general health status, social class, and mental instability/stress. Results remained significant in additional models adjusted for neuroticism, marital status, conflict with spouse, and high alcohol consumption. The results were similar for both sexes.

Life events and depressiveness – the effect of adjustment for psychosocial factors, somatic health and genetic liability

Objective: To study the nature of the relationship of life events with depressiveness.

Genetic factors in epileptic seizures : evidence from a large twin population

The Finnish Twin Cohort study (27776 individuals; all twins of the same sex born before 1958 and alive in 1967) detected 316 cases of epileptic seizures occurring in 310 twin pairs: 89 monozygotic pairs and 221 dizygotic pairs, including three concordant monozygotic pairs and three concordant dizygotic pairs. The ratio of the observed to expected number of concordant pairs for epileptic seizures was 5.48 (90% CL 1.5–14.2) in monozygotic and 2.12 (90% CL 0.6–5.5) in dizygotic pairs. The results suggest that 8% to 27% of the incidence of epileptic seizures is related to genetic variability. The study of environmental differences in discordant monozygotic pairs should provide insights into the etiology of this group of disorders.

Self-rated depression in 12,063 middle-aged adults

A nationwide epidemiologic study among 5512 men and 6551 women aged 33–60 years in Finland included the 21-item Beck Depression Inventory (BDI). Of the men, 13.5% and, of the women, 20.2% had BDI scores of more than 9, indicating at least mild depression. A BDI score of more than 18 was found in 2.6% of the men and 4.0% of the women, indicating at least moderate depression. Mean BDI scores were higher for women than for men and increased significantly with age. In threc-factor analysis, factor 1 (Performance Impairment) scores increased with age. Increased rates of depression in older subjects might be due to increased somatic symptoms mapping on to Factor 1, which included items such as fatigue, work inhibition, and sleep disturbance. Factor 2 (Negative Attitudes Toward Self) scores with items such as self-dislike, sense of failure, and guilt feelings did not increase with age. When assessing depression in older middle-aged adults, their increased tendency to report somatic symptoms should be noted.

THE USE OF TRANQUILIZERS, HYPNOTICS AND ANALGESICS AMONG 18,592 FINNISH ADULTS: ASSOCIATIONS WITH RECENT INTERPERSONAL CONFLICTS AT WORK OR WITH A SPOUSE

The use of tranquilizers, hypnotics, and analgesics was assessed by a postal questionnaire in a nationwide sample of 18,592 adults aged from 24 to 65 years: 14,800 employees, 2105 housewives and 687 unemployed persons. The use of tranquilizers was most frequent among unemployed persons whereas housewives did not use the studied medicines more than the employed women. In the multivariate analyses (adjusted for age, social class and neuroticism) unmarried status was associated with the use of tranquilizers and hypnotics among both genders. Reported recent interpersonal conflicts both at work and with a spouse were associated with the use of tranquilizers among men, whereas among women significant associations were found only for conflicts with a spouse. These results indicate that domestic factors are more likely to predict womens tranquilizer use.