Markku Koiranen

Genome-wide meta-analysis identifies new susceptibility loci for migraine

Migraine is the most common brain disorder, affecting approximately 14% of the adult population, but its molecular mechanisms are poorly understood. We report the results of a meta-analysis across 29 genome-wide association studies, including a total of 23,285 individuals with migraine (cases) and 95,425 population-matched controls. We identified 12 loci associated with migraine susceptibility (P < 5 × 10−8). Five loci are new: near AJAP1 at 1p36, near TSPAN2 at 1p13, within FHL5 at 6q16, within C7orf10 at 7p14 and near MMP16 at 8q21. Three of these loci were identified in disease subgroup analyses. Brain tissue expression quantitative trait locus analysis suggests potential functional candidate genes at four loci: APOA1BP, TBC1D7, FUT9, STAT6 and ATP5B.

Psychosocial factors as mediators between migration and subjective well-being among young Finnish adults.

This study examined the role of socioeconomic factors (such as education and employment) and psychosocial factors (such as social support, coping and attitude towards the future), in the relationship between migration, self-reported health and life satisfaction among young adults in a 31-year follow-up study of the Northern Finland Birth Cohort 1966 conducted in 1997-1998. The associations between these outcomes and socioeconomic and psychosocial factors were first examined, stratified by gender and migration, for sample members at 23 and at 31 years of age. Regression modelling was then used to study the association between migration and the outcomes after adjusting for specific socioeconomic and psychosocial factors. Results of binary logistic regression models showed that, although there was more dissatisfaction with life and more poor self-reported health in rural areas, the association was derived mostly from the mediation of unemployment, poorer education, lack of social support, passive coping strategies and greater pessimism among people living in rural areas. It is concluded that special attention should be paid to improving living conditions (educational and vocational opportunities) and enhancing the psychosocial resources of young adults in rural and remote areas.

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.

Precariousness and discontinuous work history in association with health

Aims: Precarious type of employment may have a negative impact on health, notably on low psychological wellbeing. The basis of the former relationship is constructed by definition and operationalisation of precariousness. In this research, we first experimented with a construct of work history in the operationalisation of precariousness and second studied the relationship between precariousness and health. Methods: The research data originated from a large population-based birth cohort (NFBC 1966). The study sample consists of 3449 respondents to the postal questionnaire at the age of 31 and the information supplemented by the register data of the Finnish Centre for Pensions. Health was measured by self-reports of doctor-diagnosed/treated illnesses and HSCL-25 for mental symptoms. Results: Our operationalisation with a construct of discontinuous work history captured the precarious insecure relation to work. The precarious workers were found to have proportionally more mental symptoms in comparison with permanent workers. The perception of distress was stronger among precarious workers who perceived high job insecurity. However, there were no differences in doctor-diagnosed/treated illnesses between precarious and permanent workers. Conclusions: The study suggests that the construct of work history is a useful element in defining precariousness. The study also illustrates the association of precariousness, perceived job insecurity, and mental distress. The study suggests further research on disadvantages experienced by precarious workers.

A 28 year follow up of mortality among women who smoked during pregnancy.

Abstract Objective: To investigate long term mortality among women who smoked during pregnancy and those who stopped smoking. Design: A follow up of a geographically defined cohort from 1966 through to 1993. Subjects: 11994 women in northern Finland expected to deliver in 1966, comprising 96% of all women giving birth in the area during that year. Smoking habits were recorded during pregnancy but not later. Main outcome measure: Mortality by cause (571 deaths). Results: The mortality ratio adjusted for age, place of residence, years of education and marital status was 2.3 (95% confidence interval 1.8 to 2.8) for the women who smoked during pregnancy and 1.6 (1.1 to 2.2) for those who stopped smoking before the second month of pregnancy, both compared with non-smokers. Among the smokers the relative mortality was higher for typical diseases related to tobacco intake, such as respiratory and oesophageal cancer and diseases of the cardiovascular and digestic organs and also for accidents and suicides. Conclusion: The risk of premature death seems to be higher in women who smoke during pregnancy than in other women who smoke. This may be explained either by the low proportion of those who stop later and the high proportion of heavy smokers or by other characteristics of thesesubjects that increase the risk.

Maternal build and pregnancy outcome

The effect of maternal build on the outcome of pregnancy was studied in two birth cohorts in Northern Finland, for 1966 and 1985-86. Prospectively collected data were available for 10,969 women in the earlier cohort and 9128 in the later one. The women in the earlier cohort were on average 2.9 cm shorter but 0.2 kg thinner and had 0.7 kg/m2 greater BMI. 13% of the women in the earlier cohort had a BMI below 20, but 24% in the later one, while 96% in both cohorts had BMI below 30. The women with low BMI were on average taller than the others, and at all BMI levels the women of the earlier cohort were shorter and lighter than those of the later one. The outcome of pregnancy was measured by the incidence of pre-term births and perinatal plus childhood deaths up to the age of 4 years, and the association of maternal body measurements with low birth weight (< 2500 g) and small for gestational age (SGA) infants was also studied. An additive logistic regression model was fitted in each analysis, to determine the probability of the outcome separately in terms of BMI, weight and height, adjusting for maternal age, parity, smoking, marital status, fathers social class and place of residence. No evidence was found that BMI values 20-25, commonly judged as optimum for the mothers own longevity, predicted a better prognosis for the child than values below 20.(ABSTRACT TRUNCATED AT 250 WORDS)

Experience of loneliness among adolescent girls and boys: Northern Finland Birth Cohort 1986 study

When an individuals socio-emotional needs are not being adequately met, the subjective and negative feeling of loneliness occurs. Study assessed the experiences of loneliness of 16-year-olds in the Northern Finland Birth Cohort 1986 (n=7014). Most (70.4%) adolescents reported not feeling lonely, 26.4% reported feeling somewhat and 3.2% reported feeling very lonely. Girls reported more loneliness than boys. Multinomial logistic regression was employed to describe the association of selected social, emotional, contextual and health and well-being factors between not lonely and somewhat lonely and between not lonely and very lonely adolescents. All factors grouped as emotional and health and well-being were associated with loneliness experiences, social factors related to family were not. Among girls, an association was found between being somewhat lonely and living in rural areas. Associated factors (not having close friends, feeling unliked, victim of bullying, avoiding company, feeling unhappy, sad, depressed, dissatisfaction with life, poor self-rated health) were similar to somewhat and very lonely, but very lonely adolescents, especially girls, experience them more strongly. It is important to recognise lonely individuals early on to prevent more serious social, emotional and health and well-being problems which loneliness may cause.

Associations of deliberate self-harm with loneliness, self-rated health and life satisfaction in adolescence: Northern Finland Birth Cohort 1986 Study

Background Deliberate self-harm (DSH) is an act with a non-fatal outcome in which an individual initiates a behaviour, such as self-cutting or burning, with the intention of inflicting harm on his or her self. Interpersonal difficulties have been shown to be a risk factor for DSH, but the association between subjective experience of loneliness and DSH have rarely been examined. Objective To examine the frequency of DSH or its ideation and loneliness among 16-year-olds to determine if associations exist between DSH and loneliness, loneliness-related factors, self-rated health and satisfaction with life. Design The study population (n=7,014) was taken from Northern Finland Birth Cohort 1986 (N=9,432). Cross-tabulations were used to describe the frequency of DSH by factors selected by gender. Logistic regression analysis was used to describe the association between DSH and loneliness and other selected factors. Results Nearly 8.7% (n=608) of adolescents reported DSH often/sometimes during the preceding 6 months, with girls (n=488, 13.4%) reporting DSH almost 4 times than that of boys (n=120, 3.6%). Nearly 3.2% of the adolescents (girls: n=149, 4.1%; boys: n=72, 2.2%) expressed that the statement I feel lonely was very/often true, and 26.4% (girls: n=1,265, 34.8%; boys: n=585, 17.4%) expressed that the statement was somewhat/sometimes true. Logistic regression showed that those who reported to be very/often lonely (girls: odds ratio (OR) 4.1; boys: OR 3.2), somewhat/sometimes lonely (girls: OR 2.4; boys: OR 2.4) were dissatisfied with life (girls: OR 3.3; boys: OR 3.3), felt unliked (girls: OR 2.2; boys: OR 6.0) and had moderate self-rated health (girls: OR 2.0; boys: OR 1.7), were more likely to report DSH than those without these feelings. Conclusion The results show that loneliness is associated with DSH, and that loneliness should be considered as a risk for individual health and well-being.

Temperament Clusters in a Normal Population: Implications for Health and Disease

Background The object of this study was to identify temperament patterns in the Finnish population, and to determine the relationship between these profiles and life habits, socioeconomic status, and health. Methods/Principal Findings A cluster analysis of the Temperament and Character Inventory subscales was performed on 3,761 individuals from the Northern Finland Birth Cohort 1966 and replicated on 2,097 individuals from the Cardiovascular Risk in Young Finns study. Clusters were formed using the k-means method and their relationship with 115 variables from the areas of life habits, socioeconomic status and health was examined. Results Four clusters were identified for both genders. Individuals from Cluster I are characterized by high persistence, low extravagance and disorderliness. They have healthy life habits, and lowest scores in most of the measures for psychiatric disorders. Cluster II individuals are characterized by low harm avoidance and high novelty seeking. They report the best physical capacity and highest level of income, but also high rate of divorce, smoking, and alcohol consumption. Individuals from Cluster III are not characterized by any extreme characteristic. Individuals from Cluster IV are characterized by high levels of harm avoidance, low levels of exploratory excitability and attachment, and score the lowest in most measures of health and well-being. Conclusions This study shows that the temperament subscales do not distribute randomly but have an endogenous structure, and that these patterns have strong associations to health, life events, and well-being.

Health and well-being of movers in rural and urban areas – A grid-based analysis of northern Finland birth cohort 1966

We examined the association of health and well-being with moving using a detailed geographical scale. 7845 men and women born in northern Finland in 1966 were surveyed by postal questionnaire in 1997 and linked to 1 km(2) geographical grids based on each subjects home address in 1997-2000. Population density was used to classify each grid as rural (1-100 inhabitants/km²) or urban (>100 inhabitants/km²) type. Moving was treated as a three-class response variate (not moved; moved to different type of grid; moved to similar type of grid). Moving was regressed on five explanatory factors (life satisfaction, self-reported health, lifetime morbidity, activity-limiting illness and use of health services), adjusting for factors potentially associated with health and moving (gender, marital status, having children, housing tenure, education, employment status and previous move). The results were expressed as odds ratios (OR) and their 95% confidence intervals (CI). Moves from rural to urban grids were associated with dissatisfaction with current life (adjusted OR 2.01; 95% CI 1.26-3.22) and having somatic (OR 1.66; 1.07-2.59) or psychiatric (OR 2.37; 1.21-4.63) morbidities, the corresponding ORs for moves from rural to other rural grids being 1.71 (0.98-2.98), 1.63 (0.95-2.78) and 2.09 (0.93-4.70), respectively. Among urban dwellers, only the frequent use of health services (≥ 21 times/year) was associated with moving, the adjusted ORs being 1.65 (1.05-2.57) for moves from urban to rural grids and 1.30 (1.03-1.64) for urban to other urban grids. We conclude that dissatisfaction with life and history of diseases and injuries, especially psychiatric morbidity, may increase the propensity to move from rural to urbanised environments, while availability of health services may contribute to moves within urban areas and also to moves from urban areas to the countryside, where high-level health services enable a good quality of life for those attracted by the pastoral environment.