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  • Choi, M. J., et al. (författare)
  • Suicide associated with COVID-19 infection : an immunological point of view
  • 2021
  • Ingår i: European Review for Medical and Pharmacological Sciences. - Rome, Italy : VERDUCI PUBLISHER. - 1128-3602 .- 2284-0729. ; 25:20, s. 6397-6407
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: Coronavirus disease 2019 (COVID-19) is a pandemic and leading cause of death. Beyond the deaths directly caused by the virus and the suicides related to the psychological response to the dramatic changes as socioeconomic related to the pandemic, there might also be suicides related to the inflammatory responses of the infection. Infection induces inflammation as a cytokine storm, and there is an increasing number of studies that report a relationship between infection and suicide. MATERIALS AND METHODS: We searched the World Health Organization status report and the PubMed database for keywords (COVID-19, suicide, infection, inflammation, cytokines), and reviewed five cytokine pathways between suicide and inflammation using two meta-analyses and two observational studies starting from November 31, 2020, focusing on the relationship between suicide and inflammation by infection. First, we discussed existing evidence explaining the relationship between suicidal behaviors and inflammation. Second, we summarized the inflammatory features found in COVID-19 patients. Finally, we highlight the potential for these factors to affect the risk of suicide in COVID-19 patients. RESULTS: Patients infected with COVID-19 have high amounts of IL-1 beta, IFN-gamma, IP10, and MCP1, which may lead to Th1 cell response activation. Also, Th2 cytokines (e.g., IL-4 and IL-10) were increased in COVID-19 infection. In COVID-19 patients, neurological conditions, like headache, dizziness, ataxia, seizures, and others have been observed. CONCLUSIONS: COVID-19 pandemic can serve as a significant environmental factor contributing directly to increased suicide risk; the role of inflammation by an infection should not be overlooked.
  • Leinsalu, Mall, 1958-, et al. (författare)
  • Economic fluctuations and urban-rural differences in educational inequalities in mortality in the Baltic countries and Finland in 2000-2015 : a register-based study
  • 2020
  • Ingår i: International Journal for Equity in Health. - : BioMed Central. - 1475-9276 .- 1475-9276. ; 19:1
  • Tidskriftsartikel (refereegranskat)abstract
    • We examined urban-rural differences in educational inequalities in mortality in the Baltic countries (Estonia, Latvia, Lithuania) and Finland in the context of macroeconomic changes. Educational inequalities among 30-74 year olds were examined in 2000-2003, 2004-2007, 2008-2011 and 2012-2015 using census-linked longitudinal mortality data. We estimated age-standardized mortality rates and the relative and slope index of inequality. Overall mortality rates were larger in rural areas except among Finnish women. Relative educational inequalities in mortality were often larger in urban areas among men but in rural areas among women. Absolute inequalities were mostly larger in rural areas excepting Finnish men. Between 2000-2003 and 2012-2015 relative inequalities increased in most countries while absolute inequalities decreased except in Lithuania. In the Baltic countries the changes in both relative and absolute inequalities tended to be more favorable in urban areas; in Finland they were more favorable in rural areas. The overall pattern changed during the reccessionary period from 2004-2007 to 2008-2011 when relative inequalities often diminished or the increase slowed, while the decrease in absolute inequalities accelerated with larger improvements observed in urban areas. Despite substantial progress in reducing overall mortality rates in both urban and rural areas in all countries, low educated men and women in rural areas in the Baltic countries are becoming increasingly disadvantaged in terms of mortality reduction.
  • Isaksson, Johan, et al. (författare)
  • Risk Factors Associated with Alcohol Use in Early Adolescence among American Inner-City Youth : A Longitudinal Study
  • 2020
  • Ingår i: Substance Use & Misuse. - : Taylor & Francis Group. - 1082-6084 .- 1532-2491. ; 55:3, s. 358-366
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Early alcohol use is associated with an increased risk for later alcohol dependence, as well as social and mental health problems. In this study, we investigate the risk factors (internalizing and externalizing behaviors) associated with early alcohol consumption over a period of 1 year, and examine whether the association is sex-specific. Methods: U.S. inner-city adolescents (N = 1785, Mean age = 12.11) were assessed and reassessed in the sixth and seventh grades (Mean age = 13.10). Self-reported information was obtained on the lifetime level of alcohol consumption, internalizing (depression, anxiety and posttraumatic stress [PTS]), and externalizing behaviors (sensation seeking, conduct problems and affiliation with delinquent peers). Associations between the variables were examined using structural equation modeling (SEM). Results: In an adjusted SEM analysis drinking by the sixth grade was primarily associated with externalizing behaviors, whereas PTS was linked to lower levels of alcohol consumption. In addition, alcohol consumption and greater externalizing behaviors by the sixth grade predicted higher alcohol consumption by the seventh grade, whereas anxiety and African American ethnicity were associated with less alcohol consumption. No sex differences were found in the association between internalizing and externalizing behaviors and drinking. However, in the adjusted SEM analysis female sex predicted higher lifetime consumption by the seventh grade. Conclusion: Sensation seeking behavior, conduct problems and affiliation with delinquent peers should be regarded as risk factors and taken into consideration when planning prevention efforts in order to decrease alcohol use in early adolescence.
  • Isaksson, Johan, et al. (författare)
  • Risky sexual behaviour among Russian adolescents : association with internalizing and externalizing symptoms
  • 2021
  • Ingår i: Child and Adolescent Psychiatry and Mental Health. - : Springer Nature. - 1753-2000 .- 1753-2000. ; 15:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Risky sexual behaviour (RSB) is regarded as a major health problem during adolescence. Russia has one of the highest rates of teenage pregnancy, abortion and newly diagnosed HIV infections in the world, but research on RSB in Russian youth has been limited. To address this deficit, this study examined the role of several factors, including internalizing and externalizing symptoms, in RSB among Russian adolescents.METHODS: Self-reported data were collected from 2573 Russian adolescents aged 13-17 years old (59.4 % girls; Mean age = 14.89) regarding RSB (unprotected sex, early pregnancy, multiple sexual partners and substance use during sexual encounters). Information was also obtained on externalizing (conduct problems and delinquent behaviour) and internalizing (depression, anxiety and posttraumatic stress) symptoms, as well as interpersonal risk and protective factors (affiliation with delinquent peers, parental involvement and teacher support). Hierarchical multiple binary logistic regression analysis was used to examine the associations between these variables and RSB.RESULTS: Boys reported engaging in more RSB than girls. Externalizing symptoms and affiliation with delinquent peers were most strongly associated with RSB, whereas symptoms of anxiety were negatively associated with RSB. There was an interaction effect for sex and affiliation with delinquent peers on RSB with boys reporting RSB when having more delinquent peers. Neither parental involvement nor teacher support were protective against RSB.CONCLUSIONS: Early detection of and interventions for RSB and associated externalizing symptoms may be important for adolescent physical and mental wellbeing. Affiliation with delinquent peers should, especially among boys, be regarded as a risk marker for RSB.
  • Isaksson, J., et al. (författare)
  • The danger of being inattentive – ADHD symptoms and risky sexual behaviour in Russian adolescents
  • 2017
  • Ingår i: European psychiatry. - : Elsevier. - 0924-9338 .- 1778-3585. ; :47, s. 42-48
  • Tidskriftsartikel (refereegranskat)abstract
    • AbstractBackground Prior research has indicated that attention-deficit/hyperactivity disorder (ADHD) symptoms may be associated with an increased likelihood of engaging in risky sexual behaviour (RSB). However, research on this association among adolescents has been comparatively limited and mainly confined to North America. The aim of this study was to examine if inattention and hyperactivity/impulsivity symptoms were linked to RSB in a community cohort sample of Russian adolescents. Methods The study was based on a group of 537 adolescents from Northern Russia. Information on inattention and hyperactivity/impulsivity as well as conduct problems was obtained through teacher ratings, while information on RSB (previous unprotected sex, number of sexual partners, sex while intoxicated and partner pregnancies), substance use, perception of risk, and parenting behaviour was based on students’ self-reports. Binary logistic regression analysis was used to examine associations between the variables. Results Teacher-rated inattention symptoms predicted RSB, independently of co-morbid conduct problems, substance use, risk perception, and different parenting styles (parental warmth, involvement and control). In addition, male sex, binge drinking and a lower assessment of perceived risk were all significantly associated with RSB in an adjusted model. Neither teacher-rated hyperactivity/impulsivity symptoms nor conduct problems were linked to RSB in the full model. Conclusions Deficits in planning and organizing behaviours, being easily distracted and forgetful seem to be of importance for RSB in Russian adolescents. This highlights the importance of discriminating between different types of ADHD symptoms in adolescence to prevent risk behaviours and their potentially detrimental outcomes on health and well-being.
  • Isaksson, Johan, et al. (författare)
  • The Role of Gender in the Associations Among Posttraumatic Stress Symptoms, Anger, and Aggression in Russian Adolescents.
  • 2020
  • Ingår i: Journal of Traumatic Stress. - : John Wiley & Sons. - 0894-9867 .- 1573-6598. ; 33:4, s. 552-563
  • Tidskriftsartikel (refereegranskat)abstract
    • Symptoms of posttraumatic stress disorder (PTSD) have been linked to anger and aggressive behavior in adult and veteran populations. However, research on the associations among anger, aggression, and PTSD in adolescents is lacking, particularly regarding differences between the sexes. To address this research gap, we used self-report data from Russian adolescents (N = 2,810; age range: 13-17 years) to perform a full path analysis examining the associations between PTSD symptoms and the emotional (anger traits) and cognitive (rumination) components of anger as well as physical/verbal and social aggression, after adjusting for depressive symptoms. We also examined the interaction effects between PTSD symptoms and sex on anger and aggression. The results indicated that girls scored higher on measures of anger and PTSD symptoms, ds = 0.20-0.32, whereas boys scored higher on measures of physical and verbal aggression, d = 0.54. Clinical levels of PTSD symptoms were associated with anger rumination, β = .16, and trait anger, β = .06, and an interaction effect for PTSD symptoms and sex was found for aggression, whereby boys with clinical levels of PTSD symptoms reported more physical/verbal and social aggression, βs = .05 and .20, respectively. Our findings suggest that PTSD symptoms may have an important impact on anger, anger rumination, and aggression during adolescence. In particular, boys seem to have an increased risk for aggressive behavior in the presence of PTSD symptoms. The present results highlight the importance of taking anger and aggression into account when evaluating PTSD.
  • Jukkala, Tanya, et al. (författare)
  • Age, period and cohort effects on suicide mortality in Russia, 1956-2005
  • 2017
  • Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458 .- 1471-2458. ; 17
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Russian suicide mortality rates changed rapidly over the second half of the twentieth century. This study attempts to differentiate between underlying period and cohort effects in relation to the changes in suicide mortality in Russia between 1956 and 2005. Methods: Sex-and age-specific suicide mortality data were analyzed using an age-period-cohort (APC) approach. Descriptive analyses and APC modeling with log-linear Poisson regression were performed. Results: Strong period effects were observed for the years during and after Gorbachev ' s political reforms (including the anti-alcohol campaign) and for those following the break-up of the Soviet Union. After mutual adjustment, the cohort-and period-specific relative risk estimates for suicide revealed differing underlying processes. While the estimated period effects had an overall positive trend, cohort-specific developments indicated a positive trend for the male cohorts born between 1891 and 1931 and for the female cohorts born between 1891 and 1911, but a negative trend for subsequent cohorts. Conclusions: Our results indicate that the specific life experiences of cohorts may be important for variations in suicide mortality across time, in addition to more immediate effects of changes in the social environment.
  • Kanamori, Mariko, et al. (författare)
  • Does increased migration affect the rural-urban divide in suicide? A register-based repeated cohort study in Sweden from 1991 to 2015
  • 2022
  • Ingår i: Population, Space and Place. - 1544-8444 .- 1544-8452. ; 28:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Some countries have high suicide rates in rural areas with a potentially stronger impact of rural context on foreign-born residents. In Sweden, where immigration has been increasing, dispersion policies have directed refugees/migrants to settle in rural areas. We examined whether trends in suicide mortality vary by nativity and rurality. A repeated cohort study was designed using Swedish national register data between 1991 and 2015. Our three-level analysis found that male suicide rates in rural areas were 1.2 times higher than in urban areas, with the rate decreasing over time in both urban and rural areas. We observed fluctuations in suicide mortality among foreign-born men residing in small rural communities, with high suicide rates in the 2000s. The proportion of unemployed was linked to the excess rate of suicide in rural municipalities. Dispersion policies moving migrants to rural areas should take into account the regional characteristics both within municipalities (e.g., income distribution) and between municipalities (e.g., labour market characteristics).
  • Kim, J. H., et al. (författare)
  • Environmental risk factors, protective factors, and peripheral biomarkers for ADHD : an umbrella review
  • 2020
  • Ingår i: Lancet psychiatry. - : Elsevier. - 2215-0374 .- 2215-0366. ; 7:11, s. 955-970
  • Forskningsöversikt (refereegranskat)abstract
    • Background: Many potential environmental risk factors, environmental protective factors, and peripheral biomarkers for ADHD have been investigated, but the consistency and magnitude of their effects are unclear. We aimed to systematically appraise the published evidence of association between potential risk factors, protective factors, or peripheral biomarkers, and ADHD. Methods: In this umbrella review of meta-analyses, we searched PubMed including MEDLINE, Embase, and the Cochrane Database of Systematic Reviews, from database inception to Oct 31, 2019, and screened the references of relevant articles. We included systematic reviews that provided meta-analyses of observational studies that examined associations of potential environmental risk factors, environmental protective factors, or peripheral biomarkers with diagnosis of ADHD. We included meta-analyses that used categorical ADHD diagnosis criteria according to DSM, hyperkinetic disorder according to ICD, or criteria that were less rigorous than DSM or ICD, such as self-report. We excluded articles that did not examine environmental risk factors, environmental protective factors, or peripheral biomarkers of ADHD; articles that did not include a meta-analysis; and articles that did not present enough data for re-analysis. We excluded non-human studies, primary studies, genetic studies, and conference abstracts. We calculated summary effect estimates (odds ratio [OR], relative risk [RR], weighted mean difference [WMD], Cohen's d, and Hedges' g), 95% CI, heterogeneity I2 statistic, 95% prediction interval, small study effects, and excess significance biases. We did analyses under credibility ceilings, and assessed the quality of the meta-analyses with AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews 2). This study is registered with PROSPERO, number CRD42019145032. Findings: We identified 1839 articles, of which 35 were eligible for inclusion. These 35 articles yielded 63 meta-analyses encompassing 40 environmental risk factors and environmental protective factors (median cases 16 850, median population 91 954) and 23 peripheral biomarkers (median cases 175, median controls 187). Evidence of association was convincing (class I) for maternal pre-pregnancy obesity (OR 1·63, 95% CI 1·49 to 1·77), childhood eczema (1·31, 1·20 to 1·44), hypertensive disorders during pregnancy (1·29, 1·22 to 1·36), pre-eclampsia (1·28, 1·21 to 1·35), and maternal acetaminophen exposure during pregnancy (RR 1·25, 95% CI 1·17 to 1·34). Evidence of association was highly suggestive (class II) for maternal smoking during pregnancy (OR 1·6, 95% CI 1·45 to 1·76), childhood asthma (1·51, 1·4 to 1·63), maternal pre-pregnancy overweight (1·28, 1·21 to 1·35), and serum vitamin D (WMD −6·93, 95% CI −9·34 to −4·51). Interpretation: Maternal pre-pregnancy obesity and overweight; pre-eclampsia, hypertension, acetaminophen exposure, and smoking during pregnancy; and childhood atopic diseases were strongly associated with ADHD. Previous familial studies suggest that maternal pre-pregnancy obesity, overweight, and smoking during pregnancy are confounded by familial or genetic factors, and further high-quality studies are therefore required to establish causality.
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