Geographical variation in treated psychotic and other mental disorders in Finland by region and urbanicity

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Suokas, KimmoFaculty of Social Sciences, Tampere University, Arvo Ylpön katu 34 (Arvo 1), Tampere, Finland (author)

Geographical variation in treated psychotic and other mental disorders in Finland by region and urbanicity

Article/chapterEnglish2024

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Springer,2024
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LIBRIS-ID:oai:DiVA.org:umu-212512
https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-212512URI
https://doi.org/10.1007/s00127-023-02516-xDOI

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Language:English
Summary in:English

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Purpose: In Finland, prevalence of schizophrenia is higher in the eastern and northern regions and co-occurs with the distribution of schizophrenia polygenic risk scores. Both genetic and environmental factors have been hypothesized to contribute to this variation. We aimed to examine the prevalence of psychotic and other mental disorders by region and degree of urbanicity, and the impacts of socio-economic adjustments on these associations.Methods: Nationwide population registers from 2011 to 2017 and healthcare registers from 1975 to 2017. We used 19 administrative and three aggregate regions based on the distribution of schizophrenia polygenic risk scores, and a seven-level urban–rural classification. Prevalence ratios (PRs) were calculated by Poisson regression models and adjusted for gender, age, and calendar year (basic adjustments), and Finnish origin, residential history, urbanicity, household income, economic activity, and physical comorbidity (additional adjustments) on an individual level. Average marginal effects were used to visualize interaction effects between region and urbanicity.Results: A total of 5,898,180 individuals were observed. All mental disorders were slightly more prevalent (PR 1.03 [95% CI, 1.02–1.03]), and psychotic disorders (1.11 [1.10–1.12]) and schizophrenia (1.19 [1.17–1.21]) considerably more prevalent in eastern and northern than in western coastal regions. After the additional adjustments, however, the PRs were 0.95 (0.95–0.96), 1.00 (0.99–1.01), and 1.03 (1.02–1.04), respectively. Urban residence was associated with increased prevalence of psychotic disorders across all regions (adjusted PR 1.21 [1.20–1.22]).Conclusion: After adjusting for socioeconomic and sociodemographic factors, the within-country distribution of mental disorders no longer followed the traditional east–west gradient. Urban–rural differences, on the other hand, persisted after the adjustments.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Psykiatri hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Psychiatry hsv//eng
Geographical
Mental disorders
Prevalence
Schizophrenia
Social determinants
Urbanicity

Added entries (persons, corporate bodies, meetings, titles ...)

Kurkela, OlliFaculty of Social Sciences, Tampere University, Arvo Ylpön katu 34 (Arvo 1), Tampere, Finland; National Institute for Health and Welfare, Helsinki, Finland; Laurea University of Applied Sciences, Vantaa, Finland (author)
Nevalainen, JaakkoFaculty of Social Sciences, Tampere University, Arvo Ylpön katu 34 (Arvo 1), Tampere, Finland (author)
Suvisaari, JaanaNational Institute for Health and Welfare, Helsinki, Finland (author)
Hakulinen, ChristianDepartment of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Department of Health and Social Care Systems, National Institute for Health and Welfare, Helsinki, Finland (author)
Kampman, OlliUmeå universitet,Psykiatri,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Psychiatry, The Pirkanmaa Wellbeing Services County, Tampere, Finland; Faculty of Medicine, Department of Clinical Medicine (Psychiatry), University of Turku, Turku, Finland; Department of Psychiatry, The Wellbeing Services County of Ostrobothnia, Seinäjoki, Finland(Swepub:umu)kaol0168 (author)
Pirkola, SamiFaculty of Social Sciences, Tampere University, Arvo Ylpön katu 34 (Arvo 1), Tampere, Finland; Tampere University Hospital, Tampere, Finland (author)
Faculty of Social Sciences, Tampere University, Arvo Ylpön katu 34 (Arvo 1), Tampere, FinlandFaculty of Social Sciences, Tampere University, Arvo Ylpön katu 34 (Arvo 1), Tampere, Finland; National Institute for Health and Welfare, Helsinki, Finland; Laurea University of Applied Sciences, Vantaa, Finland (creator_code:org_t)

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In:Social Psychiatry and Psychiatric Epidemiology: Springer59, s. 37-490933-79541433-9285

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By the author/editor: Suokas, Kimmo; Kurkela, Olli; Nevalainen, Jaak ...; Suvisaari, Jaana; Hakulinen, Chris ...; Kampman, Olli; show more...; Pirkola, Sami; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Psychiatry

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By the university: Umeå University

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