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Biomedical subjects

M Joukamaa

Publications and source records attributed to M Joukamaa.

At least 55 records · Page 3Linked to original sources
PubMed1995

The ability of general practitioners to detect mental disorders in primary health care.

The ability to detect mental disorders varies greatly among general practitioners in primary health care. The aim of this study was to determine the factors underlying the differences between general practitioners in the ability to recognize mental disorders in Finnish patient populations. The group studied consisted of 1000 randomly selected adult patients of primary care facilities in the city of Turku. The Symptom Checklist (SCL-25) was used as the reference method in the identification of psychiatric cases. According to the SCL-25, one fourth of the sample had mental disorders. A good recognition ability was associated with postgraduate psychiatric training and qualification as a specialist in general practice. Surprisingly, Balint group training, which is a method intended to improve the ability of general practitioners to manage their patients' mental health problems, was associated rather with poor than good detection ability.

Adult↗
PubMed1995

Are frequent attenders of primary health care distressed?

OBJECTIVE: To measure the level of distress among frequent attenders of primary health care. DESIGN: A cross-sectional study. SETTING: Two public primary health care stations in Turku, south-western Finland PARTICIPANTS: 96 frequent attenders (eleven or more visits to a physician during the previous 12 months) and 466 control patients. MAIN OUTCOME MEASURE: SCL-25, GP evaluations, self-reported symptoms and self-experienced need for care. RESULTS: Frequent attenders were significantly more distressed than other patients in primary care. However, their self-experienced need for psychiatric care was very low and it did not differ from other patients self-experienced need. The GPs estimated that over 1/3 of frequent attenders suffered from mixed (physical and psychiatric) illnesses and over 1/2 from subclinical or clinical psychiatric symptoms. The corresponding proportions for other patients were significantly lower.

Cross-Sectional Studies↗
PubMed1994

Frequent attenders of Finnish public primary health care: sociodemographic characteristics and physical morbidity.

In this article results of a Finnish study on frequent attender patients of public primary health care are reported. These patients (n = 96) were compared with other patients (n = 466) attending the same surgeries. Frequent attender patients tended to have lower vocational training and to belong to lower social groups than other patients. The frequent attender patients also had more physical diseases, were more often on disability pension and had more mixed (physical-psychiatric) complaints than the control patients. The results indicate that many frequent attender patients complaints form a complicated network departing from different levels (physical, psychological and social). The implications of the findings are discussed.

Adolescent↗
PubMed1994

SCL-25 and recognition of mental disorders reported by primary health care physicians.

A marked proportion of primary care patients have mental disorders and problems that remain unrecognized by the patients and their general practitioners. There is furthermore a great variation in the physicians' ability to detect mental disorders. The aim of the present study was to find out the overall prevalence of mental disorders among patients receiving primary health care. The material consisted of 1000 randomly selected adult patients attending primary care facilities in Turku. The mental disorders were assessed by using the Symptom Checklist (SCL-25) and by general practitioners. According to the SCL-25, one fourth of the sample had a mental disorder. Only two fifths of them could be identified by the general practitioners.

Adolescent↗
PubMed1994

Epidemiology of depression: prevalence, risk factors and treatment situation.

Depending on the way it is defined depression can be seen as a state of mood, as a symptom, as a syndrome or as a clinical diagnosis. Epidemiological studies show that depression is the most common mental disorder in man. Up to 4% of men and 8% of women suffer from a clinically significant depressive disorder, while depressive symptoms are much more common. The occurrence of depression is associated with factors such as age, marital status, social class, and social conditions. In Finland, only one third of persons suffering from depression are actually being treated for their disorder.

Adult↗
PubMed1994

Depression and cardiovascular diseases.

We first review the associations between depression and cardiovascular diseases (CVDs). Then we examine them in the nationally representative Mini-Finland Health Survey, which covers 8,000 persons. Chronic somatic diseases and mental disorders were diagnosed using standardized methods. Cross-sectionally, CVDs and neurotic depression were associated both before and after adjustment for covariates. The strongest associations were observed in the case of severe CVDs. During a 6.6 year follow-up, the risk of CVD death and coronary death was elevated in depressed persons both with and without CVDs at entry. Much of the cross-sectional association is probably due to depression caused by CVDs. The outcome of CVD may be poorer in depressed persons. The hypothesis that depression is a cause of CVDs requires further study.

Adult↗
PubMed1994

Depression and back pain.

Depressive and anxiety neuroses are the most common psychiatric disorders associated with back pain. In assessing the connections between back pain and depression, the different forms of depression should be considered. There are some depressed back pain patients with the traditional depressed mood as the principal symptom of mood disorder. It seems, however, that the depression associated with back pain is usually atypical in nature and that signs of depression other than the depressed mood have to be taken into account. Alexithymic features associated with the pain can also mask the depression.

Anxiety Disorders↗
PubMed1993

Reliability and validity of interview data on chronic diseases. The Mini-Finland Health Survey.

The Mini-Finland Health Survey was designed to obtain a comprehensive picture of health and of the need for care in Finnish adults, and to develop methods for monitoring health in the population as a whole. Out of a nationally representative sample of 8000 people aged 30 or over, 7217 (90%) were both interviewed at home by local public health nurses using simple open-ended questions and, independently of this interview, subsequently examined in a two-phase health examination. The estimate of chronic morbidity based on the health interview (56%) was close to the prevalence of definite somatic diseases diagnosed in the health examination (54%), and the agreement between the two methods was moderate (kappa = 0.53). The estimated prevalence of cardiovascular diseases was the same (23%) in the health interview and in the health examination; the agreement was substantial (kappa = 0.74). The prevalence of respiratory and musculoskeletal diseases and mental disorders was underestimated in the interview by 52, 25 and 78%, respectively; the agreement between results of the two methods was relatively low (kappa = 0.43, 0.38 and 0.30, respectively). These results suggest that both the health examination and the health interview methods, as used in this survey, have useful applications in monitoring the population's health.

Adult↗
PubMed1991

Physical and mental health changes in retirement age.

Effects of retirement on health were studied in a prospective follow-up study (TURVA project). The subjects were examined when they were 62 and 66 years old. At the beginning of the study more than half of the subjects were still working and the rest of them pensioned. Retirement had no clear effect on the subjects' physical health. Mental health of the subjects who retired at age of old-age retirement became better than that of the subjects who retired before the study. Diminished work stress may explain positive changes in mental health during retirement process.

Adaptation, Psychological↗
PubMed1991

Low back pain and psychological factors. A social psychiatric study of the population of working age.

The objective of the study was to find out how low back pain (LBP) and psychological factors are interrelated in the adult population. The study dealt with 220 individuals suffering from LBP and with a control group (n = 101). The method used was a psychiatric interview. Mental disorders were more prevalent in the LBP group than in the control group. A clinical disorder was diagnosed for 31% in the LBP group and they had many mild mental disturbances, too. The association between LBP and mental disorders was not as clear as found in previous studies with patient populations. The LBP group was divided according to the etiology of pain into functional and organic groups. No significant differences were found between the groups with regard to mental disturbance.

Adult↗
PubMed1990

Prevalence of mental disorders among adults in Finland: basic results from the Mini Finland Health Survey.

The Mini Finland Health Survey was an extensive epidemiological study of the Finnish population aged 30 or over; the prevalence of mental disorders was one aspect studied. Prevalence of symptoms in the General Health Questionnaire as well as the prevalence of self-perceived and clinically assessed mental disorders was studied. The total prevalence of clinically assessed mental disorders was 17.4%, 14.8% in the men and 19.5% in the women. A definite disorder was observed for 11.7% of the subjects. About half of the subjects suffering from a mental disorder according to clinical assessment also reported a self-perceived disorder. Of various diagnoses, the most common were phobic and anxiety neurosis (6.2%) and neurotic depression (4.6%). The prevalence of schizophrenia was 1.3%. The highest prevalence was found in the ages 50 to 64 years. The prevalence of psychoses was highest in northern and eastern Finland, and that of neuroses in southern Finland.

Adult↗
PubMed1990

Need for mental health services of the adult population in Finland: results from the Mini Finland Health Survey.

This article presents results on the self-perceived and clinically assessed met and unmet need for mental health care as indicated by the Mini Finland Health Survey, an extensive epidemiological study of the Finnish population aged 30 years or over. The prevalence of self-perceived definite or probable need for care was 6.4% in the men and 8.2% in the women. The corresponding clinical assessments were 14.5% in the men and 19.6% in the women. The need for specialist care was 7.5% in the men and 9.6% in the women. The need was greatest in the middle-aged groups. About 60% of persons in need of care were not receiving any treatment. Half of the treatment received was assessed as inadequate. The treatment situation was much better for psychoses than for neuroses, but it varied little between the different parts of the country.

Adult↗
PubMed1988

Mental health in the population approaching retirement age in relation to physical health, functional ability and creativity. Findings of the TURVA project.

This is the second paper dealing with a Finnish long-term prospective study, the objective of which is to shed light on adjustment to retirement and old age. At this point, only the results of the initial survey carried out in 1982 are available. The material consisted of a random sample of 200 individuals born in 1920 and living in Turku, and a corresponding sample of 189 persons living in rural areas in the neighborhood of Turku. The method consisted of a structured interview, certain questionnaires and a physical examination. There was a considerable discrepancy between the subjects' subjective working disability and the frequency of evident and handicapping physical illnesses found by the physician. This difference was largely explained in terms of mental problems. Dissatisfaction with life was clearly more common in subjects receiving a disability pension and in those classified as psychiatric cases than in others.

Adaptation, Psychological↗
PubMed1988

Intimacy and mental disorder in late middle age. Report of the TURVA project.

This study, which was carried out as part of the TURVA project on psychosocial adaptation in old age, is concerned with the significance of social support to people approaching retirement age. The population consisted of 200 urban dwellers and 189 rural dwellers, who were studied at the age of 62. The subjects were either about to retire in the near future or had already retired, and it was assumed that this event causes a certain amount of stress, which may lead to mental disturbance regardless of the amount of social support available to the individual. Intimate relationship and close friendship served as the measures of social support. Mental disturbances were assessed on the basis of the General Health Questionnaire (36-item version) and the number of psychic and especially depressive symptoms. The prevalence of mental disturbance and depressive symptoms was lowest in those people who lived in a close marital relationship and who also described their spouse as empathic. Psychic symptoms were most common in those people who said their relationship to their spouse was distant and who described them as unempathic. The subjects who were not married fell in-between these 2 groups regardless of whether they had an intimate relationship with someone of the opposite sex. A positive marital relationship seemed to provide a shield against depression, while a negative marital relationship tended to make the individual more vulnerable to depression. The role of a close non-marital friendship depended on the respondent's sex. In women, it was associated with a high prevalence of depressive symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗
PubMed1988

Measurement of life satisfaction. Developing a life satisfaction scale.

The purpose of this study was to develop a life satisfaction scale (LSS) suited for elderly Finnish people. The subjects were non-institutionalized elderly living in rural and urban areas in south-western Finland. They were interviewed for a prospective follow-up study (TURVA project) concerned with the psychosocial development of elderly people during retirement. Following the interview, the first version of the LSS was submitted to 339 respondents. It was completed and returned by 330 (97%). This version of the scale was then reduced to a 26-item version (LSS-A), which had a high reliability coefficient (Cronbach alpha 0.89). In factor analysis, LSS-A consisted of three main components: psychic balance, assessment of past life, and present happiness. An abbreviated 12-item scale (LSS-B) was also drawn up. When the number of items was reduced, the roles of psychic balance and present happiness were emphasized. The LSS, proved to be easy to use, its reliability was good, and the correlations between the sum score of LSS and the questions concerning life satisfaction in the interviews suggested fairly good validity. To further evaluate the validity and applicability of the scale, we need further studies in different types of elderly populations.

Adaptation, Psychological↗
PubMed1987

Mental health in the population approaching retirement age. Preliminary findings of the TURVA project.

The present paper deals with a Finnish long-term prospective study, the objective of which is to shed light on adjustment to retirement and old age. In this phase, only the preliminary findings of the initial survey carried out in 1982 are available. For the purposes of the study, a random sample of 200 individuals was drawn from among Turku inhabitants born in 1920. Another sample, consisting of 189 persons of the same age, was drawn from rural municipalities in the neighborhood of Turku. An extensive structured psychosocial interview could be conducted with a total of 339 subjects. The research methods used included e.g. the 36-item version of Goldberg's General Health Questionnaire (GHQ). Relatively little mental disturbance was revealed in the interview, and no major differences occurred between the urban and the rural sample. Somewhat over one-third of both samples were probable psychiatric cases as defined according to the GHQ.

Adaptation, Psychological↗
PubMed1987

Psychological factors in low back pain.

Even though low back pain is one of the commonest diseases, little is known about its aetiology, its natural history and its treatment. This may explain why the myth exists that low back pain is often psychogenic in origin or that psychological factors are often at least involved in low back pain. The aim of the early studies on low back pain and psychological factors was to try to divide these pains into functional (psychogenic) and organic, according to the aetiology. The aim of the studies was to predict the quality and success of the treatment. According to the current view, it is not meaningful to try to dichotomize low back pain in this way. According to the earlier literature, both conversion hysteria and psychoses were the main cause of psychogenic low back pain. More recent studies do not, however, support this view. It seems that the most common psychiatric disturbances associated with low back pain are neuroses and neurotic traits. There is controversy as to how often psychological factors are involved in low back pain. Population studies have shown that this association may be weaker than was thought earlier. It seems that individuals who suffer from low back pain, more often than others, have aggression problems and weaknesses in their ego function and more frequently have problems in interpersonal relations and sexual problems. There is no clear picture of what kind of psychotherapy is best suited to low back pain patients who have mental problems. The results attained by learning therapy and also with multidisciplinary ward programs seem quite promising.

Back Pain↗