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Biomedical subjects

M Marttunen

Publications and source records attributed to M Marttunen.

30 records · Page 2Linked to original sources
PubMed1997

Low-dose aspirin in prevention of miscarriage in women with unexplained or autoimmune related recurrent miscarriage: effect on prostacyclin and thromboxane A2 production.

Early pregnancies in women with a history of recurrent spontaneous abortion (RSA) are accompanied by a deficiency in vasodilatory and anti-aggregatory prostacyclin (PGI2) and/or overproduction of its endogenous antagonist thromboxane A2 (TXA2). We evaluated the effect of a low-dose aspirin (LDA) on PGI2 and TXA2 production and on pregnancy outcome in RSA women with and without detectable anticardiolipin antibodies (ACA). Of 82 RSA women studied, 66 became pregnant, and of them, 33 (six with elevated and 27 with normal ACA concentrations) were randomized to receive LDA (50 mg/day) and 33 (six with elevated and 27 with normal ACA concentrations) to receive placebo (PLA) from a mean of 6.6 days after the missed period to delivery. Treatment with LDA inhibited platelet TXA2 production similarly in RSA women with and without detectable ACA and with continuing pregnancies (7.0 +/- 0.7 ng/ml, LDA group versus 254.5 +/- 37.8 ng/ml, PLA group, mean +/- SEM, P < 0.0001) or miscarrying pregnancies (13.8 +/- 3.8 ng/ml compared with 233.6 +/- 59.8 ng/ml, P < 0.0001 respectively). Furthermore, LDA decreased urinary excretion of the TXA2 metabolite (2,3-dinor-TXB2) both in pregnancies which went to term (6.1 +/- 0.6 ng/mmol creatinine, LDA group versus 19.3 +/- 3.0 ng/mmol creatinine, PLA group, P < 0.0001) or again ended in miscarriage (4.7 +/- 0.8 ng/mmol creatinine versus 17.3 +/- 4.4 ng/mmol creatinine, P < 0.0001 respectively), but did not affect the excretion of the prostacyclin metabolite (2,3-dinor-6-keto-PGF1alpha). Early pregnancy ultrasound examination revealed a living fetus in 58 women. Of these, seven in the LDA group (23.3%, four with elevated and three with normal ACA concentrations) and five in the PLA group (17.9%, two with elevated and three with normal ACA concentrations; not significant) experienced a miscarriage. All infants were healthy, and the frequency of growth retardation was similar in both groups (13.0%). One woman in the LDA group (4.3%) and three women receiving PLA (13.0%) developed pre-eclampsia (not significant). Therefore, although treatment with LDA caused a desirable biochemical effect, it did not improve pregnancy outcome in RSA women with or without detectable ACA.

Abortion, Habitual↗
PubMed1997

Characteristics of out-patient adolescents with suicidal tendencies.

Suicidal adolescent out-patients were compared with non-suicidal subjects with respect to background factors, psychopathology and treatment received. Data for suicidal ideation, suicide attempts, psychiatric diagnoses (DSM-III-R) and other patient-related factors were collected prospectively during treatment of 122 male and 138 female out-patients aged 12-22 years. In total, 42% of subjects displayed suicidal tendencies, and 18% had attempted suicide. According to polychotomous regression, mood disorder, previous psychiatric treatment and low level of psychosocial functioning at treatment entry were associated with suicide attempts and with suicidal ideation for both sexes. Suicidal patients were more often receiving psychotropic medication and had more total appointments (mean number 15 vs. 9) than non-suicidal patients. Suicidal and non-suicidal patients kept their scheduled appointments to the same extent (66% vs. 65%). Treatments which meet the needs of disordered suicidal adolescents need to be developed.

Adolescent↗
PubMed1997

Differences between urban and rural suicides.

As part of a nation-wide psychological autopsy we examined the differences in DSM-III-R mental disorders, recent life events and other characteristics between urban (n = 143) and rural (n = 85) completed suicides in a random sample of 229 cases from the National Suicide Prevention Project in Finland for the period 1987-1988. Psychoactive substance use disorders (48% vs. 34%), cluster B personality disorders (24% vs. 9%) and psychiatric comorbidity (66% vs. 42%) were found more commonly among urban than rural suicides. Urban suicides were also more often reported to be preceded by a recent separation (25% vs. 8%), whereas rural suicide victims tended to have lacked a close companion of the opposite sex (36% vs. 18%) and to have had physical disorders (56% vs. 40%). Overall, urban and rural suicides may vary with regard to the prevalence of some mental disorders, their comorbidity, and physical disorders, as well as the preceding life situation. This variation may also imply the need for differences in strategies for suicide prevention in each setting.

Adolescent↗
PubMed1997

Psychosocial functioning in adolescent psychiatric patients: a prospective study on changes in psychosocial functioning among severely and moderately impaired adolescent out-patients.

Changes in psychosocial functioning during out-patient treatment among 73 adolescent male and 100 female subjects, aged 12 to 19 years, were studied. The mean number of total treatment sessions was 15 sessions among the severely impaired and 14 sessions among the moderately impaired patients. The level of psychosocial functioning improved among the severely impaired (Global Assessment Scale (GAS) at treatment entry 3.9 vs. 4.7 at the last session, 95% CI, -1.085 to -0.577) and the moderately impaired patients (GAS 5.5 vs. 6.0, 95% CI, -0.682 to -0.355). The improvement was highly dependent on the psychiatric diagnosis. The level of psychosocial impairment improved in about two-thirds of subjects with adjustment and non-comorbid mood disorders, in about one-third of those with non-comorbid personality disorders, and in about a quarter of those with disruptive disorders. Careful diagnostic evaluation and assessment of psychosocial functioning are essential elements in the development of adolescent psychiatric services.

Adjustment Disorders↗
PubMed1997

Suicide among military conscripts in Finland: a psychological autopsy study.

This study describes suicides during compulsory military service and compares them with other young male suicides as part of a nationwide psychological autopsy study of all suicides in Finland during a single year. The victims' relatives and attending health care personnel were interviewed, and data from records were collected. Five of the seven conscript suicides had a depressive syndrome, often of short duration. Two victims previously had suicidal thoughts or attempted suicide. The most common suicide method was with firearms. Compared with other young male suicides, physical illness in conjunction with a psychiatric diagnosis was less common in the conscript victims. Civilian male suicides tended to have more substance abuse and more severe psychological impairment. They also committed suicide under the influence of alcohol more often than conscripts. Interpersonal separation was more often the precipitating event of the suicide among the conscripts than among the other suicides. Conscripts should be encouraged to utilize health and social services when they have psychosocial problems or even minor psychiatric symptoms.

Adolescent↗
PubMed1996

Suicide in non-major depressions.

We compared depressive suicides who had unipolar depression not fulfilling the diagnostic criteria of major depression (non-major depressions) with suicides who had major depression. A random sample of 229 suicides representing all suicides in Finland within a 12-month period were comprehensively examined using the psychological autopsy method and diagnosed according to DSM-III-R criteria. We included in this study all cases of current depressive disorder not otherwise specified (n = 48), adjustment disorder with depressed mood (n = 6) and dysthymia (n = 4). These 58 cases of suicide in non-major depressions were compared with the suicides with unipolar major depression (n = 71) in the same random sample. The non-major depressive victims were younger, and comprised more males, more cases with psychoactive substance use disorders, more secondary depressives, and more cases not having contact with health care, or cases not having communicated suicidal intent despite such contact. Recent life events were also reported more common among those with non-major depressions, particularly during the final week. The findings suggest that suicides in major depression and in unipolar depressions not fulfilling the criteria for major depression are likely to differ in several clinically relevant characteristics besides depressive symptomatology.

Adult↗
PubMed1996

Excess mortality among former adolescent male out-patients.

Mortality among 156 males and 122 females referred to an out-patient adolescent psychiatric clinic in a Finnish town between 1984 and 1989 was examined. During the follow-up (mean duration 6 years; range 0-6.3 years for the deceased, 0.6-10.3 years for the survivors), 16 male subjects but no females had died. Among those who had died, the mode of death was suicide in 11 cases. The mortality for any cause for males was 10.3% and that for suicide was 7.1%. All male victims had similar high levels of individual and familial disturbances. Current suicidal ideation and suicide attempts, poor psychosocial functioning and a recommendation for psychiatric hospital treatment during the index treatment were associated with male mortality/suicidality. A high risk for mortality for several years after psychiatric treatment was found. It is concluded that, in clinical settings, perceived current suicidal tendencies should be assessed carefully.

Adolescent↗
PubMed1995

Project plan for studies on suicide, attempted suicide, and suicide prevention.

Completed and attempted suicide are major public health problems in most western countries. The importance of suicidal behavior as a health problem, particularly among adolescents and young adults, has been emphasized by the European Union, the WHO (Europe), as well as the Finnish authorities. Due to the exceptionally high suicide mortality, suicide prevention has been one of the main targets of Finnish health policy since the late 1980s. However, to develop feasible strategies for suicide prevention, better knowledge of the phenomenon of self-destruction is necessary. The Department of Mental Health of the National Public Health Institute has been actively involved in suicide research and the development of suicide strategies both in Finland and western Europe since 1986. The success is based on a long tradition of suicide research in Finland, the representative and reliable suicide data, a highly motivated research group, and also the necessary economic support by both the National Public Health Institute and the Finnish Academy. This article outlines our groups research plan for the next few years.

Adolescent↗
PubMedDate not supplied

Predictors of alcohol intake and heavy drinking in early adulthood: a 5-year follow-up of 15-19-year-old Finnish adolescents.

Relative contributions of earlier drinking and smoking vs mental health risk factors in predicting alcohol intake and heavy drinking in young adulthood were assessed. Higher average alcohol intake and heavy drinking (13 or more drinks on one occasion) in 1995 were significantly related to male gender and earlier high scores in 1990 of relief smoking, relief drinking, and their interaction. Parental alcohol problems, social group, perceived degree of social support, trait anxiety, number of negative life events, self-esteem, grade-point average, somatic symptoms score, or immature, neurotic, or mature defence style measured in 1990 did not predict alcohol intake or heavy drinking 5 years later. The findings suggest that alcohol intake and heavy drinking in young adulthood can be predicted by earlier self-reports on relief smoking and alcohol intake in adolescence.

Adolescent↗