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Biomedical subjects

M Rimpelä

Publications and source records attributed to M Rimpelä.

At least 19 recordsLinked to original sources
PubMed2003

Risk-taking sexual behaviour and self-reported depression in middle adolescence--a school-based survey.

BACKGROUND: Early sexual activity has been widely studied in the context of pregnancies, substance use and antisocial behaviour, but the aspects of psychosexual health have received less attention. AIM: To study the associations of early sexual activity and self-reported depression. SETTING: A school survey in Finland in 1999 and 2000 in the eighth and ninth grades. METHODS: Adolescents with experience of sexual intercourse were studied (11,793 girls and 10,443 boys, mean age 15.5 years). Scores of 8 or more in the Beck Depression Inventory were regarded as indicative of self-reported depression. Associations with sexual behaviour variables were analysed using logistic regression models. RESULTS: In both genders, self-reported depression increased in proportion to the number of sexual partners and with the non-use of contraception. A higher number of coital experiences correlated with depression only among boys. Adjusting for age and age at menarche/oigarche did not affect the associations detected. In stepwise logistic regression, an increasing number of partners increased the risk for self-reported depression [for boys with at least five partners odds ratio (OR) 2.5, 95% confidence intervals (CI) 2.2-3.0, and for girls OR 2.7, 95% CI 2.3-3.2]. Boys and girls who did not use contraception showed roughly twice as high a risk as contraceptive users. However, girls with five or more coital experiences had a significantly lower risk for depression compared to girls with only one sexual intercourse. CONCLUSIONS: Multiple sexual partners and non-use of contraception may reflect a depressive disorder in both genders. While adolescent health service providers should be aware of the risk for depression among sexually active adolescents, the sexual health of depressed adolescents also warrants special attention.

Adolescent↗
PubMed2002

Factor structure of the School Well-being Model.

The aim of this study was to confirm empirically the factor structure of the School Well-being Model. In this Model well-being was divided into school conditions, social relationships, means for self-fulfillment and health status. Data for this study were collected by the School Health Promotion Survey in Finland with 40147 respondents from Grades 8 and 9. The 43 variables from the Survey were fitted into the School Well-being Model using confirmatory factor analysis. The Goodness of Fit Index (GFI) for the four-factor model was 0.93 and GFI Adjusted for Degrees of Freedom was 0.93. The correlations between factors varied from 0.30 to 0.78 and internal consistencies (Cronbach's alphas) from 0.62 to 0.84. The categories school conditions and health status had a good variety of variables. However, the social relationships and the means for self-fulfillment categories would have benefited from additional questions. The School Well-being Model can be utilized to construct school well-being profiles both for groups of pupils and for schools as a whole. The school well-being profile could highlight the area or areas in which schools could make improvements in order to promote the well-being of its pupils.

Adolescent↗
PubMed2002

Sociodemographic differences in the occurrence of teenage pregnancies in Finland in 1987-1998: a follow up study.

STUDY OBJECTIVE: To analyse sociodemographic differences in the occurrence of pregnancies to 14 to 19 year olds and changes in these differences from 1987 to 1998. DESIGN: Follow up of adolescent survey respondents using registers. SETTING AND SUBJECTS: The dataset includes information on all registered pregnancies (abortions, births, and miscarriages, n=2743) of the female respondents (n=28 914) to the Adolescent Health and Lifestyle Survey (AHLS) from 1987 to 1998. In the AHLS, self administered questionnaires were mailed every second year to independent samples of 12, 14, 16, and 18 year olds representative for Finland. MAIN OUTCOME MEASURE: Relative risk (hazard) of becoming pregnant at teenage. MAIN RESULTS: Girls from lower socioeconomic background had a higher pregnancy risk. Girls who did not live with both parents at the baseline survey had higher pregnancy risk than those who did, and girls who lived in a stepfamily had a higher risk than those who lived in a one parent family. Swedish speaking girls had a lower pregnancy risk than the Finnish speaking girls. There was no systematic change from 1987 to 1998 in most sociodemographic differentials in the teenage pregnancy risk, however, there was some increase in the differences by family structure. Changes in the sociodemographic structure did not explain the levelling off of the downward trend in teenage pregnancy risk, nor did the regional socioeconomic differences explain regional differentials in teenage pregnancy risk. CONCLUSION: Although the reduction of socioeconomic and regional differences has been a general objective in Finnish social and health policies, the relative differences in teenage pregnancies have not decreased.

Adolescent↗
PubMed2001

Household educational level as a determinant of consumption of raw vegetables among male and female adolescents.

BACKGROUND: This study aimed to examine the association between household educational level and consumption of raw vegetables among adolescents and to assess the influence of other determinants on the association, such as family factors, school achievement, health behavior, meal pattern, and weight-related factors. A further aim was to investigate whether the associations were the same for male and female adolescents. METHODS: The study is based on data from the School Health Promotion Survey 1997-1998. Data were collected by a classroom-administered questionnaire, which was completed by 76,201 secondary school pupils. The study recorded the consumption of raw vegetables, but not the consumption of cooked vegetables. Multivariate logistic regressions were used in the analyses. RESULTS: A clear positive association between educational level of the household and daily consumption of raw vegetables was found among adolescents. The adolescent's own school achievement explained part of the association between household educational level and consumption of raw vegetables. Other factors explained the association to a small degree, with meal pattern and weight factors having no effect. The associations were similar for both genders. CONCLUSIONS: Educational level in the household is an important determinant of consumption of raw vegetables. A household with a high educational level will also presumably contain adolescents who have good school achievement, another strong predictor of frequent consumption of raw vegetables.

Adolescent↗
PubMed2001

Adolescent depression: the role of discontinuities in life course and social support.

OBJECTIVE: To study sociodemographic determinants of depression among 14-16 years old girls and boys, and the role of perceived social support in mediating the effects of the background variables. METHOD: 16464 adolescents aged 14-16 participated the School Health Promotion Study, a survey about health, health behaviour and school behaviour. Depression was measured by the Finnish modification of the 13-item Beck Depression Inventory. Moderate to severe symptoms in this scale were recorded as depression. RESULTS: Depression was associated with family structure in both sexes. Among girls, having moved recently and low parental education increased the risk for depression, among boys, unemployment in the family. Accumulating number of discontinuities in life course increased the proportion of the depressed among both girls and boys. Perceived lack of social support had the same effect. Lack of support did not explain the effect on depression of the discontinuities in life course. CONCLUSION: To detect risk groups for adolescent depressive disorders, health services should pay attention to adolescents who have experienced life changes. Perceived social support should be enquired.

Adolescent↗
PubMed2001

Early puberty and early sexual activity are associated with bulimic-type eating pathology in middle adolescence.

PURPOSE: To examine the associations between early pubertal timing and early advanced sexual development with bulimic-type eating pathology in middle adolescents. METHODS: A total of 19,321 boys and 19,196 girls aged 14-16 years (mean age 15.3 years, standard deviation 0.59) responded to the School Health Promotion Study, a class-room survey among Finnish adolescents about health, health behavior, and school experiences. Bulimic-type eating pathology was assessed with a questionnaire formulated according to the fourth edition of the Diagnostic and Statistical Manual for Mental Disorders IV (DSM-IV) criteria. Pubertal timing was assessed by self-reported age at menarche or oigarche. Statistical methods were used chi-square and logistic regression. RESULTS: Bulimic-type eating pathology among girls was associated with early menarche, early sexual experiences, and increasing age. Among boys, onset of ejaculations at the normative age was protective for bulimic-type eating pathology, and the risk was elevated among very early and late maturers. Early sexual experience was associated with bulimic-type eating pathology. CONCLUSION: To prevent bulimia nervosa and to create opportunities for early intervention, attention should be paid to early maturing girls and off-time maturing boys, as well as those with early onset of sexual activity.

Adolescent↗
PubMed2001

Depression, drinking, and substance use among 14- to 16-year-old Finnish adolescents.

Our aim was to assess the relationship between self-reported depression, alcohol consumption, and substance use among 14- to 16-year-olds. A school survey was conducted of 16,464 14- to 16-year-olds in two regions of Finland. Alcohol and other substance use were found to be significantly associated with depression. Of girls (boys) who reported drinking weekly, 24% (13%) scored as depressed, compared with 7% (4%) of those not drinking. Of girls (boys) who reported having experimented with substances five times or more, 37% (28%) scored as depressed compared with 8% (5%) of those who reported never having experimented with substances. These associations persisted in multivariate analyses controlling for sociodemographic background. In conclusion, frequent drinking and experimenting with substances indicate a risk for adolescent depressive disorders, and depressive adolescents are at risk for substance use. Health services should pay attention to the identified depressive adolescents to prevent the possibly subsequent substance use problems among them and also pay attention to frequently drinking adolescents and substance experimenters, to increase identification of depressive disorder and possibilities for early interventions.

Adolescent↗
PubMed2001

Health behavior-based selection into educational tracks starts in early adolescence.

Health behaviors and educational tracks of an individual are here presumed to have a strengthening influence on each other during the developmental process, through which individuals gradually reach their adult health and social position. This longitudinal study of a Finnish nationally representative sample of 12 year olds born in 1970 (N = 1009) examined the associations of health behaviors at ages 12 and 14 with educational track at age 16. The dependent variable, educational track, classified the respondents into five successive categories, thought to predict their adult social position. Selection into different educational tracks according to health behaviors was obvious already at age 12, when frequency of tooth brushing, consumption of sweets, coffee drinking and level of participation in physical exercise predicted educational track independently of sociodemographic background. At age 14, the independent predictors were smoking, frequency of tooth brushing and coffee drinking. At both ages, sociodemographic factors had independent associations with educational track. It seems that certain health-related behaviors in early adolescence are indicators of a person's possibilities to benefit from a country's educational supply. Both sociodemographic background and health-related behaviors influence the process of selection into educational tracks leading to social position and health in adulthood.

Adolescent↗
PubMed2001

The trend and risk factors of perceived toothache among Finnish adolescents from 1977 to 1997.

Toothache is a subjective oral health indicator that should become uncommon when oral health is improving. The aim of this study was to assess changes in perceived toothache between 1977 and 1997 among Finnish adolescents. In the Adolescent Health and Lifestyle Survey, a self-administered questionnaire was mailed to a representative sample of 12-, 14-, 16-, and 18-year-old Finns every second year. The sample sizes in the surveys varied from 2422 to 11,105, making a total of 35,349 subjects in the entire study. The incidence of toothache during the previous 2 years was requested in 1977, 1985, 1991, 1995, and 1997, and the prevalences were 31%, 25%, 28%, 29%, and 37%, respectively. The increase between 1995 and 1997 was highest among 16- and 18-year-olds. There was no tendency for perceived toothache to decline over the study period, despite the decrease in caries experience. Toothache varied by age, socioeconomic status (SES), place of residence, and toothbrushing frequency. The increase in the incidence of toothache reported after 1995 could be a warning signal that economic recession in Finland has caused changes in the dental care system.

Adolescent↗
PubMed2000

Bullying at school--an indicator of adolescents at risk for mental disorders.

A number of 14-16 year old Finnish adolescents taking part in the School Health Promotion Study (n=8787 in 1995, n=17643 in 1997) were surveyed about bullying and victimization in relation to psychosomatic symptoms, depression, anxiety, eating disorders and substance use. A total of 9 per cent of girls and 17 per cent of boys were involved in bullying on a weekly basis. Anxiety, depression and psychosomatic symptoms were most frequent among bully-victims and equally common among bullies and victims. Frequent excessive drinking and use of any other substance were most common among bullies and thereafter among bully-victims. Among girls, eating disorders were associated with involvement in bullying in any role, among boys with being bully-victims. Bullying should be seen as an indicator of risk of various mental disorders in adolescence.

Adolescent↗
PubMed2000

Trends in drinking habits among Finnish adolescents from 1977 to 1999.

AIMS: Trends in adolescent drinking habits in Finland from 1977 to 1999 are studied with special attention to the onset of problem use and gender differences. DESIGN AND SETTING: Biennial cross-sectional mailed surveys (Adolescent Health and Lifestyle Survey). PARTICIPANTS: Representative samples of 12, 14, 16 and 18-year-olds. The number of respondents varied from 2832 to 8390 and the response rate from 88% to 76%. MEASUREMENTS: The frequencies of alcohol use and perceived drunkenness obtained from self-administered questionnaires. FINDINGS: Alcohol use remained rare among 12-year-olds. The overall trends in the frequencies of alcohol use and drunkenness increased considerably over time among the 14-18-year-olds. Age-adjusted monthly drunkenness among 14, 16 and 18-year-olds rose from 13% (1981) to 27% (1999) among boys and 6% to 22% among girls. Throughout the study period, the drinking style among boys became more drunkenness-orientated with age, but the opposite was true among girls. Birth cohort investigation showed that the onset of drunkenness moved towards an earlier age. Earlier onset predicted higher prevalence of problem use at the age of 18. Boys developed a regular pattern of drunkenness steadily increasing between ages 14-18 while among girls the increase of drunkenness started to level off between ages 16 and 18. CONCLUSIONS: Alcohol use among 12-year-olds remained rare, but became more prevalent and drunkenness-orientated among 14-18 year-olds. Gender differences in problem use diminished. Nevertheless, notable differences persist in the onset and development of drunkenness-orientated use.

Adolescent↗
PubMed2000

The effect of societal changes on drunkenness trends in early adolescence.

Increased adolescent drunkenness in Finland has called for research to explore the background of this development. This study seeks to find out to what extent the societal level changes have contributed to the increased drunkenness among 14 year olds in Finland from 1981 to 1997. The data set is drawn from a nationally representative bi-annual mail study, the Adolescent Health and Lifestyle Survey, conducted since 1981 (N = 792-2533, response rate 77-90% per year). Logistic regression analysis was used to study the effect of several background factors on the drunkenness prevalence trend. Family structure, parental education, residence urbanization, weekly allowance and timing of biological maturation were associated with drunkenness. Changes within the distribution of these factors, especially in increased weekly allowance and earlier timing of biological maturation, appeared to account for a considerable part of the increased drunkenness from 1981 to 1997. The findings suggest that increased adolescent drunkenness is significantly associated with societal changes outside the scope of health and alcohol policies.

Adolescent↗
PubMed2000

Neck or shoulder pain and low back pain in Finnish adolescents.

The aim of this study was to investigate the prevalence and determinants of self-reported neck or shoulder pain (NSP) and low back pain (LBP) among 12-18-year-olds. A questionnaire was mailed to a nationally representative sample of 11,276 12-, 14-, 16- and 18-year-olds in 1991. The response rate was 77%. NSP was perceived at least once a week by 15% of 12-18-year-olds and LBP by 8%. Both symptoms were more prevalent among girls than among boys, and the prevalence increased with age. Among the determinants investigated, the number of perceived psychosomatic symptoms had the strongest association with NSP and LBP. Our study confirmed the co-morbidity of NSP and LBP, and indicated that NSP is more frequent than believed among 16-18-year-old girls. The strong association of psychosomatic symptoms with NSP and LBP suggests that the latter two pain states could be more psychosomatic than nociceptive in character.

Adolescent↗
PubMed1999

Bullying, depression, and suicidal ideation in Finnish adolescents: school survey.

OBJECTIVE: To assess the relation between being bullied or being a bully at school, depression, and severe suicidal ideation. DESIGN: A school based survey of health, health behaviour, and behaviour in school which included questions about bullying and the Beck depression inventory, which includes items asking about suicidal ideation. SETTING: Secondary schools in two regions of Finland. PARTICIPANTS: 16 410 adolescents aged 14-16. RESULTS: There was an increased prevalence of depression and severe suicidal ideation among both those who were bullied and those who were bullies. Depression was equally likely to occur among those who were bullied and those who were bullies. It was most common among those students who were both bullied by others and who were also bullies themselves. When symptoms of depression were controlled for, suicidal ideation occurred most often among adolescents who were bullies. CONCLUSION: Adolescents who are being bullied and those who are bullies are at an increased risk of depression and suicide. The need for psychiatric intervention should be considered not only for victims of bullying but also for bullies.

Adolescent↗
PubMed1999

Bulimia and bulimic behaviour in middle adolescence: more common than thought?

OBJECTIVE: Studies on the prevalence of bulimia and bulimic behaviour have focused on female populations from their late teens. This study assesses the prevalence of bulimia and bulimic behaviour in 14- to 16-year-old adolescents. Biological, sociodemographic and social correlates of these disorders are sought. METHOD: A self-report questionnaire was administered to pupils of the 8th and 9th grades of secondary school in four regions of Finland. In total, 4453 girls and 4334 boys aged 14 to 16 years participated. RESULTS: Bulimia was detected in 1.8% of girls and 0.3% of boys. Bulimic eating behaviour was reported by 14.4% of subjects. Sociodemographic variables were not associated with increased risk. Bulimia was associated with being bullied by peers and higher than average weight in both sexes. CONCLUSION: Bulimia and bulimic eating behaviour appear to be more common than was previously thought in middle adolescence, and also among boys. Bulimia deserves more attention in younger age groups than main risk groups so far considered.

Adolescent↗
PubMed1998

Health related lifestyle in adolescence predicts adult educational level: a longitudinal study from Finland.

OBJECTIVE: To assess the relative importance of perceived health and health related lifestyle in adolescence in the production of educational differences. DESIGN: A longitudinal study: survey data from 1981 and 1985 linked with Educational Registry data from 1993. SETTING: The whole of Finland. PARTICIPANTS: A representative sample of 4761, 16 and 18 year olds. The follow up rate was 82%. MEASUREMENTS AND MAIN RESULTS: The outcome variable was the attained educational level at age 24 to 30. Predictive variables described health related lifestyle and health at the age of 16 and 18. Those whose educational level was low at follow up, had in adolescence, a more health compromising lifestyle than those who had reached higher levels. They had placed less emphasis on health promoting behaviours like not smoking, physical exercise, good diet, and dental hygiene. Smoking was the outstanding predictor of attained educational level. Among the health variables, only psychosomatic symptoms predicted high educational levels in girls, and both psychosomatic symptoms and height in boys. CONCLUSION: Those who reach a high level of education in adulthood, have had a health enhancing lifestyle already in adolescence, while those reaching only a low level, have had a health compromising lifestyle. Health plays only a small part in the prediction of adult educational level. The results suggest that a health compromising lifestyle, adopted already in adolescence, is an important mechanism from which educational health differences originate.

Adolescent↗