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The barren housing conditions of farmed blue foxes (Alopex lagopus) provide few stimuli to motivate exploration and interaction with the physical environment. In the present study, wooden blocks (30x7 cm [lxdia]) were employed to clarify how such inanimate objects might serve to enrich the barren wire-mesh cages. Two separate experiments were carried out. In experiment 1, behavioural reactions of eight male blue foxes to wooden blocks were videotaped between January and May. In experiment 2, 16 male blue foxes were housed singly in cages with wooden blocks and 16 without between January and June. Pencil, confrontation, feeding and open field tests were carried out. Furthermore, 50 female blue foxes were kept singly in cages with wooden blocks and 49 without from January to July. Both groups were bred and the whelping result was recorded. In-cage behavioural tests were performed three times. Results showed that interactions with the wooden blocks were frequent, averaging 77 interactions fox’1 day1. Interactions with blocks decreased slightly with time. Blocks were mainly used for carrying, chewing, poking and sniffing. In the confrontation test, male foxes housed without blocks were more passive than those with blocks. No differences were found between the groups in the pencil, feeding or open field tests. Whelping success tended to be better for vixens housed with than without blocks. It can be concluded that wooden blocks have enrichment value by providing more choices for foxes in a barren cage and stimulating more variable behaviour.
Off-label use of antipsychotics has increased in many countries. In adult populations antipsychotics off-label prescriptions varied from 40 to 75% of all AP users.
To examine the off-label prescribing practices and experiences of antipsychotic medication in Finland.
An electronic questionnaire on physicians’ prescription practices of antipsychotics, especially for off-label use, was sent in 2019 for physicians (n=1195) in different health care facilities including primary health care, occupational health care, in- and outpatient mental health services and services for substance abuse. The sample was selected by systematic and convenience sampling covering five university hospital areas in Finland.
In total, 216 physicians (18% of the target sample) participated in the study, and 94% had prescribed antipsychotics for off-label use. The most common off-label indications were insomnia and anxiety. The most common antipsychotic used was quetiapine. Off-label antipsychotics was not prescribed as a first-choice medication: 99% of the physicians reported that the patients with off-label use have previously had other medications for the corresponding symptoms. In all, 88% of clinicians monitored the patients’ clinical condition, whereas metabolic values were followed more rarely. About 68% of physicians reported more benefit than harm from the antipsychotics off-label
Antipsychotics are often prescribed for off-label use, most commonly for insomnia and anxiety. Most of the physicians see more benefits than harms for the patient in off-label use. There is a need to analyse the long-term benefits and harms of off-label use of antipsychotics and create more detailed treatment algorithms and clinical recommendations for such use.
Substance-induced psychosis (SIP) is a serious condition and may predispose for schizophrenia. We know too little about SIP incidence over time and across countries, including substance-specific SIPs. We estimated annual incidence rate of SIP in Denmark, Norway, and Sweden according to substance, age, gender, and socioeconomic background.
Data were drawn from registries covering the whole adult population in the countries. Annual incidence rate per 100 000 persons of SIPs was estimated for Denmark and Sweden from 2000 to 2016 and for Norway from 2010 to 2015.
The annual incidence rate of any SIP fluctuated between 9.3 and 14.1. The most commonly occurring SIPs were those induced by alcohol, cannabis, amphetamines, and multiple substances. There was a steady decrease in the incidence rate of alcohol-induced psychosis from the first to the last year of the observation period in Denmark (from 4.9 to 1.5) and Sweden (from 4.5 to 2.2). The incidence rate of cannabis-induced psychosis increased in all countries, from 2.6 to 5.6 in Denmark, from 0.8 to 2.7 in Sweden, and from 1.8 to 3.0 in Norway. Median age of any SIP decreased in Denmark (from 36 to 29 years) and Sweden (from 41 to 31 years). Incidence rates were higher in men and in individuals on disability pension, and increased more among those with high parental education.
We found similar and stable incidence rates of any SIP in all Scandinavian countries through the observation period. The incidence of alcohol-induced psychosis decreased. The incidence of cannabis-induced psychosis increased.
We studied responses of carabid beetles (Coleoptera: Carabidae) to clear-cutting and wildfire in lodgepole pine forests in the foothills of Alberta, Canada during 2013–2014 and compared the results with those from a similar study conducted in the same area during 1989–1990. Assemblages from stands regenerating 12–53 years after harvest gradually recovered towards their presumed preharvest condition represented by old pyrogenic stands. Assemblage structure in postharvest stands of similar age had also largely converged with that in stands that had burned in 1957 and 1997. Composition of ground vegetation, mineral soil cover, and basal area of trees and shrubs were significantly correlated with carabid assemblage structure, suggesting that plant successional gradients and patterns in carabid assemblages are driven by similar factors. We found that no carabid species was strictly associated with old pyrogenic stands, although assemblages in pyrogenic stands were distinctive. We predict that composition of carabid assemblages in harvested stands will recover and roughly match the variable structure of assemblages remaining in old, never-cut pyrogenic stands, given sufficient time (≥ 50 years). Nonetheless, the carabid fauna of the eastern slopes of Alberta’s Rocky Mountains appears to be changing in response to factors other than forestry. Warming climate is an explanation consistent with the changes observed.
Cannabis use has been associated with increased risk of psychiatric disorders. However, associations between adolescent cannabis use, depression and anxiety disorders are inconsistently reported in longitudinal samples.
To study associations of adolescent cannabis use with depression and anxiety disorders.
We used data from the Northern Finland Birth Cohort 1986, linked to nationwide registers, to study the association between adolescent cannabis use and depression and anxiety disorders until 33 years of age (until 2018).
We included 6325 participants (48.8% male) in the analyses; 352 (5.6%) participants reported cannabis use until 15–16 years of age. By the end of the follow-up, 583 (9.2%) participants were diagnosed with unipolar depression and 688 (10.9%) were diagnosed with anxiety disorder. Cannabis use in adolescence was associated with an increased risk of depression and anxiety disorders in crude models. After adjusting for parental psychiatric disorder, baseline emotional and behavioural problems, demographic factors and other substance use, using cannabis five or more times was associated with increased risk of anxiety disorders (hazard ratio 2.01, 95% CI 1.15–3.82), and using cannabis once (hazard ratio 1.93, 95% CI 1.30–2.87) or two to four times (hazard ratio 2.02, 95% CI 1.24–3.31) was associated with increased risk of depression.
Cannabis use in adolescence was associated with an increased risk of future depression and anxiety disorders. Further research is needed to clarify if this is a causal association, which could then inform public health messages about the use of cannabis in adolescence.
Involvement with illicit drugs among young people has been explained by a risk-factor matrix. This study aims to compare childhood psychopathology as a predictor between self-reported illicit drug use without registered drug offending and police informed drug offending among males in a prospective birth cohort study.
A general population sample of 2946 8-year-old Finnish boys was followed up from age 8 to 18. In 1989, childhood psychopathology was assessed using the Rutter scale and Child Depression inventory. Information about self-reported drug use at age 18 or police-registered drug offending during years 16 to 20 years was collected from 79.3% (n=2336) of the subjects.
Childhood psychopathology predicted exclusively police registered drug offending. After adjusting for family background, both severe and moderate conduct problems and ADHD symptoms were associated with subsequent police-registered drug offence. Self-reported illicit drug use was predicted only by non-intact family structure.
Our results demonstrate a clear difference, occurring already in childhood, between young men with self reported illicit drug use and those with police registered drug offending. More severe illicit drug involvement, such as police-registered drug offending, is a continuum of a childhood externalizing problem behaviour, while self-reported occasional illicit drug use does not inevitably associate with psychopathological problems in childhood. Accordingly, the preventive needs and the age period for intervention may be dissimilar for young people with divergent involvement with illicit drugs.
We studied the relationship between depressive symptoms and quality of life (QOL) as well as functional status in primary brain tumor patients at recurrent measurements. Differences in QOL between depressive and non-depressive samples by gender were controlled for tumor characteristics and patients' psychosocial factors.
Materials and methods. –
The data consisted of 77 patients with a primary brain tumor, 30 males and 47 females. Depression of the patients was assessed by Beck Depression Inventory (BDI) and Crown-Crisp Experiential Index (CCEI), functional status by Karnofsky Performance scale (KPS) and QOL by Sintonen's 15D before tumor operation as well as at 3 months and at 1 year from surgical operation of the tumor.
The level of QOL in females was lower compared to that of males. Depression was the main predictor for worse QOL in the patients at all measurements. Depressive patients with a benign brain tumor had significantly worse QOL versus non-depressive ones.
Discussion and conclusion. –
Decreased QOL was strongly related to depression, especially among patients with a benign brain tumor. Further studies are needed to find whether sufficient depression therapy improves the QOL of patients.
Recent studies have shown that cannabis use acts as a specific risk factor provoking the onset of psychosis in vulnerable individuals. Association of adolescent cannabis use and psychosis risk was studied after adjustment with prodromal symptoms.
To assess possible causality between cannabis use and the risk of psychosis.
To examine associations between cannabis use and the risk of psychosis in 10 years follow-up while taking into account the prodromal symptoms of psychosis in a prospective general population sample.
The sample (N=6258) composed of a prospective Northern Finland Birth Cohort 1986. Questionnaire on prodromal symptoms for psychosis (PROD-screen) and on drug use was conducted when the cohort members were 15-16 years old. The participants were asked if they had tried cannabis: never, once, 2-4 times, 5 times or more. Information on psychoses was gathered from registers until age 27 years.
In total 102 new psychoses emerged. The proportion of psychoses in the groups 'never”, 'once”, '2-4 times”, '5 times or more” were 1.5%, 2.8%, 3.6%, and 8.5%, respectively. The hazard ratio (HR) for risk of psychosis in subjects who had tried cannabis 5 times or more was 5.9 (95% CI 2.4-14.4) when compared to non-users. The association remained statistically significant when adjusted for prodromal symptoms and parental psychosis (HR 2.6, 1.0-6.6). When gender and smoking was taken into account association was no longer significant (HR 2.3, 0.9-6.0).
Adolescent cannabis use associates with increased risk of first-episode psychosis even after controlling for baseline prodromal symptoms.
Longitudinal alcohol consumption in early adulthood has been studied, but reports from later adulthood are scarce.
Finding longitudinal trends in alcohol consumption using prospective birth cohort data.
To investigate trends in self-reported alcohol consumption in adulthood.
In the Northern Finland Birth Cohort 1966 (N=5,621) alcohol use was studied with questionnaires at ages 31 and 46. Participants were classified into steady drinkers, increasers and decreasers based on the change in consumption (g/day). Multinomial regression analysis was conducted with educational, marital and employment baseline statuses and their changes, and baseline alcohol use as factors influencing the change in alcohol consumption.
70% of alcohol users were classified as steady drinkers, 10% as decreasers and 20% as increasers. In all, daily alcohol consumption rose over 30%, particularly among women. The unemployed, singles and low-educated consumed the most (P<0.01). Being a divorced male (OR 1.5; 95%CI: 1.0-2.1) or a long-term unemployed female (1.6; 1.0-2.6) predicted increase in alcohol use. The probability of decrease was higher among single men (OR 1.6; 1.0-2.4) and women (2.8; 1.7-4.4) at 31y, among men entering a relationship (1.9; 1.2-3.1), and among divorced women (2.4; 1.4-3.8) and entering a relationship (2.1; 1.3-3.5).
Alcohol usage among middle-aged Northern Finns is rather stable and increase is more exhibited than decrease. Gender differences in predictors existed: changes in relationship status predicted decrease in usage in women, whereas in men divorce predicted increase in usage and a new relationship predicted decrease. Long-term unemployment predicted increase only in women.
Longitudinal studies on how temperament is related to alcohol use in general population are scarce.
Finding relations with temperament and problematic alcohol use using prospective birth cohort data.
To investigate trends in self-reported alcohol consumption in adulthood.
In the Northern Finland Birth Cohort 1966 (n = 5247), alcohol use was studied with questionnaires at ages 31 and 46. Participants were classified into abstainers, bingers, heavy drinkers, steady drinkers, increasers or reducers based on the change in consumption (g/day). Cloninger's TCI-scores were calculated for each group. Multinomial regression analysis was conducted with TCI-scores as factors influencing the change in alcohol consumption.
High novelty seeking was associated with increased consumption, binging and heavy drinking among both sexes at both time points (P < 0.01). Lower persistence was associated with increased consumption at both time points among men and among women at age 46. Baseline novelty seeking predicted both increasing (OR 1.1; 95% CI: 1.0–1.1) and reducing (1.1; 1.0–1.1) for men and for women also increasing (1.1; 1.0–1.1) and reducing (1.1; 1.0–1.1), but when adjusted with baseline alcohol use novelty seeking only predicted increasing for men (1.0; 1.0–1.1).
High novelty seeking and low persistence are associated with problematic alcohol use among middle-aged Northern Finns. Gender differences in predictors existed: novelty seeking predicted increase only for men in the adjusted model. Temperament scores do not seem to affect strongly changes in alcohol use.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Prenatal smoking exposure is one of the most common insults during the fetal period prevalence varying from 5 to 19% in the European countries .
Prenatal smoking exposure increases the risk of psychiatric morbidity in the offspring, externalizing disorders in particular. However, less is known whether maternal smoking during pregnancy increases the risk for anxiety disorders .
To study the associations between maternal smoking during pregnancy and offspring psychiatric morbidity in early adulthood in a Finnish birth cohort study.
A prospective data collection from 10th gestational week (GW10) to early adulthood (n = 475, 37% from the original sample). Information on self-reported smoking during pregnancy was collected using questionnaires at GW10 and GW28. Offspring psychiatric diagnoses and clinically relevant symptoms were assessed using Development and Well-being Assessment (DAWBA)-interviews at age 18 to 20 years. Information on parental alcohol use, depressive mood, anxiety, and education level, as well as offspring's gender, education level, and birth weight were used as covariates.
Maternal smoking during pregnancy associated independently associated with PTSD (OR = 6.9, 95% CI 1.3–35.6, P = 0.021), and conduct disorder (OR = 2.7, 95% CI 1.02–6.9, P = 0.046) in a multivariate analysis after adjusting for other psychiatric diagnoses, offspring and parental variables (OR = 1.9, 95% CI 0.5–6.9, P = 0.359).
In addition to conduct problems, prenatal nicotine exposure may increase the offspring's risk for posttraumatic stress disorder (PTSD). This relationship may be explained, in part, by effects on nicotinic acetylcholine receptors and uteroplacental mechanisms .
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Although substance use is a well-known public health risk factor, European population-based studies reporting the substance use among adult migrant populations are scarce.
We aim to: (1) determine the prevalence of alcohol use, cigarette smoking and consumption cannabis and intravenous drugs in Russian, Somali and Kurdish migrants in Finland and compare them to those of the Finnish general population; (2) determine if socio-economic and migration-related factors are associated with substance use in migrants.
We used data primarily from the Finnish migrant health and well-being study. Alcohol use was measured with the AUDIT-C questionnaire, smoking habits and the lifetime cannabis and intravenous drug use were recorded. Age-adjusted prevalence rates were determined by ethnicity and sex. The associations between background factors and substance use were analysed using logistic regression analysis.
The prevalence rate of risky drinking is lower and the proportion of abstainers is higher in migrants than in the general population. Current smoking is more common in Russian (31%, P < 0,05) and Kurdish (31%, P < 0,05) migrant men than in the general population (21%). Younger age was associated with risky drinking, socioeconomic disadvantage increased the odd for the daily smoking among migrants, and migration-related factors were associated with substance use.
Migrants report less substance use than the general population, but acculturation-related factors seem to be associated with higher levels of substance use among migrants. Substance use seems to be a gendered phenomenon in migrant populations in comparison to the general population, where lately the alcohol and tobacco consumption of women have been growing.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Background Attention-deficit/hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that often persists into adulthood and old age. Yet ADHD is currently underdiagnosed and undertreated in many European countries, leading to chronicity of symptoms and impairment, due to lack of, or ineffective treatment, and higher costs of illness.
Methods The European Network Adult ADHD and the Section for Neurodevelopmental Disorders Across the Lifespan (NDAL) of the European Psychiatric Association (EPA), aim to increase awareness and knowledge of adult ADHD in and outside Europe. This Updated European Consensus Statement aims to support clinicians with research evidence and clinical experience from 63 experts of European and other countries in which ADHD in adults is recognized and treated.
Results Besides reviewing the latest research on prevalence, persistence, genetics and neurobiology of ADHD, three major questions are addressed: (1) What is the clinical picture of ADHD in adults? (2) How should ADHD be properly diagnosed in adults? (3) How should adult ADHDbe effectively treated?
Conclusions ADHD often presents as a lifelong impairing condition. The stigma surrounding ADHD, mainly due to lack of knowledge, increases the suffering of patients. Education on the lifespan perspective, diagnostic assessment, and treatment of ADHD must increase for students of general and mental health, and for psychiatry professionals. Instruments for screening and diagnosis of ADHD in adults are available, as are effective evidence-based treatments for ADHD and its negative outcomes. More research is needed on gender differences, and in older adults with ADHD.
The association between cannabis use and the risk of psychosis has been studied extensively but the temporal order still remains controversial.
To examine the association between cannabis use in adolescence and the risk of psychosis after adjustment for prodromal symptoms and other potential confounders.
The sample (n = 6534) was composed of the prospective general population-based Northern Finland Birth Cohort of 1986. Information on prodromal symptoms of psychosis and cannabis use was collected using questionnaires at age 15–16 years. Participants were followed up for ICD-10 psychotic disorders until age 30 years using nationwide registers.
The risk of psychosis was elevated in individuals who had tried cannabis five times or more (hazard ratio, (HR) = 6.5, 95% CI 3.0–13.9). The association remained statistically significant even when adjusted for prodromal symptoms, other substance use and parental psychosis (HR = 3.0, 95% CI 1.1–8.0).
Adolescent cannabis use is associated with increased risk of psychosis even after adjustment for baseline prodromal symptoms, parental psychosis and other substance use.
We investigated the effects of fermented milk product containing isoleucine–proline–proline, valine–proline–proline and plant sterol esters (Pse) on plasma lipids, blood pressure (BP) and its determinants systemic vascular resistance and cardiac output. In a randomised, double-blind, placebo-controlled study, 104 subjects with the metabolic syndrome (MetS) were allocated to three groups in order to receive fermented milk product containing (1) 5 mg/d lactotripeptides (LTP) and 2 g/d plant sterols; (2) 25 mg/d LTP and 2 g/d plant sterols; (3) placebo for 12 weeks. Plasma lipids and home BP were monitored. Haemodynamics were examined in a laboratory using radial pulse wave analysis and whole-body impedance cardiography in the supine position and during orthostatic challenge. There were no differences between the effects of the two treatments and placebo on the measurements of BP at home or on BP, systemic vascular resistance index and cardiac index in the laboratory, neither in the supine nor in the upright position. The changes in plasma LDL-cholesterol concentration were − 0·1 (95 % CI − 0·3, 0·1 and − 0·3, 0·0) mmol/l in the 5 and 25 mg/d LTP groups, respectively, and +0·1 (95 % CI − 0·1, 0·3) mmol/l during placebo (P= 0·024). Both at baseline and at week 12, the increase in systemic vascular resistance during head-up tilt was lower in the 25 mg/d LTP group than in the 5 mg/d LTP group (P< 0·01), showing persistent differences in cardiovascular regulation between these groups. In subjects with the MetS, intake of LTP and Pse in fermented milk product showed a lipid-lowering effect of borderline significance, while no antihypertensive effect was observed at home or in the laboratory.
A growing field of discursive institutionalism has argued for the importance of ideas and discourse in policy changes. The aim of the study is to analyse framing effects empirically by examining how, and to what extent, competing frames can shape public opinion on the implementation of a specific policy change. The case study focuses on the administration of social assistance in Finland. Results indicate that the framing of ideas shapes public opinion. Analyses show that some types of frames are more effective than others. To be successful, a politician must simplify the issue and appeal to moral sentiments rather than present too many difficult ‘factual’ viewpoints. Our study also emphasizes that even frames that succeed in shaping popular opinion may fail if powerful political actors oppose reform. Therefore, we argue that the interplay between the ‘old’ power resource approach and the ‘new’ ideational approach should be taken into account when explaining institutional changes.
We describe a litter-washing technique for collecting quantitative samples of ground-beetles (Carabidae), and compare the results with those from liner extraction by Tullgren funnels and pitfall (rapping. We also compare performance of four types of pitfall traps across five habitats. Carabid species composition from litter washing and funnel extraction was similar but washing revealed higher densities. Large-bodied species predominated in pitfall samples and small-bodied species predominated in litter samples. Uncovered, round pitfall traps yielded generally higher catches than rectangular or covered, round traps but the pattern was not consistent over all species or the five habitats. Ecological studies of carabid populations and assemblages using pitfall traps may be improved if they are both designed and interpreted in light of the biology of the group and with regard to the deficiencies of pitfall trapping as discussed here and elsewhere.
Carabid beetles were collected with grids of pitfall traps during two seasons in five habitats in the ecotone between aspen parkland and boreal mixedwood forest in central Alberta. The 23 abundant species (54 species in total) were divided into the following four distributional types: (1) Pterostichus adstrictus Eschz. was numerous in all five habitats (habitat generalist); (2) Platynus decentis Say, Calathus ingratus Dej., and Scaphinotus marginatus Fisch. were abundant in all four forest habitats (forest generalists); (3) another 10 species were common in one or two forest habitats (forest specialists); (4) nine species, representing mainly Agonum, Amara, and Bembidion, were restricted to a recently cleared timothy–clover grassland (meadow species). Soil moisture seemed to be important in determining habitat associations of the species among the forest types. Captures of most species were aggregated also within habitats, and the consistency of aggregation among particular traps suggests that it is mainly a response to subtle microhabitat differences. All abundant species, except S. marginatus, showed a peak of capture in May–June. Number of species, corrected for sample size by rarefaction, was highest in the meadow (27.5) and lowest in the dry upland aspen forest (11.9). Species diversity was highest in meadow and the lakeside forest habitats, but carabid assemblages of the four forest habitats were more similar to each other than to the meadow assemblage.
Organic brain syndromes are conditions that can be traced to brain diseases, injuries, other factors affecting brain activity, or diseases of other organs or organ systems. The DSM-IVTR places organic brain syndromes in three groups: delirium, dementia, amnestic disorders, and other cognitive disorders; mental disorders due to a general medical condition; and substance-related disorders. The essential feature of dementia is memory disturbance, although debilitation may be observed in many other cognitive functions. According to the DSM-IV-TR definition, amnestic disturbances are attributable either to the direct physiological consequences of a general medical condition, the continued use of intoxicants or drugs, or exposure to toxic substances, or the cause may remain entirely unresolved. The postconcussional syndrome that arises from traumatic brain injury (TBI) typically involves memory and attention symptoms. The most significant diseases occurring concurrently with Tourette syndrome are obsessive-compulsive disease (OCD), attention-deficit hyperactivity disorder (ADHD), and learning difficulties.