Cognitive functioning in substance abuse and dependence: a population-based study of young adults

Aims   To investigate whether substance use disorders (SUDs) are associated with verbal intellectual ability, psychomotor processing speed, verbal and visual working memory, executive function and verbal learning in young adults, and to study the associations of SUD characteristics with cognitive performance.
Participants   A population-based sample ( n  = 466) of young Finnish adults aged 21–35 years.
Measurements   Diagnostic assessment was based on all available information from a structured psychiatric interview (SCID-I) and in- and out-patient medical records. Established neuropsychological tests were used in the cognitive assessment. Confounding factors included in the analyses were comorbid psychiatric disorders and risk factors for SUDs, representing behavioural and affective factors, parental factors, early initiation of substance use and education-related factors.
Findings   Adjusted for age and gender, life-time DSM-IV SUD was associated with poorer verbal intellectual ability, as measured with the Wechsler Adult Intelligence Scale–Revised (WAIS-R) vocabulary subtest, and slower psychomotor processing, as measured with the WAIS-R digit symbol subtest. Poorer verbal intellectual ability was accounted for by parental and own low basic education, whereas the association with slower psychomotor processing remained after adjustment for SUD risk factors. Poorer verbal intellectual ability was related to substance abuse rather than dependence. Other SUD characteristics were not associated with cognition.
Conclusions   Poorer verbal intellectual ability and less efficient psychomotor processing are associated with life-time alcohol and other substance use disorders in young adulthood. Poorer verbal intellectual ability seems to be related to parental and own low basic education, whereas slower psychomotor processing is associated with SUD independently of risk factors.     

Dimensions of psychotic experiences among women in the general population

Full‐information factor analysis of ordinal data was employed to determine the factorial structure of the responses of 31,822 adult Swedish women to the 20 “positive” psychotic experience items of the Community Assessment of Psychic Experiences (CAPE) questionnaire. Five separable but correlated trait dimensions were found, reflecting Paranoia, Grandiosity, Magical Thinking, Delusions, and Hallucinations. High scores on any dimension were associated with a higher probability of questionnaire‐assessed lifetime major depressive episodes or generalized anxiety disorder, though Grandiosity was so only to a very small degree. Our results closely match previous findings among adolescents and young women, and demonstrate that psychotic experiences cannot be considered a single trait. Copyright © 2013 John Wiley & Sons, Ltd.     

Schizophrenia and pregnancy: a national register-based follow-up study among Finnish women born between 1965 and 1980

Archives of Women's Mental Health - To assess psychosocial and somatic risk factors related to pregnancy, and pregnancy-related complications or disorders in women with schizophrenia compared...     

Childhood central nervous system viral infections and adult schizophrenia

OBJECTIVE: An earlier Finnish cohort study suggested that childhood viral CNS infections are associated with a fivefold increased odds of developing schizophrenia in adulthood. The authors sought to replicate this finding. METHOD: From the archives of the Department of Virology of the National Public Health Institute in Finland, 320 individuals born between 1960 and 1976 who had suffered virologically confirmed CNS infections before their 15th birthdays were identified. Of the infections, 202 had been caused by enteroviruses. The sample was followed up in the 1969-2000 records of the National Hospital Discharge Register of Finland to identify all cases of schizophrenia that emerged. RESULTS: The cumulative incidence of schizophrenia was 0.94% in the whole sample and 0.99% among individuals who had suffered enteroviral infections. These rates are comparable to that found in the general population. CONCLUSIONS: Childhood viral CNS infections were not associated with increased risk of schizophrenia.     

Impaired executive performance in healthy siblings of schizophrenia patients in a population-based study

There is increasing evidence that healthy siblings of schizophrenia patients have similar, although milder, neuropsychological deficits than their affected family members. However, the interpretation of these findings has been complicated by methodological differences, for example the selection of relatives studied and the sensitivity of tests used. We studied neuropsychological functioning in schizophrenia families in representative, population-based samples of schizophrenia patients (n=81) and healthy siblings (n=78) from 58 families, and control subjects (n=70). We found that the healthy sibling group was impaired in tests measuring performance speed and executive functions. The patients were significantly impaired in all neuropsychological variables studied when compared with the control subjects, and also when compared with the healthy siblings. The effects of age, sex and education were controlled for. In conclusion, in a study of representative, population-based sample the healthy siblings of schizophrenia patients demonstrated deficits in processing speed and executive functions.     

Incidence of schizophrenia in a nationwide cohort of patients with type 1 diabetes mellitus

CONTEXT: Patients with schizophrenia have an increased risk of type 2 diabetes mellitus. However, very few studies have dealt with the association of type 1 diabetes and schizophrenia. Preliminary evidence points to a possible inverse association. OBJECTIVE: To investigate the incidence of schizophrenia in a nationwide cohort of patients with type 1 diabetes born in 1950 through 1959 in Finland. DESIGN: A cohort study of individuals born in 1950 through 1959 with a follow-up of 1969 through 1991. SETTING: Finland. PATIENTS: All individuals born in 1950 through 1959 with type 1 diabetes were identified through nationwide registers. The incidence of schizophrenia until 1992 among the total 1950-1959 cohort and in individuals with type 1 diabetes was calculated using information from 3 health care registers. MAIN OUTCOME MEASURE: Incidence of schizophrenia. RESULTS: The incidence of schizophrenia was 0.21 per 10 000 person-years in the group with type 1 diabetes and 0.56 per 10 000 person-years in the group without type 1 diabetes (P < .001). CONCLUSION: The incidence of schizophrenia is decreased in patients with type 1 diabetes.     

Mobility limitations in persons with psychotic disorder: findings from a population-based survey

BACKGROUND: There are few reports on mobility limitations in persons with psychotic disorder although restrictions in mobility may aggravate the general functional limitations of these patients. Our aim was to investigate mobility limitations among subjects with psychotic disorder in a general population-based sample. METHODS: A nationally representative sample of 6,927 persons aged 30 and older self-reported mobility limitations in an interview and was examined in performance tests. Diagnostic assessment of DSM-IV psychotic disorders combined SCID interview and case note data. Lifetime-ever diagnoses of psychotic disorder were classified into schizophrenia, other nonaffective psychotic disorders and affective psychoses. RESULTS: Self-reported mobility limitations were highly prevalent in persons with schizophrenia and other nonaffective psychosis, but not in the affective psychosis group. After adjusting for age and sex, persons with schizophrenia and other nonaffective psychoses but not affective psychoses had significantly increased odds of having both self-reported and test-based mobility limitations as well as weak muscle strength. Schizophrenia remained an independent predictor of mobility limitations even after controlling for lifestyle-related factors and chronic medical conditions. Among persons with nonaffective psychoses, higher levels of negative symptoms predicted mobility limitations. CONCLUSION: Self-reported mobility limitations are prevalent already at a young age in persons with schizophrenia and other nonaffective psychotic disorders, and among older persons with these disorders both self-reported limitations and measured performance tests show lower capacity in mobility. Difficulties in mobility are associated with negative symptoms. Mental health care professionals should pay attention to mobility limitations in persons with psychotic disorder.     

Geographic variation and sociodemographic characteristics of psychotic disorders in Finland

BACKGROUND: Geographical variation and sociodemographic characteristics may differ in affective and nonaffective psychotic disorders. We examined the geographical variation in the lifetime prevalence of psychotic disorders in a comprehensive general population study. METHOD: A nationally representative sample of 8028 Finns aged 30 or over was screened for psychotic and bipolar I disorders and interviewed with the Structured Clinical Interview for DSM-IV. Best-estimate DSM-IV diagnoses were formed by combining interview and case note data. Nationwide health care register data were used for the nonrespondents. Associations with sociodemographic features, place of birth and residence in urban or rural areas and in five regions, and migration between the regions were examined. RESULTS: Schizophrenia and other nonaffective psychoses, but not affective psychoses, showed prominent regional variation, with highest odds found for schizophrenia among those born in the North (OR 7.72 95%CI 2.48-24.04) and the East (OR 3.99 95%CI 1.22-13.11). The risk of any psychotic disorder was lower for those born in urban areas (OR 0.73 95%CI 0.54-0.98), but no associations were found for separate diagnostic groups. Region of birth was the strongest determinant of geographical variation when both place of birth and residence were accounted for. Selective migration was not found. Education and income were higher and being employed more common in subjects with affective psychosis than in subjects with other psychotic disorders. CONCLUSIONS: Large area variation is more important than urban-rural disparity in psychotic disorders in Finland. Affective psychoses were different from nonaffective psychoses in terms of both regional variation and sociodemographic features.