Association between childhood family structure and longitudinal health behaviour changes in adulthood -Northern Finland birth cohort 1966 study.

BACKGROUND: Childhood family structure is considered to play a role in person's health and welfare. This study investigated the relationships between the longitudinal changes of adult health behaviours and childhood family structure. METHODS: From Northern Finland Birth Cohort 1966 questionnaires, we collected data on childhood family structure at the age of 14 ('two-parent family', 'one parent not living at home/no information on father', and 'father or mother deceased'), and on health behaviours (smoking, alcohol consumption and physical activity status) at the ages of 31 and 46. We used the multinomial logistic regression model to estimate the unadjusted and adjusted associations between childhood family structures and the longitudinal changes between 31 and 46 years of health behaviours (four-category variables). RESULTS: Of the study sample (n = 5431; 55.5% females), 7.1% of the offspring were represented in the 'One parent not living at home/no information on father' subgroup, 6.3% in the 'Father or mother deceased' subgroup and 86.6% in the 'Two-parent family'. 'One parent not living at home/no information on father' offspring were approximately twice as likely to smoke (adjusted OR 2.19, 95% CI 1.70-2.81) and heavily consume alcohol (adjusted OR 1.99, 95% CI 1.25-3.16) at both times in adulthood, relative to not smoking or not heavily consume alcohol, and compared with 'two-parent family' offspring. We found no statistically significant associations between childhood family structure and physical activity status changes in adulthood. CONCLUSIONS: Our findings suggest that the offspring of single-parent families in particular should be supported in early life to diminish their risk of unhealthy behaviours in adulthood.

Childhood chronic condition and subsequent self-reported internalizing and externalizing problems in adolescence: a birth cohort study.

Chronic conditions are common in childhood. We investigated the associations of childhood chronic conditions reported by parents with subsequent self-reported internalizing and externalizing problems in adolescence. A sample of 6290 children (3142 boys and 3148 girls) with data on chronic condition reported by parents both at 7 and at 16 years of age was obtained from the Northern Finland Birth Cohort 1986 (NFBC 1986), which is a longitudinal 1-year birth cohort (n = 9432) from an unselected, regionally defined population. Internalizing and externalizing problems were measured at 8 years of age with Rutter Children's Behavioral Questionnaire by teachers and at 16 years of age with Youth Self-Report by adolescents. When studying the effects of history of chronic conditions on these problems at 16 years of age, childhood internalizing and externalizing problems and social relations were adjusted. A history of chronic condition predicted subsequent somatic complaints among all adolescents. Early-onset chronic conditions were related to subsequent externalizing (OR 1.35; 1.02-1.79) and attention problems (OR 1.33; 1.01-1.75) and later onset of chronic conditions with internalizing (OR 1.49; 1.22-1.82) and thought problems (OR 1.50; 1.18-1.92). The effect was specific for sex and the type of chronic condition. CONCLUSION: Childhood chronic conditions predicted internalizing and externalizing problems in adolescence. To prevent poor mental health trajectories, children with chronic conditions during their growth to adolescence need early support and long-term monitoring. WHAT IS KNOWN: • Childhood adversities increase the risk of mental disorders. • Internalizing and externalizing problems have been suggested for measuring childhood and adolescent psychopathologies. WHAT IS NEW: • Having a chronic condition (CC) before the age of 7 or later but before the age of 16 had different outcomes in adolescence. The early onset predicted externalizing problems, whereas the late onset predicted internalizing problems and thought problems in adolescence. The risk of somatic complaints was increased regardless of CC onset time. These findings can reflect more restricted ability to mental processing in the younger children.

Parental separation and offspring morbidity in adulthood: a descriptive study of the Northern Finland Birth Cohort 1966.

Aims: Rates of parental separation have increased dramatically in recent decades. We evaluated the association of individuals' childhood family structure with their somatic health over 46 years of follow-up. Methods: Data were drawn from the Northern Finland Birth Cohort, an ongoing project in which 12,058 participants born in 1966 have been followed from their 24th gestational week. Based on information supplied at age 14 years, family structure was categorised as 'single-parent family' and 'two-parent family'. The anthropometric information, data from blood samples and medical history were collected from postal questionnaires and clinical examinations routinely performed at the ages of 31 and 46 years. Results: The study population comprised a total of 10,895 individuals; 85% (n=9253) were offspring of two-parent families and 15% (n=1642) of single-parent families. Type 2 diabetes (P=0.032) or prediabetes (P=0.007), psychoactive drug problems (P<0.001) and sexually transmitted diseases (P<0.001) were more common in the single-parent family group than in the participants from two-parent families. In addition, among men back diseases (P=0.002), and among women hypertension (P=0.003) and ovary infection (P=0.024) were more frequent in individuals affected by parental death than in those from two-parent families. Conclusions: Our results indicate the association of childhood family structure with offspring morbidity during 46 years' follow-up. The lifetime morbidity was observed to be higher among offspring from a single-parent family compared to two-parent family offspring. Public and scientific concern about the consequences of parental separation on the offspring' health exist, therefore support from healthcare professionals and society is warranted.

Mother's education and offspring asthma risk in 10 European cohort studies.

Highly prevalent and typically beginning in childhood, asthma is a burdensome disease, yet the risk factors for this condition are not clarified. To enhance understanding, this study assessed the cohort-specific and pooled risk of maternal education on asthma in children aged 3-8 across 10 European countries. Data on 47,099 children were obtained from prospective birth cohort studies across 10 European countries. We calculated cohort-specific prevalence difference in asthma outcomes using the relative index of inequality (RII) and slope index of inequality (SII). Results from all countries were pooled using random-effects meta-analysis procedures to obtain mean RII and SII scores at the European level. Final models were adjusted for child sex, smoking during pregnancy, parity, mother's age and ethnicity. The higher the score the greater the magnitude of relative (RII, reference 1) and absolute (SII, reference 0) inequity. The pooled RII estimate for asthma risk across all cohorts was 1.46 (95% CI 1.26, 1.71) and the pooled SII estimate was 1.90 (95% CI 0.26, 3.54). Of the countries examined, France, the United Kingdom and the Netherlands had the highest prevalence's of childhood asthma and the largest inequity in asthma risk. Smaller inverse associations were noted for all other countries except Italy, which presented contradictory scores, but with small effect sizes. Tests for heterogeneity yielded significant results for SII scores. Overall, offspring of mothers with a low level of education had an increased relative and absolute risk of asthma compared to offspring of high-educated mothers.

Longitudinal Pathways from Cumulative Contextual Risk at Birth to School Functioning in Adolescence: Analysis of Mediation Effects and Gender Moderation.

Children and adolescents exposed to multiple contextual risks are more likely to have academic difficulties and externalizing behavior problems than those who experience fewer risks. This study used data from the Northern Finland Birth Cohort 1986 (a population-based study; N = 6961; 51 % female) to investigate (a) the impact of cumulative contextual risk at birth on adolescents' academic performance and misbehavior in school, (b) learning difficulties and/or externalizing behavior problems in childhood as intervening mechanisms in the association of cumulative contextual risk with functioning in adolescence, and (c) potential gender differences in the predictive associations of cumulative contextual risk at birth with functioning in childhood or adolescence. The results of the structural equation modeling analysis suggested that exposure to cumulative contextual risk at birth had negative associations with functioning 16 years later, and academic difficulties and externalizing behavior problems in childhood mediated some of the predictive relations. Gender, however, did not moderate any of the associations. Therefore, the findings of this study have implications for the prevention of learning and conduct problems in youth and future research on the impact of cumulative risk exposure.

Impact of Low Maternal Education on Early Childhood Overweight and Obesity in Europe.

BACKGROUND: Comparable evidence on adiposity inequalities in early life is lacking across a range of European countries. This study investigates whether low maternal education is associated with overweight and obesity risk in children from distinct European settings during early childhood. METHODS: Prospective data of 45 413 children from 11 European cohorts were used. Children's height and weight obtained at ages 4-7 years were used to assess prevalent overweight and obesity according to the International Obesity Task Force definition. The Relative/Slope Indices of Inequality (RII/SII) were estimated within each cohort and by gender to investigate adiposity risk among children born to mothers with low education as compared to counterparts born to mothers with high education. Individual-data meta-analyses were conducted to obtain aggregate estimates and to assess heterogeneity between cohorts. RESULTS: Low maternal education yielded a substantial risk of early childhood adiposity across 11 European countries. Low maternal education yielded a mean risk ratio of 1.58 (95% confidence interval (CI) 1.34, 1.85) and a mean risk difference of 7.78% (5.34, 10.22) in early childhood overweight, respectively, measured by the RII and SII. Early childhood obesity risk by low maternal education was as substantial for all cohorts combined (RII = 2.61 (2.10, 3.23)) and (SII = 4.01% (3.14, 4.88)). Inequalities in early childhood adiposity were consistent among boys, but varied among girls in a few cohorts. CONCLUSIONS: Considerable inequalities in overweight and obesity are evident among European children in early life. Tackling early childhood adiposity is necessary to promote children's immediate health and well-being and throughout the life course.

Physical activity and obesity mediate the association between childhood motor function and adolescents' academic achievement.

The global epidemic of obesity and physical inactivity may have detrimental implications for young people's cognitive function and academic achievement. This prospective study investigated whether childhood motor function predicts later academic achievement via physical activity, fitness, and obesity. The study sample included 8,061 children from the Northern Finland Birth Cohort 1986, which contains data about parent-reported motor function at age 8 y and self-reported physical activity, predicted cardiorespiratory fitness (cycle ergometer test), obesity (body weight and height), and academic achievement (grades) at age 16 y. Structural equation models with unstandardized (B) and standardized (ß) coefficients were used to test whether, and to what extent, physical activity, cardiorespiratory fitness, and obesity at age 16 mediated the association between childhood motor function and adolescents' academic achievement. Physical activity was associated with a higher grade-point average, and obesity was associated with a lower grade-point average in adolescence. Furthermore, compromised motor function in childhood had a negative indirect effect on adolescents' academic achievement via physical inactivity (B = -0.023, 95% confidence interval = -0.031, -0.015) and obesity (B = -0.025, 95% confidence interval = -0.039, -0.011), but not via cardiorespiratory fitness. These results suggest that physical activity and obesity may mediate the association between childhood motor function and adolescents' academic achievement. Compromised motor function in childhood may represent an important factor driving the effects of obesity and physical inactivity on academic underachievement.

Work disabilities and unmet needs for health care and rehabilitation among jobseekers: a community-level investigation using multidimensional work ability assessments.

OBJECTIVE: Comprehensive understanding of the prevalence and quality of work disabilities and unmet needs for health care and rehabilitation to support return to work (RTW) among jobseekers. DESIGN: Community-level, cross-sectional analysis with multidimensional clinical work ability assessments. SETTING: Paltamo, Finland. PARTICIPANTS: Unemployed citizens either participating in the Full-Employment Project or long-term unemployed (n = 230, 81%). MAIN OUTCOME MEASURES: Based on data from theme interviews, patient records, supervisors' observations of work performance and clinical examinations, a physician concluded the individual's work ability, categorised into four groups: good work ability, good work ability expected after RTW support, able to transitional work only or unable to work. These groups were cross tabulated with primary diagnoses, types of plans to support RTW, as well as categories of social functioning and motivation, for which sensitivity and specificity scores in detecting work disability were calculated. RESULTS: Only about half of the jobseekers had good work ability, 27% were found unable to work in the open labour market and 15% even eligible for a disability pension. For 20%, care or rehabilitation was seen necessary to enable RTW. Poor supervisor- and self-rated performance at work or poor social functioning appeared as sensitive measures in detecting work disability. CONCLUSIONS: Work disabilities and unmet needs for health care and rehabilitation are highly prevalent among jobseekers, as depicted using a multidimensional work ability assessment procedure inspired by the International Classification of Functioning (ICF). Further development of work ability assessment practices is clearly needed. KEY POINTS Although the association of unemployment with poor health is well known, evidence on the work ability of the unemployed remains scarce. Work disabilities are common among the unemployed. Multidimensional work ability assessment among the unemployed reveals unmet needs for care and rehabilitation to support return to work. Context sensitivity may add to the accuracy of the doctor's conclusions on work ability.

Genome-wide association study of primary tooth eruption identifies pleiotropic loci associated with height and craniofacial distances.

Twin and family studies indicate that the timing of primary tooth eruption is highly heritable, with estimates typically exceeding 80%. To identify variants involved in primary tooth eruption, we performed a population-based genome-wide association study of 'age at first tooth' and 'number of teeth' using 5998 and 6609 individuals, respectively, from the Avon Longitudinal Study of Parents and Children (ALSPAC) and 5403 individuals from the 1966 Northern Finland Birth Cohort (NFBC1966). We tested 2 446 724 SNPs imputed in both studies. Analyses were controlled for the effect of gestational age, sex and age of measurement. Results from the two studies were combined using fixed effects inverse variance meta-analysis. We identified a total of 15 independent loci, with 10 loci reaching genome-wide significance (P < 5 × 10(-8)) for 'age at first tooth' and 11 loci for 'number of teeth'. Together, these associations explain 6.06% of the variation in 'age of first tooth' and 4.76% of the variation in 'number of teeth'. The identified loci included eight previously unidentified loci, some containing genes known to play a role in tooth and other developmental pathways, including an SNP in the protein-coding region of BMP4 (rs17563, P = 9.080 × 10(-17)). Three of these loci, containing the genes HMGA2, AJUBA and ADK, also showed evidence of association with craniofacial distances, particularly those indexing facial width. Our results suggest that the genome-wide association approach is a powerful strategy for detecting variants involved in tooth eruption, and potentially craniofacial growth and more generally organ development.

Orofacial pain and symptoms of temporomandibular disorders in Finnish and Thai populations.

OBJECTIVE: Cultural or ethnic factors may play an important role in subjects' pain reports. The aim of the study was to compare the prevalence of orofacial pain symptoms between Finnish and Thai populations. MATERIALS AND METHODS: The Finnish study population comprised the Northern Finland Birth Cohort 1966, of which 5696 subjects participated in the present study. The Thai sample consisted of 1501 randomly selected people living in 10 different districts in Bangkok. Data on orofacial pain was collected based on questionnaires. RESULTS: After adjusting for age, gender and education, the logistic regression analysis showed that Thai subjects had an increased risk for reporting oral pain (OR = 4.5, 95% CI = 3.7-5.4), tooth pain (OR = 2.0, 95% CI = 1.8-2.4) and pain in the face (OR = 1.5, 95% CI = 1.2-1.7). CONCLUSIONS: It can be concluded that Thai people report more orofacial pain symptoms than Finnish subjects. Cross-cultural factors exist in the background of reporting pain symptoms in the oral and facial area.

The path from childhood behavioural disorders to felony offending: Investigating the role of adolescent drinking, peer marginalisation and school failure.

BACKGROUND: Although a pathway from childhood behavioural disorders to criminal offending is well established, the aetiological processes remain poorly understood. Also, it is not clear if attention deficit hyperactivity disorder (ADHD) is predictive of crime in the absence of comorbid disruptive behaviour disorder (DBD). HYPOTHESIS: We examined two research questions: (1) Does ADHD have a unique effect on the risk of criminal offending, independently of DBD? (2) Is the effect of childhood behavioural disorders on criminal offending direct or mediated by adolescent processes related to school experience, substance misuse and peers? METHOD: Structural equation modelling, with latent variables, was applied to longitudinally collected data on 4644 men from the 1986 Northern Finland Birth Cohort Study. RESULTS: Both ADHD and DBD separately predicted felony conviction risk. Most of these effects were mediated by adolescent alcohol use and low academic performance. The effect of DBD was stronger and included a direct pathway to criminal offending. CONCLUSION: Findings were more consistent with the life course mediation hypothesis of pathways into crime than the behavioural continuity path, in that the effects of each disorder category were mediated by heavy drinking and educational failure. Preventing these adolescent risk outcomes may be an effective approach to closing pathways to criminal behaviour amongst behaviourally disordered children. However, as there was some evidence of a direct pathway from DBD, effective treatments targeting this disorder are also expected to reduce criminal offending.

Self-reported oral health and associated factors in the North Finland 1966 birth cohort at the age of 31.

BACKGROUND: The Northern Finland 1966 birth cohort (NFBC 1966) is an epidemiological study where the participants have been controlled since pregnancy both in field tests and using questionnaires. This study aimed to evaluate cross-sectionally the association of self-reported oral symptoms (dental caries and bleeding of gums) with sociodemographic and health behavior factors among the subjects. METHODS: Of the 11,541 original members of the cohort, 8,690 (75%) responded to the questionnaire on oral health (dental decay, gingival bleeding and self-estimated dental treatment need) and sociodemographic factors, general health and health behavior. Cross-tabulation and chi-squared tests as well as multiple logistic regression analysis were used to analyze the association between the outcome and explanatory variables. RESULTS: The study group was equally distributed between the genders. One third of the subjects reported having dental decay, one fourth gingival bleeding and a half a dental treatment need. As compared to women, men reported significantly more frequently symptoms (p < 0.05). Logistic regression analysis revealed low tooth brushing frequency increasing the odds most for all oral symptoms ((OR 1.57 (1.39-1.78) for dental decay, 1.94 (1.68-2.24) for gingival bleeding and 1.42 (1.26-1.61) for dental treatment need). Frequent smoking was associated with dental decay (OR 1.63 (1.44-1.84)) and treatment need OR (1.39 (1.23-1.56)), whereas poor general health (OR 1.71 (1.48-1.96)) and high BMI (OR 1.19 (1.03-1.36)) both were associated with gingival bleeding. CONCLUSIONS: Males with single marital status, BMI over 25, poor general health and poor oral health behaviors are at risk for self-reported poor oral health and dental treatment need.

[From the disease-based assessment of work ability and functional capacity to a multidimensional assessment mode]. / Sairauslähtöisestä työ- ja toimintakyvyn arvioinnista monialaiseen arviointimalliin.

BACKGROUND. Doctors assess an individual's work ability by comparing the diagnoses and findings to the demands of work. The accuracy of this disease-based orientation has recently been challenged. METHODS. A case study was conducted to compare a disease-based and a multidimensional functioning -based work ability assessment, illustrated through an individual case. RESULTS. Relevant potential for promoting work ability was missed by the disease-based approach, evaluating the entitlement to social security benefits. In the assessment based on multidimensional functioning, dialogue-based plans were made to improve fitness for work. CONCLUSIONS. Multidimensional functioning is recommended as the basis of assessing work ability.

Phenotype mining in CNV carriers from a population cohort.

Phenotype mining is a novel approach for elucidating the genetic basis of complex phenotypic variation. It involves a search of rich phenotype databases for measures correlated with genetic variation, as identified in genome-wide genotyping or sequencing studies. An initial implementation of phenotype mining in a prospective unselected population cohort, the Northern Finland 1966 Birth Cohort (NFBC1966), identifies neurodevelopment-related traits-intellectual deficits, poor school performance and hearing abnormalities-which are more frequent among individuals with large (>500 kb) deletions than among other cohort members. Observation of extensive shared single nucleotide polymorphism haplotypes around deletions suggests an opportunity to expand phenotype mining from cohort samples to the populations from which they derive.

Maternal hypertensive disorders during pregnancy and mild cognitive limitations in the offspring.

BACKGROUND: It remains unclear whether maternal hypertensive disorders could impact cognitive development of the child. The aim of this study was to explore the association between hypertensive disorders and other maternal biological and social factors on the risk of mild cognitive limitations (intelligence quotient 50-85) in the offspring. METHODS: An 11.5-year follow-up study of the Northern Finland Birth Cohort 1986 (n = 9432) was utilised. The analysis included 8847 singleton children, of whom 198 had mild cognitive limitations. Gestational hypertension was defined as de novo hypertension (blood pressure ≥ 140/90), diagnosed mid-pregnancy in a previously normotensive woman. Data on intelligence level of the children were based on standardised intelligence test results. RESULTS: Eleven per cent (n = 20) of mothers having a child with mild cognitive limitations had gestational hypertension. Maternal gestational hypertension was independently associated with increased odds of mild cognitive limitation in the offspring (odds ratio 2.4 [95% confidence interval 1.4, 3.9]). Other independent maternal risk factors for mild cognitive limitation were high pre-pregnancy body mass index (≥30 kg/m(2)), multiparity (≥4) and low education. In addition family's socio-economic status lower than professional, male gender and small birthweight-for-gestational age appeared as independent risk factors for mild cognitive limitation. CONCLUSIONS: Gestational hypertension should be considered as one of the adverse early risk factors that may predispose to impaired cognitive development in childhood.

Childhood chronic physical condition, self-reported health, and life satisfaction in adolescence.

The present study investigates the prevalence and type of chronic conditions at 7 years of age-with special reference to atopic conditions-and their longitudinal associations with self-reported health and life satisfaction in adolescence. The data were obtained from Northern Finland Birth Cohort 1986 (NFBC 1986), which is a longitudinal 1-year birth cohort from an unselected, regionally defined population (n = 9,432). The present study investigated a sample of 8,036 children with data of chronic conditions at 7 years of age and a sample of 6,680 children with data of chronic conditions at 16 years of age. According to parents' report the prevalence of CC at 7 years of age was 14.8 % among boys and 13.2 % among girls, these figures being at 16 years of age 20.7 and 19.4 %, respectively. Atopic conditions were the most common chronic conditions at 7 years of age (12.7 % vs. other chronic conditions 4.7 %). Childhood chronic condition was associated with subsequent self-reported health in adolescence, but not with subsequent self-reported life satisfaction. Chronic condition at 7 years of age increased the risk of reporting health as "poor" even if the chronic condition was no longer prevalent at 16 years of age. Atopic conditions seemed to be linked with self-reported poor/moderate health more often than other chronic conditions among girls. Conclusion Childhood chronic conditions seem to affect adolescent's subjective health, but fortunately, they do not affect adolescents' subjective well-being to such an extent that it could lower their life satisfaction.

The Northern Finland Birth Cohort Eye Study: Design and baseline characteristics.

BACKGROUND: To describe the rationale and design of the Northern Finland Birth Cohort (NFBC) Eye Study. METHODS: The NFBC Eye Study is a randomised prospective cohort study. The original NFBC study population consists of 12058 subjects born in the region of Lapland and the Province of Oulu. A postal questionnaire covering extensively the medical and socioeconomical background was sent to the 10300 subjects of the NFBC alive and residing in Finland. For the NFBC eye study the subjects were randomised to the screening group (50%) and the control group (50%). The screening protocol includes the following tests: automated and manifest refraction, best corrected visual acuity, central corneal thickness, intraocular pressure, Humphrey 24-2 perimetry, stereoscopic optic nerve head (ONH) and retinal nerve fibre layer (RNFL) photography and imaging with Scanning Laser Ophthalmoscopy (HRT), Scanning Laser Polarimetry (GDx) and Optical Coherence Tomography (OCT).Two ophthalmologists evaluate the ONH and RNFL photographs and the visual fields independently. All suspected glaucoma cases are re-evaluated by two independent glaucoma experts. HRT, GDx and OCT findings are assessed separately. In the future, both groups (100%) will be examined. The effectiveness and the cost-effectiveness of glaucoma screening will be calculated. The response rate of the questionnaire was 67% (n = 6855) and 871 randomised subjects had undergone the eye screening protocol by the end of April 2013. DISCUSSION: The trial is designed to address the following questions: what is the best combination of diagnostic tests for detecting glaucoma in an unscreened population, what are the benefits and disadvantages of the screening to the individual and the society and is glaucoma screening both effective and cost-effective. The prevalence, incidence and risk factors of glaucoma and other eye diseases will be evaluated, as well as their impact on quality of life.

Body mass index and overweight in relation to residence distance and population density: experience from the Northern Finland birth cohort 1966.

BACKGROUND: The effect of urban sprawl on body weight in Finland is not well known. To provide more information, we examined whether body mass index (BMI) and the prevalence of overweight are associated with an individual's distance to the local community centre and population density in his/her resident area. METHODS: The sample consisted of 5363 men and women, members of the Northern Finland Birth Cohort 1966 (NFBC), who filled in a postal questionnaire and attended a medical checkup in 1997, at the age of 31 years. Body mass index (BMI; kg/m(2)) and the prevalence of overweight (BMI ≥ 25.0 kg/m(2)) were regressed on each subject's road distance to the resident commune's centre and on population density in the 1 km(2) geographical grid in which he/she resided, using a generalized additive model. Adjustments were made for sex, marital status, occupational class, education, leisure-time and occupational physical activity, alcohol consumption and smoking. RESULTS: The mean BMI among the subjects was 24.7 kg/m(2), but it increased by increasing road distance (by 1.3 kg/m(2) from 5-10 to 20-184 km) and by decreasing population density (by 1.7 kg/m(2) from 1000-19,192 to 1-5 inhabitants/km(2)). The respective increases in overweight (overall prevalence 41%) were 13 per cent units for distance and 14 per cent units for population density. Adjusted regressions based on continuous explanatory variables showed an inverse L-shaped pattern with a mean BMI of 24.6 kg/m(2) at distances shorter than 5 km and a rise of 2.6 kg/m(2) at longer distances, and an increase of 2.5 kg/m(2) from highest to lowest population density. The associations with road distance were stronger for women than men, while the sex difference in association with population density remained indeterminate. CONCLUSIONS: We conclude that young adults in Northern Finland who live far away from local centres or in the most sparsely populated areas are fatter than those who live close to local centres or in densely populated areas. The likely explanations include variations in everyday physical activity in different residential environments, although causality of the associations remains to be confirmed.

Association of depressiveness with chronic facial pain: a longitudinal study.

OBJECTIVE: Depression and pain are often co-morbid. Temporomandibular disorders (TMD) include facial pain as one main symptom. Reports are lacking on the association between chronic facial pain and earlier depressiveness. The aim of the study was to investigate whether depressiveness increases the risk for chronic facial pain in a longitudinal population-based study. MATERIALS AND METHODS: Subjects included in the Northern Finland Birth Cohort 1966 (n = 5696) answered a questionnaire on facial pain and depressiveness using the Symptom Checklist-25 depression sub-scale at the age of 31 years. In addition, reported depression diagnosed by a doctor was enquired about. Three years later a sub-sample of the cohort, including 63 cases with chronic facial pain and 85 pain-free controls, was formed based on the question concerning facial pain. RESULTS: Of the chronic facial pain cases 17.5% and of the pain-free controls 7.1% were depressive 3 years earlier at baseline (p = 0.050, χ(2) test, crude OR = 2.8, 95% CI = 1.0-8.0). Of the chronic facial pain cases 6.3% and of the pain-free controls 1.2% reported having had diagnosed depression (p = 0.085, crude OR = 5.7, 95% CI = 0.6-52.2). After adjusting the gender, the association between depressiveness reported at the baseline and chronic facial pain was significant (OR = 4.2, 95% CI = 1.1-16.2). When widespread pain was included in the analysis, the association was not significant. CONCLUSIONS: Depressiveness increases the risk for chronic facial pain in a 3-year follow-up. This association seems to be mediated through widespread pain.

Comorbidity of disruptive behavioral disorders and attention-deficit hyperactivity disorder--indicator of severity in problematic behavior?

BACKGROUND: Disruptive behavioral disorders (DBD) and attention-deficit hyperactivity disorder (ADHD) are both characterized by certain patterns of misbehavior among adolescents. AIMS: The aim of this study was to examine how the comorbidity of DBD and ADHD affects in misbehavior among adolescents. METHODS: A total of 158 adolescents aged 16-18 years, from a subsample of the Northern Finland Birth Cohort 1986 (NFBC 1986), were interviewed with the Finnish translation of the semi-structured Schedule for Affective Disorders and Schizophrenia for School-Age Children--Present and Lifetime (K-SADS-PL) in order to obtain DBD, including conduct disorder (CD) and oppositional defiant disorder (ODD), and ADHD diagnoses. The structure of the CD symptoms, obtained from the K-SADS-PL, was compared with the previously formed model about the development of the problematic behavior. The severity of the CD symptoms was compared with adolescents diagnosed with only DBD, only ADHD and with both DBD and ADHD. Also, the associations with other psychiatric disorders diagnosed at age 16 were evaluated. RESULTS: The boys in the study sample were diagnosed with ADHD or with comorbid DBD and ADHD more often than girls. The severity of CD symptoms was statistically significantly associated with the comorbid DBD and ADHD group. The adolescents diagnosed with comorbid DBD and ADHD had an increased risk for anxiety disorders, depressive disorders and substance abuse disorders. CONCLUSIONS: The comorbidity of DBD and ADHD seems to indicate the severity of CD symptoms. CLINICAL IMPLICATIONS: The comorbidity between DBD and ADHD should be considered in clinical practice because it could indicate more serious problematic behavior than pure disorders alone.