Hospital-treated bipolar disorder in adolescence in Finland 1980-2010: Rehospitalizations, diagnostic stability, and mortality.

AIMS: Estimates of the occurrence of bipolar disorder among adolescents vary from country to country and from time to time. Long delays from first symptoms to diagnosis of bipolar disorder have been suggested. Studies among adults suggest increased mortality, particularly due to suicide and cardiovascular diseases. We set out to study the prognosis of adolescent onset bipolar disorder in terms of rehospitalizations, diagnostic stability, and mortality. METHODS: The study comprised a register-based follow-up of all adolescents admitted to psychiatric inpatient care for the first time in their lives at age 13-17 during the period 1980-2010. They were followed up in the National Care Register for Health Care and Causes of death registers until 31 December 2014. RESULTS: Incidence of bipolar disorder among 13- to 17-year-old adolescents over the whole study period was 2.8 per 100, 000 same aged adolescents, and across decades, the incidence increased six-fold. Patients with bipolar disorder during their first-ever inpatient treatment were rehospitalized more often than those treated for other reasons. Conversion from bipolar disorder to other diagnoses was far more common than the opposite. Mortality did not differ between those firstdiagnosed with bipolar disorder and those treated for other reasons. CONCLUSION: The incidence of adolescent onset bipolar disorder has increased across decades. The present study does not call for attention to delayed diagnosis of bipolar disorder. Adolescent onset bipolar disorders are severe disorders that often require rehospitalization, but diagnostic stability is modest. Mortality is comparable to that in other equally serious disorders.

Future supply of boreal forest ecosystem services is driven by management rather than by climate change.

Forests provide a wide variety of ecosystem services (ES) to society. The boreal biome is experiencing the highest rates of warming on the planet and increasing demand for forest products. To foresee how to maximize the adaptation of boreal forests to future warmer conditions and growing demands of forest products, we need a better understanding of the relative importance of forest management and climate change on the supply of ecosystem services. Here, using Finland as a boreal forest case study, we assessed the potential supply of a wide range of ES (timber, bilberry, cowberry, mushrooms, carbon storage, scenic beauty, species habitat availability and deadwood) given seven management regimes and four climate change scenarios. We used the forest simulator SIMO to project forest dynamics for 100 years into the future (2016-2116) and estimate the potential supply of each service using published models. Then, we tested the relative importance of management and climate change as drivers of the future supply of these services using generalized linear mixed models. Our results show that the effects of management on the future supply of these ES were, on average, 11 times higher than the effects of climate change across all services, but greatly differed among them (from 0.53 to 24 times higher for timber and cowberry, respectively). Notably, the importance of these drivers substantially differed among biogeographical zones within the boreal biome. The effects of climate change were 1.6 times higher in northern Finland than in southern Finland, whereas the effects of management were the opposite-they were three times higher in the south compared to the north. We conclude that new guidelines for adapting forests to global change should account for regional differences and the variation in the effects of climate change and management on different forest ES.

Comparing soil inventory with modelling: Carbon balance in central European forest soils varies among forest types.

Forest soils represent a large carbon pool and already small changes in this pool may have an important effect on the global carbon cycle. To predict the future development of the soil organic carbon (SOC) pool, well-validated models are needed. We applied the litter and soil carbon model Yasso15 to 1838 plots of the German national forest soil inventory (NFSI) for the period between 1985 and 2014 to enables a direct comparison to the NFSI measurements. In addition, to provide data for the German Greenhouse Gas Inventory, we simulated the development of SOC with Yasso15 applying a climate projection based on the RCP8.5 scenario. The initial model-calculated SOC stocks were adjusted to the measured ones in the NFSI. On average, there were no significant differences between the simulated SOC changes (0.25 ±â€¯0.10 Mg C ha-1 a-1) and the NFSI data (0.39 ±â€¯0.11 Mg C ha-1 a-1). Comparing regional soil-unit-specific aggregates of the SOC changes, the correlation between both methods was significant (r2 = 0.49) although the NFSI values had a wider range and more negative values. In the majority of forest types, representing 75% of plots, both methods produced similar estimates of the SOC balance. Opposite trends were found in mountainous coniferous forests on acidic soils. These soils had lost carbon according to the NFSI (-0.89 ±â€¯0.30 Mg C ha-1 a-1) whereas they had gained it according to Yasso15 (0.21 ±â€¯0.10 Mg C ha-1 a-1). In oligotrophic pine forests, the NFSI indicated high SOC gains (1.36 ±â€¯0.17 Mg C ha-1 a-1) and Yasso15 much smaller (0.29 ±â€¯0.10 Mg C ha-1 a-1). According to our results, German forest soils are a large carbon sink. The application of the Yasso15 model supports the results of the NFSI. The sink strength differs between forest types possibly because of differences in organic matter stabilisation.