Mental health after the COVID-19 pandemic among Finnish youth: a repeated, cross-sectional, population-based study.

BACKGROUND: High levels of mental health problems among young people were reported during the COVID-19 pandemic, but studies of the post-pandemic period are scarce. We assessed mental health problems among Finnish youth before, during, and after the COVID-19 pandemic using nationwide population-based samples. Our aim was to examine in which direction the heightened levels of adolescent mental health problems have developed after the pandemic. METHODS: In this national, repeated cross-sectional, population-based study in Finland, we recruited students at lower and upper secondary level (aged 13-20 years) who were taking part in the Finnish School Health Promotion (SHP) survey in 2015-23 (119 681-158 897 participants per round). The SHP is based on total sampling and conducted biennially between March and May. Self-reports covered the seven-item Generalized Anxiety Disorder Scale; the two-item Patient Health Questionnaire for depression; the Mini Social Phobia Inventory for social anxiety; the Short Warwick-Edinburgh Mental Wellbeing Scale for mental wellbeing; loneliness; the Sick, Control, One Stone, Fat, Food measure for disordered eating; and suicidality (suicidal ideation, deliberate self-harm, and suicide attempts). Scales were dichotomised using validated cutoffs. Presence of any and comorbid mental health problems was assessed. Logistic (for dichotomised outcomes) and linear (for Short Warwick-Edinburgh Mental Wellbeing Scale) mixed effects models were used to analyse the effect of survey year on mental health, controlling for sociodemographic background factors and stratified by gender and school level. Cisgender and transgender youth were compared. FINDINGS: Between 2015 and 2023, the SHP study recruited 722 488 students (371 634 [51·6%] girls and 348 857 [48·4%] boys) with a mean age of 15·8 years (SD 1·3) who were either in the eighth and ninth grades of comprehensive school or the first and second years of general and vocational upper secondary schools in Finland. The proportion of participants with generalised anxiety, depression, and social anxiety symptoms above the cutoff increased from pre-COVID-19 levels to 2021 and remained at these higher levels in 2023 among all study groups. Among girls in lower secondary education, prevalence of generalised anxiety, depression, and social anxiety symptoms increased from 2021 to 2023, as did social anxiety among girls in upper secondary education. Among boys, the proportion with social anxiety symptoms decreased between 2021 and 2023. Mental wellbeing scores decreased in all groups between 2021 and 2023, and disordered eating increased in girls, and in boys in lower secondary education. Suicidality increased in girls but not in boys. Loneliness was the only measure to show improvement in all groups from 2021 to 2023. In 2023, 55 895 (72·6%) of 76 994 girls and 22 718 (32·8%) of 69 205 boys reported at least one mental health problem, and 37 250 (48·4%) girls and 9442 (13·6%) boys reported comorbid mental health problems. Among both transfeminine and transmasculine youth, the prevalence of generalised anxiety and depression symptoms decreased from 2021 to 2023, but compared with cisgender youth, the proportions were significantly higher throughout. INTERPRETATION: The effects of the COVID-19 pandemic on youth mental health could be long lasting. In this study, the substantial change for the better among transgender youth was a positive exception. Providing adequate support and treatment for young people with poor mental health is essential, but solutions to the mental health crisis need to address a wider societal perspective and should be developed in partnership with young people. FUNDING: NordForsk, Research Council of Finland. TRANSLATIONS: For the Finnish and Swedish translations of the abstract see Supplementary Materials section.

Stability of morningness/eveningness and changes in sleep and mental health during mid-adulthood.

Objective: A change toward Eveningness in circadian sleep-wake behavior is generally seen from childhood to adolescence, but less is known about circadian changes during adulthood. Circadian changes during mid-adulthood are of high interest, since Eveningness associates with a range of health-related problems, including psychological symptoms and mental disorders. In this study, we examined the circadian stability across 10 years, from 42 to 52 years of age, and how it is associated with sleep and mental health in a Finnish general population cohort follow-up-based (n = 976). Method: Circadian type was assessed at both ages with a widely used item for self-estimated Morningness/Eveningness from the original Horne-Östberg Morningness-Eveningness Questionnaire. Generalized estimating equations were used for analyzing how a change in Morningness/Eveningness was associated with sleep and mental health longitudinally. Results: Our findings indicate that the circadian type is a highly stable trait during mid-adulthood with mainly moderate changes occurring in 42.2% of adults and no circadian change among 57.8% of adults. Most changes occurred within the same circadian type (23.9%), second to changes between moderate circadian types (13.3%). Changes between the Definite Evening-types and Morning-types were very rare (0.5%). Stable Evening-types reported more insufficient sleep, discrepancy between sleep duration on workdays and free days, and depression as compared to stable Morning-types. Moderate changes toward Morningness, comprising mostly those within Morning-types, were associated with reduced distress and psychological symptoms. Conclusions: In conclusion, our findings show high stability of mid-adulthood circadian type. However, changes toward Morningness seem to be associated with improved mental health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Immigrant Origin and Disability Increase Risk for Anxiety Among Youth During COVID-19: The Role of Unmet Needs for Support in Distance Learning and Family Conflicts.

PURPOSE: Shifting to distance learning due to COVID-19 may decrease teacher support and increase family conflicts, potentially increasing anxiety. Nevertheless, there is scarce information on this topic among disability and/or immigrant-origin groups. Thus, we investigated whether these minority groups reported more anxiety than the reference group-Finnish-origin youth without disabilities-and whether unmet needs for support in distance learning and family conflicts mediated differences in anxiety during the pandemic. Differences in these mediators were also investigated. METHODS: Population-based data of 165,033 youth aged 12 to 29 from the cross-sectional Finnish School Health Promotion study were obtained in 2021 using total population sampling. Logistic regressions with Stata were used to investigate the differences between the target (youth with disabilities, immigrant backgrounds, or both of these characteristics) and reference groups. The Karlson-Holm-Breen method was used to test for mediation. RESULTS: The groups with disabilities (odds ratio [OR] = 4.14 [95% confidence interval (CI): 4.02-4.27]), immigrant backgrounds (OR = 1.15 [95% CI: 1.06-1.25]), or both of these characteristics (OR = 5.03 [95% CI: 4.59-5.52]) reported anxiety more often than the reference group. The difference between the minority and reference groups in unmet needs in distance learning and family conflicts were significant. Immigrant-origin youth with disabilities were most vulnerable to family conflicts, and the groups with disabilities were more prone to unmet needs. Unmet needs and family conflicts accounted for 28% of the association between immigrant-origin youth without disabilities and anxiety, whereas the mediating percentage was smaller for immigrant-origin youth with disabilities (13%) and Finnish-origin youth with disabilities (11%). DISCUSSION: Immigrant-origin youth with disabilities need targeted support to prevent anxiety. Alleviating family conflicts and unmet needs in distance learning during crises could help decrease anxiety. Support for distance learning should be provided to youth with disabilities, regardless of their immigrant backgrounds.

Life course associations between smoking and depressive symptoms. A 30-year Finnish follow-up study.

INTRODUCTION: Relatively little is known whether the association between smoking and depressive symptoms changes with age and how the trajectories of smoking and depressive symptoms are intertwined during the life course. In this population-based study, these associations were examined from young adulthood to middle age. METHODS: Participants of a Finnish cohort study (N=1955) were assessed at the ages of 22, 32, 42, and 52 using questionnaires covering daily smoking (yes/no) and the short 13-item Beck Depression Inventory. Longitudinal latent class and longitudinal latent profile analyses were used identify life course trajectories of smoking and depressive symptoms. RESULTS: The proportions of daily smokers decreased, while levels of depressive symptoms increased among both females and males from age 22 to 52 years. Smoking was associated with higher levels of depressive symptoms from age 22 to 42, while not at 52. Associations among males prevailed when adjusting for education, marital status, and alcohol use. Four life course classes of daily smoking (non-smokers, decreasing prevalence of smoking, persistent smokers, and increasing prevalence of smoking) and four trajectories of depressive symptoms (low, increasing/moderate, decreasing/moderate, and high) were identified. In males, persistent daily smokers (RRR=4.5, 95% CI: 2.2-9.2) and those in the class with increasing smoking prevalence (RRR=3.2, 95% CI: 1.1-9.1) had an increased risk of belonging to the high depressive symptoms profile. In females these associations were non-significant. CONCLUSIONS: Compared to females, the relationship between smoking and depressive symptoms seems more robust among males during adulthood. Specifically, males smoking persistently from young adulthood to middle age have an increased risk of high depressive symptoms trajectory. IMPLICATIONS: This population-based cohort with 30 years of follow-up showed that the life course trajectories of daily smoking and depressive symptoms are associated. Persistent daily smokers and those starting late had an increased risk of belonging to the profile with constantly high levels of depressive symptoms during the life course. However, these associations were statistically significant only in males. Actions should be strengthened, especially in males, to prevent smoking initiation, to help smoking cessation and identify and treat depression in smokers with significant depressive symptoms.

Social anxiety in Finnish adolescents from 2013 to 2021: change from pre-COVID-19 to COVID-19 era, and mid-pandemic correlates.

PURPOSE: Social anxiety disorder (SAD) is prevalent in adolescents. Increase in levels of general anxiety since 2010's has been observed in young people. Little is known of time trends in symptoms of social anxiety during 2010's, of pre- to during-COVID-19 era changes, or of associations between social anxiety symptoms and pandemic severity, distance education, and COVID-19-related experiences in young people. METHODS: We examined social anxiety symptoms, their temporal changes, and their associations with COVID-19 related factors in a sample of 450 000 13-to-20-year-old Finns in 2013-2021. Data from nationwide School Health Promotion study was used. Social anxiety symptoms were assessed with the Mini-SPIN using cut-off score ≥ 6 as indicator of high social anxiety. Multivariate logistic regression analyses were used, controlling for gender, age, family SES, and symptoms of general anxiety and depression. RESULTS: High-level social anxiety symptoms increased markedly from 2013/2015 to 2021 among both sexes. A steeper increase was found among females. In 2021, 47% of females self-reported high social anxiety, a two-fold increase relative to 2013/2015. No association between regional COVID-19 incidence and change in social anxiety symptoms was found. No clear associations between time spent in distance education and social anxiety symptoms were found. Fears of getting infected or transmitting coronavirus, and reports of not getting needed support for schoolwork during distance education were all associated with high social anxiety. CONCLUSION: Prevalence of high social anxiety in young people aged 13-20 has increased considerably from 2013 to 2021, especially among girls. During COVID-19 pandemic, socially anxious young people report a need for educational support and suffer from infection-related fears.

Population-level changes in anxiety and depression and the unmet need for support at school among adolescents with and without disabilities, 2017-2021: The effects of the COVID-19 pandemic.

BACKGROUND: Adolescents' mental health problems increased during the COVID-19 pandemic, but little information is available on how adolescents with disabilities were affected. OBJECTIVE: We investigated the population-level changes in depression and anxiety and the unmet need for support at school from social workers/psychologists, doctors/nurses, and teachers among adolescents with specific disabilities and those without disabilities before (2017-2019) and during (2021) the pandemic. METHODS: We analyzed population-based cross-sectional data from the Finnish School Health Promotion study of lower secondary school students obtained in 2017 (n = 73,678), 2019 (n = 87,215), and 2021 (n = 91,560). Students with disabilities were classified into four groups based on self-reporting: disabilities only in mobility, cognition, sensory, or two or more domains. Regression models were applied to investigate population-level changes. RESULTS: From 2017-2019 to 2021, anxiety and depression increased at the population level among all adolescents. The interaction analysis revealed that the increase was higher among adolescents with cognitive and mobility disabilities and lower among those with sensory disabilities compared to adolescents without disabilities. The increase in the prevalence of the unmet need for support was similar for those with and without disabilities, except for support from social workers/psychologists, where the unmet need was higher among those with mobility disabilities. CONCLUSION: The COVID-19 pandemic had more detrimental effects on the mental health of adolescents with mobility and cognitive disabilities than those without disabilities. There is an urgent need for resources and targeted support to prevent anxiety and depression among adolescents with mobility and cognitive disabilities during crises.

Associations of generalized anxiety and social anxiety with perceived difficulties in school in the adolescent general population.

INTRODUCTION: Generalized anxiety disorder (GAD), marked by excessive worry, and social anxiety disorder (SAD) are among the clinically most important anxiety disorders in the adolescent population. This study aimed to explore the associations between perceived difficulties in school and heightened levels of self-reported noncomorbid and comorbid GAD and SAD symptoms. METHODS: Survey data of 37,905 Finnish upper secondary school students with a mean age of 17.33 years (SD = 0.63) were obtained from the School Health Promotion study, implemented in April and May 2015 in Finland. Exploratory factor analysis was used to determine indicators of academic and social difficulties in school. Logistic regression analysis was conducted to examine multivariate associations between anxiety symptoms and difficulties in the school. The anxiety symptom thresholds were based on the seven-item Generalized Anxiety Disorder Scale (≥10 points) for GAD-related symptoms and the Mini-SPIN (≥6 points) for SAD-related symptoms. RESULTS: Self-reported generalized anxiety and social anxiety were both significantly associated with various perceived difficulties in school among this adolescent general population sample. Noncomorbid and comorbid GAD and SAD symptoms were both associated with an increased risk of academic and social difficulties, even when controlling for school performance. Comorbid symptoms were associated with significantly higher rates of social difficulties than noncomorbid symptoms of GAD or SAD. Furthermore, GAD symptoms were associated with a high risk for academic difficulties, irrespective of comorbidity. CONCLUSIONS: Excessive worry, a defining feature of GAD, is central to school-related impairments among adolescents. The present study highlights the importance of school-based interventions for anxious adolescents. Interventions to improve adolescents'; school functioning should account for the interference of pathological worry related to GAD.

Development of Body Dissatisfaction in Women and Men at Different Educational Levels During the Life Course.

BACKGROUND: Our study examines the rarely investigated associations between body dissatisfaction and educational level over the life course in women and men. METHODS: A Finnish cohort (N = 1955) was followed by questionnaires at ages 22, 32, 42, and 52. Body dissatisfaction was measured by asking the respondents to evaluate their appearance using five response options. Analyses were done using logistic regression, while latent class analyses were used to identify classes of body dissatisfaction trajectories over the life course. RESULTS: Body dissatisfaction increased with age in women and men. Among men, body dissatisfaction was related to lower education at the ages of 32 and 42. Also, men with lower education were more likely to maintain a less positive body image over the life course. In women, increasing body dissatisfaction during the life course was associated with lower education. CONCLUSIONS: Differences in body dissatisfaction based on educational level are important to take into account in public health actions aiming to reduce socioeconomic inequalities in health and well-being.

Socioeconomic disparities in adolescent anxiety and depression in Finland have not increased during the COVID-19 pandemic.

AIMS: The purpose of this research was to assess whether socioeconomic disparities in adolescent depression and anxiety in Finland increased among middle adolescents during the COVID-19 pandemic. METHODS: Repeated cross-sectional surveys (the School Health Promotion Study) from spring 2019 and spring 2021 were compared. The respondents were 87,283 eighth and ninth graders (14-16-year-olds) in 2019 and 91,560 in 2021, corresponding respectively to 73% and 75% of the age groups. Depression was measured by Patient Health Questionnaire-2 (PHQ-2), and anxiety with GAD-7, and adverse socioeconomic background using low parental education, not living with both parents, and family's poor financial situation. Associations of socioeconomic adversities with depression and generalised anxiety, and the effect of COVID-19 (2021 vs 2019), were analysed using logistic regression. RESULTS: Depression and anxiety were more common in both sexes the more sociodemographic adversities there were in the adolescent's background. However, increases in the prevalence of anxiety and depression from pre- to in-pandemic time did not differ with accumulating sociodemographic adversities. CONCLUSIONS: Depression and anxiety increased in prevalence among Finnish adolescents during the pandemic. Sociodemographic disparities in depression and anxiety show no increase. Emotional symptoms are nevertheless more common in adolescents from lower socioeconomic status families.

Stress-induced eating and drinking and their associations with weight among women and men during 30-year follow-up.

BACKGROUND: Stress is associated with obesity through several mechanisms, including coping methods used in stressful situations. However, long-term prospective studies investigating stress-induced eating and drinking in parallel and their relationships with weight are scarce. PURPOSE: We examined the prevalence of stress-induced eating and drinking and their associations with body mass index (BMI) among women and men during a 30-year follow-up, as well as BMI trajectories from early adulthood to middle age. METHODS: Participants of a Finnish cohort study were followed by questionnaires at the ages of 22 (N = 1656), 32 (N = 1471), 42 (N = 1334), and 52 (N = 1160). Their coping methods were evaluated by asking how common it was for them to act in certain ways when they encountered stressful situations. We used linear regression analysis to examine the associations between coping methods and BMI, and latent growth models to analyze the BMI trajectories. RESULTS: The prevalence of stress-induced eating was higher among women than men throughout the follow-up, whereas stress-induced drinking was more common among men at 22 and 32 years of age. Stress-induced eating was associated with higher BMI at all ages among women, and from the age of 32 among men. Eating as a persistent coping method over the life course was associated with a higher and faster growth rate of BMI trajectories. Stress-induced drinking was associated with higher BMI in middle age, and with a faster growth of BMI among men. CONCLUSIONS: Effective, appropriate stress management may be one essential factor in preventing weight gain in the adult population.

Generalized anxiety among Finnish youth from 2013 to 2021-Trend and the impact of COVID-19.

BACKGROUND: Alarming levels of emotional symptoms among youth were reported during the COVID-19 pandemic. Studies assessing these figures against the pre-pandemic developments are rare. We examined the trend of generalized anxiety (GA) in adolescents in the 2010s and the effect of the COVID-19 pandemic against this trend. METHODS: Data from the Finnish School Health Promotion study with 750,000 participants aged 13-20 between 2013 and 2021 was analyzed using GAD-7 to measure self-reported GA (cut-off ≥10). Inquiries were made about remote learning arrangements. Effects of time and COVID-19 were analyzed with logistic regression. RESULTS: Among females, an increasing trend in GA between 2013 and 2019 was found (OR per year 1.05), and the prevalence increased from 15.5 % to 19.7 %. Among males, the trend was decreasing (OR = 0.98), with prevalence from 6.0 % to 5.5 %. Increase in GA from 2019 to 2021 was stronger in females (19.7 % to 30.2 %) than males (5.5 % to 7.8 %), while the effect of COVID-19 on GA was equally strong (OR = 1.59 vs. OR = 1.60) against the pre-pandemic trends. Remote learning was associated with elevated levels of GA, especially among those with unmet needs for learning support. LIMITATIONS: The design of repeated cross-sectional surveys doesn't allow analyses of within individual changes. CONCLUSIONS: Given the pre-pandemic trends of GA, the COVID-19 effect on it appeared equal in both sexes. The increasing pre-pandemic trend among adolescent females and the strong effect of COVID-19 on GA among both sexes warrants constant monitoring of mental health of the youth in the aftermath of the COVID-19 pandemic.

Psychiatric symptoms and the association with parents' psychiatric symptoms among recently arrived asylum-seeking children in Finland.

This study examined psychiatric symptoms and the association with parents' psychiatric symptoms among recently arrived accompanied asylum-seeking children in the age groups of 2-6 years (n = 93) and 7-12 years (n = 91). Children and parents were assessed using mental health and trauma measures (SDQ, HSCL-25 and PROTECT). The prevalence of total difficulties was 34.9% among 2-6-year-olds and 29.6% among 7-12-year-olds. The most common symptoms in both age groups were peer problems, followed by conduct problems among 2-6-year-olds and emotional symptoms among 7-12-year-olds. In both age groups, the children's emotional symptoms were associated with the parents' anxiety and depression as well as the trauma symptoms, while the conduct problems were only associated with the parents' trauma symptoms. In conclusion, peer problems as well as conduct problems and emotional symptoms are common among recently arrived asylum-seeking children. To support the mental health of these children, both children and parents need adequate support.

Paternal perinatal stress is associated with children's emotional problems at 2 years.

BACKGROUND: Paternal mental health in pregnancy and postpartum has been increasingly highlighted as important both in its own right, but also as crucial for the development of children. Rates of help-seeking among fathers is low, possibly due to conceptualising their own difficulties as stress rather than problems with mood. The relationship between paternal stress and child outcomes has not been investigated. METHODS: This study used data from the Finnish CHILD-SLEEP birth cohort. Data were available for 901 fathers and 939 mothers who completed questionnaires on demographics, stress, anxiety and depression at 32 weeks gestation, 3 months, 8 months and 24 months postpartum. Parental report of child emotional and behavioural problems was collected at 24 months. RESULTS: Around 7% of fathers experienced high stress (over 90% percentile) at each timepoint measured in the perinatal period, rising to 10% at 2 years postpartum. Paternal stress measured antenatally, at 3 and 24 months was associated with child total problems at 24 months, while paternal depression and anxiety were not related to child outcomes when in the same model. After adjusting for concurrent maternal depression, anxiety and stress, an association remained between paternal stress at each timepoint and child total problem scores at 24 months. The strongest association was with paternal stress at 3 months (OR 3.17; 95% CI 1.63-6.16). There were stronger relationships between paternal stress and boys' rather than girls' total problem scores, although the interactions were not statistically significant. CONCLUSIONS: Paternal stress is an important manifestation of perinatal distress and is related to child mental health, particularly when present in the early postpartum months. Paternal stress should therefore be assessed in the perinatal period, which presents opportunities for early intervention and prevention of difficulties for both father and child.

Parenting in place: The reception centre as the spatial context for laying the foundations for asylum-seeking children's healthy development.

Brain architecture is shaped by early childhood experiences, which thus affect future physical and mental health. These experiences consist primarily of parenting, intertwined with environment. The mental health of migrants has received much attention in research; however, early childhood experiences and the spatiality of parenting have largely been ignored. This study examines asylum-seeking parents' perceptions of parenting their 2-6-year-old children, focusing on the spatial context of the reception centre. We conducted 26 semi-structured interviews among parents in three reception centres in Finland. The results show that parenting was challenged by all three dimensions of place: location, locale and sense of place. The findings indicate that for parents, the reception centre is an essential factor interacting with parenting, enabling or impeding caregiving. These findings are discussed from the viewpoints of transnationalism, insufficient children's spaces and activities and lost sense of place. We urge policy-makers to improve the spatial context for parenting in reception centres by ensuring adequate children's spaces and activities, including opportunities for early learning, privacy of the family, parents' social support and possibilities for establishing everyday routines. We suggest that these improvements would have far-reaching beneficial implications for the healthy development and future mental health of asylum-seeking children.

Life course associations between smoking and depressive symptoms. A 30-year Finnish follow-up study.

BACKGROUND: While the association between smoking and depressive symptoms has been studied quite extensively, only little is known whether the association changes and how the trajectories of smoking and depressive symptoms are intertwined during the life course. In this population-based study, we examined these associations from young adulthood to middle age. METHODS: Participants of a Finnish cohort study (N = 1955) were addressed at ages 22, 32, 42 and 52 using postal questionnaires including questions of daily smoking and depressive symptoms (the short 13-item Beck Depression Inventory). Linear and logistic regression analyses and longitudinal latent class and profile analyses were used. RESULTS: The percentages of daily smokers decreased, while levels of depressive symptoms increased among both women and men from age 22 to 52 years. Daily smoking was associated with higher levels of depressive symptoms between ages 22 and 42, while not at age 52. Associations among men prevailed also in the adjusted models. Four life course trajectories of daily smoking (non-smokers, quitters, persistent smokers, and late starters) and four depressive symptoms (low, increasing/moderate, decreasing/moderate, and high) were identified. In the adjusted models, persistent daily smokers and late starters had significantly higher risk of belonging to the high depressive symptoms profile in men, but not in women. CONCLUSIONS: Compared to women the associations between daily smoking and depressive symptoms seem more robust among men during adulthood. Especially those men smoking persistently from young adulthood to middle age have an increased risk of high depressive symptoms trajectory during the life course.

Suicides from 2016 to 2020 in Finland and the effect of the COVID-19 pandemic.

The COVID-19 pandemic has had negative mental health outcomes in populations, but the suicide numbers in Finland have remained unchanged compared with expected levels based on the pre-pandemic period. We included all deaths from suicide verified by the official cause-of-death investigations, including forensic autopsy with analysis of forensic toxicology samples, between 1 January 2016 and 31 December 2020 in Finland. There was a decline in suicide incidence from 2016 to 2020 in men, and a declining tendency in suicide rates for every consecutive month during the COVID-19 pandemic period. The COVID-19 governmental policy responses do not seem to have led to an increase in suicide numbers.

The associations of socioeconomic status and financial strain with restrained and emotional eating among 42-year-old women and men.

The current study investigated how different aspects of socioeconomic status (SES) and experiencing financial strain are associated with restrained and emotional eating among 42-year-old Finnish women and men. Lower SES is shown to be associated with diets of poorer nutritional quality and obesity. Nevertheless, little research has been done on the association between SES, financial strain and psychological dimensions of eating behaviour. The study was based on questionnaire data from 734 women and 600 men aged 42 years who were participants in a Finnish cohort study. SES was measured through three different dimensions: education, occupation and household income. Data were analyzed using binary logistic regression models. Results showed that restrained eating was associated with higher household income level in women and with higher occupational position in men. Emotional eating was associated with higher financial strain among women. Also, women with lower college education had higher odds for emotional eating compared to women with vocational education or less. Among men, emotional eating was not statistically significantly associated with any of the SES variables nor with financial strain, which may also be due to the very low level of emotional eating reported by men. In conclusion, our findings indicate that restrained eating would be associated with higher status brought by belonging to a higher income or occupational group. Emotional eating, in turn, would be related to experiencing financial strain, rather than to traditional SES dimensions, in women. These results are relevant when health-related interventions are targeted to different SES groups.

Stress, development and mental health study, the follow-up study of Finnish TAM cohort from adolescence to midlife: cohort profile.

PURPOSE: This cohort profile describes the Stress, development and mental health study (TAM), which is a cohort study investigating risk and protective factors as well as longitudinal associations regarding mental health and well-being from adolescence to midlife. This interdisciplinary cohort study operates, for example, in the fields of public health, social medicine, psychiatry and the life course perspective. PARTICIPANTS: In 1981 (n=2242, 98.0% of the target population), 1982 (n=2191, 95.6%) and 1983 (n=2194, 96.7%) during school classes, surveys were conducted to all Finnish-speaking pupils (mostly born 1967) in the Tampere region in Finland. Participants of the school study at age 16 in 1983 (n=2194) comprised the base population for the longitudinal data and were followed-up using postal questionnaires in the years 1989, 1999, 2009 and 2019 at ages 22 (n=1656, 75.5% of the age 16 participants), 32 (n=1471, 67.0%), 42 (n=1334, 60.8%) and 52 (n=1160, 52.9%). FINDINGS TO DATE: The self-reported questionnaires include information on physical and mental health (eg, depression and mood disorders, anxiety disorders), health behaviour and substance misuse (eg, alcohol, tobacco and exercise), socioeconomic conditions, psychosocial resources (eg, self-esteem), social relationships and support, life events, etc. The numerous studies published to date have examined mental health and various factors from several perspectives such as risk and protective factors, individual developmental paths (eg, trajectories) and pathway models (mediation and moderation). FUTURE PLANS: Current and future research areas include, for example, longitudinal associations between mental health (eg, depressive symptoms, self-esteem) and (1) substance use (alcohol and tobacco), (2) family transitions (eg, parenthood, relationship status) and (3) retirement. Next follow-up is planned to be conducted at the latest at age 62 in 2029. Before that it is possible to link the data with cause-of-death register.

Associations between relationship status and mental well-being in different life phases from young to middle adulthood.

The aim of this study was to assess the associations between relationship status and mental well-being in four different phases during the life course, and to identify whether relationship quality moderated these associations. We used a broader concept of relationship status (instead of marital status) and also included the positive dimension of mental health. Participants in a Finnish cohort study were followed up at ages 22 (N = 1,656), 32 (N = 1,471), 42 (N = 1,334), and 52 (N = 1,159). Measures in all study panels covered relationship status (marriage, cohabitation, dating, single and divorced/widowed), Short Beck Depression Inventory (S-BDI), self-esteem (seven items) and relationship quality (six items). Analyses were carried out using linear regression. Compared to marriage, being single or being divorced/widowed were associated with depressive symptoms at every age in men. For women, in turn, being single - but not being divorced/widowed - was associated with depressive symptoms. Among men, being single or being divorced/widowed were also associated with lower self-esteem at age 32, 42 and 52, but in women, only one association between lower self-esteem and being single was found at age 32. Of the age stages, the age 32 is highlighted in men, at which point all relationship statuses were risk factors compared to marriage. There were only few indications of the moderating role of the relationship quality. Compared to marriage, being single or being divorced/widowed were quite consistently associated with poorer mental well-being during the life course, especially among men. For dating and cohabiting the associations were more fragmented depending on age and gender; particularly among women, these relationship statuses tended not to differ from marriage in terms of mental well-being. These observations on mental well-being across five relationship statuses are important in our contemporary society, where the number of marriages is decreasing, and other forms of relationships are becoming more common.

Factors contributing to psychological distress in the working population, with a special reference to gender difference.

BACKGROUND: Psychological distress refers to non-specific symptoms of stress, anxiety and depression, and it is more common in women. Our aim was to investigate factors contributing to psychological distress in the working population, with a special reference to gender differences. METHODS: We used questionnaire data from the nationally representative Finnish Regional Health and Well-being Study (ATH) collected in the years 2012-2016 (target population participants aged 20 +, n = 96,668, response rate 53%), restricting the current analysis to those persons who were working full-time and under 65 of age (n = 34,468). Psychological distress was assessed using the Mental Health Inventory-5 (MHI-5) (cut-off value <=52). We studied the following factors potentially associated with psychological distress: sociodemographic factors, living alone, having children under18 years of age, lifestyle-related factors, social support, helping others outside of the home and work-related factors. We used logistic regression analysis to examine association between having work-family conflict with the likelihood for psychological distress. We first performed the models separately for men and women. Then interaction by gender was tested in the combined data for those independent variables where gender differences appeared probable in the analyses conducted separately for men and women. RESULTS: Women reported more psychological distress than men (11.0% vs. 8.8%, respectively, p < 0.0001). Loneliness, job dissatisfaction and family-work conflict were associated with the largest risk of psychological distress. Having children, active participation, being able to successfully combine work and family roles, and social support were found to be protective factors. A significant interaction with gender was found in only two variables: ignoring family due to being absorbed in one's work was associated with distress in women (OR 1.30 (95% CI 1.00-1.70), and mental strain of work in men (OR 2.71 (95% CI 1.66-4.41). CONCLUSIONS: Satisfying work, family life and being able to successfully combine the two are important sources of psychological well-being for both genders in the working population.