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.

Highly increased risk of type 2 diabetes in patients with binge eating disorder and bulimia nervosa.

OBJECTIVE: We aimed to examine the prevalence and incidence of type 2 diabetes (T2D) in a large patient cohort treated for binge eating disorder (BED), bulimia nervosa (BN), and anorexia nervosa. METHOD: Patients (N = 2,342) treated at the Eating Disorder Unit of Helsinki University Central Hospital over the period up to 16 years were compared with matched general population controls (N = 9,368) in three stages: before entering to the treatment for an eating disorder, after the entrance until the end of the study period, and combined any time before, during, and after the treatment. The study population was linked with the oral TSD medication data of 17 years from The Medical Reimbursement Register. Data were analyzed using conditional and Poisson regression models. RESULTS: Before entering to the treatment for eating disorders, the risk of T2D was substantially increased in patients compared with controls (OR 6.6, 95% CI 4.0-10.7). At the end of the study period, the lifetime prevalence of T2D was 5.2% among patients, 1.7% among controls (OR 3.4, 95% CI 2.6-4.4), and in male patients, it was significantly higher compared with females. Of those treated for BED, every third had T2D by the end of the study period (OR 12.9, 95% CI 7.4-22.5), whereas the same was true for 4.4% of those with BN (OR 2.4, 95% CI 1.7-3.5). DISCUSSION: Our findings provide strong support for the association between T2D and clinically significant binge eating. Disturbed glucose metabolism may contribute to the onset and maintenance of BED and BN.

[The Finnish first year junior high school students gambling behaviour is associated with substance use and low academic performance]. / Seitsemäsluokkalaisten rahapelaaminen on yhteydessä pähteiden käyttöön ja heikkoon koulumenestykseen.

BACKGROUND: The study investigated Finnish 7th grade school children's gambling behaviour and gambling prevalence. METHOD: Participants (N = 988) in this study were from eleven schools in Finland.Χ2X-tests, mean comparisons and correlations were used to analyse the data. The retention rate was 9.,6%. RESULTS: Nearly one-third of the participants had gambled once or twice. .,0% of the participants were problem gamblers and .,8% gambled at-risk level. Significant others' gambling was associated with participants 'problem gambling. CONCLUSIONS: Adolescent problem gambling prevalence and at-risk level of gambling were higher compared to the adult population. Replication of this study with the larger sample is needed in order to confirm the results.

At-risk and problem gambling among adolescents: a convenience sample of first-year junior high school students in Finland.

BACKGROUND: Adolescent gambling and substance use are viewed as a public health concern internationally. The early onset age of gambling is a known risk factor for developing gambling problems later in life. The aims of this study are: to evaluate the internal consistency reliability, factorial validity and classification accuracy of the Finnish version of DSM-IV-Multiple Response-Juvenile (DSM-IV-MR-J) criteria measuring at-risk/problem gambling (ARPG); to examine gender differences in gambling participation, ARPG and substance use among first-year junior high school students; and to investigate the association of gambling and gaming (video game playing) participation, substance use and social variables with ARPG. METHODS: This study examined 988 adolescents (mean age 13.4 years) at 11 public schools in Finland between October-December 2013. The response rate was 91.6%. Chi-squared test and binary logistic regression analysis were used. RESULTS: 'Illegal acts' was the most endorsed and sensitive, but the least specific criteria identifying ARPG. During the past year, 51.6% of the respondents had gambled, 7.9% were identified as at-risk/problem gamblers (DSM-IV-MR-J score ≥ 2), 8.0% had smoked and 8.9% had been drinking for intoxication, and the first three were significantly more common among boys than girls. The odds ratio of being a male past-year at-risk/problem gambler was 2.27, 5.78 for gambling often or sometimes, 2.42 for video game playing weekly or more often and 6.23 for having peer gamblers. CONCLUSIONS: Overall, the Finnish version of the DSM-IV-MR-J had acceptable internal consistency reliability and factorial validity. None of the DSM-IV-MR-J criteria were accurate enough to screen ARPG per se. ARPG past-year prevalence was relatively high with males gambling more than females. ARPG was as common as drinking alcohol for intoxication and smoking. Peer gambling was strongly associated with ARPG. Efficient strategies to minimise the risks of gambling problems, tools for prevention and identification of ARPG among the underage are needed.

Suicide attempts and mortality in eating disorders: a follow-up study of eating disorder patients.

OBJECTIVE: The aim of this study is to explore the prevalence of hospital-treated suicide attempts in a large clinical population of eating disorder patients. METHOD: Follow-up study of adults (N=2462, 95% women, age 18-62 years) admitted to the Eating Disorder Clinic of Helsinki University Central Hospital in the period 1995-2010. For each patient, four controls were selected and matched for age, sex and place of residence. The end point events were modeled using Cox's proportional hazard model, taking matching into account. RESULTS: We identified 156 patients with eating disorder (6.3%) and 139 controls (1.4%) who had required hospital treatment for attempted suicide. Of them, 66 (42.3%) and 37 (26.6%) had more than one attempt. The rate ratio (RR) for suicide attempt in patients with eating disorder was 4.70 [95% confidence interval (CI) 1.41-15.74]. In anorexia nervosa, RR was 8.01 (95% CI 5.40-11.87), and in bulimia nervosa, it was 5.08 (95% CI 3.46-7.42). In eating disorder patients with a history of suicide attempt, the risk of death from any cause was 12.8%, suicide being the main cause in 45% of the deaths. CONCLUSION: Suicide attempts and repeated attempts are common among patients with eating disorders. Suicidal ideation should be routinely assessed from patients with eating disorders.

The increased risk for autoimmune diseases in patients with eating disorders.

OBJECTIVE: Research suggests autoimmune processes to be involved in psychiatric disorders. We aimed to address the prevalence and incidence of autoimmune diseases in a large Finnish patient cohort with anorexia nervosa, bulimia nervosa, and binge eating disorder. METHODS: Patients (N = 2342) treated at the Eating Disorder Unit of Helsinki University Central Hospital between 1995 and 2010 were compared with general population controls (N = 9368) matched for age, sex, and place of residence. Data of 30 autoimmune diseases from the Hospital Discharge Register from 1969 to 2010 were analyzed using conditional and Poisson regression models. RESULTS: Of patients, 8.9% vs. 5.4% of control individuals had been diagnosed with one or more autoimmune disease (OR 1.7, 95% CI 1.5-2.0, P<0.001). The increase in endocrinological diseases (OR 2.4, 95% CI 1.8-3.2, P<0.001) was explained by type 1 diabetes, whereas Crohn's disease contributed most to the risk of gastroenterological diseases (OR 1.8, 95% CI 1.4-2.5, P<0.001). Higher prevalence of autoimmune diseases among patients with eating disorders was not exclusively due to endocrinological and gastroenterological diseases; when the two categories were excluded, the increase in prevalence was seen in the patients both before the onset of the eating disorder treatment (OR 1.5, 95% CI 1.1-2.1, P = 0.02) and at the end of the follow-up (OR 1.4, 95% CI 1.1-1.8, P = 0.01). CONCLUSIONS: We observed an association between eating disorders and several autoimmune diseases with different genetic backgrounds. Our findings support the link between immune-mediated mechanisms and development of eating disorders. Future studies are needed to further explore the risk of autoimmune diseases and immunological mechanisms in individuals with eating disorders and their family members.