Religion and mental health in young adulthood: a register-based study on differences by religious affiliation in sickness absence due to mental disorders in Finland.

BACKGROUND: Religiosity and spirituality are known to be positively correlated with health. This is the first study to analyse the interrelation between religious denomination and sickness absence due to mental disorders using population register data with detailed ICD codes. METHODS: The follow-up study was based on the entire population born in Finland between 1984 and 1996 (N=794 476). Each person was observed from age 20 over the period from 2004 to 2018. Cox proportional hazards models were applied to analyse the association between religious denomination and first-time sickness allowance receipts for any cause and mental disorder. Mental disorders were categorised as severe mental illness (F20-F31), depression (F32-F33), anxiety (F40-F48) and any other mental disorder (all other F codes). Men and women were analysed separately. RESULTS: The differences in sickness absence due to mental disorder were substantial between religious affiliations. Compared with members of the Evangelical Lutheran state church, the relative hazard for mental disorders among non-affiliated women was 1.34 (95% CI 1.30 to 1.39), while that among women with other religions was 1.27 (95% CI 1.19 to 1.35), after adjusting for own and parental characteristics. The corresponding numbers for men were 1.45 (95% CI 1.39 to 1.50) and 1.42 (95% CI 1.30 to 1.54), respectively. The gradient was larger for severe mental illness and depression than for anxiety and other mental disorders. For any cause of sickness absence, there was no difference between Lutherans, non-affiliated individuals and those with other religions. CONCLUSIONS: Epidemiologists and public health practitioners should further examine the association between mental disorders and church membership using administrative registers.

Birth order and sickness absence: Register-based evidence from Finland.

BACKGROUND: In working ages, sickness absence is strongly related to persons' health condition. We studied how birth order was associated with receipt of sickness allowance, distinguishing between mental disorders, musculoskeletal disorders and injuries. METHODS: A follow-up study based on the entire Finnish population was conducted for sibling groups born 1969-1982, in which each sibling was observed from age 35 years in the period 2004-2018. Focus was on within-family variation in first-time sickness allowance receipt. RESULTS: Results of stratified Cox regressions revealed that each increase in birth order was associated with a slightly higher risk of sickness absence from any cause. For mental disorders, associations were stronger; the hazard ratio as compared to first borns was 1.03 (95% CI: 0.98-1.08) of second borns, 1.10 (0.99-1.22) of third borns, and 1.52 (1.25-1.85) of fourth or higher borns. Corresponding numbers for musculoskeletal disorders were 1.12 (1.07-1.17), 1.19 (1.09-1.30) and 1.15 (0.96-1.38), and for injuries 1.06 (1.01-1.12), 1.09 (1.21-1.14) and 0.96 (0.77-1.20), respectively. CONCLUSIONS: Birth order effects were generally stronger for women than men, and to some extent influenced by educational level, occupation, income, and family composition. Possible latent mechanisms behind the associations may relate to within-family dynamics at childhood.

Life Expectancy of the Ethnically Mixed: Register-Based Evidence from Native Finns.

As the ethnic composition around the world is becoming more diverse, the need to produce vital statistics for ethnically mixed populations is continuously increasing. Our aim is to provide the first life expectancy estimates for individuals with uniform Finnish, uniform Swedish, and mixed Finnish-Swedish backgrounds, based on individuals in the native population of Finland who can be linked to both their parents. Life expectancy at birth in the period 2005-2015 was calculated from population and mortality numbers at the one-year level based on each person's sex, year of birth, and the unique ethnolinguistic affiliation of the index person and each parent. Swedish-registered individuals with Swedish-registered parents had the longest life expectancy at birth, or 85.68 years (95% CI: 85.60-85.77) for females and 81.36 for males (95% CI: 81.30-81.42), as compared to 84.76 years (95% CI: 84.72-84.79) and 78.89 years (95% CI: 78.86-78.92) for Finnish-registered females and males with Finnish-registered parents. Persons with mixed backgrounds were found in between those with uniform Finnish and uniform Swedish backgrounds. An individual's own ethnolinguistic affiliation is nevertheless more important for longevity than parental affiliation. Similar register-based analyses for other countries with mixed populations would be useful.

Sickness Absence and Disability Pension in the Very Long Term: A Finnish Register-Based Study With 20 Years Follow-Up.

Sickness allowance is paid for short-term sickness absence and is thus an indicator of temporary ill health, but it is also associated with a heightened risk of receiving disability pension. Using event history analysis, we examined the long-term risk for disability pension receipt after first observed receipt of medically certified sickness allowance in each single year after sickness allowance was first recorded. Utilizing longitudinal data from the Finnish population register, covering the period 1989-2010, we observed 110,675 individuals aged 16-40 years at baseline. Using discrete-time hazard models, we estimated how the first observed receipt of sickness allowance was related to the risk of receiving disability pension, with an average follow-up time of 20.6 years. In this population, about 40 percent received sickness allowance and 10 percent received disability pension. In the first years after sickness allowance receipt, there was a substantial difference between long-term and short-term sickness allowance recipients in the hazard of becoming a disability pensioner. This difference levelled out over time, but even 20 years after the first observed sickness allowance receipt, the hazard of disability retirement was more than 15 times higher than that of non-recipients of sickness allowance. Patterns were similar for men and women. First observed receipt of sickness allowance is a powerful predictor for disability pension receipt, also in the very distant future. Thus, it can be used to monitor people with heightened risk of becoming more permanently ill and falling outside the labour market.

Sense of mastery differences between working-age Swedish- and Finnish-speaking Finns: a population-based study.

AIM: To examine the probability of a high sense of mastery in a population-representative sample of working-age people and to study the differences in mastery between Finnish-speaking and Swedish-speaking Finns in particular. METHODS: The data originates from the Western Finland Mental Health Surveys (2008-2014). Associations between sense of mastery and language groups were analyzed with logistic regressions. RESULTS: Swedish-speaking Finns have a higher sense of mastery and the association is mediated by social support. Moreover, a difference in a high sense of mastery is found between Swedish- and Finnish-speaking married women that are outside the labor market. CONCLUSIONS: Our findings imply that Finnish-speaking women that are outside the labor market, e.g. on maternity leave or taking care of the household, should be recognized in health and social care services as a group that can benefit from additional support.

Identification of a common polymorphism in the TopBP1 gene associated with hereditary susceptibility to breast and ovarian cancer.

Besides BRCA1 and BRCA2 other genes are also likely to be involved in hereditary predisposition to breast and/or ovarian cancer. TopBP1 (topoisomerase IIbeta binding protein 1) displays sequence homology as well as functional similarities with BRCA1, and the two proteins have been suggested to function partly in the same cellular processes. TopBP1 is crucial for DNA damage and replication checkpoint controls. Based on its biological significance, we reasoned that TopBP1 is a plausible susceptibility gene for hereditary breast and/or ovarian cancer and therefore screened affected index cases from 125 Finnish cancer families for germline changes by conformation sensitive gel electrophoresis (CSGE). Altogether 19 different sequence alterations were detected. A novel heterozygous Arg309Cys variant was observed at elevated frequency in the familial cancer cases compared to healthy controls (15.2% versus 7.0%; P=0.002). Current results suggest that Arg309Cys is a commonly occurring germline alteration possibly associated with a slightly increased breast and/or ovarian cancer risk. This is the first study reporting mutation screening of the TopBP1 gene in a familial cancer material.

TopBP1 localises to centrosomes in mitosis and to chromosome cores in meiosis.

Topoisomerase IIbeta binding protein 1 (TopBP1), previously shown to localise to sites of DNA damage and to stalled replication forks, has been implicated in DNA replication and in DNA damage response. In this work we showed that TopBP1 was localised in structures other than stalled replication forks. In late mitosis TopBP1 localises to centrosomes in a manner similar to other DNA damage response proteins such as BRCA1 and p53. Spindle checkpoint activation does not affect this centrosomal localisation. Moreover, in the testis, we detected high levels of TopBP1 associated with meiotic prophase chromosome cores and the X-Y pair. Together, these data suggest a direct role of TopBP1 during both mitosis and meiotic prophase I.

TopBP1 and ATR colocalization at meiotic chromosomes: role of TopBP1/Cut5 in the meiotic recombination checkpoint.

Mammalian TopBP1 is a BRCT domain-containing protein whose function in mitotic cells is linked to replication and DNA damage checkpoint. Here, we study its possible role during meiosis in mice. TopBP1 foci are abundant during early prophase I and localize mainly to histone gamma-H2AX-positive domains, where DNA double-strand breaks (required to initiate recombination) occur. Strikingly, TopBP1 showed a pattern almost identical to that of ATR, a PI3K-like kinase involved in mitotic DNA damage checkpoint. In the synapsis-defective Fkbp6(-/-) mouse, TopBP1 heavily stains unsynapsed regions of chromosomes. We also tested whether Schizosaccharomyces pombe Cut5 (the TopBP1 homologue) plays a role in the meiotic recombination checkpoint, like spRad3, the ATR homologue. Indeed, we found that a cut5 mutation suppresses the checkpoint-dependent meiotic delay of a meiotic recombination defective mutant, indicating a direct role of the Cut5 protein in the meiotic checkpoint. Our findings suggest that ATR and TopBP1 monitor meiotic recombination and are required for activation of the meiotic recombination checkpoint.