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South Ostrobothnia, Finland

Aromaa E.,Finnish National Institute for Health and Welfare | Tolvanen A.,University of Jyvaskyla | Tuulari J.,South Ostrobothnia Hospital District | Wahlbeck K.,Finnish National Institute for Health and Welfare
BMC Psychiatry | Year: 2011

Background: A minority of people suffering from depression seek professional help for themselves. Stigmatizing attitudes are assumed to be one of the major barriers to help seeking but there is only limited evidence of this in large general population data sets. The aim of this study was to analyze the associations between mental health attitude statements and depression and their links to actual use of mental health services among those with depression.Methods: We used a large cross-sectional data set from a Finnish population survey (N = 5160). Attitudes were measured by scales which measured the belief that people with depression are responsible for their illness and their recovery and attitudes towards antidepressants. Desire for social distance was measured by a scale and depression with the Composite International Diagnostic Interview Short Form (CIDI-SF) instrument. Use of mental health services was measured by self-report.Results: On the social discrimination scale, people with depression showed more social tolerance towards people with mental problems. They also carried more positive views about antidepressants. Among those with depression, users of mental health services, as compared to non-users, carried less desire for social distance to people with mental health problems and more positive views about the effects of antidepressants. More severe depression predicted more active use of services.Conclusions: Although stronger discriminative intentions can reduce the use of mental health services, this does not necessarily prevent professional service use if depression is serious and views about antidepressant medication are realistic. © 2011 Aromaa et al; licensee BioMed Central Ltd. Source


Aromaa E.,Finnish National Institute for Health and Welfare | Tolvanen A.,University of Jyvaskyla | Tuulari J.,South Ostrobothnia Hospital District | Wahlbeck K.,Finnish National Institute for Health and Welfare
Nordic Journal of Psychiatry | Year: 2011

Background: For planning effective and well-targeted initiatives to reduce stigma, we need to identify which factors are associated with stigmatizing of people with mental disorders. Aims: This study examined how well a combination of variables predicts stigmatizing attitudes and discrimination in a general population. Methods: A survey questionnaire was sent to 10,000 persons aged 15-80 years residing in western Finland. Attitudes were measured using a scale consisting of negative stereotypes about people with depression and stereotypical beliefs connected with mental problems, while discrimination was measured by a social distance scale. Predictors included demographic variables, mental health resources, personal experience of depression or psychological distress, knowing someone who suffers from mental health problems, and negative stereotypical beliefs. Results: Although 86% of the population thought that depression is a real medical condition, the majority of respondents believed that people with depression are responsible for their illness. Social discrimination was significantly associated with respondents' age, gender, native language, sense of mastery, depression, stereotypical beliefs and familiarity with mental problems. Conclusions: The results suggest that the need to address stigma is higher among men, older people and those without familiarity with mental problems. When planning interventions to shape stereotypes, the need for change is highest among those with a low sense of life control and poor social networks. Direct interactions with persons who have mental problems may change the stereotypical beliefs and discriminative behaviour of those who do not have familiarity with mental problems. © 2011 Informa Healthcare. Source


Saaristo T.,Pirkanmaa Hospital District | Moilanen L.,Kuopio University Hospital | Korpi-HYOVALTI E.,South Ostrobothnia Hospital District | Vanhala M.,Unit of Family Practice | And 9 more authors.
Diabetes Care | Year: 2010

OBJECTIVE - To investigate 1-year outcomes of a national diabetes prevention program in Finland. RESEARCH DESIGN AND METHODS - Altogether 10,149 individuals at high risk for diabetes were identified with the Finnish Diabetes Risk Score (FINDRISC; scoring ≥15 points), by a history of impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), cardiovascular disease, or gestational diabetes mellitus in 400 primary health care centers. One-year follow-up data were available for 2,798 participants who were nondiabetic at baseline (919 men and 1,879 women, aged 56.0 ± 9.9 and 54.0 ± 10.7 years [mean ± SD] with BMI 30.9 ± 4.6 and 31.6 ± 5.4 kg/m2). RESULTS - The incidence of diabetes was 2.0 and 1.2% in men and women with normal glucose tolerance at baseline, 13.5 and 7.4% in those with IFG, and 16.1 and 11.3% in those with IGT, respectively. Altogether 17.5% of the subjects lost ≥5% weight with no sex difference. The relative risk of diabetes was 0.31 (95% CI 0.16-0.59) in the group who lost ≥5% weight, 0.72 (0.46-1.13) in the group who lost 2.5-4.9% weight, and 1.10 (0.77-1.58) in the group who gained ≥2.5% compared with the group who maintained weight. CONCLUSIONS - The FIN-D2D was the first national effort to implement the prevention of diabetes in a primary health care setting. Methods for recruiting high-risk subjects were simple and easy to use. Moderate weight loss in this very high-risk group was especially effective in reducing risk of diabetes among those participating in the program. © 2010 by the American Diabetes Association. Source


Rautio N.,University of Oulu | Jokelainen J.,University of Oulu | Oksa H.,University of Oulu | Saaristo T.,University of Oulu | And 7 more authors.
Scandinavian Journal of Public Health | Year: 2011

Aims: Lifestyle intervention is effective in prevention of type 2 diabetes (T2D) in high-risk individuals. However, health behaviour and health outcomes are modified by socioeconomic position through various mechanisms. It is therefore possible that success in lifestyle intervention may be determined by factors such as level of education or occupation. In this study we assessed the impact of the level of education and occupation on the baseline anthropometric and clinical characteristics and their changes during a one-year follow-up in a cohort of Finnish men and women at high risk for T2D aged 20-64 years. Methods: As part of a Finnish national diabetes prevention programme 2003-2007 (FIN-D2D), high-risk individuals were identified using opportunistic screening for lifestyle intervention in primary health care. 1,067 men and 2,122 women had one-year follow-up data. Education and occupation were used as factors of socioeconomic position. Measures of anthropometric and clinical characteristics included weight, body mass index (BMI), waist circumference, systolic and diastolic blood pressure, total, HDL and LDL cholesterol, triglycerides, FINDRISC scores and glucose tolerance status. Results: The effect of intervention was similar in all socioeconomic groups, but the level of education was related to glucose tolerance status in both genders. In addition, socioeconomic differences existed in blood pressure, weight, BMI, waist circumference and HDL cholesterol. Conclusions: Socioeconomic position did not seem to have any impact on the effectiveness of lifestyle intervention in individuals at high risk for T2D, which is encouraging from the point of view of reducing health inequalities. © 2011 the Nordic Societies of Public Health. Source


Rautio N.,Pirkanmaa Hospital District | Jokelainen J.,University of Oulu | Oksa H.,Pirkanmaa Hospital District | Saaristo T.,Pirkanmaa Hospital District | And 9 more authors.
Diabetic Medicine | Year: 2012

Aims To investigate whether a positive family history of diabetes is associated with the effectiveness of lifestyle counselling on cardio-metabolic risk factors and glucose tolerance status in a 1-year follow-up in a cohort of Finnish men and women at high risk for Type 2 diabetes. Methods Altogether, 10149 individuals who had high risk of Type 2 diabetes participated in the implementation programme of the national diabetes prevention programme at baseline. One-year follow-up data were available for 2798 individuals without diabetes. Family history of diabetes was based on self-report. Lifestyle interventions were individual or groups sessions on lifestyle changes. The effectiveness of lifestyle intervention was measured as changes in cardiovascular risk factors, glucose tolerance status and incidence of Type 2 diabetes. Results Family history was associated with the effectiveness of lifestyle intervention in men, but not in women. During the 1-year follow-up, body weight, BMI, systolic blood pressure, total cholesterol, LDL cholesterol and score for 10-year risk for fatal cardiovascular disease (SCORE) decreased and glucose tolerance status improved more in men without a family history of diabetes than in men with a family history of diabetes. Of the participating men and women, 10% and 5% developed Type 2 diabetes, respectively. Family history was not related to the incidence of Type 2 diabetes in either gender. Conclusions Men without a family history of diabetes were more successful in responding to lifestyle counselling with regard to cardio-metabolic measurements and glucose tolerance than those with a family history of diabetes. Similar results were not seen in women. In keeping with findings from earlier studies, the prevention of Type 2 diabetes is not influenced by a family history of diabetes. © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK. Source

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