Publications
2026
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Effectiveness of guided self-help, guided internet-delivered cognitive behavioral therapy, and face-to-face cognitive behavioral therapy for depression and anxiety: protocols of four parallel randomized controlled non-inferiority trials of the Finnish First-Line Therapies -Initiative (FLT-Step)
No abstract -
Optimizing antipsychotic dosing for relapse prevention in cannabis-induced psychosis: A nationwide cohort study
CONCLUSIONS: Findings indicate dose-dependent real-world effectiveness of antipsychotics in CIP, with most agents performing best at 0.6-<1.4 DDDs/day. These results support optimizing dosing of oral antipsychotic medications for relapse prevention after CIP to balance efficacy and adverse effects. -
Associations of prior treatment, waiting time, symptom severity, and session frequency with symptom change in CBT for depression and anxiety in primary care
CONCLUSIONS: In routine CBT, clients with higher baseline severity benefited substantially, supporting equitable access to CBT regardless of initial symptom level. Clinical improvement was driven by the total number of attended treatment sessions rather than by the rate of attendance (i.e., the number of sessions per unit of time). This supports flexible scheduling without compromising outcomes. Longer waiting times did not systematically predict poorer results, suggesting that client- versus... -
Machine learned text topics improve drop-out risk prediction but not symptom prediction in online psychotherapies for depression and anxiety
Objective: Internet-delivered cognitive behavior therapies (iCBT) are effective and scalable treatments for depression and anxiety. However, treatment adherence remains a major limitation that could be further understood by applying machine learning methods to during-treatment messages. We used machine learned topics to predict drop-out risk and symptom change in iCBT. Method: We applied topic modeling to naturalistic messages from 18,117 patients of nationwide iCBT programs for depression and...
2025
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Treatment adherence in first-episode psychosis: A one-year follow-up study comparing self-reported adherence, pharmacy refill data, and therapeutic drug monitoring
CONCLUSION: Medication non-adherence is common in FEP. Pharmacy refill data provided a more accurate adherence measure than self-report. Enhancing adherence requires psychoeducation, follow-up, and proactive monitoring. Measuring drug concentrations after hospital discharge could help detect early non-adherence and optimize treatment. -
Meta-analyses of clozapine, norclozapine levels and their ratio across three genome wide association studies
Recent genome wide association studies (GWAS) found associations between clozapine serum levels and single nucleotide polymorphisms (SNP) in intragenic region between cytochrome P450 1A1 (CYP1A1) and CYP1A2 and nuclear factor 1B (NFIB). The aim of this study was to perform another GWAS of polymorphisms associated with the serum levels of clozapine and norclozapine, their ratios, and to perform meta-analyses with two previous GWAS. Finnish clozapine patients (n = 170) with known smoking habits... -
Therapists' Role in Patient Adherence to Internet-Based Cognitive Behavioral Therapy: Qualitative Study
CONCLUSIONS: The role of the therapist should not be diminished in the pursuit of digitalization, as human support remains a critical element of effective iCBT. -
Suicidal acts and thoughts among persons with psychotic disorders in the Finnish SUPER study
CONCLUSIONS: Prevalence of register-based self-harm and self-reported suicide attempts differ markedly. Suicidal acts are common in psychotic disorders, particularly in those with a mood component. Very short inpatient stays may not be adequate in these disorders. -
IL-8 and IL-1RA serum levels predicting depression treatment response in 6-week follow-up
CONCLUSION: Higher baseline IL-1Ra and IL-8 concentrations were associated with a lesser relative response to depression treatment, particularly in patients with mild depression. Results on IL-8 concur with earlier findings, whereas the association between higher IL-1Ra serum concentrations reduced treatment response is a novel finding. -
Targeted Learning for Optimal Patient Assignment to Psychotherapy
CONCLUSION: Identifying optimal treatment rules for psychotherapy frameworks is feasible and may significantly improve outcomes. -
Socioeconomic status, antidepressant use, and return to work after disability due to common mental disorders
CONCLUSIONS: An alarming result was the absence of recommended medication in fewer than every seventh patient estimated to be disabled due to pharmacologically treatable psychiatric disorders. Contrary to expectations, SES had only a minor predictive role in antidepressant adherence in this patient group. Contrary to taking antidepressants, rehabilitation was associated with RTW. The results adduced the importance of CMD treatment optimization regardless of SES. -
Real-world effectiveness of antipsychotic medication in relapse prevention after cannabis-induced psychosis
CONCLUSIONS: In particular, LAIs, clozapine and oral aripiprazole were associated with a decreased risk of psychosis relapse following CIP. Prescribers should consider using more LAIs for better treatment outcomes after CIP. -
Effects of high impact exercise on systemic cytokines in women with mild knee osteoarthritis: A 12-month RCT
CONCLUSION: A progressive high-impact exercise regimen did not affect systemic cytokine levels compared to the reference group and could therefore offer a possible mode of exercise for postmenopausal women with mild knee OA. -
Sleep and schizophrenia polygenic scores in non-affective and affective psychotic disorders
CONCLUSION: Genetic risks for sleep and diurnal preference vary between non-affective psychosis, affective psychosis, and the general population. The findings in this study emphasize the heterogeneity in genetic etiology of the objective features of disease severity and the more subjective measures related to well-being and self-reported measures of sleep.
2024
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General medical comorbidities in psychotic disorders in the Finnish SUPER study
Schizophrenia (SZ), schizoaffective disorder (SZA), bipolar disorder (BD), and psychotic depression (PD) are associated with premature death due to preventable general medical comorbidities (GMCs). The interaction between psychosis, risk factors, and GMCs is complex and should be elucidated. More research particularly among those with SZA or PD is warranted. We evaluated the association between registry-based psychotic disorders and GMC diagnoses in a large national sample of participants with... -
Developing a European Psychotherapy Consortium (EPoC): Towards Adopting a Single-Item Self-Report Outcome Measure Across European Countries
CONCLUSIONS: We conclude this first stage of the overall project by discussing the future potential of the Consortium in relation to the development of procedures that allow crosswalks of outcome measures and the creation of a task force that may be consulted when new data sets are collected, aiming for new common measures to be implemented and shared. -
Leptin and leptin receptor gene polymorphisms and depression treatment response
CONCLUSION: Our findings suggest that LEPR polymorphisms are associated with depression treatment response. We also found associations between leptin levels and depression independently of BMI. Further studies and meta-analyses are needed to confirm the significance of found SNPs and the role of leptin in depression. -
High Burden of Ileus and Pneumonia in Clozapine-Treated Individuals With Schizophrenia: A Finnish 25-Year Follow-Up Register Study
CONCLUSIONS: Clozapine-induced ileus and pneumonia were notably more frequent than has previously been reported and were associated with increased mortality. Two CYP genes influenced pneumonia risk. Pneumonia and ileus call for improved utilization of available preventive measures. -
Learning Outcomes of e-Learning in Psychotherapy Training and Comparison With Conventional Training Methods: Systematic Review
CONCLUSIONS: e-Learning seems to have good potential to enhance psychotherapy training by increasing access, scalability, and cost-effectiveness while maintaining quality in terms of learning outcomes. Results are congruent with findings related to e-learning in health education in general where e-learning as a pedagogy is linked to an opportunity to carry out learner-centric practices. Recommendations for conducting psychotherapy training programs in blended settings supported by activating... -
What to take up from the patient's talk? The clinician's responses to the patient's self-disclosure of their subjective experience in the psychiatric intake interview
During psychiatric diagnostic interviews, the clinician's question usually targets specific symptom descriptions based on diagnostic categories for ICD-10/DSM-5 (2, 3). While some patients merely answer questions, others go beyond to describe their subjective experiences in a manner that highlights the intensity and urgency of those experiences. By adopting conversation analysis as a method, this study examines diagnostic interviews conducted in an outpatient clinic in South Finland and... -
In response to "Nitrous oxide inhalation: History and experiences," a letter to the Editor by Kroneberg et al
No abstract -
A retrospective analysis of iv ketamine outcome on hospitalisations in an unselected psychiatric sample
CONCLUSION: Iv ketamine treatment showed effectiveness in reducing depressive symptoms even with complex patients in a real-world clinical setting. However, this did not translate to a reduction in hospitalisation. Highlighting the multifaceted challenges posed when implementing iv ketamine treatment in clinical practice. -
Polymorphisms in <em>ERBB4</em> and <em>TACR1</em> associated with dry mouth in clozapine-treated patients
CONCLUSION: Use of valproate or antipsychotic polypharmacy may increase the risk of sialorrhea. Genetic variations in ERBB4 and TACR1 might contribute to experienced dryness of mouth among patients treated with clozapine. -
More than just joy: A qualitative analysis of participant experiences during nitrous oxide sedation
CONCLUSIONS: Experiences under nitrous oxide sedation are extremely variable and not always pleasant. These findings can improve our understanding of the likes/dislikes of patients undergoing nitrous oxide sedation. Further qualitative studies should focus on the experiences of other groups, such as children or women in labor.