Publications
2026
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Joint factor structure of self-reported cognitive and affective problems in a help-seeking population
CONCLUSION: This study replicates the transdiagnostic structure of affective problems and suggests that cognitive complaints do not fit a comparable general factor structure. Findings highlight the complexity of self-reported cognitive issues - particularly those related to attention and executive function - and underscore the need for comprehensive assessments that go beyond self-report measures. -
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... -
Targeted Learning for Optimal Patient Assignment to Psychotherapy
CONCLUSION: Identifying optimal treatment rules for psychotherapy frameworks is feasible and may significantly improve outcomes. -
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. -
Rebound electroencephalographic responses to nitrous oxide exposure in men
Nitrous oxide (N(2)O) may elicit antidepressant effects after its elimination from the brain. We sought to investigate whether short-term administration of N(2)O triggers power within the delta (0.5-4 Hz) and/or theta (4-7 Hz) frequency ranges in the electroencephalogram (EEG) after it's administration, as we have recently seen such rebound effects to N(2)O in studies conducted on mice. Twenty healthy male participants were randomly allocated to receive 50% N(2)O either continuously for 20 min... -
Response to the Commentary "Can a 1-Item Scale for Psychotherapy Outcomes Be Psychometrically Robust?"
No abstract -
Influence of CYP2D6 phenotype on adherence, adverse effects, and attitudes in aripiprazole and risperidone users
Non-adherence and negative attitudes towards medication are major problems in treating psychotic disorders. Cytochrome P450 2D6 (CYP2D6) contributes to the metabolism of aripiprazole and risperidone, and variations in CYP2D6 activity may affect treatment response or adverse effects. However, the impact of these variations on adherence and medication attitudes is unclear. This study investigates the relationships between CYP2D6 phenotype, self-reported adherence, adverse effects, and attitudes... -
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... -
Unveiling the impact of competition weight loss on gut microbiota: alterations in diversity, composition, and predicted metabolic functions
CONCLUSIONS: The study highlights the dynamic nature of gut microbiota and its response to fat loss and regain in non-obese fitness/physique competitors and provides novel insights into how competitive sports and sports nutrition can influence the gut ecosystem. -
Efficacy and effectiveness of therapist-guided internet versus face-to-face cognitive behavioural therapy for depression via counterfactual inference using naturalistic registers and machine learning in Finland: a retrospective cohort study
BACKGROUND: According to meta-analyses of randomised controlled trials (RCTs), therapist-guided internet-delivered cognitive behavioural therapy (iCBT) is as effective a treatment for depression as traditional face-to-face CBT (fCBT), despite its substantially lower costs. However, RCTs are not always representative of routine practice, which could inflate effectiveness estimates. We combined rich data with counterfactual causal statistical reasoning to provide an fCBT-iCBT comparison... -
Repurposing Semaglutide and Liraglutide for Alcohol Use Disorder
CONCLUSIONS AND RELEVANCE: Among patients with AUD and comorbid obesity/type 2 diabetes, the use of semaglutide and liraglutide were associated with a substantially decreased risk of hospitalization due to AUD. This risk was lower than that of officially approved AUD medications. Semaglutide and liraglutide may be effective in the treatment of AUD, and clinical trials are urgently needed to confirm these findings.
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. -
Antipsychotic medications and sleep problems in patients with schizophrenia
CONCLUSIONS: Prevalence of sleep problems is markedly related to the antipsychotic medication the patient uses. These findings underline the importance of considering and assessing sleep problems when treating schizophrenia patients with antipsychotics. -
Genetic contribution to disease-course severity and progression in the SUPER-Finland study, a cohort of 10,403 individuals with psychotic disorders
Genetic factors contribute to the susceptibility of psychotic disorders, but less is known how they affect psychotic disease-course development. Utilizing polygenic scores (PGSs) in combination with longitudinal healthcare data with decades of follow-up we investigated the contributing genetics to psychotic disease-course severity and diagnostic shifts in the SUPER-Finland study, encompassing 10 403 genotyped individuals with a psychotic disorder. To longitudinally track the study participants'... -
Antipsychotic Use and Psychiatric Hospitalization in First-Episode Non-affective Psychosis and Cannabis Use Disorder: A Swedish Nationwide Cohort Study
CONCLUSIONS: These findings support the use of clozapine, LAI formulations of second-generation antipsychotics other than olanzapine, or oral aripiprazole to prevent hospitalization in FEP and co-occurring CUD. -
Association of antidepressant and benzodiazepine use, and anticholinergic burden with cognitive performance in schizophrenia
Schizophrenia is characterized by cognitive impairment affecting everyday functioning. Earlier research has hypothesized that antidepressants may associate with better cognitive functioning, but results are mixed. This study explored the association between antidepressant use and cognitive performance in terms of reaction time and visual learning in a clinical sample. In addition, we examined benzodiazepine use and anticholinergic burden. Study participants were drawn from the SUPER-Finland... -
Adolescent alcohol and cannabis use and early adulthood educational attainment in the 1986 Northern Finland birth cohort study
CONCLUSIONS: Assessments of age of first alcohol intoxication, high self-reported alcohol tolerance and frequency of intoxication during adolescence should be included when implementing screening strategies aimed at identifying adolescents at risk for subsequent social problems. -
Genetic risk scores associated with temperament clusters in Finnish depression patients
CONCLUSION: GRSs seem to associate with an individual's temperament profile, which can be observed in the clusters used. Further research needs to be conducted on these types of clusters and their clinical applicability. -
Socioeconomic status, psychotherapy duration, and return to work from disability due to common mental disorders
Objective Low socioeconomic status (SES) is a risk factor for work disability due to common mental disorders (CMDs), one possible reason being inequal use of services. Psychotherapy is an evidence-based treatment for CMDs. This study examines socioeconomic and sociodemographic differences in psychotherapy attendance and an association of psychotherapy duration with return to work (RTW).Methods The study subjects (N = 12,263) were all Finnish citizens granted a disability pension (DP) due to CMDs... -
Geographical variation in treated psychotic and other mental disorders in Finland by region and urbanicity
CONCLUSION: After adjusting for socioeconomic and sociodemographic factors, the within-country distribution of mental disorders no longer followed the traditional east-west gradient. Urban-rural differences, on the other hand, persisted after the adjustments.