- PhD Med (Karolinska Institute, Stockholm), Professor on Mental Health at Tallinn University, PI at Estonian-Swedish ... morePhD Med (Karolinska Institute, Stockholm), Professor on Mental Health at Tallinn University, PI at Estonian-Swedish Mental health and Suicidology Institute, Board Member of private clinic (psychology, joga, massages).edit
There is expedient evidence showing that differences in adolescent alcohol consumption and other risk-behaviour depend on both family structure and family member drunkenness exposure. Data were obtained among adolescents (N = 12,115, mean... more
There is expedient evidence showing that differences in adolescent alcohol consumption and other risk-behaviour depend on both family structure and family member drunkenness exposure. Data were obtained among adolescents (N = 12,115, mean age 14.9 ± 0.89) in Austria, Estonia, France, Germany, Hungary, Ireland, Israel, Italy,Romania, Slovenia and Spain within the European Union'ss 7th Framework Programme funded project, 'Saving and Empowering Young Lives in Europe (SEYLE)’. The current study reveals how adolescents' alcohol consumption patterns are related to their family structure and having seen their family member drunk. The results revealed statistically significant differences in adolescent alcohol consumption depending on whether the adolescent lives in a family with both birth parents, in a single-parent family or in a family with one birth parent and one step-parent. The study also revealed that the abstaining from alcohol percentage among adolescents was greater ...
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Background: The current study is aimed to assess the relationship between the ‘economic/employment’ and ‘social/welfare’ dimensions of social exclusion and suicide mortality in Europe. Methods: Suicide rates for 26 countries were obtained... more
Background: The current study is aimed to assess the relationship between the ‘economic/employment’ and ‘social/welfare’ dimensions of social exclusion and suicide mortality in Europe. Methods: Suicide rates for 26 countries were obtained from the WHO. Data on social expenditure were obtained from the OECD database. Employment rates and GDP were obtained from the Total Economy Database. Questions about citizens’ attitudes towards different aspects of social exclusion were taken from the European Social Survey. Structural equation modelling was applied to research the theoretical structure of the variables. Results: All variables are statistically significant in male and female models except of the relationships between ‘economic/employment’ and ‘social/welfare’ dimensions and female suicides; and the relationship between ‘employment rates’ and ‘economic/employment’ dimension. Suicide mortality rates among both males and females are influenced negatively by ‘economic/employment’ and ...
Research Interests:
Research Interests:
Research Interests:
Research Interests: Suicide, Suicide prevention, Adolescent, Medicine, Linear models, and 15 moreHumans, Sex Difference, Europe, Female, Poisoning, Male, Middle Aged, International Classification of Diseases, Adult, Public health systems and services research, Sex Factors, Age Factors, Substance-Related Disorders, Socioeconomic Factors, and Cause of death
Research Interests:
The former USSR covered 22.4 million square kilometres and had a population of 288,362,296 in 1990. During 1984-1990 the former USSR consisted of 15 republics, which formed culturally, geographically and historically different regions.... more
The former USSR covered 22.4 million square kilometres and had a population of 288,362,296 in 1990. During 1984-1990 the former USSR consisted of 15 republics, which formed culturally, geographically and historically different regions. Yearly, approximately 45,000-50,000 males and 14,000-15,000 females committed suicide. Suicide rates in the former USSR during 1984-1990 varied greatly between different regions, from 3.5 cases per 100,000 inhabitants in the Caucasus (Georgia, Azerbaijan and Armenia) to 11.8 in Central Asia (Kazakhstan, Kirgizia, Turkmenistan, Uzbekistan and Tajikistan), 18.1 in Moldova, 25.6 in the Slavic region (Russia, the Ukraine and Belarus) and 28.0 in the Baltic region (Latvia, Lithuania and Estonia). The same pattern of great variation between different regions was observed for both men and women in the former USSR, with suicide rates for men ranging from 4.9 in the Caucasian region to 45.9 in the Baltics, and suicide rates for women ranging from 2.1 in the Ca...
Research Interests:
Research Interests:
Research Interests:
The community-based 4-level-intervention concept developed within the “European Alliance against Depression” (http://www.eaad.net/) combines two important aims: to improve the care and treatment of patients with depression and to prevent... more
The community-based 4-level-intervention concept developed within the “European Alliance against Depression” (http://www.eaad.net/) combines two important aims: to improve the care and treatment of patients with depression and to prevent suicidal behavior. It has been shown to be effective concerning the prevention of suicidal behavior [1–4] and is worldwide the most broadly implemented community-based intervention targeting depression and suicidal behavior. The 4-level intervention concept comprises training and support of primary care providers (level 1), a professional public relation campaign (level 2), training of community facilitators (teacher, priests, geriatric caregivers, pharmacists, journalists) (level 3), and support for self-help of patients with depression and for their relatives (level 4). In order to deepen the understanding of factors influencing the effectiveness of the intervention, a systematic implementation research and process analysis was performed within th...
Research Interests:
Research Interests:
Observed changes in subcategories of injury death were used to test the hypothesis that a sizeable proportion of ''injury deaths of undetermined intent'' (Y10-Y34 in ICD 10) in the Baltic and Slavic countries after the... more
Observed changes in subcategories of injury death were used to test the hypothesis that a sizeable proportion of ''injury deaths of undetermined intent'' (Y10-Y34 in ICD 10) in the Baltic and Slavic countries after the USSR dissolved in 1991 were hidden suicides. Using male age-adjusted suicide rates for two distinctly different periods, 1981-90 and 1992-2005, changes, ratios and correlations were calculated. The data were compared with the EU average. After the USSR broke up, the obligation to make a definitive diagnosis became less strict. A massive increase in ''injury deaths of undetermined intent'' resulted. The mean rate for the second period reached 52.8 per 100,000 males in Russia (the highest rate) and 12.9 in Lithuania (the lowest), against 3.2 in EU-15. The rise from the first to the second period was highest in Belarus (56%) and Russia (44%). The number of injury deaths of undetermined intent was almost equal to that of suicides in Russia ...
Research Interests:
Research Interests:
Trends of male and female suicides in the Baltic countries--Estonia, Latvia and Lithuania--in the years 1968-90 were studied. As throughout the former USSR, suicide rates declined sharply from 1986, the year marking the onset of turbulent... more
Trends of male and female suicides in the Baltic countries--Estonia, Latvia and Lithuania--in the years 1968-90 were studied. As throughout the former USSR, suicide rates declined sharply from 1986, the year marking the onset of turbulent social change. During the "period of stagnation" from 1968 to 1984, the mean value of male suicide rates per 100,000 males were 55.7 in Estonia, 52.5 in Latvia and 51.7 in Lithuania. The figures for female suicide rates were 14.3, 14.3 and 10.4, respectively. Suicide rates remained consistently high in Estonia and Latvia, while in Lithuania the male suicide rate rose gradually from 33.0 to 61.3 and the female rate from 8.0 to 13.1 during the stagnation period. In conjunction with perestroika in the former USSR (including a restrictive alcohol policy and the first tentative steps towards democracy), annual male suicide rates per 100,000 in the years 1986-90 fell considerably below those in the stagnation period. Mean values of male suicide...
Research Interests:
Research Interests:
Research Interests: Community-Based Mental Health Services, Suicide, International Cooperation, Self Help Groups, Humans, and 12 moreProgram Development, Europe, Major Depressive Disorder, Incidence, Risk factors, Clinical Sciences, Prevalence, World Health Organization, Risk Factors, Social Facilitation, Community Based Mental Health Services, and Neurosciences
The purpose of this study was to analyze the differences in the disposition and frequency of recent life events preceding suicide in two cities with different socio-political backgrounds: Tallinn in Estonia and Frankfurt/Main in Germany.... more
The purpose of this study was to analyze the differences in the disposition and frequency of recent life events preceding suicide in two cities with different socio-political backgrounds: Tallinn in Estonia and Frankfurt/Main in Germany. The information about 156 suicidents in Tallinn and 163 suicidents in Frankfurt was compiled using the psychological autopsy technique [Shneidman, E. S. (1981). The psychological autopsy. Suicide and Life-Threatening Behavior, 11, 325-340; Jacobs, D., & Klein-Benheim, M. (1995). The psychological autopsy: A useful tool for determining proximate causation in suicide cases. Bulletin of American Academy of Psychiatry Law, 23(2), 165-182]. General population controls were matched by age and sex. The occurrence of recent life events was similar among suicidents in Tallinn (81%) and Frankfurt (77%). However, in both sites only male suicides had higher risk of occurrence of any life event than controls (Tallinn: OR'=1.9; 95% CI=1.1-3.7; Frankfurt: OR'=2.0; 95% CI=1.0-4.1) and the mean number of life events was significantly higher among male suicidents in Tallinn in comparison with controls. This may indicate that males are more sensitive to the rapid changes in a society undergoing transition. It seems that it is not the number of life events, but rather their meaning and disposition that creates the risk of suicide. Family discord (weighted OR=4.5; 95% CI=2.5-8.1), loss of job (weighted OR=2.6; 95% CI=1.0-6.4) and financial deterioration (weighted OR=2.2; 95% CI=1.3-3.8) were more prevalent among suicides in Tallinn in comparison with those in Frankfurt. The most significant differences between suicides and controls were family discord, separation and loss of job in Tallinn and somatic illness in Frankfurt. These differences between the two societies, post-Soviet Estonia and Germany, could be explained by the different positions of Estonia and Germany on the survival/self-expression dimensions recorded by the World Value Survey. People in Estonia tend to emphasize economic and physical security above all other goals, and feel threatened by the changes taking place in society. In Germany, good health is considered a necessity for a consumer and self-expressive style of life, and poor health is perceived as a serious threat to the quality of life in a post-materialistic value system.
Research Interests:
Research Interests:
ABSTRACTBackground: National attitudes towards the elderly and their association with elderly suicide mortality in 26 European countries were assessed, and Eastern and Western European countries compared.Methods: For each country, mean... more
ABSTRACTBackground: National attitudes towards the elderly and their association with elderly suicide mortality in 26 European countries were assessed, and Eastern and Western European countries compared.Methods: For each country, mean age-adjusted, gender-specific elderly suicide rates in the last five years for which data had been available were obtained from the WHO European Mortality Database. Questions about citizens’ attitudes towards the elderly were taken from the European Social Survey. Correlations between attitudes and suicide rates were analyzed using Pearson's test. Differences between mean scores for Western and Eastern European attitudes were calculated, and data on labor-market exit ages were obtained from the EUROSTAT database.Results: Perception of the elderly as having higher status, recognition of their economic contribution and higher moral standards, and friendly feelings towards and admiration of them are inversely correlated with suicide mortality. Suicid...
Research Interests: Family, Employment, Humans, Age, Europe, and 15 moreFemale, Male, Attitudes, Attitude, Interpersonal Relations, Intergenerational Relations, Psychogeriatrics, Aged, Questionnaires, European social survey, Health surveys, Risk Factors, Friends, Psychology and Cognitive Sciences, and Medical and Health Sciences
Research Interests:
Research Interests:
Research Interests:
Research Interests:
ABSTRACT The present study attempted to assess the complex role of several suicide risk and protective factors in Ukraine.Methods Suicide rates, prevalence of alcoholism and alcoholic psychosis, prevalence of drug addictions, percentage... more
ABSTRACT The present study attempted to assess the complex role of several suicide risk and protective factors in Ukraine.Methods Suicide rates, prevalence of alcoholism and alcoholic psychosis, prevalence of drug addictions, percentage of urban population and gross regional product for 26 provinces of Ukraine were obtained from the State Statistical Office of Ukraine and the WHO. Questions related to citizens’ religiosity and education were obtained from the European Social Survey. Structural equation modelling (SEM) was applied to research the complex theoretical structure of variables that might influence suicide mortality.ResultsReligion presented strong statistically significant negative association with suicide mortality. The relationship between education and suicide was weak negative and not statistically significant. The relationship between the prevalence of alcoholism and alcoholic psychosis and suicide mortality was weak positive and statistically significant. Medium positive statistically significant association was revealed between the prevalence of drug addiction and suicide. The relationship between urbanisation and suicide mortality was medium negative but statistically significant among females only. No relationship was revealed between gross regional product and male suicide while the relationship with female suicide was slightly negative and not statistically significant.Conclusions Religiosity was found to be the protective factor most strongly linked to suicide mortality followed by urbanisation. Harmful role of drug addiction and alcoholism was confirmed. The role of education level and GRP is controversial. No striking gender differences were found.
Research Interests:
Research Interests:
Research Interests:
Background: The present paper is based on a WHO Collaborative Cross-National Study “Health Behavior in School-Aged Children (HBSC).” Aims: It aimed at describing and analyzing how the sexual behaviors of 13- to 15-year-old Estonian school... more
Background: The present paper is based on a WHO Collaborative Cross-National Study “Health Behavior in School-Aged Children (HBSC).” Aims: It aimed at describing and analyzing how the sexual behaviors of 13- to 15-year-old Estonian school children were associated with self-reported depressive feelings and suicidality. Distinctive behavioral traits in relation to age of first sexual intercourse were also investigated. Methods: Self-reported questionnaires from school children (n = 3,055) were analyzed. Results: In total, 15.2% of school children reported being nonvirgin. Among 13-year-olds, 2.9% of girls and 6.8% of boys were nonvirgins. Approximately 25% of the 15-year-old girls and boys were nonvirgins. The likelihood of depressive feelings and suicidal ideation increased significantly in both genders with loss of virginity. Boys who had lost their virginity at 13 years or younger were 4.2 times more likely to have suicidal thoughts; comparable girls were 7.8 times more likely to h...
Research Interests: Psychology, Depression, Adolescent, Emotions, Crisis, and 15 moreHumans, Estonia, Female, Male, Confidence intervals, Questionnaires, Longitudinal Studies, Communication and media Studies, Odds ratio, Adolescent Sexual Behavior, Age Factors, Chi Square Distribution, Risk Factors, Risk Behavior, and Logistic Models
Research Interests: Cultural Studies, Psychology, Spirituality, Brazil, Sri Lanka, and 15 moreVietnam, Iran, South Africa, Humans, Estonia, Religion and psychology, Interpersonal Relations, Self Concept, Case Control Study, Suicide Attempt, Cross Sectional Studies, Protective Factor, Socioeconomic Factors, attitude to health, and cultural characteristics
A significant decline (34.5%) in the suicide rate occurred in 1984-1988 throughout the USSR. The decline was observed shortly after the introduction of strict restrictions on the sale of alcohol. We tested the hypothesis that the... more
A significant decline (34.5%) in the suicide rate occurred in 1984-1988 throughout the USSR. The decline was observed shortly after the introduction of strict restrictions on the sale of alcohol. We tested the hypothesis that the restrictive alcohol policy in the first years of perestroika (June 1985) caused the fall in suicide rates in the former USSR. Data on alcohol consumption, violent death caused by external injury and poisoning (n = 916,315), death due to accidental alcohol poisoning (n = 77,837), suicide (n = 192,305) and death undetermined whether accidentally or purposely (n = 54,253) were analyzed for all former Soviet republics for 1984, 1986, 1988 and 1990. Men were chosen for the analysis, since men are more prone to abuse alcohol than women. Regression analysis with alcohol consumption as the independent variable and suicide rates and violent death rates as dependent variables shows that suicide and alcohol consumption were positively correlated as were violet death and alcohol consumption. In the republics with high alcohol consumption (Slavic and Baltic), suicide rates were also high. In the Caucasian republics, low alcohol consumption was associated with low suicide rates. For most republics, alcohol seems to explain more than 50% of suicides. Alcohol also has considerable explanatory value for violent death. Thus, a restrictive alcohol policy might be a way to reduce suicide and violent death.
Research Interests: Epidemiology, Violence, Suicide, Regulation, Preventive medicine, and 14 moreHealth Policy, Humans, Inquiry, Alcohol Drinking, Male, Regression Analysis, Sales, USSR, Alcohol Consumption, Prevalence, Reproducibility of Results, Psychology and Cognitive Sciences, Cause of death, and Medical and Health Sciences
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests: Cultural Studies, Psychology, Spirituality, Brazil, Sri Lanka, and 14 moreVietnam, Iran, Cross-Cultural Comparison, South Africa, Humans, Estonia, Religion and psychology, Interpersonal Relations, Self Concept, Case Control Study, Suicide Attempt, Cross Sectional Studies, Protective Factor, and Socioeconomic Factors
At the same time as substantial and rapid socio-political and socio-economic changes took place during the period of perestroika, suicide rates in the former USSR decreased by approximately 32% for men and 19% for women. The decreases in... more
At the same time as substantial and rapid socio-political and socio-economic changes took place during the period of perestroika, suicide rates in the former USSR decreased by approximately 32% for men and 19% for women. The decreases in the suicide rates of men in the former USSR were unlike the suicide rate decreases taking place in 22 other European countries, where rates decreased by approximately 8% for men and 17% for women during this time period. Declines in suicide rates from 1984 to 1986-1988 occurred in all republics, with the largest decreases in Russia and Belarus, at 42% for men and 20% for women. The decrease in suicide rates of men in the former USSR was most pronounced until 1986-1988, after which time an increasing trend was observed. Suicide rates for men in the former USSR decreased 3.8-fold more than they did for men in other parts of Europe, while decreases in the suicide rates for women in the former USSR were on the same level as in Europe.