A hypothesis of a psychosocial origin of depression in diabetic persons (mainly patients with non-insulin-dependent diabetes mellitus, NIDDM) was tested. The population consisted of all the 1008 persons born in 1935 and living in a Finnish city (Oulu) on 1 October 1990. Data were collected in two phases. A screening for NIDDM and a collection of back ground data were carried out in the first phase. Oral glucose tolerance tests (OGTTs) were performed in the second phase in order to detect those with previously undiagnosed NIDDM, and depressive symptoms were measured with the Zung Self-Rating Depression Scale (ZSDS). Participants who scored 45 raw sum points or more were considered as suffering from depression. All those who were aware of their diabetes before the second phase were considered as previously diagnosed diabetics. Depression (raw sum score 45 points or more on the ZSDS) was associated with previously diagnosed diabetes mellitus, while it was not associated with undiagnosed diabetes. The sum scores on the ZSDS did not differ significantly from each other in the groups classified according to diabetic status. This finding was explained by the sum score of the ZSDS among the previously diagnosed diabetics, which had a skewed distribution towards higher sum scores. Among the previously diagnosed diabetic patients, all those who were depressed were on sick leave or retired, while the corresponding proportion for non-depressed patients was 52% (P = 0.009). The number of diagnosed diseases was higher among the former than the latter group (P = 0.025). Severe depressive symptoms were not associated with a more serious metabolic disease, but they tended to be associated with a great number of diagnosed diseases and with being on sick leave or retired. The results showed that the impact of diabetes mellitus itself on depression was not strong. Depression was not connected to elevated fasting blood glucose levels, but instead to a great number of diagnosed diseases and unfavourable social factors, such as being on sick leave or retired, which suggests a psychosocial origin of depression in NIDDM patients.

Summary.We studied the prevalence of diabetes mellitus in men aged 65 to 84 years in Finland. The study sample consisted of 763 men, the survivors of the Finnish cohort of the "Seven Countries Study" first examined in 1959. The participation rate in the present survey was 94%. Blood glucose, fasting and 2 h after a 75-g oral glucose load, was determined from capillary blood. Current WHO criteria for diabetes mellitus were used. The mean fasting blood glucose level, adjusted for age and body mass index, was higher in east than west Finland. It rose with age in both areas. The prevalence of diabetes was 38% in the east and 36% in west Finland. About one-third of the men had impaired glucose tolerance. In the age group 75 to 79 years, the prevalence of diabetes was 65% in the east and 50% in the west. No systematic variation in the prevalence of impaired glucose tolerance with age was found. The mean levels of body mass index decreased with age in the same way in men with diabetes, impaired glucose tolerance and normal glucose tolerance. Body mass index was not higher in men with diabetes or impaired glucose tolerance than in men with normal glucose tolerance.

The incidence of bronchiectasis has probably declined in developed countries in recent years, but no reliable statistical data on this are available. The present paper describes the use made of hospital services by bronchiectatic patients in Finland. Data on a total of 12,539 treatment periods for bronchiectasis that had occurred between 1972 and 1992 were collected from the discharge register maintained by the National Research and Development Centre for Welfare and Health (diagnosis 518 in the International Classification of Diseases up to 1986, and 494 from 1987 onwards). The number of admissions, new occurrences of bronchiectasis and days in hospital were calculated by sex and age in relation to the total population at the end of each year. There were 143 and 87 admissions per million inhabitants in 1972 and 1992, respectively. The admissions, new occurrences and the days in hospital all decreased, at annual rates of 1.3, 4.2 and 5.7%, respectively. Thus, where the number of new occurrences was 50 per million persons in 1977, it was 27 per million in 1992. In summary, bronchiectasis-related hospital treatment declined markedly between 1972 and 1992. Trend is attributed to effective treatment of pulmonary infections and the reduction in tuberculosis.