Psykiatrinen terveydenhuoltotutkimus

Maamme psykiatrinen terveydenhuolto on monien muutosten kohteena. Vaikka Suomessa onkin psykiatristen epidemiologisten tutkimusten ansiosta saatu paljon tietoa psyykkisten häiriöiden esiintyvyydestä, tarvitaan edelleen tietoa erilaisten hoitomuotojen, -ohjelmien ja -järjestelmien vaikuttavuudesta ja tehokkuudesta. Tätä työtä edellyttää psykiatrinen terveydenhuoltotutkimus. Terveydenhuoltotutkimuksella tarkoitetaan maan terveydenhuoltojärjestelmän rakenteiden, toiminnan ja laadun tuloksellisuuden tutkimusta. Terveydenhuoltotutkimus on käsitteenä uusi ja sitä on tehty vasta parin vuosikymmenen ajan. Psykiatrian ala asettaa tälle tutkimukselle monia erityisvaatimuksia. Käsitteet "mielenterveys", "mielenterveyden häiriö" ja "psykiatrisen hoidon tarve" vaikuttavat terveydenhuoltotutkimuksen soveltamiseen psykiatriseen terveydenhuoltoon. Tärkeitä psykiatrisen terveydenhuoltotutkimuksen kohteita Suomessa ovat perusterveydenhuollon mielenterveystyön tutkimus, psykiatrisen aluevastuuyksikön rakenteen ja toiminnan tutkimus, psykiatristen pitkäaikaispotilaiden kuntoutuksen tutkimus, psykiatristen hoitomallien arviointi ja arviointimenetelmien kehittäminen, pakon käytön psykiatriassa ja psykiatrisen hoidon etiikka sekä geropsykiatrinen terveydenhuoltotutkimus

Did female prisoners with mental disorders receive psychiatric treatment before imprisonment?

© 2015 Mundt et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.BackgroundThroughout the world, high prevalence rates of mental disorders have been found in prison populations, especially in females. It has been suggested that these populations do not access psychiatric treatment. The aim of this study was to establish rates of psychiatric in- and outpatient treatments prior to imprisonment in female prisoners and to explore reasons for discontinuation of such treatments.Methods150 consecutively admitted female prisoners were interviewed in Berlin, Germany. Socio-demographic characteristics, mental disorders, and previous psychiatric in- and outpatient treatments were assessed by trained researchers. Open questions were used to explore reasons for ending previous psychiatric treatment.ResultsA vast majority of 99 prisoners (66%; 95% CI: 58¿73) of the total sample reported that they had previously been in psychiatric treatment, 80 (53%; 95 CI: 45¿61) in inpatient treatment, 62 (41%; 95 CI: 34¿49) in outpatient treatment and 42 (29%; 21¿39) in both in- and outpatient treatments. All prisoners with psychosis and 72% of the ones with any lifetime mental health disorder had been in previous treatment. The number of inpatient treatments and imprisonments were positively correlated (rho¿=¿0.27; p¿<¿0.01). Inpatient treatment was described as successfully completed by 56% (N¿=¿41) of those having given reasons for ending such treatment, whilst various reasons were reported for prematurely ending outpatient treatments.ConclusionThe data do not support the notion of a general `mental health treatment gap¿ in female prisoners. Although inpatient care is often successfully completed, repeated inpatient treatments are not linked with fewer imprisonments. Improved transition from inpatient to outpatient treatment and services that engage female prisoners to sustained outpatient treatments are needed

Psychiatric inpatients' views on self-determination

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Mielenterveyden ja sen häiriöiden mittaaminen

Mielenterveyden häiriöitä voidaan syystä pitää yhtenä tärkeimpänä kansantautiemme ryhmänä. Väestön psykiatrisen sairastavuuden tutkimiseen liittyy sekä teoreettisia että metodologisia ongelmia, joita toistaiseksi on vain osittain pystytty ratkaisemaan. Erityisen ongelmallista psykiatrisessa epidemiologiassa on syy-seuraussuhteen tutkiminen ja tulkitseminen. Artikkelissa käsitellään mielenterveyden häiriöiden tunnistamisen metodologiaa sekä esitellään tämän alueen keskeisimpiä tutkimuskohteita

Cutting a Long Story Short? The Clinical Relevance of Asking Parents, Nurses, and Young Children Themselves to Identify Children’s Mental Health Problems by One or Two Questions

Background and Aims. Assessing young children’s mental health is a crucial and challenging task. The aim of the study was to evaluate the clinical relevance of asking parents, nurses, and young children themselves to identify children’s mental health problems by only one or two questions. Methods. In regular health check-ups of 4- to 9-year-old children (n=2682), parents and public health nurses assessed by one question whether the child had any emotional or behavioral difficulties. The child completed a self-evaluation enquiry on his/her emotional well-being. A stratified proportion of the participating parents were invited to a diagnostic interview. Results. Sensitivities were fairly good for the parents’ (68%), nurses’ (65%), and their combined (79%) one-question screens. Difficulties identified by parents and nurses were major risks (OR 10–14) for any child psychiatric disorders (P<0.001). The child’s self-evaluation was related to 2-fold to 3-fold risks (P<0.05) for any psychiatric diagnosis, for any emotional diagnosis, and for negative situational factors. Conclusion. The one-question screen for parents and public health nurses together quite adequately identified the young children with mental health problems. The child’s self-evaluation provided relevant and complementary information on his/her mental health and especially emotional problems

One or Two Questions

Background and Aims. Assessing young children&apos;s mental health is a crucial and challenging task. The aim of the study was to evaluate the clinical relevance of asking parents, nurses, and young children themselves to identify children&apos;s mental health problems by only one or two questions. Methods. In regular health check-ups of 4-to 9-year-old children ( = 2682), parents and public health nurses assessed by one question whether the child had any emotional or behavioral difficulties. The child completed a self-evaluation enquiry on his/her emotional well-being. A stratified proportion of the participating parents were invited to a diagnostic interview. Results. Sensitivities were fairly good for the parents&apos; (68%), nurses&apos; (65%), and their combined (79%) onequestion screens. Difficulties identified by parents and nurses were major risks (OR 10-14) for any child psychiatric disorders ( &lt; 0.001). The child&apos;s self-evaluation was related to 2-fold to 3-fold risks ( &lt; 0.05) for any psychiatric diagnosis, for any emotional diagnosis, and for negative situational factors. Conclusion. The one-question screen for parents and public health nurses together quite adequately identified the young children with mental health problems. The child&apos;s self-evaluation provided relevant and complementary information on his/her mental health and especially emotional problems

The Impact of an Early Eclectic Rehabilitative Intervention on Symptoms in First Episode Depression among Employed People

Peer reviewe

The Latest Mania: Selling Bipolar Disorder

Healy analyzes the surge in diagnoses of bipolar disorder and the evidence on the effectiveness of antipsychotic drugs and anticonvulsants in prophylaxis against the disorder