Browsing by Subject "Masennus"

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  • Kyrklund, Emma (Helsingin yliopisto, 2019)
    Masennus on kansanterveydellisesti merkittävä ongelma, sillä suomalaisista n. 5 % sairastuu vuoden aikana. Sairaus vaikuttaa selvästi elämänlaatuun heikentämällä toiminta- ja työkykyä. Erilaisia neuromodulaatiomenetelmiä on käytetty jo pitkään masennuksen hoidossa, erityisesti hoitoresistentissä taudissa. Vanhin niistä on sähköhoito, jota on käytetty jo 1930-luvulta lähtien. Viime aikoina on myös kehitetty uusia, ei-invasiivisia hoitoja. Uusin niistä on tDCS, eli transkraniaalinen tasavirtastimulaatio. Tähän työhön liittyy lyhyt katsaus masennuksesta ja erilaisista neuromodulaatiomenetelmistä. Tämän lisäksi tehtiin HYKS psykiatrian kautta pilottitutkimus tasavirtastimulaatiohoidosta. Tutkimuksen tarkoituksena oli selvittää hoitomenetelmän hyötyä vaikeahoitoisten masennuspotilailla. Potilaita rekrytoitiin HUS alueelta Keravalta ja Järvenpäästä. Yhteensä tutkimukseen osallistui 15 potilasta. Tutkimuksessa annettiin 2 mA tasavirtastimulaatiohoitoa 30 minuutin ajan 5 päivänä viikossa 3 viikon ajan. Tuloksia mitattiin ensijaisesti PHQ9-oirekyselyllä, lisäksi potilaat täyttivät BDI-, Oasis-, Sheehan toimintakykyasteikko-, Core5- ja 15D-kaavakkeet. Kaavakkeita kerättiin potilailta hoidon alussa ja jokaisen hoitoviikon jälkeen. Tutkimuksella ei osoitettu tilastollisesti merkittävää hyötyä tDCS-hoidosta. Potilaiden PHQ9 pisteet vähenivät keskimäärin n. 20 %. Kolme potilasta, eli 20 % osallistuneista, saavuttivat remission, joka määriteltiin 50 % laskuksi PHQ9 pisteissä. Pisteet vähenivät keskiarvoltaan 18,80 (SD ±6,3) pisteestä 15,00 (SD±7,3) pisteeseen. P-arvo oli 0,06. Tutkimuksen tulokset viittaavat aiempiin tutkimuksiin vertaillen heikompaan tehoon, mikä osittain voi selittyä vaikeahoitoisemmalla potilasmateriaalilla ja tutkimuksen pienellä otoksella.
  • Korhonen, Emma (Helsingin yliopisto, 2018)
    Goals: Social relationships and social support are considered to have significant impact on people’s mental health. Significance of social support is highlighted in psychotherapy, as confidential therapeutic relationship between a client and a therapist is seen as one of the most important factors predicting effectiveness of the therapy. Accordingly, opportunity for the patient to get social support outside of the therapy may be beneficial for the success of the therapy. The aim of this study was to examine if self-reported social support predicts changes of work ability in psychotherapy and whether the prediction varies in different therapies. Methods: This study is part of the Helsinki Psychotherapy Study and is based on it’s study population, where 326 patients suffering either mood or anxiety disorder were randomly assigned to short-term solution-focused therapy (SFT), short-term psychodynamic psychotherapy (SPP) or long-term psychodynamic psychotherapy (LPP). Participants were divided to groups of strong and weak social support by the mediation of the total score of the Brief Inventory of Social Support and Integration (BISSI). Effectiveness of therapies in different groups was evaluated by changes in work ability assessed with five different methods in five-year follow-up. Results and conclusions: Self-reported social support had different impact on work ability in different therapy groups. The most significant and completely new finding was that patients with weak social support benefited from SFT more than LPP in the beginning of the follow-up and more than SPP at the end of the follow-up. Also in the group of weaker social support short therapies had a faster response than long therapy and LPP better results than SPP in long-term follow-up. In the group of better social support similar differences occurred only when both length and type of therapy were different. This study suggests that prediction varies in different therapies, but differences inside therapy groups are lesser than expected. Amount of researches of the subject is very limited and more research is needed.
  • Kieseppä, Valentina (Helsingfors universitet, 2015)
    Objectives. The loss of insight is a consistent feature of psychotic illness. In prior studies low insight has been linked to more severe positive and negative symptoms, lower adherence to treatment, and lower global functioning, but also to increased depression and suicidality. The aim of this study was to investigate (1) the relationship between insight and symptoms, (2) the relationship between symptoms and changes in insight and (3) the relationship between changes in symptoms and changes in insight in first episode psychosis patients. In addition to depression, the relationship between insight and anxiety, suicidality, adherence to treatment, global functioning, and positive and negative symptoms were studied. Methods. The participants of the current study were 70 first-episode psychosis patients (women = 23, mean age = 25.5) from the broader "Varhaisen psykoosin riskitekijät, kulku ja ennuste" -study. 53 (women = 19) participated in the follow-up. The study included baseline assessment as soon as possible after the presentation of psychotic symptoms and a follow-up after two months. In both assessments internationally accepted and widely used instruments for measurement were used. Results and conclusions. Good insight was found to correlate with better adherence to treatment and less severe positive and negative symptoms. Of the baseline symptoms only adherence to treatment could predict changes in insight in the follow-up, but increased insight could predict increases in both adherence to treatment and depression. These results are in line with prior research and support the hypothesis that improvements in insight are associated with increased depression, but also with better global functioning, better adherence to treatment, and less severe psychotic symptoms.