Browsing by Subject "Psychotherapy"

Sort by: Order: Results:

Now showing items 1-14 of 14
  • Puustjärvi, Anita; Voutilainen, Arja; Pihlakoski, Leena (2016)
    Tic- ja pakko-oireet ovat lapsilla tavallisia varsinkin lyhytaikaisina ja ohimenevinä. Pitkäkestoisten oireiden kulku on usein aaltoileva. Oireet voivat alkaa myös äkillisesti ja voimakkaina. Streptokokki-infektioon yhteydessä olevassa PANDAS-oireyhtymässä tic- tai pakko-oireet alkavat ­poikkeuksellisen äkillisinä ja voimakkaina infektion jälkeen. Tutkimustieto syy-yhteydestä on ristiriitaista. Lapsuusiän äkillisten neuropsykiatristen oireyhtymien PANS ja CANS määritelmissä akuutin pakko-oireisuuden kanssa esiintyy lisäoireita ja etiologia on laveampi kuin PANDAS-oireyhtymän. Psykoterapia ja lääkehoito tehoavat myös infektion laukaisemien neuropsykiatristen oireiden hoidossa.
  • Heinonen, Erkki; Knekt, Paul; Härkänen, Tommi; Virtala, Esa; Lindfors, Olavi (2018)
    Childhood adversities frequently precede adulthood depression and anxiety. Yet, how they impact needed treatment duration, type or focus in these common disorders, is unclear. For developing more individualized and precise interventions, we investigated whether specific early adversities associate with patients' distinct psychiatric problems, psychological vulnerabilities, and suitability for psychotherapy. A total of 221 depressed and anxious adult outpatients (excluding psychotic, severe personality, bipolar, and substance abuse disorders) referred from community, student, occupational, and private healthcare services filled the Childhood Family Atmosphere Questionnaire (CFAQ). They also filled self-reports on interpersonal behavior and problems, perceived competence, dispositional optimism, sense of coherence, defenses, and psychiatric history. Clinicians assessed the patients' symptomatology, personality, object relations, cognitive performance, and psychotherapy suitability. Regression analyses were conducted. Childhood adversities predicted both worse current psychological functioning (e.g., interpersonal problems), and better clinician-rated capacities for benefiting from psychotherapy (e.g. self-reflection, capacity for interaction). Parental problems had the most numerous negative associations to psychological functioning. Best capacities for psychotherapy were predicted by recollected family unhappiness. Associations with psychiatric criteria were, however, largely non-significant. In conclusion, for psychosocial treatment planning, patients' early adversities may indicate both vulnerability and resources. As childhood adversities are frequent among treatment-seekers, further studies examining how early adversities predict psychotherapy outcome are needed.
  • Rissanen, Julius (Helsingin yliopisto, 2021)
    Abstract Faculty: Faculty of Social Sciences Program: Economics Study track: General Track Author: Julius Vili Henrik Rissanen Title: Comparing cost-effectiveness of short-term and long-term psychodynamic psychotherapies focusing on patients with depressive disorder and their work ability during a 5-year follow-up. Level: Master’s Thesis Month and Year: November 2021 Number of Pages: Keywords: Psychotherapy; cost-effectiveness; Work Ability; psychodynamic; randomized trial; Instructors: Roope Uusitalo, Lauri Sääksvuori, Costanza Biavaschi, Olavi Lindfors Deposited at: Helsingin Yliopiston kirjasto Other information: Abstract: Background: Mental health disorders pose significant burden to the society, for example, because of decreased work ability. Psychotherapy as one of the most important treatment methods also causes significant costs for the healthcare system. Putting effort into cost-effectiveness between the different therapy types can help promote better targeting of treatments and economic efficiency in society. Aims: Explore cost-effectiveness in improving work ability between short-term and long-term psychodynamic psychotherapy in patients with depression. Methods: The 192 depressive patients randomized to two psychotherapies of different lengths in the Helsinki Psychotherapy Study were measured in baseline and annually for five years. Work Ability Index (WAI) and Global Assessment of Functioning (GAF) as an effectiveness outcome measures were compared to the total direct costs with incremental cost-effectiveness ratios (ICER) between the treatments. Results: The total direct cost of short-term psychodynamic psychotherapy (SPP; €7,087) was significantly lower than for long-term psychodynamic psychotherapy (LPP; €19,959). The biggest explanatory factor between the cost of the treatments was protocol study therapy costs (SPP €1304; LPP €16,715). In addition, those randomized to the SPP had significant costs during the follow-up from the non-protocol auxiliary psychotherapy treatments (€5142) which were more than fives times compared to the LPP. All of these cost differences between the treatment groups were statistically significant. Psychotropic medication and outpatient care each averaged below €2000, and the differences weren’t statistically significant. Psychiatric hospitalization during the follow-up was rare but yielded significant costs to the associated patients. Differences of effectiveness between the treatment groups on the work ability were not statistically significant. The incremental cost-effectiveness ratio was highly unstable due to small differences in efficiency, but large differences in cost. Conclusions: The study found a clear difference in cost in favour of SPP without losing in the effectiveness of the treatment. However, patients in the SPP used a significant amount of non-protocol auxiliary psychotherapy treatments which may be an indication of insufficient therapy treatment. The absence of difference in the effectiveness can be thus attributed to the widespread utilization of additional treatments in the SPP. Going forward, expanding the study to account for the impact of patient’s suitability to the treatment, particularly in understanding SPP cost-effectiveness, would be worthwhile.
  • Isometsä, Erkki (2017)
    Masennuslääkkeitä on tutkittu sadoissa kliinisissä kokeissa. Niiden tehosta ja haitoista depression hoidossa käydään usein keskustelua julkisuudessa. •Meta-analyysien tilastolliset arviot lääkkeiden tehosta lumeeseen verrattuna ovat suuruusluokaltaan ¬yhdenmukaisia. Yleensä erimielisyydet koskevat havaitun tehon kliinistä merkitystä. •Hoitotuloksessa yhdistyvät todellinen lääkevaikutus ja lumevaikutus. Pelkkää lumetta ei terveydenhuollossa käytetä, vaan aktiivista hoitoa joko annetaan tai ei. •Potilaalle tehoton tai haittoja aiheuttava lääkehoito yleensä lopetetaan jo akuuttivaiheessa. •Lyhytpsykoterapiat ja lääkkeet tehoavat depression oireisiin lähes yhtä hyvin. Yleensä tehokkainta on niiden yhdistäminen.
  • Stenberg, Jan-Henry; Blanco Sequeiros, Sanna; Holi, Matti; Kampman, Olli; Kieseppä, Tuula; Korkeila, Jyrki; Mäki, Pirjo; Wahlbeck, Kristian; Joffe, Grigori; Häll, Pasi; Joutsenniemi, Kaisla (2016)
    Psykologisia etähoitoja voidaan antaa reaaliaikaisesti tai toisaalta ajasta riippumatta. Erilaisia etähoitoja on moniin eri häiriöihin ja monet niistä ovat tutkitusti tehokkaita. Hoitojen lisäksi on toimivia mielenterveyden edistämisen, kriisiauttamisen ja itsemurhien ehkäisyn menetelmiä. Tekniikan ja tiedonlouhinnan kehitys tuo yhä merkittävämpiä apuvälineitä mielenterveyden häiriöiden hoitoon.
  • Häkkänen-Nyholm, Helinä; Lyytinen, Nina; Heinimaa, Markus; Heiskala, Mikko; Varis, Atte (2020)
    • Koronakriisissä työskentelevien terveydenhuollon ammattilaisten psyykkisen stressin ja sairastavuuden riski on huomattava. • Ulkomaisten tutkimusten mukaan psyykkiseen sairastavuuteen ovat voimakkaimmin yhteydessä huoli ja pelko tartunnasta, ns. etulinjassa työskenteleminen, epidemian alkuvaiheessa työskenteleminen ja kokemuksen puute. • Moraalisen vamman kokemus ja sen vaikutus psyykkiseen sairastavuuteen on huomioitava ongelmien ehkäisyssä. • Etänä toteutettavat psykoterapiat ja työnohjaukset mahdollistavat nopean avun saamisen psyykkisiin oireisiin.
  • Knekt, Paul; Grandell, Leena; Sares-Jäske, Laura; Lindfors, Olavi (2021)
    Background: Patient suitability has been suggested to predict treatment non-attendance but information on its effect is limited. Aim: To study the prediction of the Suitability for Psychotherapy Scale (SPS), on occurrence of treatment non-attendance. Methods: Altogether 326 outpatients, with depressive or anxiety disorder, were randomized to short-term psychodynamic psychotherapy (SPP), long-term psychodynamic psychotherapy (LPP), and solution-focused therapy (SFT). SPS was based on seven components from three suitability domains: nature of problems, ego strength, and self-observing capacity. Treatment non-attendance was defined as refusal of engaging therapy and of premature termination. The Cox model and logistic regression were used. Results: Treatment non-attendance was significantly more common in LPP patients with poor SPS (RR = 2.76, 95% CI = 1.45-5.26). This was mainly due to poor flexibility of interaction, poor self-concept, and poor reflective ability. Premature termination in SFT showed a similar trend but due to other SPS components: absence of a circumscribed problem, poor modulation of affects, and poor response to trial interpretation. On the contrary, individuals with good values of SPS were more prone to premature termination in SPP. Limitations: The prediction of suitability on refusal could only be studied in the LPP group due to few refusals in the short-term therapy groups. The sample consisted of patients who participated in a trial. Thus the findings may not be directly generalized to unselected patients in the public mental health setting. Conclusions: Poor suitability, apparently, predicts non-attendance in LPP and SFT, but not in SPP. More studies on large cohorts are needed.
  • Mattila-Holappa, Pauliina; Joensuu, Matti; Ahola, Kirsi; Koskinen, Aki; Tuisku, Katinka; Ervasti, Jenni; Virtanen, Marianna (2016)
    Background: We examined the extent to which psychotherapeutic and work-oriented interventions were included in a medical treatment and rehabilitation plan and whether they predicted future employment among young adults with work disability due to a mental disorder. Methods: Data were obtained from the treatment and rehabilitation plans of 1163 young adults aged 18. 34 years, who in 2008 were granted fixed-term work disability compensation due to a mental disorder and were followed for 5 years. Results: Forty-six percent had no proposal for psychotherapy or a work-oriented intervention in their treatment and rehabilitation plan, 22 % had a plan for only a psychotherapeutic intervention, 23 % had a plan for only a work-oriented intervention, and 10 % had both types of interventions planned. Having a planned psychotherapeutic intervention (HR = 1.35, 95 % CI 1.07-1.69) and of the work-oriented interventions, planned rehabilitative courses and training (HR = 1.34, 95 % CI 1.03-1.70) predicted quicker entry into competitive employment. Having a plan for both a psychotherapeutic and work-oriented intervention was associated with being employed at the end of the follow-up (OR = 1.77, 95 % CI 1.07-2.95). Conclusions: Young adults with a long-term psychiatric work disability episode rarely have a recorded plan for rehabilitation in their treatment and rehabilitation plan although psychotherapeutic interventions and a combination of a psychotherapeutic and work-oriented intervention might help them gain employment.
  • Hiekkala-Tiusanen, Laura; Halunen, Minna; Mehtälä, Tuukka; Kieseppä, Tuula (2019)
  • Saarni, Suoma; Stenberg, Jan-Henry; Holi, Matti (2020)
  • Laukkala, Tanja; Suominen, Inkeri; Granö, Niklas; Talaslahti, Tiina; Koponen, Hannu; Marttunen, Mauri (2020)
    Psykoterapian tavallisimpia käyttöaiheita ovat ahdistuneisuus-, masennus- ja eriasteiset kuormitusoireet traumaperäisiin oireisiin asti. Psykoterapia voi riittää lievien ja keskivaikeiden sairauksien hoidoksi ja olla osa hoitoa ja kuntoutusta myös useiden vaikeiden mielenterveyden häiriöiden yhteydessä. Ohjausta toteutetaan eri ikäryhmissä eri tavoin. Kaikkien ikäryhmien psykoterapiat edellyttävät huolellista kliinistä tutkimusta ja asianmukaista psykoterapia-arviota. Aikuisten lyhyitä psykoterapioita toteutetaan jatkossa perustasolla yhä enemmän. Psykoterapialle tulee asettaa tavoitteet, ja hoidon toteutus ja intensiteetti tulee suunnitella yksilölliset tekijät huomioiden. Hoidon etenemistä seurataan tavoitteiden saavuttamisen ja mahdollisten haittojen osalta. Tarvittaessa psykoterapiaan yhdistetään muita hoitoja, esimerkiksi lääkehoito.
  • Sailas, Eila; Heimola, Mikko; Stenberg, Jan-Henry (2019)
  • Heinonen, Erkki; Kurri, Katja; Melartin, Tarja (2016)
    Vain va­jaa kol­mannes suoma­lai­sista psy­ko­te­ra­peu­teista ar­vioi asiak­kai­densa saa­neen riit­tävää oh­jausta psy­ko­te­rapiaan. Psy­ko­te­rapiaa edel­tävä ar­viointi ja oh­jaus edis­tävät hoi­toon sitou­tu­mista ja te­rapian tulok­sel­li­suutta. Po­tilaan muutos­valmius, ky­ky tarkas­tella it­seä ja omia tun­teita se­kä jous­tavuus vuoro­vai­ku­tuk­sessa ­ennus­tavat toden­nä­köi­sempää ky­kyä tera­peut­tiseen työsken­telyyn ja lyhyes­täkin psy­ko­te­ra­piasta ­hyö­ty­miseen. Po­tilaan ja psy­ko­te­ra­peutin hy­vä yhteis­työ­suhde en­nustaa hoito­tu­losta merkit­tä­västi. Poti­lasta on syy­tä val­mentaa ar­vioimaan, minkä­laisen psy­ko­te­ra­peutin kans­sa hän ko­kee voi­vansa muo­dostaa hy­vän yhteis­työ­suhteen. Po­tilaan val­miuksien ja psy­ko­te­rapian tavoit­teiden ol­lessa epä­selviä on syy­tä konsul­toida psy­kiat­rista ­eri­kois­sai­raan­hoitoa.