Lifetime psychiatric diagnoses among adolescents with severe conduct problems-A register-based follow-up study

Background: Both delinquency and out-of-home care (OOHC) are associated with a wide spectrum of psychiatric disorders. Reform schools (RS) are Finnish OOHC institutions for adolescents with severe conduct problems. Objective: We investigated the prevalence of psychiatric diagnoses among individuals with a history of RS placement. Participants and setting: The data consisted of individuals placed in a RS on the last day of the years 1991, 1996, 2001, 2006 or 2011 (N = 1074) and a matched comparison group (N = 5313). Methods: Information on lifetime psychiatric diagnoses, grouped into eight categories, was collected from the nationwide health care registry. The follow-up time ranged from 17 to 44 years. Results: Among RS population, 59.5 % had some psychiatric diagnosis, which was 12-fold compared to general population peers (hazard ratio HR = 12.4). The most prevalent categories were Conduct disorders and/or ADHD (30.7 %, HR = 41.5), Substance use disorders (29.3 %, HR = 16.8,), Other childhood disorders (8.6 %, HR = 11.9) and Personality disorders (10.9 %, HR = 11.6) followed by Mental retardation (6.4 %, HR = 8.4), Schizophrenia spectrum disorders (9.7 %, HR = 7.9), Affective disorders (17.9 %, HR = 7.3), and Disorders of psychological development (6.1 %, HR = 4.4). All differences were statistically significant (p < .001). Conclusions: RS background associates with an excess of psychiatric disorders, which adds to the burden of other known risk factors for adult age well-being. Effective screening and intervention for psychiatric problems should be available both during the RS placement and after-care.Peer reviewe

Vanhuksen gerastenia - tunnista riskipotilas

•Gerastenia on useiden elinjärjestelmien toiminnan heikentymisestä ja reservien hiipumisesta aiheutuva oireyhtymä, joka nivoutuu osin päällekkäin monisairastavuuden ja toimintakyvyn laskun kanssa. •Pienikin stressitekijä, kuten infektio tai uusi lääke, voi romahduttaa haurastuneen elimistön tasapainon ja johtaa toimintakyvyn laskuun, deliriumiin, kaatumisiin, sairaalahoitoon ja itsenäisyyden menetykseen. •Gerastenia voidaan määritellä usealla eri tavalla, joista tunnetuimmat ovat fenotyyppimalli ja toiminnan vajeista sekä sairauksista laskettuun Frailty-indeksiin perustuva malli. •Gerastenian varhainen tunnistaminen sekä kokonaisvaltainen geriatrinen arviointi ja yksilöllinen hoito¬suunnitelma auttavat estämään toimintakyvyn laskua entisestään.Peer reviewe