Miten psykiatrinen tautiluokitus kehittyy? ICD-11 ja DSM-5 vertailussa

• ICD-11- ja DSM-5-tautiluokituksia on pyritty yhtenäistämään, mutta niissä on edelleen oleellisia eroja.• ICD-11 siirtää transsukupuolisuuden mielenterveyden häiriöistä seksuaaliterveyden lukuun. Uni- ja valvetilan häiriöt erotetaan omaksi luvukseen. Terminologiasta poistuvat mm. somatoforminen häiriö ja Aspergerin oireyhtymä.• Uusia diagnooseja ICD-11:ssä ovat mm. pelaamishäiriö ja pakonomainen seksuaalinen käyttäytyminen. DSM-5 ei niitä tunne.• Tulevaisuudessa häiriöiden syiden ja hoitojen tutkimus lävistää diagnoosiluokat yhä laajemmin

Tavoitteena aivojen elämänmittainen terveys : Suunta kohti aivosairauksien terveysohjelmaa

Teema: Terveet aivot 100 vuott

Näkökulmia lihavuuden psykologiaan

Ihmisaivot kehittyivät aikana, jolloin ravinnon saanti oli epävarmaa. Nykyihmisen voi siksi olla vaikea tunnistaa nälän ja kylläisyyden signaaleja.Stressi lisää syömistä ja siten viskeraalisen rasvan kertymistä etenkin kortisolipitoisuuden suurenemisen vaikutuksesta.Aivojen opioidireseptorien poikkeava määrä näyttää liittyvän lihavuuteen.Elintapojen muutoksessa on kiinnitettävä huomiota automatisoituneisiin toimintoihin, sillä suuri osa arkisesta toiminnasta toteutuu ilman tietoista harkintaa.</p

Organization of Community Psychiatric Services in Finland

Background. The Finnish psychiatric treatment system has undergone a rapid transformation from operating in institutional settings to a adopting a community-based approach, through implementation of national plans; this process was carried out quickly, due to a severe economic recession in the early 1990s.Methods. This paper is a narrative review, based on relevant documents by national authorities, academic dissertations and published scientific literature, between 1984 and 2018, as well as the interviews of key experts in 2019.Results. The municipality is currently the primary organization, responsible for all health services. Municipalities may also work together in organizing the services, either through “unions of municipalities” or hospital districts. Services are to a great extent outpatient-oriented. The number of beds is one fifth of the previous number, around four decades ago, despite the increase in population. In 2017, 191,895 patients in total (Conclusion. Psychiatric patients have, in general, benefitted greatly from the shift from institutions to the community. This does not preclude the fact that there are also shortcomings. The development of community care has, to date, focused too heavily on resource allocation, at the expense of strategic planning, and too little on methods of treatment.</p

Measuring aspects of mental health

Mental Health Indicator (MHI) Project, a project included in the EU Health Monitoring Programme; ks. myös Minimum data set of European mental health indicators -julkais

Clinicians' experiences on patients' demands and shared decision making in Finnish specialized mental health care

Purpose Psychiatric patients' awareness of treatments options and their possibilities to influence their care has increased. For the clinicians, the management of evidence-based care, as well as organizational and resource aspects, set different goals for the clinical encounter. In this article we are focusing on the clinicians' experiences and ask: How do the clinicians view situations in which there is a conflict between patients' individual needs and goals and other aspects in decision-making? Materials and methods We implemented a qualitative study of 13 thematic semi-structured interviews with clinicians working in psychiatry. We used discourse analysis to investigate how the clinician view the doctor-patient interaction. Results We identified three discources which were termed the medical standpoint, the psychodynamic standpoint and the standpoint of the patient's experience. Conclusions In their talk, the clinicians use the three discources to make sense of the diverse expectations from both the patient and the mental health care system. The three discources also reflect different aspects in psychiatric treatment cultures, such as evidence-based medicine, the ideal of patient-centeredness, therapeutic interaction and organizational requirements.Peer reviewe

Structure of needs among persons with schizophrenia

Background: The importance of needs assessment for service development has been widely recognised. Several studies have focused on the associations between ratings of needs by patients and staff and have found clear differences, especially concerning the unmet needs.Methods: The present study is part of a Nordic Multicentre study that investigates the life and care of outpatients with a schizophrenia group illness in all the Nordic countries. The aim of this paper is to study the patterns of needs as identified by patients and staff according to the Camberwell Assessment of Needs (CAN). Quality of life, level of functioning, and psychiatric symptoms were assessed.Results: The sample includes 300 patients, 194 (65%) men and 106 (35%) women. The factor analysis identified five factors for patients and four factors for staff in the questionnaire on ratings of needs. In four of the five patient-related factors a meaningful interpretation was possible, and the factors were named skills, illness, coping, and substance abuse. The staff-related factors were named skills, impairment, symptom, and substance abuse. There were significant associations between the sum scores constructed from the factors and measures of functioning level and symptoms.Conclusions: It seems that the sum factor reflecting secondary needs was the most important of the identified factors among both patient and staff ratings. The item-by-item comparisons in previous studies have emphasised differences between patient and staff ratings, but our analysis of the structure of needs also found similarities in the structures and in the associations between the identified sum scores and measures of symptoms, functioning level, and quality of life.</p