Nuorten itsetuhoisuuden ja epävakaiden piirteiden psykoterapeuttisten hoitomuotojen vaikuttavuus : Systemaattiseen hakuun perustuva kirjallisuuskatsaus

• Itsetuhoisten nuorten hoidossa suositellaan ensisijaisesti psykososiaalisia hoitoja. Myös tavanomainen hoito on tutkimuksissa vähentänyt itsetuhoisuutta, mutta ajankohtaisesti itsetuhoisille nuorille se ei yleensä ole riittävä. • Epävakaista piirteistä ja itsetuhoisuudesta kärsivät nuoret hyötyvät erityisesti dialektisesta käyttäytymis­terapiasta. Myös mentalisaatioon perustuvan terapian ja kognitiivis­analyyttisen psykoterapian vaikuttavuudesta on alustavaa tutkimusnäyttöä. • Nuorten itsetuhoisuuden ja myös epävakaiden piirteiden hoitomuodoissa perheterapeuttisten elementtien yhdistäminen psykoterapiaan on hyödyllistä. • Hoitosuositusten antamiseksi tarvitaan lisätutkimusta eri psykoterapiamuotojen vaikuttavuudesta.Peer reviewe

The long read t recovery: treatment outcome and cost among adolescents treated for anorexia nervosa in specialized care

Peer reviewe

Nuorten käytöshäiriöt: arviointi ja hoito

Peer reviewe

Depressio : Käypä hoito -suositus

Peer reviewe

Improvement in cognitive and psychosocial functioning and self image among adolescent inpatient suicide attempters

BACKGROUND: Psychiatric treatment of suicidal youths is often difficult and non-compliance in treatment is a significant problem. This prospective study compared characteristics and changes in cognitive functioning, self image and psychosocial functioning among 13 to 18 year-old adolescent psychiatric inpatients with suicide attempts (n = 16) and with no suicidality (n = 39) METHODS: The two-group pre-post test prospective study design included assessments by a psychiatrist, a psychologist and medical staff members as well as self-rated measures. DSM-III-R diagnoses were assigned using the SCID and thereafter transformed to DSM-IV diagnoses. Staff members assessed psychosocial functioning using the Global Assessment Scale (GAS). Cognitive performance was assessed using the Wechsler Adult Intelligence Scale, while the Offer Self-Image Questionnaire (OSIQ) was used to assess the subjects' self-image. ANCOVA with repeated measures was used to test changes from entry to discharge among the suicide attempters and non suicidal patients. Logistic regression modeling was used to assess variables associated with an improvement of 10 points or more in the GAS score. RESULTS: Among suicide attempter patients, psychosocial functioning, cognitive performance and both the psychological self and body-image improved during treatment and their treatment compliance and outcome were as good as that of the non-suicidal patients. Suicidal ideation and hopelessness declined, and psychosocial functioning improved. Changes in verbal cognitive performance were more pronounced among the suicide attempters. Having an improved body-image associated with a higher probability of improvement in psychosocial functioning while higher GAS score at entry was associated with lower probability of functional improvement in both patient groups. CONCLUSION: These findings illustrate that a multimodal treatment program seems to improve psychosocial functioning and self-image among severely disordered suicidal adolescent inpatients. There were no changes in familial relationships, possibly indicating a need for more intensive family interventions when treating suicidal youths. Multimodal inpatient treatment including an individual therapeutic relationship seems recommendable for severely impaired psychiatric inpatients tailored to the suicidal adolescent's needs