15 aastat teadusuuringuid Eesti-Rootsi Vaimse Tervise ja Suitsidoloogia Instituudis: ülevaade tulemustest

Eesti-Rootsi Vaimse Tervise ja Suitsidoloogia Instituut (ERSI) on oma 15 tegevusaasta jooksul käsitlenud suitsidaalset käitumist nii üldkogumi kui ka indiviidi tasandil koostöös suitsidaalse käitumise uurijatega Karolinska Instituudist (NASP) ning erinevatest maadest WHO ja Euroopa Komisjoni projektide raames. Viimastel aastatel on teadusuuringud laienenud vaimsele tervisele tervikuna. Artiklis on antud lühiülevaade ERSI teadusuuringute tulemustest valitud viidetega. Kogumikus “ERSI Essential Papers on Suicidology” (1) on saadaval 26 ISI Web of Science’is ja Current Content’is ära toodud, 7 rahvusvaheliselt retsenseeritavates teadusžurnaalides publitseeritud teadusartiklite täisteksti ja 9 rahvusvahelise kõlapinnaga kirjastustes välja antud raamatute peatükki. Kogumikus on loeteluna esitatud 9 nimetatud kategooria ajakirjadesse vastu võetud ning 17 eesti- ja muukeelset artiklit. Eesti Arst 2008; 87(7−8):535−53

Promicanje mentalnog zdravlja u Europskoj uniji

Tijekom prošlih desetljeća u medicinskom svijetu je prevladavao “patogeni” pristup mentalnim poremećajima i bolestima, koji nastoji otkriti uzroke i simptome bolesti te odgovarajuću terapiju. Medicinski stručnjaci godinama su bili usmjereni na patologiju i čimbenike rizika, a ne na čimbenike zdravlja, prevenciju mentalnih poremećaja ili promicanje mentalnog zdravlja. U novije vrijeme težište se stavlja na “salutogene” čimbenike koji nas čine zdravima i poboljšavaju mentalno zdravlje i blagostanje (well-being). Usmjerenost prema čimbenicima zdravlja potiče “salutogeni” pristup koji rezultira poboljšanjem kvalitete života, individualne životne snage i produktivnosti te smanjuje broj ljudi kojima je potrebno liječenje i terapija lijekovima. Važno je naglasiti da pojedinac bez mentalnog poremećaja ili smetnji u ponašanju, ne mora biti i mentalno zdrav. Isto tako, pojedinci koji boluju od mentalnih poremećaja mogu imati različite stupnjeve mentalnog zdravlja. Istraživanje “Eurobarometar 2005” o mentalnom zdravlju provedeno u zemljama članicama EU, ukazalo je na velike razlike medju stanovnicima Europske Unije u odnosu na osobni osjećaj “bespomoćnosti i depresije”. Mentalni poremećaji česti su uzrok prijevremenog odlaska u invalidsku mirovinu (Mental Health Economist 2003, SZO 2010). Pretpostavlja se da će globalna ekonomska kriza, rastuće stope nezaposlenosti, smanjenje mjesečnih primanja i socijalne dislokacije dovesti do ponovnog porasta broja stanovništva koji boluju od mentalnih poremećaja. Problem održavanja mentalnog zdravlja je sve izraženiji problem. Uslijed rastućih stopa morbiditeta od mentalnih poremećaja širom Europe i davanje prioriteta pozitivnom mentalnom zdravlju, potpisana je Europska povelja o mentalnom zdravlju (2005). Povelja posebno ističe četiri važna područja djelovanja: prevenciju depresije i suicida, edukaciju mladih o mentalnom zdravlju, unaprijedjenje mentalnog zdravlja na radnim mjestima te promicanje mentalnog zdravlja u ustanovama koje skrbe za starije osobe (SZO 2005)

Suitsidaalsus ühiskonnas ja suitsiidikatse sooritamist prognoosivad tegurid

Artikli eesmärgiks on selgitada välja suitsidaalsuse levik ühiskonnas ning analüüsida suitsiidikatse sooritamise riskitegureid. Töös kasutati WHO ülemaailmse uuringu SUPRE-MISS raames kogutud andmeid. Uuring koosnes kahest osast: vähemalt 15aastaste suitsiidikatse sooritanute uuring Põhja-Eesti Regionaalhaigla Mustamäe korpuses ja Tallinna psühhiaatriakliinikus ning ühiskonna uuring (kontrollrühm) Tallinna piirkonnas juhuvaliku põhjal erinevate perearstide nimistutesse kantud isikutest. Tallinna ühiskonna uuringust selgus, et rohkem kui iga kümnes uuritav oli oma senise elu jooksul mõelnud enesetapu sooritamisele ning suitsiidikatseid on suurema tõenäosusega sooritanud need, kes on varem suitsiidile mõelnud ja/või seda planeerinud. Suitsiidikatse sooritamist prognoosivate teguritena tulid esile naissugu, vanus alla 30 eluaasta, kooselu puudumine, töö puudumine ning varasemad suitsiidikatsed. Eesti Arst 2004; 83 (11): 744–74

Depressiivsete ja suitsidaalsete kooliõpilaste seksuaalkäitumine

Artiklis on kirjeldatud ja analüüsitud Eesti õpilaste enesehinnangulist depressiivsust ja suitsidaalsust, seksuaalkäitumist ning depressiivsuse-suitsidaalsuse ja seksuaalkäitumise seost. Uurimuses kasutati kooliealiste laste tervisekäitumise rahvusvahelise uuringu andmeid 7. ja 9. klassi õpilaste kohta. Anonüümsest ankeetküsitlusest selgus, et 39% vastanutest väljendas depressiivsust ja/või suitsidaalsust; seksuaalkogemuse oli omandanud 15% õpilastest – 17% poistest ja 13% tütarlastest. Seotuks osutus ka seksuaalkäitumine ja subjektiivne depressiivsus-suitsidaalsus: suitsidaalsed ja/või depressiivsed õpilased olid suurema tõenäosusega alustanud seksuaalelu ning kasutanud viimasel vahekorral väiksema tõenäosusega kondoomi. Eesti Arst 2009; 88(3):156−16

Media Roles in Suicide Prevention: A Systematic Review

The aim of the current systematic review was to monitor and provide an overview of the research performed about the roles of media in suicide prevention in order to find out possible effects media reporting on suicidal behaviours might have on actual suicidality (completed suicides, attempted suicides, suicidal ideation). The systematic review was performed following the principles of the PRISMA statement and includes 56 articles. Most of the studies support the idea that media reporting and suicidality are associated. However, there is a risk of reporting bias. More research is available about how irresponsible media reports can provoke suicidal behaviours (the ‘Werther effect’) and less about protective effect media can have (the ‘Papageno effect’). Strong modelling effect of media coverage on suicide is based on age and gender. Media reports are not representative of official suicide data and tend to exaggerate sensational suicides, for example dramatic and highly lethal suicide methods, which are rare in real life. Future studies have to encounter the challenges the global medium Internet will offer in terms of research methods, as it is difficult to define the circulation of news in the Internet either spatially or in time. However, online media can provide valuable innovative qualitative research material

Depression Awareness and Self-Management Through the Internet: Protocol for an Internationally Standardized Approach

BACKGROUND: Depression incurs significant morbidity and confers increased risk of suicide. Many individuals experiencing depression remain untreated due to systemic and personal barriers to care. Guided Internet-based psychotherapeutic programs represent a promising means of overcoming such barriers and increasing the capacity for self-management of depression. However, existing programs tend to be available only in English and can be expensive to access. Furthermore, despite evidence of the effectiveness of a number of Internet-based programs, there is limited evidence regarding both the acceptability of such programs and feasibility of their use, for users and health care professionals. OBJECTIVE: This paper will present the protocol for the development, implementation, and evaluation of the iFightDepression tool, an Internet-based self-management tool. This is a cost-free, multilingual, guided, self-management program for mild to moderate depression cases. METHODS: The Preventing Depression and Improving Awareness through Networking in the European Union consortium undertook a comprehensive systematic review of the available evidence regarding computerized cognitive behavior therapy in addition to a consensus process involving mental health experts and service users to inform the development of the iFightDepression tool. The tool was implemented and evaluated for acceptability and feasibility of its use in a pilot phase in 5 European regions, with recruitment of users occurring through general practitioners and health care professionals who participated in a standardized training program. RESULTS: Targeting mild to moderate depression, the iFightDepression tool is based on cognitive behavioral therapy and addresses behavioral activation (monitoring and planning daily activities), cognitive restructuring (identifying and challenging unhelpful thoughts), sleep regulation, mood monitoring, and healthy lifestyle habits. There is also a tailored version of the tool for young people, incorporating less formal language and additional age-appropriate modules on relationships and social anxiety. The tool is accompanied by a 3-hour training intervention for health care professionals. CONCLUSIONS: It is intended that the iFightDepression tool and associated training for health care professionals will represent a valuable resource for the management of depression that will complement existing resources for health care professionals. It is also intended that the iFightDepression tool and training will represent an additional resource within a multifaceted approach to improving the care of depression and preventing suicidal behavior in Europe

Adolescent subthreshold-depression and anxiety: psychopathology, functional impairment and increased suicide risk

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Life-time prevalence and psychosocial correlates of adolescent direct self-injurious behavior: A comparative study of findings in 11 European countries

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