Aalto-Setälä T, Marttunen M. Nuoren psyykkinen oireilu- häiriötä vai ei? Duodecim 2007;123;207-13

Peer reviewe

Low self-esteem and high psychological distress are common among depressed adolescents presenting to the Pediatric Emergency Department

Background: Increasing psychiatric disorders and alcohol intoxication challenge the pediatric emergency departments (PEDs) to which adolescents are referred owing to acute alcohol intoxication. Objective: This study examined the degree to which adolescents presenting to PED with alcohol intoxication or deliberate self-harm report symptoms of depression and how they differed from non-depressed patients in terms of alcohol use, perceived social support, psychological distress, self-esteem, and suicidal thoughts. Methods: In a sample of 138 adolescents, 12- to 16-years old (62 % females), we assessed the patients' psychiatric status using self-report scales and analyzed blood samples for alcohol. Before discharge, a consulting psychiatrist interviewed each patient to evaluate possible suicidality and organized aftercare when necessary. The mediating data-driven hypothesis was examined. Adolescents scoring >= 10 on the Beck Depression Inventory (BDI) were deemed as screening positive for depression. Results: In 55% of participants, intoxication was by alcohol consumption. Deliberate self-harm was found in 17% of the participants. Of the 138 adolescents, 39 % scored positive on the BDI for depressive symptoms, occurring more commonly in girls. Logistic regression showed that the most significant variables associated with depressive symptoms were female gender, high psychological distress, and low self-esteem. Symptoms of depression served as a mediator between gender and self-esteem and the blood alcohol level. Conclusions: Our findings underscore the importance of identifying mood disorders, suicidality, and self-esteem among adolescents with acute alcohol intoxication at the PED. Intensive psychiatric evaluation in an emergency department is necessary in order to detect those adolescents requiring additional treatment and support.Peer reviewe

Vaikuttavammat mielenterveyspalvelut lapsille ja nuorille : toimenpidesuositus

Useissa selvityksissä on toistuvasti kirjoitettu lasten ja nuorten mielenterveyspalvelujen epäkohdista kuten palvelujen sirpaleisuudesta, yhteistyön sekä yhdenvertaisten palveluiden saatavuuden puutteista. Palvelujärjestelmä ei tällä hetkellä kykene riittävän hyvin vastaamaan mielenterveysongelmien vuoksi apua hakevien lasten, nuorten ja perheiden tarpeisiin. Tässä julkaisussa esitetään toimenpide-ehdotuksia, joilla voidaan lisätä lasten ja nuorten mielenterveys-, päihde- ja riippuvuustyön vaikuttavuutta erityisesti perustason mielenterveyspalveluissa

Lasten ja nuorten mielenterveystyön vaikuttavuuden lisääminen : Kansallisen lapsistrategian toimenpiteen 13 loppuraportti

Lasten ja nuorten mielenterveyspalvelujen ongelmia ovat palvelujärjestelmän sirpaleisuus, tarpeenmukaisten hoitomenetelmien huono saatavuus sekä yhteistyön ja tiedonkulun vaikeudet eri toimijoiden välillä. Rakenteelliset puutteet ja riittämätön koordinaatio vaikeuttavat mielenterveysongelmien vuoksi apua hakevien lasten, nuorten ja perheiden tarpeiden mukaista ja yhdenvertaista auttamista. Raportissa kuvataan Suomen ensimmäisen kansallisen lapsistrategian toimeenpanosuunnitelman toimenpiteen 13 toteutus. Toimenpiteen tehtävänä oli lisätä lasten ja nuorten mielenterveystyön vaikuttavuutta kehittämistarpeiden kartoittamisella ja hyvien käytäntöjen ja osaamisen tukemisella. Toimenpiteessä tunnistettiin lasten ja nuorten mielenterveystyön vaikuttavuutta edistäviä ja haittaavia tekijöitä sekä ehdotettiin toimia, joilla selkeytetään mielenterveyspalveluiden kokonaisuutta sekä edistetään hoidon saatavuutta ja jatkuvuutta lapsen oikeudet huomioivalla tavalla. Toimenpiteen kehittämisehdotukset sisältävät muutoksia lainsäädäntöön, palvelujen järjestämiseen, johtamiskokonaisuuksiin, uusia palvelumuotoja sekä vaikuttavien tuki- ja hoitomenetelmien käytön ja lasten ja nuorten parissa työskentelevien työntekijöiden osaamisen suunnitelmallisen lisäämisen. Ehdotukset sisältävät sekä laajaa pitkäjänteistä kehittämistä edellyttäviä että pienempiä ja nopeammin toteutettavia toimenpiteitä. Jotkut ehdotukset edellyttävät lisäselvityksiä ja pitempikestoista valmistelua toteutuksen suunnittelemiseksi

Nuorten päihdehäiriöiden varhaistunnistaminen : Tietoa nuorten kanssa työskenteleville aikuisille

Liitteenä AUDIT- ja CRAFFT -kysymykse

Decreasing Trend in the Use and Long-Term Use of Benzodiazepines Among Young Adults

Objective: Patterns of benzodiazepine (BZD) use and long-term use among young adults are not well known. Our aim was to study trends in BZD use and long-term use among 18-25-year-old young adults by gender and active substance in a nationwide retrospective longitudinal register-based setting. Methods: All Finns aged 18-25 years with reimbursed purchases of BZDs in 2006-2014 recorded to the Finnish Prescription Register were included. Annual prevalence rates of BZD use and long-term use among young adults were reported overall, according to gender, drug group (anxiolytic or hypnotic), and active substance. Long-term use of BZDs was defined as purchasing 180 Defined Daily Doses (DDDs) in at least two drug purchases during a calendar year. Results: Overall prevalence of BZD use among young adults decreased from 24.0 to 18.8 users per 1000 inhabitants in 2006-2014. Prevalence of long-term use decreased from 5.5 to 3.3 users per 1000 inhabitants. Overall BZD use was higher among females, whereas long-term use was more common among males. Use of anxiolytics was more common than use of hypnotics. Oxazepam, alprazolam, zopiclone, and zolpidem were the most used BZDs, whereas alprazolam and clonazepam were the substances with most long-term use. The use and long-term use of BZDs have decreased annually since 2008 among Finnish young adults. Further research is needed to investigate the reasons behind the decline.Peer reviewe

Social anxiety in Finnish adolescents from 2013 to 2021 : change from pre-COVID-19 to COVID-19 era, and mid-pandemic correlates

Purpose: Social anxiety disorder (SAD) is prevalent in adolescents. Increase in levels of general anxiety since 2010’s has been observed in young people. Little is known of time trends in symptoms of social anxiety during 2010’s, of pre- to during-COVID-19 era changes, or of associations between social anxiety symptoms and pandemic severity, distance education, and COVID-19-related experiences in young people. Methods: We examined social anxiety symptoms, their temporal changes, and their associations with COVID-19 related factors in a sample of 450 000 13-to-20-year-old Finns in 2013–2021. Data from nationwide School Health Promotion study was used. Social anxiety symptoms were assessed with the Mini-SPIN using cut-off score ≥ 6 as indicator of high social anxiety. Multivariate logistic regression analyses were used, controlling for gender, age, family SES, and symptoms of general anxiety and depression. Results: High-level social anxiety symptoms increased markedly from 2013/2015 to 2021 among both sexes. A steeper increase was found among females. In 2021, 47% of females self-reported high social anxiety, a two-fold increase relative to 2013/2015. No association between regional COVID-19 incidence and change in social anxiety symptoms was found. No clear associations between time spent in distance education and social anxiety symptoms were found. Fears of getting infected or transmitting coronavirus, and reports of not getting needed support for schoolwork during distance education were all associated with high social anxiety. Conclusion: Prevalence of high social anxiety in young people aged 13–20 has increased considerably from 2013 to 2021, especially among girls. During COVID-19 pandemic, socially anxious young people report a need for educational support and suffer from infection-related fears.Peer reviewe

Nuorten masennus – vakava sairaus, hoitoa tutkittu vähän. Suom Lääkäril 2005;60:2879-2883

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