Browsing by Subject "masennus"
Now showing items 1-20 of 115
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(2021)The aim of the study. Maternal depression during pregnancy occurs in up to one in four women. It is a serious condition that can have long-term negative effects on the development of the foetus and the child through a harmful intrauterine environment. Maternal depression during pregnancy is for instance associated with internalizing mental health symptoms and temperament in children. However, there is little research evidence on the association of maternal depression during pregnancy with anxiety symptoms in school-aged children. Childhood anxiety symptoms can have serious and long-term consequences for an individual in terms of psychosocial, academic and professional functioning. This study examines whether maternal depressive symptoms during pregnancy increases the risk of anxiety symptoms in school-age children. I also investigate whether infant negative emotionality mediates the association between maternal depression symptoms during pregnancy and anxiety symptoms in school-age children. Methods. The sample of this study, which consists of 1625 mother-child pairs, was part of a larger PREDO (The Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction) follow-up study. Data from 3-12 months infancy follow-up and follow-up at the age of 7 to 11 years were used in this study. Mothers rated depressive symptoms during pregnancy using a self-assessment questionnaire (Center for Epidemiologic Studies Depression Scale). Mothers assessed their children's negative emotionality (Revised Infant Behavior Questionnaire) in the infant follow-up and their children's anxiety symptoms (Spence Children's Anxiety Scale, parent report version & The Short Form of the Fear Survey Schedule for Children-Revised) in the school-age follow-up. The associations between maternal depressive symptoms during pregnancy and anxiety symptoms in school-age children were examined with linear regression analysis. Negative emotionality in infancy as a mediator of this relationship was examined with mediation analysis. Results and conclusions. According to this study, maternal depressive symptoms during pregnancy increased the risk of anxiety symptoms in school-age children. The observed associations between maternal depressive symptoms and anxiety symptoms in children were independent of all the covariates selected for this study, such as maternal depression symptoms during follow-up at the age of 7 to 11. Preliminary research findings were also obtained on negative emotionality in infancy as partly mediating the association between maternal depressive symptoms during pregnancy and anxiety symptoms in school-age children. This study helps to increase understanding of the early risk factors of anxiety symptoms in children and the importance of preventive measures during pregnancy. High negative emotionality in early childhood is also a justified target for interventions.
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(2021)The aim of the study. Maternal depression during pregnancy occurs in up to one in four women. It is a serious condition that can have long-term negative effects on the development of the foetus and the child through a harmful intrauterine environment. Maternal depression during pregnancy is for instance associated with internalizing mental health symptoms and temperament in children. However, there is little research evidence on the association of maternal depression during pregnancy with anxiety symptoms in school-aged children. Childhood anxiety symptoms can have serious and long-term consequences for an individual in terms of psychosocial, academic and professional functioning. This study examines whether maternal depressive symptoms during pregnancy increases the risk of anxiety symptoms in school-age children. I also investigate whether infant negative emotionality mediates the association between maternal depression symptoms during pregnancy and anxiety symptoms in school-age children. Methods. The sample of this study, which consists of 1625 mother-child pairs, was part of a larger PREDO (The Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction) follow-up study. Data from 3-12 months infancy follow-up and follow-up at the age of 7 to 11 years were used in this study. Mothers rated depressive symptoms during pregnancy using a self-assessment questionnaire (Center for Epidemiologic Studies Depression Scale). Mothers assessed their children's negative emotionality (Revised Infant Behavior Questionnaire) in the infant follow-up and their children's anxiety symptoms (Spence Children's Anxiety Scale, parent report version & The Short Form of the Fear Survey Schedule for Children-Revised) in the school-age follow-up. The associations between maternal depressive symptoms during pregnancy and anxiety symptoms in school-age children were examined with linear regression analysis. Negative emotionality in infancy as a mediator of this relationship was examined with mediation analysis. Results and conclusions. According to this study, maternal depressive symptoms during pregnancy increased the risk of anxiety symptoms in school-age children. The observed associations between maternal depressive symptoms and anxiety symptoms in children were independent of all the covariates selected for this study, such as maternal depression symptoms during follow-up at the age of 7 to 11. Preliminary research findings were also obtained on negative emotionality in infancy as partly mediating the association between maternal depressive symptoms during pregnancy and anxiety symptoms in school-age children. This study helps to increase understanding of the early risk factors of anxiety symptoms in children and the importance of preventive measures during pregnancy. High negative emotionality in early childhood is also a justified target for interventions.
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(2020)Tiivistelmä - Referat - Abstract Objective. Attention deficit/hyperactivity disorder (ADHD) is developmental neurobiological disability. The aim of the current study was to examine what symptoms women diagnosed as adults with ADHD recognize emerged in their childhood before puberty, which symptoms were reported to manifest together and whether the reported symptoms fit the diagnostic criteria used by health care. In addition, the aim was to find out which were the most common reasons to apply for support as an adult. Untreated ADHD has been found to be associated with depression, exclusion from education, and an increased risk of substance use. Early identification and proper targeting of support measures can reduce health risks and improve quality of life. Method. The data were collected through the online survey, that the Finnish ADHD Association published on social media carried on the social network service Facebook in April 2020. The questionnaire was made based on previous research for this study, and was created with the E-lomake -program of the University of Helsinki. The participants (n = 360) were women diagnosed with ADHD in adulthood, aged 20 to 50 years, who retrospectively assessed their own ADHD symptoms in childhood. The data thus gathered was analysed using statistical methods in the IBM SPSS Statistics 25 -program. Results and conclusions. The most commonly reported symptoms of ADHD included attentional regulation, systemicity, minor motor restlessness, and emotional and verbal impulsivity. The most common symptoms were reported to be co-occurring, but the review of also showed large variability for some symptoms. Of the eleven most commonly reported symptoms, only three were directly related to the diagnostic criteria in use. The most common reasons for applying assessment of ADHD as an adult were the identification of one's own symptoms, previously diagnosed depression, and feedback from close relatives. Based on this thesis, the diagnostic criteria in use do not adequately cover the dimensions of girls ’ ADHD symptoms are expressed. Two of the common symptoms were absorption in games intense and losing sense of time, that is comparable to with hyperfocusing, and clinging to details. The results are consistent with previous research data; the diagnostic criteria are based on research data obtained from boys with ADHD.
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(2020)Tiivistelmä - Referat - Abstract Objective. Attention deficit/hyperactivity disorder (ADHD) is developmental neurobiological disability. The aim of the current study was to examine what symptoms women diagnosed as adults with ADHD recognize emerged in their childhood before puberty, which symptoms were reported to manifest together and whether the reported symptoms fit the diagnostic criteria used by health care. In addition, the aim was to find out which were the most common reasons to apply for support as an adult. Untreated ADHD has been found to be associated with depression, exclusion from education, and an increased risk of substance use. Early identification and proper targeting of support measures can reduce health risks and improve quality of life. Method. The data were collected through the online survey, that the Finnish ADHD Association published on social media carried on the social network service Facebook in April 2020. The questionnaire was made based on previous research for this study, and was created with the E-lomake -program of the University of Helsinki. The participants (n = 360) were women diagnosed with ADHD in adulthood, aged 20 to 50 years, who retrospectively assessed their own ADHD symptoms in childhood. The data thus gathered was analysed using statistical methods in the IBM SPSS Statistics 25 -program. Results and conclusions. The most commonly reported symptoms of ADHD included attentional regulation, systemicity, minor motor restlessness, and emotional and verbal impulsivity. The most common symptoms were reported to be co-occurring, but the review of also showed large variability for some symptoms. Of the eleven most commonly reported symptoms, only three were directly related to the diagnostic criteria in use. The most common reasons for applying assessment of ADHD as an adult were the identification of one's own symptoms, previously diagnosed depression, and feedback from close relatives. Based on this thesis, the diagnostic criteria in use do not adequately cover the dimensions of girls ’ ADHD symptoms are expressed. Two of the common symptoms were absorption in games intense and losing sense of time, that is comparable to with hyperfocusing, and clinging to details. The results are consistent with previous research data; the diagnostic criteria are based on research data obtained from boys with ADHD.
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(2019)Introduction and aims. Multiple different neurobiological alterations have been hypothesized to underlie Major Depression Disorder (MDD), but no unifying theory exists to explain the mechanisms of the disorder. The aberrant brain dynamics in MDD can be seen in the alterations of long-range temporal correlations (LRTCs), which have been proposed to be an indication of criticality in healthy brain. Alterations in LRTCs have been suggested to reflect deficiencies in excitation-inhibition (E/I) balance, neuromodulation or connectivity patterns, which have also been proposed to be the underlying mechanisms of MDD. There has been controversy whether the pathology is related to attenuated or increased LRTCs, and the sources of altered brain dynamics have not yet been localized. The aim of this study was to find in which frequency bands and where in the brain the neuronal LRTCs are altered in MDD on source level. In addition to analyzing the correlations between neuronal LRTCs and depression severity in parcel level, we studied correlations in functional networks to get a better understanding of the system level alterations in MDD. We also studied whether behavioral LRTCs correlate with depression severity or with behavioral performance. Methods. We investigated the long-range temporal correlations in a cohort of 19 depressed subjects by using magnetoencephalography (MEG) for recording brain activity during resting state and response inhibition task and performed DFA analysis on the amplitude envelopes of cortical oscillations. The depression severity was measured with BDI-21 questionnaire. Results and conclusions. We found the LRTCs to be positively correlated with depression severity in the alpha frequency band (8–12Hz) predominantly in the limbic system that underlies emotional control. This result was supported by the parcel level analysis in which correlations between alpha band LRTCs and depression severity were observed in the orbitofrontal cortex and temporal pole, indicating that the hyper-activation of limbic system could explain the negative bias characteristic to depression. Positive correlations were also found in frontoparietal, ventral, and dorsal attentional networks that support cognitive control. Alpha band LRTCs correlated also with behavioral LRTCs during both resting state and task conditions. However, we observed more wide-spread correlations between alpha range LRTCs and depression severity than between neuronal LRTCs and behavioral LRTCs. Behavioral LRTCs correlated with depression severity, but not with behavioral performance. These results indicate that depression is characterized by vast alterations in the brain dynamics and imply that the wide range of different symptoms in MDD could be explained by alterations in the excitation/inhibition balance in the limbic system and cognitive networks.
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(2019)The goal of this review is to show the possible connections between depressive disorders and the Big Five personality traits. Also, the focus is to examine the personality traits which have a possible influence on the outcome of psychotherapy when treated depression. Research shows that especially Neuroticism is connected to depression. Other personality traits connected to depression are low Conscientiousness and low Extraversion. Personality traits which influence the positive outcome of the treatment are Conscientiousness, Extraversion and Agreeableness. The personality profile connected to depression seems to be an obstacle in the treatment of depression. More research about the real connection sizes between depression and personality traits is needed to help the clinicians to offer the best treatment for patients suffering from depression.
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(2018)Autism spectrum disorder is associated to high rates of comorbid mental disorders, where depression is probably most common disorder. Although the high prevalence of depression in autism is well-known thing, relatively little is known about its underlying risk factors or explaining factors. This study aimed to examine whether there is evidence that some characteristic features of autism spectrum disorder would have an impact on high prevalence of depression in autism spectrum disorder. We discuss about two psychological factors: emotion regulation and its deficits and the tendency to perseverate and ruminate. Two factors related to perseveration, cognitive flexibility impairments and rumination were associated with depression and depression symptoms. The association between emotion regulation deficits and depression manifested in the use of maladaptive coping skills and in tendency to ruminate. More research is still needed to replicate these results and gain stronger evidence. The depression diagnosis in autism spectrum disorder is problematic in many ways, therefore all results concerning the subject should be interpreted with caution.
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Cognitive performance in adulthood : the roles of stress-related exhaustion and depressive symptoms (2021)Objective: Both stress-related exhaustion and depression have previously been associated with a decline in cognitive performance, but there is a lack of evidence on whether these conditions have different associations with different cognitive domains and whether they have additive effects on cognitive performance. Furthermore, very little is known about the cognitive effects of chronic stress-related exhaustion. Consequently, the aims of this study were to 1) examine the associations between current stress-related exhaustion and cognitive performance, 2) investigate whether different developmental trajectories of stress-related exhaustion are differently associated with cognitive performance, 3) compare the association between stress-related exhaustion and cognitive performance to the relationship between depressive symptoms and cognitive performance, 4) examine if individuals with comorbid stress-related exhaustion and depression have lower cognitive performance than individuals with at most one of these conditions (i.e., whether clinical stress-related exhaustion and clinical depression might have additive effects on cognitive performance). Methods: The data used in the study was a Finnish population-based sample of six cohorts born between 1962 and 1977 from the Cardiovascular Risk in Young Finns Study. Stress-related exhaustion was assessed using the Maastricht Questionnaire, depressive symptoms with the Beck Depression Inventory, and cognitive performance with four subtests of the Cambridge Neuropsychological Test Automated Battery, measuring visuospatial associative learning, reaction time, sustained attention, and executive functions. Cognitive performance and depressive symptoms were assessed in 2012, and stress-related exhaustion in 2001, 2007, and 2012. Participants were 35 to 50 years old in 2012. Linear associations between stress-related exhaustion and cognitive performance (N = 905) and depressive symptoms and cognitive performance (N = 904) were examined by conducting multivariate regression analyses. Age, sex, socioeconomic status, and parents’ socioeconomic status were controlled in the regression models. Additionally, multivariate analyses of variance were performed to investigate the different developmental trajectories of stress-related exhaustion and their relation to cognitive performance (N = 541) and the associations of comorbid stress-related exhaustion and depression with cognitive performance (N = 1273). Results and conclusion: The main finding was that high stress-related exhaustion is associated with slower reaction times, but not with performance in spatial working memory, visuospatial associative learning, or executive functions. Ongoing, chronic stress-related exhaustion was more strongly associated with slower reaction times than short-term exhaustion experienced years ago. Compared to depressive symptoms, high stress-related exhaustion was associated with slower reaction times also when subclinical cases were included, whereas only clinical levels of depressive symptoms had an association with slower reaction times. There were no differences in cognitive performance between individuals with only stress-related exhaustion or depression and those with comorbid stress-related exhaustion and depression, which supports the notion that these conditions do not have additive effects on cognitive performance. These findings add to the existing evidence of the cognitive effects of stress-related exhaustion in the general population and have several practical implications. Further research is needed on the topic, preferably with longitudinal designs, more comprehensive cognitive measures, and clinical assessment of the psychiatric symptoms.
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Cognitive performance in adulthood: the roles of stress-related exhaustion and depressive symptoms (2021)Objective: Both stress-related exhaustion and depression have previously been associated with a decline in cognitive performance, but there is a lack of evidence on whether these conditions have different associations with different cognitive domains and whether they have additive effects on cognitive performance. Furthermore, very little is known about the cognitive effects of chronic stress-related exhaustion. Consequently, the aims of this study were to 1) examine the associations between current stress-related exhaustion and cognitive performance, 2) investigate whether different developmental trajectories of stress-related exhaustion are differently associated with cognitive performance, 3) compare the association between stress-related exhaustion and cognitive performance to the relationship between depressive symptoms and cognitive performance, 4) examine if individuals with comorbid stress-related exhaustion and depression have lower cognitive performance than individuals with at most one of these conditions (i.e., whether clinical stress-related exhaustion and clinical depression might have additive effects on cognitive performance). Methods: The data used in the study was a Finnish population-based sample of six cohorts born between 1962 and 1977 from the Cardiovascular Risk in Young Finns Study. Stress-related exhaustion was assessed using the Maastricht Questionnaire, depressive symptoms with the Beck Depression Inventory, and cognitive performance with four subtests of the Cambridge Neuropsychological Test Automated Battery, measuring visuospatial associative learning, reaction time, sustained attention, and executive functions. Cognitive performance and depressive symptoms were assessed in 2012, and stress-related exhaustion in 2001, 2007, and 2012. Participants were 35 to 50 years old in 2012. Linear associations between stress-related exhaustion and cognitive performance (N = 905) and depressive symptoms and cognitive performance (N = 904) were examined by conducting multivariate regression analyses. Age, sex, socioeconomic status, and parents’ socioeconomic status were controlled in the regression models. Additionally, multivariate analyses of variance were performed to investigate the different developmental trajectories of stress-related exhaustion and their relation to cognitive performance (N = 541) and the associations of comorbid stress-related exhaustion and depression with cognitive performance (N = 1273). Results and conclusion: The main finding was that high stress-related exhaustion is associated with slower reaction times, but not with performance in spatial working memory, visuospatial associative learning, or executive functions. Ongoing, chronic stress-related exhaustion was more strongly associated with slower reaction times than short-term exhaustion experienced years ago. Compared to depressive symptoms, high stress-related exhaustion was associated with slower reaction times also when subclinical cases were included, whereas only clinical levels of depressive symptoms had an association with slower reaction times. There were no differences in cognitive performance between individuals with only stress-related exhaustion or depression and those with comorbid stress-related exhaustion and depression, which supports the notion that these conditions do not have additive effects on cognitive performance. These findings add to the existing evidence of the cognitive effects of stress-related exhaustion in the general population and have several practical implications. Further research is needed on the topic, preferably with longitudinal designs, more comprehensive cognitive measures, and clinical assessment of the psychiatric symptoms.
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(2020)Objective. The FRIENDS programme is a group cognitive behavioural therapy (CBT) programme, developed for the prevention and treatment of child and adolescent anxiety and depression. In the context of prevention, FRIENDS has been extensively researched; however, little research has been conducted on FRIENDS in a treatment setting and with different populations. To help fill this gap, the aim of the present study was to evaluate the effectiveness of the Finnish version of FRIENDS in reducing internalising symptoms in children diagnosed with psychiatric and neuropsychiatric disorders. Methods. The present study was conducted at Helsinki University Hospital (HUS) Child Psychiatry outpatient clinics in the Helsinki metropolitan area, Finland. The participating children (n = 99, mean age = 9.45 years, range 6–13 years, 68.7 % boys) were randomly assigned to either FRIENDS (n = 52) or a waitlist control group (n = 47), which received treatment as usual for a period of 3 months before the intervention. The children’s internalising symptoms were assessed using parent- and teacher-report questionnaires (Child Behavior Checklist and Teacher’s Report Form) at referral to treatment, pre-treatment, post-treatment, and six-month follow-up. Results and conclusions. In both groups, there was a medium-sized statistically significant decrease in parent-reported internalising symptoms immediately after the intervention; however, these improvements were not retained at six-month follow-up. Teacher-reported internalising symptoms followed a similar pattern of decrease during the intervention and increase during follow-up; however, these changes were smaller in magnitude and did not reach statistical significance, possibly due to loss of statistical power caused by missing data. Neither parent- or teacher-reports showed an intervention effect, with children’s internalising symptoms exhibiting similar changes regardless of whether they belonged to the intervention group or the waitlist control group, which received treatment as usual during the wait period. These results raise questions on the durability of treatment effects and the superiority of FRIENDS over active waitlist control conditions or treatment as usual when treating children diagnosed with diverse psychiatric and neuropsychiatric disorders in a community setting where treatment adherence and integrity may not be ideal.
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(2020)Objective. The FRIENDS programme is a group cognitive behavioural therapy (CBT) programme, developed for the prevention and treatment of child and adolescent anxiety and depression. In the context of prevention, FRIENDS has been extensively researched; however, little research has been conducted on FRIENDS in a treatment setting and with different populations. To help fill this gap, the aim of the present study was to evaluate the effectiveness of the Finnish version of FRIENDS in reducing internalising symptoms in children diagnosed with psychiatric and neuropsychiatric disorders. Methods. The present study was conducted at Helsinki University Hospital (HUS) Child Psychiatry outpatient clinics in the Helsinki metropolitan area, Finland. The participating children (n = 99, mean age = 9.45 years, range 6–13 years, 68.7 % boys) were randomly assigned to either FRIENDS (n = 52) or a waitlist control group (n = 47), which received treatment as usual for a period of 3 months before the intervention. The children’s internalising symptoms were assessed using parent- and teacher-report questionnaires (Child Behavior Checklist and Teacher’s Report Form) at referral to treatment, pre-treatment, post-treatment, and six-month follow-up. Results and conclusions. In both groups, there was a medium-sized statistically significant decrease in parent-reported internalising symptoms immediately after the intervention; however, these improvements were not retained at six-month follow-up. Teacher-reported internalising symptoms followed a similar pattern of decrease during the intervention and increase during follow-up; however, these changes were smaller in magnitude and did not reach statistical significance, possibly due to loss of statistical power caused by missing data. Neither parent- or teacher-reports showed an intervention effect, with children’s internalising symptoms exhibiting similar changes regardless of whether they belonged to the intervention group or the waitlist control group, which received treatment as usual during the wait period. These results raise questions on the durability of treatment effects and the superiority of FRIENDS over active waitlist control conditions or treatment as usual when treating children diagnosed with diverse psychiatric and neuropsychiatric disorders in a community setting where treatment adherence and integrity may not be ideal.
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(2020)Masennus on WHO:n arvion mukaan merkittävin toimintakykyä heikentävä sairaus koko maailmassa. Jo oirekuvan perusteella sen voidaan ajatella heikentävän elämän merkityksellisyyttä. Tässä tutkielmassa masennuksen sairastaminen hahmotetaan coping-prosessina, jossa selviytymistä määrittää elämän merkityksellisyyden ylläpitäminen. Sairastavien elämän merkityksellisyyttä ylläpitävät selviytymiskeinot eivät aina ole riittävän toimivia, jolloin masennus johtaa elämän merkityksellisyyden kriisiin. Tällaisia sairauskertomuksia on myös dokumentoitu. Tässä tutkielmassa pyrin abduktiivisen päättelyn avulla löytämään niitä elämän merkityksellisyyttä heikentäviä tekijöitä, jotka selittävät elämän merkityksellisyyden kriisin syntymisen. Tutkielmaa varten kerättiin kirjoituspyynnöllä ja puolistrukturoidulla teemahaastatteluilla kolmenkymmenen kolmen masennusta sairastaneen ja toipuneen kokemuksia omasta sairaudestaan. Kerätty aineisto analysoitiin aineistolähtöistä sisällönanalyysiä käyttäen. Analyysissa löydettiin kahdeksan elämän merkityksellisyyttä heikentävää tekijää: 1.Ulkopuolisuus ja yhteydettömyys 2. Itsen menettäminen tai sekoittuminen sairauteen 3. Psyykkinen kipu, itsetuhoisuus ja itsemurha-ajatukset 4. Epäselvyys masennuksen syistä 5. Pitkäkestoisuus ja hoitoresistenssi 6. Psyykkinen turvattomuus 7. Korkea uusiutumisriski ja epälineaarinen toipuminen 8. Toimintakyvyn heikentyminen tai menettäminen. Tutkielman tulokset selittävät, miksi sairastavat voivat tarvita elämän merkityksellisyyden kriisiä selviytyäkseen. Onnistunut kriisin läpikäynti luo elämään täysin uutta merkityksellisyyttä ja auttaa sopeutumaan haastaviin olosuhteisiin. Osa masennuksen merkityksellisyyttä heikentävistä tekijöistä saattoi kuormittaa toipuvaa vielä varsinaisen akuutin masennustilan katoamisen jälkeenkin. Tulokset viittaavat siihen, että elämän merkityksellisyyden ylläpitäminen tulisikin nähdä nykyistä tärkeämpänä osana masennuksesta toipumista. Sairastavia ja toipuvia tulisi tukea myös elämän merkityksellisyyden ylläpitämisessä, eikä vain sairauden hoidon muodossa. Erityisesti elämän merkityksellisyyden kriisit tulisi huomioida, sillä niiden epäonnistunut käsittely voi johtaa selviytymisprosessin katkeamiseen.
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(2020)Masennus on WHO:n arvion mukaan merkittävin toimintakykyä heikentävä sairaus koko maailmassa. Jo oirekuvan perusteella sen voidaan ajatella heikentävän elämän merkityksellisyyttä. Tässä tutkielmassa masennuksen sairastaminen hahmotetaan coping-prosessina, jossa selviytymistä määrittää elämän merkityksellisyyden ylläpitäminen. Sairastavien elämän merkityksellisyyttä ylläpitävät selviytymiskeinot eivät aina ole riittävän toimivia, jolloin masennus johtaa elämän merkityksellisyyden kriisiin. Tällaisia sairauskertomuksia on myös dokumentoitu. Tässä tutkielmassa pyrin abduktiivisen päättelyn avulla löytämään niitä elämän merkityksellisyyttä heikentäviä tekijöitä, jotka selittävät elämän merkityksellisyyden kriisin syntymisen. Tutkielmaa varten kerättiin kirjoituspyynnöllä ja puolistrukturoidulla teemahaastatteluilla kolmenkymmenen kolmen masennusta sairastaneen ja toipuneen kokemuksia omasta sairaudestaan. Kerätty aineisto analysoitiin aineistolähtöistä sisällönanalyysiä käyttäen. Analyysissa löydettiin kahdeksan elämän merkityksellisyyttä heikentävää tekijää: 1.Ulkopuolisuus ja yhteydettömyys 2. Itsen menettäminen tai sekoittuminen sairauteen 3. Psyykkinen kipu, itsetuhoisuus ja itsemurha-ajatukset 4. Epäselvyys masennuksen syistä 5. Pitkäkestoisuus ja hoitoresistenssi 6. Psyykkinen turvattomuus 7. Korkea uusiutumisriski ja epälineaarinen toipuminen 8. Toimintakyvyn heikentyminen tai menettäminen. Tutkielman tulokset selittävät, miksi sairastavat voivat tarvita elämän merkityksellisyyden kriisiä selviytyäkseen. Onnistunut kriisin läpikäynti luo elämään täysin uutta merkityksellisyyttä ja auttaa sopeutumaan haastaviin olosuhteisiin. Osa masennuksen merkityksellisyyttä heikentävistä tekijöistä saattoi kuormittaa toipuvaa vielä varsinaisen akuutin masennustilan katoamisen jälkeenkin. Tulokset viittaavat siihen, että elämän merkityksellisyyden ylläpitäminen tulisikin nähdä nykyistä tärkeämpänä osana masennuksesta toipumista. Sairastavia ja toipuvia tulisi tukea myös elämän merkityksellisyyden ylläpitämisessä, eikä vain sairauden hoidon muodossa. Erityisesti elämän merkityksellisyyden kriisit tulisi huomioida, sillä niiden epäonnistunut käsittely voi johtaa selviytymisprosessin katkeamiseen.
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(2014)Aims. There is a growing body of research indicating that childhood experiences interact with genetic vulnerabilities in the development of depression. Parent-child relationship quality has been shown to have a critical role in the development of depression later in life. Moreover, research has shown that the quality of parenting can also have long-term and persistent effects on various neurobiological systems, such as the hypothalamic-pituitary-adrenal (HPA) axis. Indeed, the impaired function of HPA axis has been the most consistently found association with depression. This makes genes related to HPA axis regulation of particular interest to researchers. One possible candidate gene is FK506 binding protein 51 (FKBP5) gene, which has been shown to interact with adverse childhood experiences in predicting future risk of depression. This study examines whether perceived quality of parent-child relationship predicts depressive symptoms in adulthood and whether this association is moderated by the FKBP5 polymorphisms. Methods. This study is part of The Helsinki Birth Cohort Study. Total of 1 667 subjects completed a psychological questionnaire in 2004, including the Beck Depression Inventory (21 item, BDI) and the Parental Bonding Instrument (25 item, PBI). This study utilised the three factor structure of PBI; care, denial of psychological autonomy and encouragement of behavioral freedom, which were measured separately for mother and father. The study looked at three FKBP5 gene polymorphisms: rs1360780, rs9394309 and rs9470080 extracted from the genome-wide data genotyped with modified Illumina 610k array. The study utilised two models 1 and 2; model 1 adjusted for age and gender and additionally model 2 adjusted for childhood and adulthood socioeconomic status (SES) as well as separation experiences. Results and conclusions. As hypothesised and in line with previous studies the quality of parenting predicted depressive symptoms in adulthood. Participants, who perceived having received more care and encouragement of behavioral freedom reported fewer depressive symptoms. Whereas denial of psychological autonomy resulted in reporting more depressive symptoms. None of the polymorphisms predicted depressive symptoms. More importantly, this is the first study to show that FKBP5 polymorphisms modify the relationship between perceived mother-child relationship and depressive symptoms. Among participants with two minor alleles, perceived lack of maternal care and maternal denial of psychological autonomy were most strongly associated with more depressive symptoms. Participants with one minor allele had similar results. Whereas among participants with two major alleles, perceived parenting had a smaller effect on the amount of depressive symptoms. These findings indicate that in addition to adverse experiences and traumas, also deficiencies in parenting can predispose to depression depending on the amount of minor alleles in FKBP5 polymorphisms.
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(2018)Individualism and collectivism, known amongst cultural psychology, have been long studied in relation to mental health. On one hand, it has been studied whether there is a relationship between depression and individualism or collectivism on a cultural level. On the other hand it’s equally interesting whether there is a relationship between depression and individualism and collectivism on an individual/personal level, also known as idiocentrism and allocentrism. It seems cultural level collectivism or individualism is not a risk factor or a protective factor for depression. However, a conflict between cultural orientation and personal orientation appears to be positively related with depression. Allocentrics living in individualistic cultures get depressed easier than allocentrics in collectivistic cultures or idiocentrics in individualistic cultures. People with individual tendencies get depressed for different reasons than people with collectivistic tendencies. Individualists are more sensitive to failures and disappointments related to success and personal goals, whereas collectivists are more sensitive to lack of social support or negative social feedback such as rejection, lack of approval or lack of intimate relationships. These different predispositions for depression show already a on genetic level.
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(2021)Aims: Major depression is associated with substantial individual and societal burden due to its high prevalence. Current treatments are estimated to only reduce about one-third of the economic burden of depressive disorders. Depression prevention could be an alternative means to alleviate this disease burden. However, current face-to-face prevention programs have several limitations including limited health care resources and mental health stigma. Internet and mobile based (IM) preventions could potentially overcome the limitations of face-to face prevention programs. The aim of this review is to introduce different types of IM-preventions of depression and to evaluate effectiveness and cost-effectiveness of these prevention programs. Methods: A literature search was conducted on pubmed database and google scholar using search terms “depression prevention” and “internet and mobile based” with terms “cost-effectiveness” and “adherence”. Results and conclusions: The results of this review indicate that major depression could be prevented with IM-preventions. The length of an effective treatment is most likely 5-8 weeks and it usually includes human support while less effective treatment is most likely self-help based. The importance of human support can be attributed to the adherence to the treatment and enhancing adherence is particularly important in populations with more severe symptoms. Indicative, selective and universal preventions are equally effective. It is not possible to compare different approaches since nearly all preventions utilise cognitive-behavioural techniques and are internet-based. Studies that examine the cost-effectiveness of depression prevention are far and between, but according to one study internet and mobile based prevention of depression could be a cost-effective alternative to the primary healthcare services. The available evidence suggests that it would be fruitful to try internet and mobile based depression prevention in a context of a workplace or a school but there is inadequate evidence for national prevention programs.
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(2016)Objectives. Bipolar disorder is a mood disorder in which the mood varies between depressive state and mania or hypomania. In earlier studies it has been observed that the depressive episode of bipolar disorder might be often inaccurately diagnosed as recurrent depression or unipolar depression. This might lead to lengthening of the symptoms and at worst, to use of antidepressants without the simultaneous use of mood stabilizers which in turn might lead to mania or hypomania. Thus, the objective of this review is to study the distinctive factors of the depressive episodes between bipolar disorder type I and II and unipolar depression, emphasizing genetic factors, the symptoms during depressive episodes, comorbid disorders, subthreshold hypomanic symptoms and the effects of pharmacotherapy during the depressive episodes. Results and conclusions. In the review it was found that many factors distinguished the depressive episodes of bipolar disorder and unipolar depression although for comorbid disorders, especially for alcohol and substance dependence and abuse, the number of depressive episodes, and the severity of depressive symptoms the evidence was contradictory. The family history of bipolar disorder, the depressive symptoms and the age at the onset of the mood disorder were found to be associated with the onset of bipolar disorder. The use of antidepressants in bipolar disorder without the simultaneous use of mood stabilizers was noted to possibly lead to a switch from depression to mania or hypomania. Bipolar disorder was also found to share genetic factors with depression and schizophrenia which supports the idea that mood disorders constitute a dimension. In the future, it would be important to increase the accuracy of diagnostics and diagnostic criteria should be re-evaluated. Moreover, the caregivers should be educated about the differences between the depressive episodes in bipolar disorder and unipolar depression and the assessment of family history of bipolar disorder should be established as a basic procedure in the assessment of a mood disorder. Also, one should pay more attention to the occurrence of subthreshold hypomanic symptoms and the use of pharmacotherapy and its effects on the individual during the treatment of a depressive episode. It would also be important to develop a pharmacological treatment that could be used in the treatment of both unipolar depression and bipolar depressive episode.
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(2022)Klassisten psykedeelien potentiaalista psykiatrisessa hoidossa on saatu näyttöä mm. ahdistuksen, pakko-oireisen häiriön ja riippuvuushäiriöiden sekä vakaviin sairauksiin liittyvän ahdistuksen ja masennuksen osalta. Tämän katsauksen tarkoituksena oli tarkastella klassisten psykedeelien terapeuttisia mahdollisuuksia masennuksen ja hoitoresistentin masennuksen hoidossa. Lisäksi käytiin läpi klassisten psykedeelien neurobiologisia ja psykologisia vaikutusmekanismeja sekä tarkasteltiin psykedeeliavusteista terapiaa ja pohdittiin sen merkitystä hoidon vaikuttavuuden kannalta. Tutkimukset haettiin Google Scholar ja PubMed-tietokannoista hakusanoilla “depression”, “treatment resistant depression”, “classic psychedelic”, “psychedelic”, “classic hallucinogenic”, “hallucinogenic”, “psilocybin”, “DMT” ja “ayahuasca”. Katsaukseen valittiin ne artikkelit, joissa tutkittiin klassisten psykedeelien terapeuttisia mahdollisuuksia masennuksen tai hoitoresistentin masennuksen hoidossa. Tämä sulki pois mm. tutkimukset vakaviin sairauksiin ja kuolemanpelkoon liittyvästä masennuksesta. Katsaukseen valittiin kahdeksan (8) tuoretta tutkimusta (N=388), joista viisi (5) käsitteli psilosybiiniä ja kolme (3) DMT:tä. Tuoreita tutkimuksia muilla klassisilla psykedeeleillä ei löytynyt. Tutkimuksissa kartoitettiin ja seurattiin muutoksia masennusoireisiin erilaisten masennuskyselyiden avulla, ja tulokset ilmoitettiin keskimääräisinä muutoksina näiden kyselyiden pisteissä tai responssin ja remission käsitteillä. Masennusoireet vähenivät kaikissa tarkastelluissa tutkimuksissa. Vaikutukset kestivät päivistä viikkoihin ja jopa kuukausiin. Tulokset viittaavat siihen, että klassisilla psykedeeleillä on potentiaalia masennuksen ja hoitoresistentin masennuksen hoidossa, mutta lisää tutkimusta tarvitaan. Tällä hetkellä epäselvää on, miten klassiset psykedeelit vaikuttavat mielenterveyden häiriöiden, kuten masennuksen, hoitamisessa. Lisäksi tulisi selvittää millainen vaikutus psykedeeliavusteisella terapialla on verrattuna pelkkään klassisen psykedeelin annosteluun.
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