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Background: Delirium is a common, under-diagnosed and serious problem among critically ill patients. Episodes of delirium are associated with a number of adverse outcomes; it seems to carry a considerable risk for future complications, increased future morbidity, long-term impairments in cognitive abilities, and even death. Approximately 80% of patients in intensive care unit (ICU) will develop delirium during their stay in hospital, making it to be a rather common condition – especially among elderly patients. With aging of the patient population in ICU incidence of delirium is likely to increase in future. Early recognition, prevention and treatment for delirium in and after ICU is extremely important for future recovery. There is promising evidence suggesting that delirium could be used as an effective tool for predicting future recovery and health complications after release from ICU. Aim of the study: To identify adverse consequences of post-operative delirium (POD) in ICU (with main focus on future cognitive decline), recognize possible risk groups and current screening and treatment procedures. Methods: A systematic review was conducted, following the Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Literature was collected between September and October 2019 from PubMed ja Ovid Medline data bases using keywords ’delirium’, ’critical illness’, ’consequences’, ’effects’,’cognitive decline’, and ’cognitive impairments’. The search yielded 23 peer reviewed articles which are included in this revies. Results: Episodes of non-dementia delirium in ICU were associated with a number of health complications, prolonged hospital stay and higher risk for readmissions, higher morbidity and mortality, increased risk of falls, accident and injuries, social problems, increased stress and distress, cognitive impairments and increased risk for developing dementia. Different subtypes of delirium (hypoactive vs. hyperactive) seemed to lead to somewhat different adverse consequences; however, all recognized subtypes were hazardous. Conclusions: Delirium is a common, severe and under-diagnosed health problem among ICU patients. It has shown to be associated with various adverse outcomes that create serious economical costs for both individuals and societies, as well as significantly impair patients’ health and later quality of life. Episodes of ICU delirium can cause cognitive impairments and accelerate cognitive decline associated with neuropsychiatric disorders (such as dementia). Although the majority of healthcare professionals acknowledge the severity of problem, the current procedures for prevention, treatment, screening and monitoring are severely lacking. Both current screening tools and training of medical staff are in dire need for improvements.

Syfte. Studier har indikerat att en stor andel av den åldrade befolkningen har hörselnedsättning och att dessa personer behöver stöd i vardagliga kommunikationssituationer. Personer med nedsatt hörsel har visat sig varsebli tal bättre i diskussionssituationer där den visuella läppbilden är närvarande tillsammans med det auditiva talljudet. Samma fenomen har också noterats bland normalt hörande personer i bullrig ljudmiljö. För att få reda på vilken nytta rehabiliteringen av visuell talperceptionsförmåga (läppläsningsförmåga) har för vuxna personer med hörselnedsättning, behövs grundläggande statistisk information om hurudan den auditiva, den visuella och den audiovisuella talperceptionsförmågan hos vuxna personer är. Syftet med denna kandidatavhandling är att granska hur den visuella talperceptionsförmågan förändras i vuxen ålder. Avhandlingen jämför unga vuxnas visuella talperceptionskunskaper med äldre vuxnas visuella talperceptionskunskaper. Arbetshypotesen är att den visuella talperceptionsförmågan försämras med åldern på grund av försvagade kognitiva förmågor. Metoder. Det valda ämnet granskades genom en integrerad litteraturöversikt. Forskningsfrågan omvandlades till en engelskspråkig sökfras enligt Booles logik och sökfrasen genomfördes i databaserna Ovid Medline, PubMed och Scopus. Använda termer vid litteratursökningen var speechreading, lipreading, audiovisual speech perception, audiovisual speech recognition, audiovisual integration, aptitude, skill och ability. Litteratursökningen resulterade i 506 artikelträffar som utgående från rubrik, abstrakt och tillgänglighet slutligen avgränsades till fyra artiklar. Utöver dessa handplockades ytterligare två artiklar. De valda sex artiklarna var fall-referentstudier som behandlade visuell talperceptionskunskap hos unga och hos äldre vuxna. Artiklarna granskades kritiskt och deras resultat jämfördes sinsemellan. Resultat och slutsatser. Studierna visade enhetligt att unga vuxna har bättre visuell talperceptionsförmåga än äldre vuxna, vilket även har konstaterats i tidigare forskning. Arbetshypotesen fick stöd i och med att artiklarna uppskattade att den försämrade förmågan i visuell talperception hos äldre vuxna beror på försämrade kognitiva förmågor och på grund av försämrade integrationskunskaper.

Depression is one of the most common psychological symptoms that often occurs with dementia. It can be a risk factor for dementia to develop, or it can also appear after dementia causes losses to a patient’s abilities. Depression has been shown to hinder the functional status of a patient with dementia even further. Using medication to treat depression in patients with dementia holds the risk of side effects. Instead, psychosocial treatments should be considered essential in the treatment of depression in dementia patients. The purpose of this review is to examine psychosocial treatments used for treating depression in patients with dementia. Of these treatments, psychotherapy, music therapy and reminiscence therapy are considered further. The evidence for psychotherapy, music therapy and reminiscence therapy is partly conflicting, but overall quite promising. In the future, more randomized controlled trials should be carried out, but there is also a need for qualitative studies to clarify which mechanisms enable treatments to affect depression in dementia patients.

Dissociation is defined as disruption in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior. The definition has some similarities with five symptom domains of schizophrenia; hallucinations, delusions, disorganized thinking, disorganized motor behavior, and negative symptoms. This review aims to clarify the relationship between dissociation and schizophrenia from three perspectives. These are; dissociative symptoms in schizophrenia patients; schizophrenia related symptoms in dissociative patients; and the correlation between schizophrenia related symptoms and dissociative symptoms. The most systematically studied area was dissociative symptoms in schizophrenia patients, and the results showed that schizophrenia patients do not have particularly high dissociative symptoms compared to other mental health disorders. In contrast schizophrenia related symptoms in patients with dissociative disorder diagnosis is somewhat understudied area; yet a very few studies have found connections particularly between dissociative disorders and auditory hallucinations. There seems to be relatively high correlation between schizophrenia related symptoms and DES-scores. Research evidence was compared to three theories that have tried to explain the relationship between dissociation and schizophrenia. The theory by Moskowiz, Read, Farrelly, Rudgeair and Williams, according to which all symptoms of schizophrenia, (possibly excluding negative symptoms) would be caused by dissociation, found no support. The duality model by Şar and Öztürk, and Ross’ and Keyes’ model of dissociative subgroup within schizophrenia, were not in conflict with research evidence. However, more research is needed for reliable evaluation of these models.

Kielellinen erityisvaikeus on merkittävä riskitekijä lukivaikeuksille. Jopa 50 %:lla kielihäiriöisistä lapsista todetaankin dysleksia ja vielä suuremmalla määrällä on lievempiä kirjoitetun kielen prosessoinnin ongelmia. Dysleksia on pohjimmiltaan fonologisen prosessoinnin häiriö ja myös kielihäiriöön liittyy usein samankaltaisia fonologisia ongelmia, mikä tekee häiriöiden toisistaan erottamisesta usein vaikeaa. Aiemmat tutkimukset ovat kuitenkin osoittaneet sen olevan mahdollista fonologista prosessointia tarkemmin analysoimalla. Sekä SLI että dysleksia heikentävät usein merkittävästi koulumenestystä ja häiriöiden esiintyessä yhdessä on negatiivinen vaikutus koulumenestykseen vielä suurempi. Olisikin tärkeää pystyä mahdollisimman varhaisessa vaiheessa erottamaan kielihäiriöisistä lapsista ne, jotka ovat dysleksiariskissä, jotta heidän lukivalmiuksiensa kuntoutus päästäisiin aloittamaan jo ennen koulun alkamista. Tämän tutkielman tarkoituksena on koota tutkimustietoa kielihäiriöisten lasten dysleksiariskistä ja erityisesti siitä, mitkä piirteet alle kouluikäisten kielihäiriöisten lasten fonologisessa prosessoinnissa ennakoivat dysleksiaa. Tämä kuvailevan kirjallisuuskatsauksen muodossa toteutettu tutkielma pohjautuu neljään tutkimusartikkeliin, jossa yhteensä 133:n kielihäiriöisen lapsen fonologista prosessointia arvioitiin 4-6-vuotiaana ja tuloksia verrattiin heidän teknisen lukemisensa sekä lukemisen sujuvuuden taitoihin ensimmäisinä kouluvuosina. Tutkimusten tuloksista kävi ilmi, että lyhytkestoisella kielellisellä muistilla ei ollut yhteyttä SLI-lasten dysleksiariskiin. Merkittäväksi dysleksiaa ennustavaksi tekijäksi osoittautui sen sijaan pulmat nopeassa sarjallisessa nimeämisessä, varsinkin mikäli lapsella oli ongelmia myös fonologisessa tietoisuudessa. Aiempaa tutkimusta aiheesta on tehty vasta vähän, mutta nyt saatujen tulosten perusteella näyttää kuitenkin siltä, että kielihäiriöisten lasten dysleksiariskiä ei voida ennustaa samoin kuin tyypillisesti kehittyneiden lasten dysleksiariskiä.

Body dysmorphic disorder (BDD) is a disorder that consists of a distressing and impairing preoccupation with a nonexistent or slight defect in appearance. Patients often seek surgical, dermatologic and other nonpsychiatric medical treatment for their perceived appearance flaws. Psychological and pharmacological interventions are suggested format for the treatment. The aim of this study is to determine the effectiveness of the treatments of body dysmorphic disorder. The main interest is in the effectiveness of psychotherapy and which therapeutic techniques or strategies are effective in the treatment of body dysmorphic disorder. Although research on treatment is still limited, findings support the effectiveness of psychotherapy suggesting that cognitive-behavioral therapy is effective in treating patients with body dysmorphic disorder. Effective therapy may consist of both cognitive and/or behavioral elements, but use of exposure and response prevention is reported in many studies. Findings also suggest that serotonin reuptake inhibitors may be useful in treating patients with body dysmorphic disorder but nonpsychiatric medical treatment usually does not improve BDD symptoms. Although treatments improved the appearance of the treated body part, it led not to improvement in BDD symptoms.

Objective. Transdiagnostic models of psychopathology assume that the commonalities across disorders may outweigh their differences. While these models acknowledge that disorder-specific symptoms and features undoubtedly exist, the same underlying factors are perceived to cause and maintain various disorders. In recent years, this approach has received growing attention and several new forms of therapy have been developed based on it. These may be well-suited for the treatment of mixed-diagnosis groups or individuals with comorbid disorders, and as such, they hold the promise of being very cost-effective. One of the most established transdiagnostic treatments is the Unified Protocol (UP), designed to help patients suffering from depression and the full range of anxiety disorders. The purpose of the present study is to review the evidence regarding the efficacy and effectiveness of the UP for the transdiagnostic treatment of adult anxiety and depression. Methods. For this review, systematic literature searches were performed using the PsychInfo and PubMed online databases in October 2018. The search term used was “Unified Protocol”. The search yielded 114 results in PsychInfo and 138 in PubMed. Ten of these matched the following study selection criteria and were included in the current review: a) the study measured either the efficacy or effectiveness of the cognitive-behavioral UP therapy developed by Barlow (2011), b) treatment was delivered face-to-face in either individual or group setting, c) treatment followed the UP therapist guide without major modifications, d) participants suffered from an anxiety disorder or depression, e) participants were over 18 years of age, d) the study was published in 2015 or later, and f) the study was published in English in a peer-reviewed journal. Results and conclusions. The UP appeared both efficacious and efficient in reducing the severity of adult anxiety and depression as well as the number of comorbid diagnoses; however, there were some conflicting findings regarding recovery rates and effect sizes. The results achieved were comparable to those achieved using diagnosis-specific cognitive-behavioral therapy. The UP treatment had a positive impact on the patients’ functioning and quality of life and the amount of positive and negative affect they experienced. Treatment retention was generally high, particularly when treatment was delivered individually, and the UP received high ratings from those who participated in the studies. All in all, the current empiric evidence regarding the UP appears fairly promising. However, these results must be interpreted with caution, as the research concerning the UP is still in its infancy and a large part of it has been conducted by researchers affiliated with the treatment.

Tavoitteet. Monia ei-avusteisia ja avusteisia viestintäkeinoja on kehitetty mahdollistamaan niitä tarvitsevien viestinnällisten tarpeiden täyttyminen. Yhteistä linjaa sille, mikä näistä puhetta tukevista, täydentävistä tai korvaavista viestintäkeinoista tukee kuntoutujaa parhaiten, ei koeta olevan. Tämän tutkielman tavoitteena oli aiemman tutkimustiedon kautta selvittää millaista vertailevaa tutkimusta ei-avusteisten ja avusteisten viestintäkeinojen välillä on tehty ja miten nämä viestintäkeinot eroavat tutkituilla osa-alueilla. Tutkielman tuloksia voidaan soveltaa tukemaan ammattilaisia ei-avusteisten ja avusteisten keinojen valinnassa kuntoutujalle. Menetelmät. Tämän kandidaatintutkielman tutkimusmenetelmänä käytettiin integroivaa kirjallisuuskatsausta. Tutkimusartikkelit valikoitiin Scopus-, MedLine- ja PsycINFO-tietokannoista huhtikuussa 2022. Hakulausekkeen termit liittyivät puhetta tukevaan ja korvaavan viestintään, ei-avusteiseen viestintään ja vertailevaan näkökulmaan. Lopulliseen aineistoon valikoitui yhdeksän vuosina 2012-2021 julkaistua alkuperäistutkimusta. Aineisto valikoitiin mukaanotto- ja poissulkukriteerejä noudattaen Tulokset ja johtopäätökset. Tutkittavia oli yhteensä 369, joista 32 oli ei-avusteisia ja avusteisia keinoja käyttäviä ja 337 eri sidosryhmiin kuuluvia aikuisia. Avusteiset keinot, erityisesti puhelaiteen käyttö osoittautui lapsille mieluisimmaksi tavaksi viestiä ja mahdollisesti tätä kautta myös nopeimmaksi oppia ja kuvanvaihdon rinnalla varmimmaksi ylläpitää. Samoin puhelaitteella kysytyt kysymykset saivat aiheeseen perehtymättömiltä sidosryhmään kuuluvilta vuorovaikutuskumppaneilta halutun vahvistuksen, viittoen kysyttyjen kysymysten jäädessä kokonaan ymmärtämättä. Sen sijaan kouluympäristössä toimivat puheterapeutit kokivat olevansa itsevarmempia arvioidessaan ja ohjatessaan ei-avusteisia keinoja, kun avusteisia keinoja. Tämän tutkielman tulokset kertovat laajempien näkökulmien tarpeesta tutkimuksessa sekä tarpeesta kiinnittää huomiota ammattilaisten itsevarmuuden tukemiseen ohjaamisessa. Tämän lisäksi tuloksia voidaan hyödyntää kliinisessä työssä huomioimalla mieltymyksen vaikutus viestintäkeinon valinnassa ja käyttöönotossa kannattavana tekijänä.

First impressions are quickly formed observations of a new acquaintance. The basis of these observations is to find out what are the intentions of the other person. Therefore, the question behind is to find out whether they are a friend or an enemy. This happens automatically and as studies have found within mere fraction of seconds. It has been found that longer observations of others lead to more precise conclusions and after five seconds people are able to judge each other’s extroversion above chance level. Furthermore, studies point out that first impressions are vulnerable to error as for example positive features like physical attractiveness and success are linked together. In addition, studies show that features signaling threat are seen faster than positive features. According to evolutionary psychology this behavior is valuable for staying alive. Studies also show that to some extent people can impact on their first impression and in photographs people have been successfully able to act extraversion and openness. The purpose of this overview is to consider first impressions and the questions of how they are formed and if they are truthful. In addition, this overview analyzes whether people are aware of the first impressions made of them and whether they can have an impact on them.

Studies have shown that childhood physical abuse is associated with later adverse psychological development and mental health. Additionally, people who have experienced physical abuse have a higher risk for later violence. However, most people who have experienced childhood abuse do not become violent offenders which implies that the two factors are not directly linked. Mediating factors might account for the relationship. Alcohol related problems and antisocial personality disorder are psychiatric disorders which have been associated with childhood physical abuse and intimate partner violence. These disorders are examined here as possible mediators in the relationship between childhood physical abuse and later intimate partner violence. There are mixed results concerning the mediating role of alcohol related problems. These results indicate that alcohol related problems do not mediate the relationship between childhood abuse and violence. Alcohol related problems might work as a mediator for individuals with other risk factors. Studies have found that antisocial personality disorder has a mediating role in the relationship between childhood physical abuse and intimate partner violence. Abuse in childhood combined with a genetic risk for antisocial personality may lead to the development of the disorder which increases the risk for violence. In order to develop effective interventions, it is important to understand the adverse effects of childhood abuse. Moreover, mediating factors should be considered when designing interventions targeting intimate partner violence.