Browsing by Subject "nettiterapia"
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(2024)Tavoitteet. Antisosiaalinen persoonallisuushäiriö (ASPD) on moninkertaisesti valtaväestöä yleisempää mielenterveyspotilaiden, päihteidenkäyttäjien ja rikollisten keskuudessa, ja sen on todettu olevan yhteydessä vakavampaan mielenterveys- ja päihdehäiriöoireiluun. ASPD-diagnoosin saaneiden ei ole kuitenkaan havaittu vastaavan tehoon niin hyvin kuin muu väestö, minkä lisäksi heidän on havaittu olevan hoitoa karttavia sekä lopettavan sen ennenaikaisesti. Tässä tutkimuksessa tarkastellaan ASPD-diagnoosin saaneiden henkilöiden ja niiden henkilöiden, joiden lähisukulaisella on ASPD-diagnoosi, riskiä keskeyttää internetissä toteutettu psykoterapia muuhun väestöön verrattuna. Lisäksi tarkastellaan sitä, ovatko henkilöt hyötyneet terapiasta, mikäli ovat sen suorittaneet loppuun. Menetelmät. Tutkimusaineisto koostui HUSin nettiterapiadatasta, THL:n potilasrekisteridatasta sekä DVV:n rekisteridatasta. ASPD-diagnoosina käytettiin ICD-10 -tautiluokituksen diagnoosia F60.2. Nettiterapian keskeyttämisalttiutta tutkittiin logistisella regressioanalyysillä erikseen 70 % ja 100 % suoritettujen terapiaistuntojen perusteella. Lisäksi terapian vähintään 70 %:sti loppuun saattaneiden potilaiden kohdalla tarkasteltiin heidän oirepistemuutostensa avulla sitä, olivatko he hyötyneet nettiterapiasta. Tulokset ja johtopäätökset. Sekä ASPD-diagnoosin saaneilla että niillä henkilöillä, joiden lähisukulaisella on ASPD-diagnoosi, havaittiin olevan huomattavasti kohonnut riski keskeyttää terapia. Riski oli suurempi ASPD-diagnoosin saaneilla. Toisaalta terapian vähintään 70 %:sti loppuun saattaneen antisosiaalisen väestön selkeän enemmistön havaittiin hyötyneen terapiasta. Näin ollen tutkimus antaa alustavia tuloksia antisosiaalisen väestön hyötymisestä nettiterapiana tarjottavasta psykoterapiasta, joskin erityistä huomiota tulisi kohdistaa antisosiaalisen väestön motivoimiseen terapiassa käymiseen erityisesti hoidon alussa. Kaiken kaikkiaan yksilön antisosiaalinen tausta tulisi havaita mahdollisimman varhain.
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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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(2018)There are now internet-based interventions for most of the common mental health disorders, and the evidence for their effectiveness indicates that these treatments are a promising way to improve the availability of mental health services. Given that there are, however, only few interventions for psychotic disorders, the objective of this review was to describe the content of these interventions and to assess their effectiveness. The reviewed web-based interventions for psychotic disorders consist of psychoeducation, social support and therapeutic exercises. Multimedia content was utilized in psychoeducation, and moderated internet forums were an essential part of interventions that offered social support. The therapeutic sessions consisted of independent exercises, which emphasized ways to recognize harmful thoughts and develop coping skills. The interventions were considered feasible and helpful for the most part. There is also promising evidence for treatment effects, especially with regard to depression and psychosocial functioning. Due to methodological deficiencies, however, the evidence is scarce. In the future researchers should focus on systematic research with strong methodological quality. It is also important that the development of these interventions is user-centered. In addition, there is remarkable variation as far as effectiveness is concerned, and the underlying causes should be unraveled.
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(2021)Panic disorder is an anxiety disorder, which impairs one's daily life on areas of life quality and functioning. In a large proportion of the patients, the disorder remains unrecognized and untreated, although seeking help from health care is quite common among people with panic disorder. Issues with accessibility to therapy can set barriers to receiving mental health care. In addition to face-to-face therapy, internet-based cognitive behavioral therapies (iCBT) have been developed, and they are also available in Finland and have been developed by HUS. The implementation and research of internet-based therapies have mostly been focused on cognitive behavioral therapy, which is known to be effective in treating panic disorder. The aim of this literature review is to get an overview of iCBT's usability in treating panic disorder by examining the effectiveness and efficiency of treatment and the importance of support in the treatment outcome. Literature search was collected from the OvidMedline and Pubmed databases in February 2021 using combinations of the keywords panic disorder, iCBT, self help, web-based, internet treatment, online therapy and computer-assisted therapy. Controlled randomized trials in which subjects were diagnosed with panic disorder and the treatment used cognitive behavioral internet-based therapy without face-to-face contact were included. Using these criteria, nine research articles were selected for the review. The studies presented in this review supported that internet-based cognitive behavioral therapies are useful in reducing panic symptom severity. Treatment results of the internet therapy did not differ statistically significantly when compared to the treatment results of face-to-face therapy. Receiving support from a therapist is also important during panic disorder internet therapy, but due to the heterogeneity of the studies selected for this review, no firm conclusions could be drawn about the optimal amount of support for treatment outcome and maintenance. In addition, the results of the studies provided support for the cost-effectiveness of internet-based treatment methods in treating panic disorder. Altogether, the results of this review provide evidence that the use of internet-based therapy as a treatment for panic disorder can help address the resource problem between the supply and demand of psychotherapy services, as it is equally effective and at the same time more cost-effective when compared to face-to-face therapy.
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