Browsing by Subject "psykoosi"

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.

Psychotic disorders are quite rare but severe mental disorders. For example, the life time prevalence for schizophrenia is only 0.5 %, whereas the life time prevalence for psychotic symptoms is approximately 5 - 6 %. Psychotic symptoms can predict problems with mental health and they are often considered to be early signs of the beginning of a psychotic disorder. Psychotic disorders can cause impairments in a person’s ability to handle daily tasks and they are known to have a negative impact on the general quality of life. Therefore, it is extremely important to recognize factors that may cause psychotic disorders in order to prevent their development. It is known, that psychotic symptoms and psychotic disorders can be explained by multiple different factors, but it has been suggested that childhood sexual abuse is one of these explaining factors. However, victims of sexual abuse will not always develop a psychotic disorder. Therefore, it is especially important to understand, which of the underlying factors could possibly transmit or moderate the link between childhood sexual abuse and psychotic symptoms. When the association is known, victims of sexual abuse can be supported properly. For the literature selection of my thesis, I chose studies which discussed psychotic symptoms of persons with sexual abuse history in childhood as well as studies, which examined traumatic childhood experiences retrospectively of patients with first-episode psychosis. In addition, the literature selection included population based studies, which examined both sexual abuse history in childhood and psychotic symptoms from randomly selected sample. Many of the studies used retrospective self-report questionnaires in the collection of data, while there were also some studies where data was based on medical records. In my thesis I examine the link between childhood sexual abuse and psychotic symptoms and especially that which factors have an impact on such link and which moderate it. The symptoms of general psychopathology, such as anxiety, are essential factors transmitting the link. Additionally, other childhood trauma experiences also have an impact on the link: emotional and physical abuse transmit the path to the positive psychotic symptoms whereas physical neglect mediates the path to the negative symptoms. It is also known, that the link between sexual abuse and psychotic symptoms is stronger with females than males. Childhood sexual abuse is strongly associated with psychotic symptoms. Therefore, psychotic symptoms increase the risk of developing psychotic disorder and hence, it is important to take notice for the showing symptoms as soon as possible.

Psychosis is a condition in which a person's sense of reality is weakened and he/she has considerable difficulty in distinguishing what is true and what is not. Psychosis includes a number of different symptoms. The most typical symptoms are various hallucinations and delusions, fragmentation of thought and speech and abnormal behavior. For example, schizophrenia, psychotic depression, bipolar disorder, schizoaffective disorder and various personality disorders may include psychotic episodes. In schizophrenia there are significant difficulties in all domains of cognition. Difficulties can be observed in childhood. Children who develop schizophrenia in later years experience difficulties which have been observed as early as age 3. In first grade, their grades are about one standard deviation lower than those of their peers. The cognitive level prior to illness has not been associated with the timing of the illness, so the deficits in cognition can not be explained by pre-symptoms. As psychotic illness progresses, the level of cognitive function remains stable. This hypothesis is supported by most of the research. However, the results are in some respects contradictory. According to some research, cognitive functioning weakens steadily as the illness progresses. Some results have found that cognitive functioning improves as the disease progresses. Similarly, there are contradictory results as to the relationship between psychotic symptoms (positive and negative) and cognitive functioning. Support is most prevalent in the hypothesis that there is no connection between the level of difficulty of psychotic symptoms and cognitive deficits. In psychotic patients, the level of cognitive impairment has a greater effect on overall functional capacity than the symptoms of psychosis. The difficulty of cognitive disorders predicted lower real world functioning more than the difficulty of positive or negative symptoms. In addition to the clinical symptoms of psychosis, it is important to always evaluate cognitive functioning and aim to rehabilitate cognition.