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Sökning: hsv:(MEDICIN OCH HÄLSOVETENSKAP) hsv:(Klinisk medicin) hsv:(Psykiatri)

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5421.
  • Lindsäter, Elin, et al. (författare)
  • Exhaustion disorder : scoping review of research on a recently introduced stress-related diagnosis
  • 2022
  • Ingår i: BJPsych Open. - : Cambridge University Press. - 2056-4724. ; 8:5
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundSymptoms related to chronic stress are prevalent and entail high societal costs, yet there is a lack of international consensus regarding diagnostics and treatment. A new stress-related diagnosis, exhaustion disorder, was introduced into the Swedish version of ICD-10 in 2005. Since then, use of the diagnosis has increased rapidly.AimsTo create the first comprehensive synthesis of research on exhaustion disorder to report on the current state of knowledge. Preregistration: Open Science Framework (osf.io), doi 10.17605/OSF.IO/VFDKW.MethodA PRISMA-guided scoping review of all empirical studies of exhaustion disorder was conducted. Searches were run in the MEDLINE, PsycInfo and Web of Science databases. Data were systematically charted and thematically categorised based on primary area of investigation.ResultsEighty-nine included studies were sorted into six themes relating to lived experience of exhaustion disorder (n = 9), symptom presentation and course (n = 13), cognitive functioning (n = 10), biological measures (n = 24), symptom measurement scales (n = 4) and treatment (n = 29). Several studies indicated that individuals with exhaustion disorder experience a range of psychiatric and somatic symptoms beyond fatigue, but robust findings within most thematic categories were scarce. The limited number of studies, lack of replication of findings and methodological limitations (e.g. small samples and scarcity of specified primary outcomes) preclude firm conclusions about the diagnostic construct.ConclusionsMore research is needed to build a solid knowledge base for exhaustion disorder. International collaboration regarding the conceptualisation of chronic stress and fatigue is warranted to accelerate the growth of evidence.
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5422.
  • Lindsäter, Elin, et al. (författare)
  • Psychometric and structural properties of the Karolinska Exhaustion Disorder Scale : a 1,072-patient study
  • 2023
  • Ingår i: BMC Psychiatry. - : BioMed Central (BMC). - 1471-244X. ; 23
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: Exhaustion disorder is a stress-related diagnosis that was introduced in 2005 to the Swedish version of the International Statistical Classification of Diseases and Related Health Problems, 10th edition (ICD-10). The Karolinska Exhaustion Disorder Scale (KEDS) was developed to assess exhaustion disorder symptomatology. While the KEDS is intended to reflect a single construct and be used based on its total score, the instrument's characteristics have received limited attention. This study investigated the KEDS's psychometric and structural properties in a large clinical sample.Methods: The study relied on data from 1,072 patients diagnosed with exhaustion disorder that were included in two clinical trials in Sweden. We investigated the dimensionality, homogeneity, and reliability of the KEDS using advanced statistical techniques, including exploratory structural equation modeling (ESEM) bifactor analysis.Results: A one-factor confirmatory analytic model exhibited a poor fit, suggesting at least a degree of multidimensionality. The ESEM bifactor analysis found the general factor to explain about 72% of the common variance extracted, with an omega hierarchical coefficient of 0.680. Thus, the ESEM bifactor analysis did not clearly support the scale's essential unidimensionality. A homogeneity analysis revealed a scale-level H of only 0.296, suggesting that KEDS's total scores do not accurately rank individuals on the latent continuum assumed to underlie the measure. The KEDS's reliability was modest, signaling considerable measurement error.Conclusion: Findings reveal important limitations to the KEDS with possible implications for the status of exhaustion disorder as a nosological category.
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5423.
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5424.
  • Lindwall, Lillemor, 1951-, et al. (författare)
  • Patient dignity in psychiatric nursing practice
  • 2012
  • Ingår i: Journal of Psychiatric and Mental Health Nursing. - : Wiley-Blackwell. - 1351-0126 .- 1365-2850. ; 19:7, s. 569-576
  • Tidskriftsartikel (refereegranskat)abstract
    • Professional nurses have an ethical responsibility to protect and preserve the patients' dignity. The aim of this study was to describe how nurses experienced incidents relating to patients' dignity in a psychiatric nursing practice. A hermeneutic approach was used and data were collected using the critical incident technique. Data included 77 written critical incidents, which were interpreted by using a hermeneutic text interpretation. The findings show preserved dignity – caregivers have the courage to be present, and offended dignity – caregivers create powerlessness taken away by the patient. These findings show that patients' dignity in a psychiatric nursing practice can be preserved when caregivers act on their ethical responsibility. When patients' dignity is offended, the caregiver has become an inner value conflict, something they have been a part of against their own will.
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5425.
  • Lingiardi, Vittorio, et al. (författare)
  • RELATIONAL TURN AND PSYCHOTHERAPY RESEARCH
  • 2016
  • Ingår i: Contemporary psychoanalysis. - : ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD. - 0010-7530 .- 2330-9091. ; 52:2, s. 275-312
  • Tidskriftsartikel (refereegranskat)abstract
    • Psychoanalytic authors have traditionally been skeptical of nomothetic studies, in which group averages obscure the uniqueness of individual cases. Several relational psychoanalytic authors have expressed more pronounced skepticism, affirming, for example, that given the uniqueness of each therapist-patient dyad, systematic empirical research is particularly problematic. In this article we highlight the potential synergy between relational thinking and todays psychotherapy research, by exploring some of the ways in which the work of relational authors has influenced relational psychotherapy research, shifting the focus of study from validation of the models of treatment to the study of the clinical variables such as: countertransference, therapist empathy, self-disclosure, rupture and resolution in therapeutic alliance, intersubjective negotiation, and the patient-therapist attachment relationship. In conclusion, the aim of this article is to facilitate the dialogue between relational psychoanalysis and the field of psychotherapy research, by exploring ways in which these two different worlds can reciprocally stimulate and enrich one another.
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5426.
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5427.
  • Linton, Steven J, 1952-, et al. (författare)
  • Early identification of patients at risk of developing a persistent back problem : The predictive validity of the Örebro musculoskeletal pain questionnaire
  • 2003
  • Ingår i: The Clinical Journal of Pain. - : Ovid Technologies (Wolters Kluwer Health). - 0749-8047 .- 1536-5409. ; 19:2, s. 80-86
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To test the predictive utility of the Orebro Musculoskeletal Pain Screening Questionnaire in identifying patients at risk for developing persistent back pain problems. Design: Prospective, where participants completed the questionnaire and their cases were followed for 6 months to assess outcome with regard to pain, function, and absenteeism due to sickness. Participants: One hundred seven patients, recruited from seven primary care units. Results: Discriminant analyses showed that the items on the questionnaire were significantly related to future problems. For absenteeism due to sickness, 68% of the patients were correctly classified into one of three groups, whereas an even distribution would have produced 33%. The analyses for function correctly classified 81%, and for pain 71%, into one of two groups, compared with a chance level of 50%. A total score analysis demonstrated that a cutoff score of 90 points had a sensitivity of 89% and a specificity of 65% for absenteeism due to sickness, and a sensitivity of 74% and a specificity of 79% for functional ability. Conclusions: The results underscore that psychological variables are related to outcome 6 months later, and they replicate and extend earlier findings indicating that the Örebro Screening Questionnaire is a clinically reliable and valid instrument. The total score was a relatively good predictor of future absenteeism due to sickness as well as function, but not of pain. The results suggest that the instrument could be of value in isolating patients in need of early interventions and may promote the use of appropriate interventions for patients with psychological risk factors.
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5428.
  • Lipsicas, Cendrine Bursztein, et al. (författare)
  • Attempted suicide among immigrants in European countries : an international perspective
  • 2012
  • Ingår i: Social Psychiatry and Psychiatric Epidemiology. - : Springer Science and Business Media LLC. - 0933-7954 .- 1433-9285. ; 47:2, s. 241-251
  • Tidskriftsartikel (refereegranskat)abstract
    • This study compares the frequencies of attempted suicide among immigrants and their hosts, between different immigrant groups, and between immigrants and their countries of origin. The material, 27,048 persons, including 4,160 immigrants, was obtained from the WHO/EURO Multicentre Study on Suicidal Behaviour, the largest available European database, and was collected in a standardised manner from 11 European centres in 1989-2003. Person-based suicide-attempt rates (SARs) were calculated for each group. The larger immigrant groups were studied at each centre and compared across centres. Completed-suicide rates of their countries of origin were compared to the SARs of the immigrant groups using rank correlations. 27 of 56 immigrant groups studied showed significantly higher, and only four groups significantly lower SARs than their hosts. Immigrant groups tended to have similar rates across different centres. Moreover, positive correlation between the immigrant SAR and the country-of-origin suicide rate was found. However, Chileans, Iranians, Moroccans, and Turks displayed high SARs as immigrants despite low suicide rates in the home countries. The similarity of most immigrant groups' SARs across centres, and the correlation with suicidality in the countries of origin suggest a strong continuity that can be interpreted in either cultural or genetic terms. However, the generally higher rates among immigrants compared to host populations and the similarity of the rates of foreign-born and those immigrants who retained the citizenship of their country of origin point to difficulties in the acculturation and integration process. The positive correlation found between attempted and completed suicide rates suggests that the two are related, a fact with strong implications for suicide prevention.
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5429.
  • Lipsicas, Cendrine Bursztein, et al. (författare)
  • Repetition of attempted suicide among immigrants in Europe
  • 2014
  • Ingår i: Canadian journal of psychiatry. - : SAGE Publications. - 0706-7437 .- 1497-0015. ; 59:10, s. 539-547
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: To compare frequencies of suicide attempt repetition in immigrants and local European populations, and the timing of repetition in these groups.METHOD: Data from 7 European countries, comprising 10 574 local and 3032 immigrant subjects, were taken from the World Health Organization European Multicentre Study on Suicidal Behaviour and the ensuing Monitoring Suicidal Behaviour in Europe (commonly referred to as MONSUE) project. The relation between immigrant status and repetition of suicide attempt within 12-months following first registered attempt was analyzed with binary logistic regression, controlling for sex, age, and method of attempt. Timing of repetition was controlled for sex, age, and the recommended type of aftercare.RESULTS: Lower odds of repeating a suicide attempt were found in Eastern European (OR 0.50; 95% CI 0.41 to 0.61, P < 0.001) and non-European immigrants (OR 0.68; 95% CI 0.51 to 0.90, P < 0.05), compared with the locals. Similar patterns were identified in the sex-specific analysis. Eastern European immigrants tended to repeat their attempt much later than locals (OR 0.58; 95% CI 0.35 to 0.93, P < 0.05). In general, 32% of all repetition occurred within 30 days. Repetition tended to decrease with age and was more likely in females using harder methods in their index attempt (OR 1.29; 95% CI 1.08 to 1.54, P < 0.01). Large variations in the general repetition frequency were identified between the collecting centres, thus influencing the results.CONCLUSIONS: The lower repetition frequencies in non-Western immigrants, compared with locals, in Europe stands in contrast to their markedly higher tendency to attempt suicide in general, possibly pointing to situational stress factors related to their suicidal crisis that are less persistent over time. Our findings also raise the possibility that suicide attempters and repeaters constitute only partially overlapping populations.
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5430.
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