| 1. |
- Paulson-Karlsson, Gunilla, et al.
(författare)
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A pilot study of a family-based treatment for adolescent anorexia nervosa: 18- and 36-month follow-ups.
- 2009
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Ingår i: Eating disorders. - : Informa UK Limited. - 1532-530X .- 1064-0266. ; 17:1, s. 72-88
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Tidskriftsartikel (refereegranskat)abstract
- The current study evaluated the outcome of family-based treatment for female adolescents with anorexia nervosa (N = 32), at the Anorexia-Bulimia Outpatient Unit in Göteborg, Sweden. Patients/parents were assessed pre-treatment, at 18- and 36-month follow-ups concerning eating disorder symptoms, general psychopathology, family climate and BMI. At the 36-month follow-up, 75% of the patients were in full remission with reduction in eating disorder symptoms and internalizing problems and they experienced a less distant and chaotic atmosphere in their families. These results show that family-based treatment appears to be effective in adolescent anorexia nervosa patients regarding areas examined in this study.
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| 2. |
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| 3. |
- Engström, Ingemar
(författare)
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Adolescents' perception of coercive treatment : conclusions and clinical implications
- 2007
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Ingår i: BMC Psychiatry. - 1471-244X. ; 7:Suppl 1, s. S108-
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe aim of the study was to describe how involuntarily and voluntarily admitted adolescents talk about their experiences from child and adolescent psychiatric care with special focus on coercion, participation and dialogue. MethodsTwenty-one adolescents, ten involuntarily and eleven voluntarily admitted, were interviewed in-depth. The transcriptions were analyzed based on theories on participation and human dialogue. ResultsThe adolescents' experiences of coercion show a wide variation that didn't correspond very well with the formal situation. Coercion was experienced in many ways and was also valued quite differently with respect to the impact of the treatment in their lives. The adolescents' experience of participation in the planning of the treatment was very sparse. The requirements for participation of patients in Swedish law were seldom met, according to the adolescents. The adolescents' experiences of dialogue with the staff also varied considerably. Examples will be given from different experiences during the presentation. Conclusion Coercion is, from a subjective perspective, a concept with many meanings. The correspondence between formal coercion and experienced coercion is quite weak. Adolescents seldom feel genuinely engaged in the planning of their own treatment, despite legal requirements. Trustful and reciprocal relations were sometimes to be found in their stories. This seems difficult, but not impossible, to reach even under coercive circumstances.
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| 4. |
- Engström, Ingemar
(författare)
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Apathetic children : a phenomenological interpretation of a psychiatric epidemic in Sweden
- 2008
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Konferensbidrag (refereegranskat)abstract
- Purpose: Since 2001, over four hundred children and adolescents in Sweden, who all have been asylum seekers, have developed a psychiatric syndrome with more or less complete loss of mental and physical functions. These children have been called “apathetic”. This epidemic has led to considerable interest, both in Sweden and abroad. The media debate about this epidemic has mostly centred on the possibilities of simulation or parental forcing of their children. The psychiatric debate has centred mostly on different diagnostic possibilities. There has also been an extensive ethical debate both among professionals and on the public arena. Not much interest has been paid to the syndrome from a phenomenological perspective.Method: I will in this paper present the key case that I was summoned by the Swedish government to examine. This is the case of Makram, 11 years of age, who had been in an almost persistent apathetic state since one and a half year. The case will be interpreted using thoughts from Karl Jaspers and Martin Heidegger.Results: The life experience of Makram will be discussed in terms of a total withdrawal from the world, which is interpreted as a solution to lift off an all too heavy burden within the family. The process into apathy will be discussed in relation to psychiatric and philosophical concepts like withdrawal and stupor. My discussion will centre on possible interpretations from a phenomenological perspective based on interviews with patients.Conclusion: The key interpretation will be that this is a syndrome characterized by a withdrawal from being in the communal world and stay in a private world until circumstances have changed enough to elicit a longing for coming back to the real world.
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| 8. |
- Engström, Ingemar
(författare)
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Justifications of coercion : are decisions of coercive care psychiatric or ethical?
- 2008
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Konferensbidrag (refereegranskat)abstract
- Questions on coercion in psychiatric care have long been controversial themes for psychiatry. Health care is usually based on the patient’s wish for help whereas psychiatric care to a large extent is based on the decisions of others, first and foremost by psychiatrists. Due to the reduction of beds in psychiatric care, an increasing proportion of beds are used for committed patients. This makes the questions even more relevant, despite a decrease in absolute numbers.The legal prerequisites for coercive care are based only on psychiatric criteria, which points to a notion of fact-based rationality, whereas ethical reasons for coercion at best may be implicit. This paper is based on an ongoing study of coercive care in child and adolescent psychiatry, where the files and the certificates for all committed patients during one year in Sweden are analyzed with respect to given reasons for decisions of coercive care. The core question is whether ethical reasons are present and if so, what ethical values are judged to be at risk in different clinical situations.This paper advocates a stronger emphasis on ethical questions in discussions of the use of coercion in psychiatry. We advocate an open discussion of which fundamental values may be at stake in such instances and the ethical reasons involved in making these judgments. The need for a transparent deliberative process involving all parties to the coercion is emphasized.
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| 9. |
- Engström, Ingemar
(författare)
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Människa och läkare
- 2008
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Ingår i: Svensk psykiatri. - Sundsvall : Svenska psykiatriska föreningen (SPF). - 1653-8579. ; :4, s. 37-37
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Tidskriftsartikel (populärvet., debatt m.m.)
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