| 1. |
- Forsman, Anna K., et al.
(författare)
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Contribution of the Nordic School of Public Health to the public mental health research field : a selection of research initiatives, 2007-2014
- 2015
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 43, s. 66-72
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Tidskriftsartikel (refereegranskat)abstract
- The field of public mental health has been defined by an expert group convened by the Nordic School of Public Health (NHV) as encompassing the experience, occurrence, distribution and trajectories of positive mental health and mental health problems and their determinants; mental health promotion and prevention of mental disorders; as well as mental health system policies, governance and organization. The mental health priorities of the Nordic Council of Ministers in 2010 signalled a mutual Nordic exchange of knowledge in the following thematic areas: child and adolescent mental health; working life and mental health; mental health in older people; strengthening the role of primary care in mental health service provision; stronger involvement of users and carers; and reduction of use of coercion in psychiatric care. Efforts to realize these priorities included commissioning the Nordic Research Academy for Mental Health, an NHV-based network of research institutions with a common interest in mental health research across the Nordic countries, to develop, organize and follow-up projects on public mental health. The research initiatives included mental health policy analysis, register-based research and research focused on the users' perspective in a Nordic context, as well as EU-level research policy analysis. The public mental health research conducted at the NHV highlighted the complexity of mental health and emphasized that the broad determinants of mental health need to be increasingly addressed in both public health research and practice. For example, health promotion actions, improved access to health care, a healthy alcohol policy and prevention of suicides and violence are all needed to reduce the life expectancy gap - a red flag indicator of public health inequalities. By exchanging knowledge and best practice, the collaboration between the Nordic countries contributes to the welfare of the region. The expertise and traditions developed at the NHV are of significant importance in this work.
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| 2. |
- Forsman, Anna K, et al.
(författare)
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Research priorities for public mental health in Europe: recommendations of the ROAMER project.
- 2015
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Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 25:2, s. 249-254
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Tidskriftsartikel (refereegranskat)abstract
- The ROAdmap for MEntal health Research in Europe project aimed to create an integrated European roadmap for mental health research. Leading mental health research experts across Europe have formulated consensus-based recommendations for future research within the public mental health field.
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| 3. |
- Laursen, Thomas Munk, et al.
(författare)
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Life expectancy and death by diseases of the circulatory system in patients with bipolar disorder or schizophrenia in the Nordic countries.
- 2013
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 8:6
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Excess mortality from diseases and medical conditions (natural death) in persons with psychiatric disorders has been extensively reported. Even in the Nordic countries with well-developed welfare systems, register based studies find evidence of an excess mortality. In recent years, cardiac mortality and death by diseases of the circulatory system has seen a decline in all the Nordic countries, but a recent paper indicates that women and men in Denmark, Finland, and Sweden, who had been hospitalised for a psychotic disorder, had a two to three-fold increased risk of dying from a cardiovascular disease. The aim of this study was to compare the mortality by diseases of the circulatory system among patients with bipolar disorder or schizophrenia in the three Nordic countries Denmark, Sweden, and Finland. Furthermore, the aim was to examine and compare life expectancy among these patients. Cause specific Standardized Mortality Rates (SMRs) were calculated for each specific subgroup of mortality. Life expectancy was calculated using Wiesler's method.RESULTS: The SMR for bipolar disorder for diseases of the circulatory system was approximately 2 in all countries and both sexes. SMR was slightly higher for people with schizophrenia for both genders and in all countries, except for men in Denmark. Overall life expectancy was much lower among persons with bipolar disorder or schizophrenia, with life expectancy being from 11 to 20 years shorter.CONCLUSION: Our data show that persons in the Nordic countries with schizophrenia or bipolar disorder have a substantially reduced life expectancy. An evaluation of the reasons for these increased mortality rates should be prioritized when planning healthcare in the coming years.
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| 5. |
- Nordentoft, Merete, et al.
(författare)
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Excess mortality, causes of death and life expectancy in 270,770 patients with recent onset of mental disorders in Denmark, Finland and Sweden.
- 2013
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Excess mortality among patients with severe mental disorders has not previously been investigated in detail in large complete national populations.OBJECTIVE: To investigate the excess mortality in different diagnostic categories due to suicide and other external causes of death, and due to specific causes in connection with diseases and medical conditions.METHODS: In longitudinal national psychiatric case registers from Denmark, Finland, and Sweden, a cohort of 270,770 recent-onset patients, who at least once during the period 2000 to 2006 were admitted due to a psychiatric disorder, were followed until death or the end of 2006. They were followed for 912,279 person years, and 28,088 deaths were analyzed. Life expectancy and standardized cause-specific mortality rates were estimated in each diagnostic group in all three countries.RESULTS: The life expectancy was generally approximately 15 years shorter for women and 20 years shorter for men, compared to the general population. Mortality due to diseases and medical conditions was increased two- to three-fold, while excess mortality from external causes ranged from three- to 77-fold. Mortality due to diseases and medical conditions was generally lowest in patients with affective disorders and highest in patients with substance abuse and personality disorders, while mortality due to suicide was highest in patients with affective disorders and personality disorders, and mortality due to other external causes was highest in patients with substance abuse.CONCLUSIONS: These alarming figures call for action in order to prevent the high mortality.
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| 6. |
- Pihkala, Heljä, 1961-
(författare)
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Beardslees preventiva familjeintervention för barn till föräldrar med psykisk sjukdom. Svenska familjers erfarenheter
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- It has been known for many years that the children of parents with mental illness run a high risk of developing psychiatric and other problems both during their childhood and later in adulthood. Meeting and providing support for the patients’ children has, however, been a neglected area in adult psychiatry until today. Recent supplementary legislation in the Nordic countries obligates the professionals in health services to take account of the needs for information and support of the children and their families when a parent suffers from a serious illness. Beardslee’s preventive family intervention (FI) is the first family-based and structured method used in psychiatric services in Sweden. The method has some evidence of positive long-term effects for the children and families with parental depression. The purpose of this thesis was to investigate the FIs safety and feasibility in Sweden (paper I), its’ perceived impact for the families (papers I, III and IV) and also to examine the process of the FI from the perspective of the ill parent, the other parent and the children (papers II, III and IV). The studies were conducted in naturalistic settings. The data in paper I was collected by using a questionnaire to parents and children (117 parents and 89 children responded) one month after an FI. Paper II comprises interviews with ten parents, suffering from depression, about their decision process for participation in an FI. In papers III and IV the data from 25 interviews with parents and 14 interviews with children about the experiences of the FI is presented. Seventy five professionals from 29 psychiatric units had conducted the FIs for the families that participated in the studies. The data was analyzed by descriptive statistics and chi2 (I), Grounded theory (II and III) and Qualitative content analysis (IV). The results in paper I showed that the overall satisfaction with the FI was high for both parents and children. Ninety three percent of the answers from parents to questions concerning the satisfaction with the FI were positive, and 71 % of the answers from the children. The reported perceived impact of the FI was also predominantly positive. Feelings of guilt decreased for 89 % of the children who had had feelings of guilt towards the parent prior to the FI. Knowledge about the parent’s illness was perceived to increase for 74 % of the children. There were a few negative answers about the impact of FI from the children; five children experienced increased concerns about the parent and three children reported a lower level of well-being after the FI. In paper II the interviews with the depressed parents revealed ambivalence in the decision to participate in an FI. The parents longed for knowing how their children were feeling, how they thought about the illness and if it had harmed them. On the other hand, the parents were anxious about hearing the answers to their questions, as feelings of shame and guilt were associated with these. Exposure to outside opinion was also both relieving and scaring. The examination of the parents’ experiences continued in paper III. The process of opening up the dialogue about the illness with the children was demanding. To listen to the children’s experiences, to find the words to speak about the illness to the children and finally to be able to start to talk about it in the family session required a solid base of confidence and security in the professionals and in the method. The FI as a method seemed to provide favorable conditions for an establishment of an alliance with the parents. The children’s experiences of the FI are presented in paper IV. Most of the children described a sense of relief because of better knowledge about the parent’s illness and increased communication in the family and thus they also felt released from some worry for the parent. They could spend more time with their friends and did not need to take so much responsibility at home. Parents and children in the same families described the changes in similar ways, indicating mutual understanding in the families. The parents experienced themselves as stronger in their roles as parents and less ashamed. In summary, the families are satisfied with their participation in FI, they report a positive impact and the number of perceived negative effects is low. The children describe a sense of relief from concerns about the parent’s illness.
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| 9. |
- Westman, Jeanette, et al.
(författare)
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Cardiovascular mortality in bipolar disorder: a population-based cohort study in Sweden
- 2013
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 3:4, s. 002373-002373
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Tidskriftsartikel (refereegranskat)abstract
- Objective To estimate the cardiovascular mortality among persons with bipolar disorder in Sweden compared to the general population. Design Population register-based cohort study with a 20-year follow-up. Setting Sweden. Participants The entire population of Sweden (n=10.6 million) of whom 17101 persons were diagnosed with bipolar disorder between 1987 and 2006. Main outcome measures Mortality rate ratios (MRR), excess mortality (excess deaths), cardiovascular disorder (CVD) and specifically cerebrovascular disease, coronary heart disease, acute myocardial infarction, sudden cardiac deaths and hospital admission rate ratio (ARR). Results Persons with bipolar disorder died of CVD approximately 10years earlier than the general population. One third (38%) of all deaths in persons with bipolar disorder were caused by CVD and almost half (44%) by other somatic diseases, whereas suicide and other external causes accounted for less than a fifth of all deaths (18%). Excess mortality of both CVD (n=824) and other somatic diseases (n=988) was higher than that of suicide and other external causes (n=675 deaths). MRRs for cerebrovascular disease, coronary heart disease and acute myocardial infarction were twice as high in persons with bipolar disorder compared to the general population. Despite the increased mortality of CVD, hospital admissions (ARR) for CVD treatment were only slightly increased in persons with bipolar disorder when compared to the general population. Conclusions The increased cardiovascular mortality in persons with bipolar disorder calls for renewed efforts to prevent and treat somatic diseases in this group. Specifically, our findings further imply that it would be critical to ensure that persons with bipolar disorder receive the same quality care for CVD as persons without bipolar disorder.
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