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The ability of general practitioners to detect mental disorders in primary health care.

https://arctichealth.org/en/permalink/ahliterature216423
Source
Acta Psychiatr Scand. 1995 Jan;91(1):52-6
Publication Type
Article
Date
Jan-1995
Author
M. Joukamaa
V. Lehtinen
H. Karlsson
Author Affiliation
Department of Psychiatry, University of Turku, Finland.
Source
Acta Psychiatr Scand. 1995 Jan;91(1):52-6
Date
Jan-1995
Language
English
Publication Type
Article
Keywords
Adult
Clinical Competence
Curriculum
Education, Medical, Graduate
Family Practice - education
Female
Finland
Humans
Male
Mental Disorders - diagnosis - psychology - therapy
Patient care team
Primary Health Care
Psychiatry - education
Psychophysiologic Disorders - diagnosis - psychology - therapy
Sampling Studies
Somatoform Disorders - diagnosis - psychology - therapy
Abstract
The ability to detect mental disorders varies greatly among general practitioners in primary health care. The aim of this study was to determine the factors underlying the differences between general practitioners in the ability to recognize mental disorders in Finnish patient populations. The group studied consisted of 1000 randomly selected adult patients of primary care facilities in the city of Turku. The Symptom Checklist (SCL-25) was used as the reference method in the identification of psychiatric cases. According to the SCL-25, one fourth of the sample had mental disorders. A good recognition ability was associated with postgraduate psychiatric training and qualification as a specialist in general practice. Surprisingly, Balint group training, which is a method intended to improve the ability of general practitioners to manage their patients' mental health problems, was associated rather with poor than good detection ability.
Notes
Comment In: Acta Psychiatr Scand. 1995 Oct;92(4):3198848961
PubMed ID
7754788 View in PubMed
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Adaption of pregnancy anxiety questionnaire-revised for all pregnant women regardless of parity: PRAQ-R2.

https://arctichealth.org/en/permalink/ahliterature279025
Source
Arch Womens Ment Health. 2016 Feb;19(1):125-32
Publication Type
Article
Date
Feb-2016
Author
A C Huizink
M J Delforterie
N M Scheinin
M. Tolvanen
L. Karlsson
H. Karlsson
Source
Arch Womens Ment Health. 2016 Feb;19(1):125-32
Date
Feb-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Anxiety - diagnosis - psychology
Anxiety Disorders - diagnosis - psychology
Delivery, Obstetric - methods
Female
Finland
Humans
Longitudinal Studies
Parity
Parturition
Predictive value of tests
Pregnancy
Pregnant Women - psychology
Psychometrics - instrumentation
Reproducibility of Results
Surveys and Questionnaires - standards
Abstract
The 10-item Pregnancy-Related Anxiety Questionnaire-Revised (PRAQ-R) is a widely used instrument to assess and identify pregnancy-specific anxiety in nulliparous women. It has good psychometric values and predictive validity for birth and childhood outcomes. Nonetheless, the PRAQ-R is not designed for use in parous women, as particularly one item of the questionnaire is not relevant for women who gave birth before. We tested the factorial and scalar invariance of a modified PRAQ-R2 across nulliparous and parous women with an adapted item to fit both groups of pregnant women. A longitudinal study among 1144 pregnant women (n = 608 nulliparous and n = 536 parous) with two repeated measures of the PRAQ-R2 was used to test for measurement invariance of the instrument. Results show metric and scalar invariance, indicating that the PRAQ-R2 measures similar constructs on the same scale for all pregnant women at two different times during pregnancy. We conclude that the PRAQ-R2 can be used, compared, or combined in a sample of nulliparous and parous women.
Notes
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Cites: J Child Psychol Psychiatry. 2003 Sep;44(6):810-812959490
PubMed ID
25971851 View in PubMed
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Alexithymia and psychological distress among frequent attendance patients in health care.

https://arctichealth.org/en/permalink/ahliterature213347
Source
Psychother Psychosom. 1996;65(4):199-202
Publication Type
Article
Date
1996
Author
M. Joukamaa
H. Karlsson
B. Sholman
V. Lehtinen
Author Affiliation
Department of Psychiatry, University of Turku, Finland.
Source
Psychother Psychosom. 1996;65(4):199-202
Date
1996
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Affective Symptoms - epidemiology - psychology
Causality
Chi-Square Distribution
Comorbidity
Female
Finland - epidemiology
Humans
Logistic Models
Male
Middle Aged
Primary Health Care - statistics & numerical data
Sampling Studies
Stress, Psychological - epidemiology
Abstract
The aim of the present study was to find out whether alexithymia is common in frequently attending primary health care patients and whether alexithymia and psychological distress are associated in these patients.
Alexithymia was measured by the TAS-26 and psychological distress by the SCL-25 in a random sample of 394 working-age primary health care patients. Frequent attendance was defined as a minimum of 11 visits during 1 year to different kinds of outpatient health care services, excluding specialized psychiatric care.
Frequently attending patients with psychological distress were found to be alexithymic more commonly than other patients, but this was not the case with other frequently attending patients. In other words, frequent attendance and alexithymia had an association mediated by psychological distress.
There is a subgroup of frequently attending patients, who are alexithymic and have psychological distress, too. They usually visit health-care services because of a somatic complaint. We hypothesize that their expression of psychological distress was masked and somatized just because of alexithymia.
PubMed ID
8843500 View in PubMed
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[Bias and discussion on nuclear power problems].

https://arctichealth.org/en/permalink/ahliterature245947
Source
Vardfacket. 1980 Mar 6;4(5):71
Publication Type
Article
Date
Mar-6-1980
Author
H. Karlsson
Source
Vardfacket. 1980 Mar 6;4(5):71
Date
Mar-6-1980
Language
Swedish
Publication Type
Article
Keywords
Humans
Nuclear Reactors
Power Plants
Radiation Protection
Sweden
PubMed ID
6899696 View in PubMed
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Comparison of clinical and best-estimate research DSM-IV diagnoses in a Finnish sample of first-admission psychosis and severe affective disorder.

https://arctichealth.org/en/permalink/ahliterature191872
Source
Nord J Psychiatry. 2001;55(2):107-11
Publication Type
Article
Date
2001
Author
T. Taiminen
K. Ranta
H. Karlsson
H. Lauerma
K M Leinonen
E. Wallenius
A. Kaljonen
R K Salokangas
Author Affiliation
Department of Psychiatry, University of Turku, Rakennus 9, III kerros, Kunnallissairaalantie 20, FI-20700 Turku, Finland.
Source
Nord J Psychiatry. 2001;55(2):107-11
Date
2001
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Bipolar Disorder - complications - diagnosis - epidemiology
Female
Finland - epidemiology
Hospitalization
Hospitals, Psychiatric
Humans
Male
Middle Aged
Mood Disorders - diagnosis - epidemiology
Patient Admission - statistics & numerical data
Predictive value of tests
Psychiatric Status Rating Scales
Psychotic Disorders - epidemiology - etiology - rehabilitation
Schizophrenia - complications - diagnosis - epidemiology
Severity of Illness Index
Abstract
The purpose of this study was to investigate diagnostic agreement between clinicians and a research group in a sample of first-admission psychosis and severe affective disorder patients. Clinical DSM-IV discharge diagnoses and best-estimate DSM-IV research diagnoses were compared in 116 first-episode patients in the city of Turku, Finland. The best-estimate research diagnoses were made at consensus meetings by integrating longitudinal data; patients' medical records; and findings of a clinical interview, the structured SCAN-interview, and symptom severity ratings. Overall diagnostic agreement was moderate, with a kappa value 0.51 (95% confidence interval (CI), 0.39- 0.63). Of the diagnostic groups, schizophrenic disorders had the lowest kappa value of 0.44 (95% CI, 0.26-0.63). Clinicians had a tendency to miss depressive symptoms in psychotic patients; to overdiagnose psychotic symptoms in depressive patients; and to fail to discover earlier hypomanic or depressive episodes in depressive patients. In conclusion, hospital diagnoses were not reliable in first-episode patients. Inappropriate diagnoses may compromise both treatment and epidemiologic findings based on discharge diagnoses.
PubMed ID
11802907 View in PubMed
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Differences between patients with identified and not identified psychiatric disorders in primary care.

https://arctichealth.org/en/permalink/ahliterature196476
Source
Acta Psychiatr Scand. 2000 Nov;102(5):354-8
Publication Type
Article
Date
Nov-2000
Author
H. Karlsson
M. Joukamaa
V. Lehtinen
Author Affiliation
University of Turku, Department of Psychiatry, Finland.
Source
Acta Psychiatr Scand. 2000 Nov;102(5):354-8
Date
Nov-2000
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Diagnosis, Differential
Diagnostic Errors - statistics & numerical data
Education
Family Practice - statistics & numerical data
Female
Finland - epidemiology
Humans
Male
Mass Screening
Mental Disorders - diagnosis - epidemiology
Middle Aged
Psychiatric Status Rating Scales
Risk factors
Sampling Studies
Severity of Illness Index
Socioeconomic Factors
Abstract
The aim of this study was to discover the differences between the primary care patients with a psychiatric disorder whose illness was detected and the patients whose disorder was not detected.
We collected 1000 randomly selected PC patients. We used SCL-25 as a screening method and PSE as a diagnostic tool.
Ninety-one (89.2%) of the interviewed patients received a psychiatric diagnosis. The physicians detected a disorder in 36 (36.9%). A larger part of the undetected group belonged to the highest social groups. Also the SCL-25 mean scores differed significantly, indicating that the symptoms of the undetected cases were milder. The detected cases had higher levels of anxiety and depression, but the difference in anxiety symptoms was greater between the groups. Detection was associated with treatment.
The GPs should also be aware of psychiatric morbidity in patients with a higher social status, a good level of education and milder symptoms.
PubMed ID
11098807 View in PubMed
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Factors predicting readmissions in personality disorders and other nonpsychotic illnesses. A retrospective study on 64 first-ever admissions to the Psychiatric Clinic of Turku, Finland.

https://arctichealth.org/en/permalink/ahliterature214678
Source
Acta Psychiatr Scand. 1995 Aug;92(2):138-44
Publication Type
Article
Date
Aug-1995
Author
J A Korkeila
H. Karlsson
H. Kujari
Author Affiliation
Psychiatric Clinic, Turku City Hospital, Department of Psychiatry, University of Turku, Finland.
Source
Acta Psychiatr Scand. 1995 Aug;92(2):138-44
Date
Aug-1995
Language
English
Publication Type
Article
Keywords
Chronic Disease
Cohort Studies
Combined Modality Therapy
Cross-Sectional Studies
Female
Finland - epidemiology
Hospitals, Psychiatric - utilization
Humans
Incidence
Male
Mental Disorders - epidemiology - psychology - therapy
Patient Readmission - statistics & numerical data
Personality Disorders - epidemiology - psychology - therapy
Psychotherapy
Psychotropic Drugs - therapeutic use
Retrospective Studies
Treatment Outcome
Abstract
A retrospective study of factors predicting readmissions and follow-up treatment was undertaken of all first-ever episodes of inpatient care (age under 65), excluding psychotic and organic mental disorders, during 1987 and 1988 in University Psychiatric Clinic in Turku City Hospital, Finland. The cohort consisted of 64 subjects, 24 men and 40 women. The study was carried out in the end of 1993, thus allowing about 5 years of follow-up. The diagnosis of personality disorder did not predict readmission. The only factor predicting readmission nearly significantly was not having a relationship. The incidence of the revolving door syndrome, defined as 4 or more admissions within 5 years, was 12.5%. Women had a greater risk of readmission, but not that of the revolving door. Patients who had psychotherapy as follow-up treatment showed a frequency of 8% for 4 or more admissions, whereas patients who had no follow-up treatment had a frequency of 21% for 4 or more readmissions. The only factor significantly predicting follow-up treatment arrangement was previous treatment contact.
PubMed ID
7572260 View in PubMed
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[Five new antiepileptic agents approved during the 1990's--an observation study on the utilization of the new preparations in routine clinical practice].

https://arctichealth.org/en/permalink/ahliterature198299
Source
Lakartidningen. 2000 May 3;97(18):2208-10, 2213-4
Publication Type
Article
Date
May-3-2000
Author
H. Karlsson
C. Lagerstedt
Author Affiliation
Blekingesjukhuset, Karlshamn. harald.karlsson@ltblekinge.se
Source
Lakartidningen. 2000 May 3;97(18):2208-10, 2213-4
Date
May-3-2000
Language
Swedish
Publication Type
Article
Keywords
Adult
Anticonvulsants - administration & dosage - adverse effects - economics
Cost of Illness
Drug Approval
Drug Costs
Drug Utilization - statistics & numerical data
Epilepsy - diagnosis - drug therapy - economics
Epilepsy, Generalized - drug therapy
Female
Humans
Male
Middle Aged
Physician's Practice Patterns - statistics & numerical data
Retrospective Studies
Sweden
Abstract
Since 1990, five new antiepileptic drugs have been approved in Sweden for add-on therapy of partial epilepsy. The optimal use of these drugs has not yet been established. In a county general hospital, 75 of 382 adult patients with epilepsy were treated with newer antiepileptic drugs. Fifty-two continued treatment with a newer drug for one year or longer mainly because of improved seizure control. The newer drugs represented 18 per cent of total sales of antiepileptic drugs in the area served by the hospital but the corresponding cost was 70 per cent. Despite their higher price, use of the newer drugs seems justifiable when significant improvement of seizure control can be achieved.
PubMed ID
10850051 View in PubMed
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Frequent attender profiles: different clinical subgroups among frequent attender patients in primary care.

https://arctichealth.org/en/permalink/ahliterature209392
Source
J Psychosom Res. 1997 Feb;42(2):157-66
Publication Type
Article
Date
Feb-1997
Author
H. Karlsson
M. Joukamaa
I. Lahti
V. Lehtinen
T. Kokki-Saarinen
Author Affiliation
Department of Psychiatry, University of Turku, Finland.
Source
J Psychosom Res. 1997 Feb;42(2):157-66
Date
Feb-1997
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Female
Finland
Health Services Misuse
Humans
Male
Mental Disorders - diagnosis - psychology
Middle Aged
Patient care team
Personality Assessment
Primary Health Care
Psychophysiologic Disorders - diagnosis - psychology
Somatoform Disorders - diagnosis - psychology
Abstract
Psychiatric and physical morbidity among frequently attending patients in primary care is high. However, very few efforts have been made to sort out the complex patterns of problems these patients have. We developed a clinical grouping of these patients. Our sample consisted of 67 frequent attenders. The measures included physical and psychiatric illnesses, presenting symptoms, sociodemographic data, psychosocial situation, level of distress, global functioning, experienced life satisfaction, illness attribution, and current psychiatric treatment. We identified five groups with different profiles: (1) patients with entirely physical illnesses; (2) patients with clear psychiatric illnesses; (3) crisis patients; (4) chronically somatizing patients; and (5) patients with multiple problems. The grouping was based on multidimensional operational criteria. The majority in all groups attended for solely physical illnesses or symptoms suggesting different forms of somatization. Only a few patients were undergoing any psychiatric treatment. Differences between groups were found regarding sociodemographic factors, physical illnesses, global functioning, and satisfaction.
PubMed ID
9076643 View in PubMed
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Frequent attenders of Finnish public primary health care: sociodemographic characteristics and physical morbidity.

https://arctichealth.org/en/permalink/ahliterature216772
Source
Fam Pract. 1994 Dec;11(4):424-30
Publication Type
Article
Date
Dec-1994
Author
H. Karlsson
V. Lehtinen
M. Joukamaa
Author Affiliation
Department of Psychiatry, University of Turku, Finland.
Source
Fam Pract. 1994 Dec;11(4):424-30
Date
Dec-1994
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Bone Diseases - epidemiology
Demography
Disabled persons - statistics & numerical data
Educational Status
Female
Finland - epidemiology
Humans
Male
Mental Disorders - epidemiology
Middle Aged
Morbidity
Muscular Diseases - epidemiology
Primary Health Care - statistics & numerical data - utilization
Public Health - statistics & numerical data
Social Class
Socioeconomic Factors
Vocational Education - statistics & numerical data
Abstract
In this article results of a Finnish study on frequent attender patients of public primary health care are reported. These patients (n = 96) were compared with other patients (n = 466) attending the same surgeries. Frequent attender patients tended to have lower vocational training and to belong to lower social groups than other patients. The frequent attender patients also had more physical diseases, were more often on disability pension and had more mixed (physical-psychiatric) complaints than the control patients. The results indicate that many frequent attender patients complaints form a complicated network departing from different levels (physical, psychological and social). The implications of the findings are discussed.
Notes
Comment In: Fam Pract. 1995 Sep;12(3):3708536844
PubMed ID
7895972 View in PubMed
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23 records – page 1 of 3.