Skip header and navigation

2 records – page 1 of 1.

Complaints of poststroke insomnia and its treatment with mianserin.

https://arctichealth.org/en/permalink/ahliterature187264
Source
Cerebrovasc Dis. 2003;15(1-2):56-62
Publication Type
Article
Date
2003
Author
Heikki Palomäki
Anu Berg
Esa Meririnne
Markku Kaste
Riitta Lönnqvist
Matti Lehtihalmes
Jouko Lönnqvist
Author Affiliation
Department of Neurology, University of Helsinki, Helsinki, Finland. heikki.palomaki@hus.fi
Source
Cerebrovasc Dis. 2003;15(1-2):56-62
Date
2003
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Antidepressive Agents, Second-Generation - therapeutic use
Depression - epidemiology - etiology - therapy
Dose-Response Relationship, Drug
Double-Blind Method
Female
Finland - epidemiology
Follow-Up Studies
Humans
Male
Mianserin - therapeutic use
Middle Aged
Patient satisfaction
Predictive value of tests
Prevalence
Quality of Life
Risk factors
Severity of Illness Index
Sex Factors
Sleep Initiation and Maintenance Disorders - epidemiology - etiology - therapy
Statistics as Topic
Stroke - complications - epidemiology - therapy
Time Factors
Treatment Outcome
Abstract
We assessed the prevalence and associations of symptoms of insomnia in patients with acute ischemic stroke, and evaluated whether mianserin as a sedative antidepressant is beneficial in the treatment of poststroke insomnia. One hundred consecutively hospitalized patients were randomized to receive 60 mg/day of mianserin (n = 51) or placebo for 1 year in a double-blind trial with a 6-month follow-up after the therapy. Symptoms of insomnia were assessed with the three insomnia-related items of the Hamilton Depression Scale; patients were defined as insomniacs if any of these items was positive. Complaints of insomnia occurred in 68% of patients on admission, and in 49% at 18 months, and they were as frequent in all subgroups of patients. From 2 months, symptoms of insomnia were associated independently with depression. Living alone before stroke (at 0 and 2 months) and age (at 12 months) were other independent predictors of insomnia. The rate of recovery as evaluated by the insomnia score was more rapid in patients on mianserin than in those on placebo. At 2 months, the scores were significantly different favoring mianserin treatment (1.3 vs. 0.8, p = 0.02). We conclude that insomnia is a common complaint after ischemic stroke. Mianserin had a beneficial influence on the recovery from symptoms of insomnia, even though the intensity of poststroke depression was low.
PubMed ID
12499712 View in PubMed
Less detail

Physicians' experiences with sickness absence certification in Finland.

https://arctichealth.org/en/permalink/ahliterature309769
Source
Scand J Public Health. 2019 Dec; 47(8):859-866
Publication Type
Journal Article
Date
Dec-2019
Author
Katariina Hinkka
Mikko Niemelä
Ilona Autti-Rämö
Heikki Palomäki
Author Affiliation
Research Department, Social Insurance Institution of Finland, Turku, Finland.
Source
Scand J Public Health. 2019 Dec; 47(8):859-866
Date
Dec-2019
Language
English
Publication Type
Journal Article
Keywords
Attitude of Health Personnel
Certification
Finland
Humans
Physicians - psychology - statistics & numerical data
Sick Leave
Surveys and Questionnaires
Work Capacity Evaluation
Abstract
Aims: The aim of this study was to explore Finnish physicians' perceptions of sickness absence (SA) certification. Methods: A questionnaire was sent to 50% of the physicians in Finland who provide care to working-age patients in a clinical practice setting. Of the 8867 physicians, 3089 responded. Physicians handling SA certification patients at least a few times per month were included (n = 2472). Results: At least a few times per month, 61% of all physicians perceived SA issues as problematic, 60% had experienced a lack of time in dealing with SA matters, 36% had disagreed with a patient on SA certification, and 36% had met a patient who wanted a SA certificate for reasons other than a disease or injury. Physicians were least worried about patients filing complaints (4%), exhibiting threatening behaviour (2%), or switching physicians for SA certification reasons (1%). A total of 60% of physicians had prescribed SA for a longer period than necessary because of long waiting times for further care/measures. Non-specialized physicians, general practitioners, and psychiatrists experienced problems more frequently than surgeons and occupational health physicians. Over 50% of the respondents had a fairly large or very large need to deepen their knowledge of social insurance matters. The need for national guidelines for all or some diseases was reported by 80% of the respondents. Conclusions: Many physicians perceive SA tasks as problematic and are unable to dedicate enough time to them. Shortcomings in physicians' sickness certification know-how, as well as obstacles in the healthcare and rehabilitation system, prolong the SA process. Attitudes towards the adoption of national guidelines on the duration of SA were positive.
PubMed ID
29485317 View in PubMed
Less detail