Bakgrund: Forskning visar att personer som är inneliggande på psykiatrisk heldygnsvård ofta upplever en brist på aktiviteter. Tillgången till aktiviteter är en viktig del för människans välbefinnande och skapar förutsättningar för att kunna vara delaktig i samhället. Syfte: Att beskriva arbetsterapeuters upplevelser om behovet av att använda aktiviteter inom psykiatrisk heldygnsvård, och vid behov; vilken typ av aktiviteter? Metod: En kvalitativ, fenomenologisk ansats användes. Urvalet skedde på flera sätt - både avsiktligt och maximalt varierat, samtidigt med snöbollsurval. Den transkriberade datan bearbetades och en kvalitativ innehållsanalys utfördes, vilket resulterade i tre huvudkategorier och tio underkategorier. Resultat: Totalt tio informanter deltog i studien och resultatet utmynnade i huvudkategorierna Aktiviteters betydelse, Aktivitetsanvändning och Resurser. Det ansågs finnas ett behov av aktiviteter inom den psykiatriska heldygnsvården. Aktiviteterna upplevs minska psykiatriska symtom och förkorta rehabiliteringsprocessen. Det är viktigt att aktiviteterna upplevs meningsfulla för patienterna. Arbetsterapeuterna upplever ofta att det är svårt att få tiden att räcka till i deras yrkesroll vilket påverkat möjligheterna till att använda aktiviteter i behandlande syfte. Slutsatser: Tillgången till aktiviteter är viktigt även inom psykiatrisk heldygnsvård, då aktiviteter har en betydande roll i rehabiliteringsprocessen. / Background: Research shows that psychiatric inpatients often experience a lack of activities. To have access to activities is important since it enhances well-being and creates conditions for participation in the society. Purpose: To describe occupational therapists experiences about the need to use activities in psychiatric inpatient care, and if needed; which type of activities? Method: A qualitative, phenomenological approach was used. The sample was conducted in several ways - purposive and maximal variety, together with snowballing. The transcribed collected data was analyzed, and a qualitative content analysis was performed, which resulted in three main categories and ten sub categories. Results: Ten informants participated in the study and the results culminated in the main categories “The meaning of activities”, “Activity usage” and “Resources”. It was considered there is a need of activities in psychiatric inpatient care. Activities were perceived to reduce psychiatric symptoms and to shorten the rehabilitation process. It is however important that the activities are meaningful for the patients. The experience often is that there is a lack of time in their professional role which has affected the possibilities to use activities in treatment purposes. Conclusions: To have access to activities is important in psychiatric inpatient care, since activities has a meaningful role in the rehabilitation process.

This study seeks to investigate the attitudes towards mental illness in Sweden in comparison with India. To measure attitudes towards people with mental illness the questionnaire Community Attitudes Towards Mental Illness (CAMI) was used containing positive and negative statements regarding mental illness. These statements are divided into the four attitude categories of Authoritarianism, Benevolence, Social Restrictiveness and Community Mental Health Ideology. The questionnaire study consisted of a total of 410 students; 272 from Sweden and 138 from India. Sweden and India were chosen because of their differences based on factors that recent studies have shown affect a community’s attitudes towards mental illness; socio-economic, religion and culture. The results show that there is a difference in attitudes between the two countries in three out of the four attitude categories, where India showed a more positive attitude than Sweden towards mental illness meaning they have a greater sense of authoritative approach, goodwill, and social inclusion. This result was expected in the sense that there was a significant difference between the countries but not in the sense that India was to be the country to have a more positive attitude than Sweden since it goes against what previous research indicated. / Följande studie söker att undersöka attityderna gentemot psykisk ohälsa i Sverige i jämförelse med Indien. För att mäta attityderna gentemot personer med psykisk ohälsa användes frågeformuläret Community Attitudes Towards Mental Illness (CAMI) innehållandes positiva samt negativa påståenden inom ämnet mental ohälsa. Dessa uttalanden är uppdelade i de fyra attityd-kategorierna: Authoritarianism, Benevolence, Social Restrictiveness and Community Mental Health Ideology. Studien bestod av totalt 410 studenter; 272 från Sverige och 138 från Indien. Sverige och Indien blev valda som länder genom deras skillnader baserade på faktorer som tidigare studier har visat ha effekt på ett samhälles attityder gentemot psykisk ohälsa; socioekonomi, religion samt kultur. Resultaten visar att det finns en skillnad i attityd mellan de två länderna i tre utav de fyra attityd-kategorierna där Indien visade på en mer positiv attityd gentemot psykisk ohälsa än vad Sverige gjorde vilket innebär att Indien har ett mer auktoritärt förhållningssätt, social inkludering samt känsla för välvilja. Detta resultat var delvis förväntat då vi förutspådde en skillnad mellan länderna men då tidigare forskning indikerat, genom faktorerna nämnda tidigare, att Sverige borde ha en mer positiv attityd än Indien var den delen av resultaten inte förväntad.

Bakgrund: Patienter med psykisk ohälsa är en växande patientgrupp. I denna litteraturöversikt ses psykisk ohälsa som ett vitt begrepp som rymmer både lindrigare former av psykisk ohälsa och inkluderar allvarligare psykiska tillstånd och diagnoser. Gemensamt är att dessa patienter får ett bristfälligt bemötande i kontakt med vården. Personcentrerad vård är ett begrepp som används flitigt inom sjukvården. Avsikten är att stärka patienters autonomi och bidra till en trygg och säker vård. Syfte: Att belysa vilka faktorer som påverkar sjuksköterskans bemötande av patienter med psykisk ohälsa på sjukhus. Metod: Studien har genomförts som en litteraturöversikt. Utifrån sökdatabaserna PubMed, CINAHL och PsycINFO har 14 artiklar valts ut. Publiceringsår 2011-2017. Resultat: Flera olika faktorer påverkar sjuksköterskans bemötande av patienter med psykisk ohälsa på sjukhus. Dessa är attityder och känslor, organisation och kunskap. Patienter med psykisk ohälsa och sjuksköterskor har olika syn på vårdrelationen vilket också påverkar sjuksköterskans bemötande. Konklusion: Flera av faktorerna som presenteras i litteraturöversiktens resultat är påverkbara. Sjuksköterskor behöver vetskap om vilka faktorer som påverkar deras bemötande av patienter med psykisk ohälsa på sjukhus för att kunna skapa förutsättningar för att möta deras komplexa omvårdnadsbehov. Kunskapen behöver även implementeras på vårdavdelningar och spridas vidare inom hälso- och sjukvårdsorganisationen. / Background: Patients with mental illness are an increasing group. In this literature review, mental illness is seen as a widely spread concept that includes both minor forms of mental illness and more serious mental conditions and diagnosis. Patients with mental illness receives poor treatment encounter the healthcare. Person-centered care is a term that is frequent used in healthcare. The intention is to strengthen patients' autonomy to ensure secure care to all patients. Aim: To illustrate factors that affect the nurse treatment of patients with mental illness in hospitals. Method: The study was conducted as a literature review. Data collection was found through searches in PubMed, CINAHL and PsycINFO. 14 articles between 2011-2017 were selected. Results: Attitudes and emotions, organization and knowledge is factors that affect nurses treatment of patients with mental illness in hospital. Nurses and patients with mental illness have different views on the nurse-patient relation. Conclusion: These factors are possible to change. Nurses need knowledge about the factors that affect their treatment of patients with mental illness in hospitals to create circumstances that offers adequat care. It is important that knowledge spreads in healthcarewards and also implements furhter in the healthcare organisation.

Bakgrund: Närstående till patienter med psykisk ohälsa och patienter med psykisk ohälsa upplever att det är svårt att få god vård. Bristande kommunikation var en del som gjorde vårdandet sämre. Patienter upplever sig kränkta eller diskriminerade av vården. Syfte: Att beskriva sjuksköterskors upplevelser av att vårda patienter med psykisk ohälsa. Metod: Systematisk litteraturstudie enligt Evans (2002), där 12 kvalitativa vårdvetenskapliga artiklar har analyserats med en beskrivande ansats. Resultat: Sjuksköterskor upplevde att kommunikation var viktigt inom vårdandet, även relationer var viktiga, både till patienter och till patienters närstående. Att upprätthålla en god relation och god kommunikation var delar sjuksköterskor upplevde som svåra, om det inte lyckades kunde sjuksköterskor uppleva att de misslyckats med vårdandet. Slutsats: Sjuksköterskor upplevde att kommunikation och att skapa en relation är viktigt mellan sjuksköterskor och patienter för att vårdandet ska ge förutsättningar för en god vård. Lyckades in en relation skapas upplevde sjuksköterskor ofta att vårdandet misslyckades. Viktigt var även att närstående som ville vara delaktiga i vårdandet tilläts vara involverade för det kunde gynna vårdandet. Bemötandet sjuksköterskor ger kan således ses som en grundläggande del som behöver förbättras för att vårdandet ska upplevas bättre för alla involverade parter. / Background: Relatives to patients with mental illness and patients with mental illness experience that it’s hard to get proper healthcare. Lack of communication was a part of the issues that made the healthcare worse. Patients expressed being discriminated against by the healthcare. Aim: To explore nurse’s experiences of working with mental health patients. Method: Systematic literature review with a descriptive synthesis following Evans (2002), twelve qualitative research articles were analysed with an inductive approach. Result: Nurses experienced that communication was an important part of the care, relations were also an important part for the healthcare, both to patients and to relatives of the patient. If this didn’t occur nurses would experience that the healthcare had failed. Conclusion: Nurses experienced that communication and creating relationships between patients was monumental for the outcome to be good. Did this not succeed, nurses felt that they’d failed. It was also important that relatives of the patient could get involved in the healthcare, since it could benefit the recovery of the patient. How nurses treated both patients and relatives were then a good start in getting improvements for how the treatment could be improved for everyone.

Bakgrund: I Sverige är ångest och depressionssyndrom de vanligaste orsakerna till att människor oavsett ålder drabbas av psykisk ohälsa och hör till de vanligaste folksjukdomarna. Det har rapporterats om den psykiatriska vården vilket har lett till att det har diskuterats mer om psykisk ohälsa. Massmedia, har på senare år rapporterat om människors ohälsa men även hur ohälsan har ökat bland kvinnor. Detta visar att sjuksköterskan kan möta personer med psykisk ohälsa i olika vårdkontext därför är det av vikt att försöka förstå att psykisk ohälsa är ett omfattande problemområde. Syfte: Att beskriva kvinnors upplevelser av psykisk ohälsa i form av ångest och depression. Metod: Datamaterialet analyserades med en narrativ analysmetod. Data insamlades genom sju bloggar. Resultat: Ur analysen framträdde tre kategorier: Farhågor om sjukdomen bekräftas, Försöka förstå orsaken till sjukdomen, Behöver fasta kontakter med åtta underkategorier. Konklusion: Denna studie har bidragit med kunskaper och förståelse för kvinnors upplevelser med psykisk ohälsa. Psykisk ohälsa kan uttrycka sig på många olika sätt och därför behövs en förändring i förhållningssättet hos vårdpersonalen gentemot patienterna. Upplevelserna är individuella och därför behövs en individanpassad vård en fast vårdkontakt som ger kontinuitet genom hela vårdprocessen. / Background: In Sweden, anxiety and depression disorder are the most common causes of people suffering of mental illness from all ages and belonging to the most common people's diseases. It has been reported about psychiatric care, which has led to the discussion of mental disorder. Massmedia has reported in recent years about people's mental illness, but also how mental illness has increased among women. This shows that the nurse can meet people with mental illness in different healthcare contexts. It is therefore important to try to understand that mental illness is an extensive problem area. Purpose: Women's experiences of mental illness. A qualitive study in form of anxiety and depression. Method: The data was analyzed using a narrative method of analysis. Data was collected through seven blogs. Result: From the analysis appeared three categories: Fear of the disease confirmed, Try to understand the cause of the disease, Steady contacts are needed with eight subcategories. Conclusion: This study has contributed with knowledge and understanding of women's experiences of mental illness. Mental illness can express itself in many different ways and therefore a change in the attitude of healthcare staff towards the patients is needed. The experiences are individual and therefore, individualized care is a permanent care contact that provides continuity throughout the care process.

No description available.

Deficits in a number of cognitive domains have been associated with core symptoms of schizophrenia, including working memory, attention, motor skills, reaction time, episodic memory and executive function. Bipolar Disorder is also associated with cognitive impairment; however the level of impairment appears to be less severe than that seen in schizophrenia. A translocation (t(1;11)) containing the Disrupted-in-Schizophrenia 1 (DISC1) gene has been found to be highly associated with schizophrenia, bipolar disorder and major depressive disorder. As such, this gene has been the focus of much research and to date DISC1 has been found to be associated with brain development, brain structure and the glutamate system - all key factors in current models of schizophrenia and affective disorders. The aim of this PhD is to identify cognitive domains that are differentially impaired or unimpaired in a large Scottish family, some of whom carry this rare DISC1 variant, a balanced translocation (t (1;11) (q 42; q14.3)), that segregates with schizophrenia and affective disorders, as well as psychiatric patients with schizophrenia and bipolar disorder and healthy control subjects. All participants have undergone standardised cognitive assessments to measure premorbid I.Q. (NART), current I.Q. (WASI) verbal memory, working memory, verbal fluency, processing speed, motor skills, executive function (BACS) and selected CANTAB tasks to assess simple and five-choice reaction time. Polygenic risk profile scores and self-report questionnaire data have also been investigated. Results indicate an impact of the DISC1 t(1;11) translocation on general intelligence and attention and processing speed. Significant differences were also identified between DISC1 t(1;11) carriers and non-carriers on self-report questionnaire data. Mean scores for polygenic risk for bipolar disorder were significantly different between DISC1 t(1;11) carriers and non-carriers and polygenic risk for schizophrenia was significantly associated with symptom severity, as measured by the Positive and Negative Symptom Scale (PANSS). Within the patient groups, a measure of processing speed (the token motor task) was found to be significantly different between those with schizophrenia and bipolar disorder and there was also a trend for attention and processing speed. As expected, I.Q. was significantly different between patients and control participants. Clinical ratings were significantly associated with neuropsychological and self-report measures. Polygenic risk for major depressive disorder was found to be significantly associated with impaired general intelligence (current IQ) and slowed reaction time in patients who were not currently depressed, suggesting there may be genetic risk markers in this population which impact on cognition. This is a novel finding and further suggests the possibility of a biological component related to the genetics of depression. In conclusion, and in line with the literature, psychosis has a negative impact on cognition with reduced performance across several neuropsychological tasks between patient groups, with schizophrenia patients performing worse than patients with bipolar disorder and both patient groups performing worse than healthy control participants. Cognition is markedly more impaired in DISC1 t(1;11) translocation carriers and especially in those with psychosis. The DISC1 t(1;11) translocation and psychosis may therefore confer a “double hit” on cognition - in addition to psychosis itself - which is known to impair cognitive function, significantly increasing the level of cognitive impairment and increasing the risk for psychosis in general.

Representations of mental illness in mainstream media have historically been infantilizing and dangerous. In the last century, dominant media has perpetuated inaccurate and damaging tropes about bipolar disorder in particular, perpetuating misunderstanding and stigma. Despite this fact, art can provide an outlet through which healthy images that promote understanding and sympathy can be dispersed. My project, Polarized, presents a more accurate representation of the disorder and its effects on individuals who struggle with it, as well as their loved ones. Bipolar disorders are a group of mental illnesses that cause dramatic shifts in an individual’s mood, energy, thinking ability, and sexual drive. In popular media, bipolar is represented in a number of different problematic ways ranging from childishness to irrational violence, which provide damaging stereotypes of the bipolar community and ultimately serve to further ostracize the bipolar community. Polarized’s critique of representations of disability in hegemonic discourse is informed by true stories and histories of mental illness. The short’s narrative is fictional, inspired by my own experience as a young woman with Bipolar II and augmented with the research and memoirs of manic-depressive diagnosed clinician Kay Jamison as written in An Unquiet Mind: A Memoir of Moods and Madness.

The dementias are illnesses which have significant cultural prominence and feature in a wide range of contemporary writing, often as a trope for old age. This thesis examines how stories of dementia are told in fiction and in the clinic. To do this, the work uses Arthur Frank's socio-narratology to examine twelve selected texts in which a key protagonist has dementia. Three of the selected texts have been written by authors with direct experience of dementia within their family and form a subset of texts, memoir fiction. How stories of dementia are told is considered by examining the clinic as a storytelling venue, the creation of faux medical notes from information in the texts and a Triple Analysis of the memoir fiction using three reading templates. The templates have been created from clinical practice, using the questions posed by Frank's socio-narratological practice of Dialogical Narrative Analysis, and using the parameters of Rita Charon's version of Close Reading drill in Narrative Medicine. The work is informed by autoethnography which uses my position as a clinician and reader to examine how fiction has been used in my clinical practice and how it informs my reading of the selected texts.

Depression received much attention in the professional literature as a stimulus both for experimental as well as applied research. It continued to be the subject of much controversy in respect to its definition, identification, and classification. Attempts were made to objectify the assessment of depression using self-report scales to tap various aspects though to be related to its etiology as well as its symptomology. Two of the most popular and reportedly well-validated self-report scales identified in the literature for determining and quantifying depressive symptoms were the Beck Depression Inventory (Beck) and the Zung Self-Rating Depression Scale (Zung).The present study was designed to determine if there were factors in common between the Beck and the Zung scales and, in addition, to test whether these factors would differentiate subjects by sex class membership, diagnostic category, and by some linear combination of biographical or life-history information. The major purpose was the identification of outstanding charactersitics of depression predicted from biographical data and the determination of the relationship of these data to self-rating psychometric measures of depression. This study makes it clear that the Beck and Zung scales are measuring different aspects of depression and thus are likely based on separate constructs. The need of developing a depression index based on separate factor scores is highlighted. Also, a multimodal approach to assessment in general is indicated. Studies relating biographical information to factors of depression are suggested. This study makes several inroads, generating descriptive factors and significant biographical or life history correlates. These findings could be expanded and further research could lead to the development of assessment tools useful in the identification of patients with distinct depressive syndromes, as well as at-risk subject groups, in order to implement both primary and secondary prevention.