Bakgrund: Bipolär sjukdom är vanlig i världen och det blir vanligare i Sverige att personer med sjukdomen söker vård, både inom öppenvården och slutenvården. Omvårdnaden riktar in sig på att stödja och vägleda i hantering av symptom och sjukdomstecken. Hälsoutbildning har visats kunna fördröja återinsjuknandet och en personcentrerad vårdplan likaså. Många med bipolär sjukdom är odiagnostiserade och sjuksköterskan har en viktig roll i att bidra till att uppmärksamma dessa, för att kunna ge en god omvårdnad. Syfte: Syftet var att belysa personers upplevelser och erfarenheter av att leva med bipolär sjukdom. Metod: En litteraturöversikt har gjorts för att få en överblick över kunskapsläget inom det valda området. Den är baserad på tio kvalitativa vetenskapliga artiklar som hämtades från två databaser. Resultat: Resultatet redovisas i fem övergripande teman med tillhörande subteman. De övergripande teman är: Hur sjukdomen uppfattas, Erfarenheter och upplevelser av sjukdomshantering, Relationer, Upplevelser av stigmatisering och Hur arbetet/studier/ekonomi påverkas av sjukdomen. Diskussion: Resultatet diskuterades tillsammans med livsvärldsbegreppet, bakgrunden och ny forskning. Det som diskuterades var om hur livsvärlden kan hjälpa sjuksköterskan att bidra till identifiering av diagnosen bipolär sjukdom, hur viktig vårdrelationen är och hur viktigt det är för personerna att sjuksköterskan tar del av deras livsvärld. Det diskuterades även om vilken betydelse det har för personerna att få stöd från andra som också har bipolär sjukdom. / Background: Bipolar disorder is common in the world and it is becoming more common in Sweden that people with the illness seek care, both outpatient and inpatient care. Nursing care focus on supporting and guiding the management of symptoms and signs of disease. Health education has been shown to delay the relapse and a person-centered care plan as well. Many people with bipolar disorder are undiagnosed and nurses have an important role in helping to address these in order to provide good care. Aim: The aim was to highlight people's experiences of living with bipolar disorder. Method: A literature review has been made to get an overview of the state of knowledge in the chosen field. It is based on ten qualitative research articles which were collected from two databases. Results: The results are reported in five overarching themes with related subthemes. The overarching themes are: How the disease is perceived, Experiences of disease management, Relationships, Experiences of stigmatization and How the work/study/economy is affected by the disease. Discussion: The results were discussed together with the lifeworld term, background and new research. The discussion was how the lifeworld can help the nurse contribute to identify the diagnose bipolar disorder, how important the care relationship is and how important it is to the persons that the nurse takes part of their lifeworld. It was also discussed about how important it is for the persons to get support from others who also have bipolar disorder.

A perícia psicológica tem ocupado lugar de destaque na Justiça do Trabalho, pois vêm aumentando os casos de afastamento no trabalho em decorrência de transtornos mentais. Quando um trabalhador ingressa com uma ação trabalhista, pleiteando o recebimento de uma indenização por ter adquirido uma doença mental no trabalho, o juiz é obrigado, por força de lei, a nomear um perito judicial para fazer a investigação do nexo de causalidade entre a patologia mental e o trabalho. A presente pesquisa teve por objetivo investigar como são feitas essas perícias psicológicas, optando-se pela realização de entrevistas individuais semiestruturadas com peritos judiciais e juízes do trabalho, além de pesquisa bibliográfica sobre o tema. Para a interpretação dos dados, a pesquisa se utilizou da técnica análise de conteúdo que comporta três fases fundamentais: pré-análise, exploração do material e tratamento dos resultados. Os dados revelaram que os juízes do trabalho estão insatisfeitos com a qualidade das perícias psicológicas, pois consideram os laudos deficientes, sem fundamentação, condicionais e inconclusivos. De acordo com os juízes, as perícias psicológicas são produzidas pelos médicos numa espécie de linha de produção, por meio de um único encontro com o reclamante, estando recheadas de textos padronizados e desprovidas de uma análise mais aprofundada da pessoa do trabalhador e do ambiente de trabalho. Os juízes também afirmaram que não existem bons profissionais da área da saúde interessados em realizar a perícia psicológica na Justiça do Trabalho. Já os peritos judiciais disseram que o valor dos honorários periciais é muito baixo, o que inviabiliza que sejam realizadas várias entrevistas com o trabalhador e visitas à empresa, comprometendo a qualidade dos laudos. Para os peritos, os honorários periciais deveriam ser fixados em um montante justo e proporcional ao trabalho a ser desenvolvido, como também serem pagos, ainda que parcialmente, antes do início da investigação pericial. As entrevistas demonstraram que os peritos, tanto médicos quanto psicólogos, têm pouco conhecimento na área da Saúde Mental e Trabalho. Também revelaram que o trabalho pericial está voltado essencialmente para uma análise diagnóstica, ou seja, para a verificação acerca da existência ou não de um transtorno mental no trabalhador, não havendo uma investigação aprofundada das condições de trabalho e da relação destas com a subjetividade do indivíduo. A pesquisa concluiu que para se compreender o vínculo entre o transtorno mental do trabalhador e as condições de trabalho seria necessário que o perito judicial averiguasse como se deu a relação entre a subjetividade do indivíduo e o contexto de trabalho. Caberia ao perito avaliar o limite subjetivo de cada trabalhador para as pressões sofridas no ambiente de trabalho, quais foram suas ações adaptativas e em que momento se operou a ruptura, instalando-se o adoecimento mental. Para isso, seria importante que o perito tivesse formação na área da Saúde Mental e Trabalho a fim de adquirir competências técnicas para melhor investigar como o modo operativo do trabalho afeta os processos subjetivos dos trabalhadores / Psychological expertise has had great importance in Labor Court, since cases of work leave due to mental disorders have increased. When a worker takes legal action against his/her employee, claiming compensation for having acquired mental illness at work, the judge is required, according to the law, to designate a judicial expert to investigate the causal link between the mental pathology and the job. The aim of the present research was to investigate how these psychological inquiries are performed, carrying out individual semi-structured interviews with judicial experts and labor judges, as well as bibliographic research about the subject. Interpretation of the data was performed using the technique of content analysis, which involves three fundamental phases: pre-analysis, material exploration and treatment of results. The data revealed that labor judges are unsatisfied with the quality of psychological inquiries, due to the deficiency of the reports that have no foundation, are conditional and inconclusive. According to the judges, psychological inquiries are performed by doctors in an automatic way, with only a single meeting with the claimant. The reports are filled with standardized texts and without a deeper analysis of the individual and the workplace. The judges also stated that good health professionals are not interested in performing psychological inquiries in the Labor Court. On the other hand, judicial experts have said that their wages are very low, therefore it is not possible to carry out several interviews with the employee and to pay visits to the company, affecting the quality of the reports. For the experts, expert wages should be proportional to the amount of work to be performed, but also be paid, at least partially, before the beginning of the investigation. The interviews showed that the experts, both doctors and psychologists, have scarce knowledge about mental health and work. They also revealed that the work of the experts is focused essentially on a diagnostic analysis, only to verify if the worker has or doesnt have a mental disorder, without a deep investigation of the conditions of work and with the subjectivity of the individual. The research concluded that in order to understand the link between the mental disorder of the worker and his working conditions, it would be necessary that the judicial expert investigate the occurrence of the relationship between the subjectivity of the individual and the work context. It would be the responsibility of the expert to evaluate the subjective limit that each worker has towards the pressure in the work environment, what were his adaptive actions and when the rupture happened, causing mental illness. It would be essential that the expert has specific training in the area of mental health and work in order to acquire technical skills to better evaluate how the operative mode of work affects the subjective processes of the workers

La maladie mentale, véritable problème de santé publique, interpelle sur les droits et libertés fondamentales des personnes qui en sont atteintes. La maladie mentale peut perturber le discernement des malades. Elle nécessite parfois l’application d’une législation spécifique qui a pour finalité de protéger, par le soin et l’enfermement, la personne elle-même et autrui. Les personnes atteintes de troubles mentaux sont des malades, mais également des sujets de droit. Ils doivent disposer des mêmes droits et libertés fondamentales que toute autre personne et surtout des mêmes garanties lorsque, par nécessité, une atteinte leur est portée. Leur liberté d’aller et venir, leur vie privée et leur dignité sont particulièrement exposées. Il s’agit de déterminer si au regard des réflexions menées sur les droits de l’homme, leur atteinte est toujours justifiée et si les garanties offertes pour leur protection sont effectives à l’égard des malades mentaux. Les concepts de consentement et de dignité méritent d’être révisés pour qu’ils puissent s’étendre à cette catégorie de malades et puissent efficacement les protéger. Si des progrès ont été faits pour garantir les libertés et droits fondamentaux, d’autres restent à faire pour les malades mentaux privés de leur liberté en raison des soins qu’ils nécessitent / Mental disease is a public health challenge that questions about the fundamental rights and freedoms of people with it. Mental disease can disrupt the discernment of patients. It sometimes requires the application of specific legislation whose purpose is to protect, through care and confinement, the person himself and others. People with mental disorders are not only sick, but also subjects of the law. They must have the same rights and fundamental freedoms as any other person and, above all, they require the same guarantees when, out of necessity, they are restricted. Their freedom to come and go, their private life and their dignity are particularly exposed. The question is whether, in the light of human rights reflections, their infringement is always justified and whether the guarantees offered for their protection are effective with regard to the people with mental disease. The concepts of consent and dignity need to be revised so that they can extend to this category of patients and can effectively protect them. While progress has been made to guarantee fundamental rights and freedoms, much remains to be done for people suffering of mental disease and deprived of their liberty because of the care they require

Made available in DSpace on 2016-04-27T18:47:31Z (GMT). No. of bitstreams: 1 Edineia Ramos Fernandes.pdf: 394377 bytes, checksum: e11cef75ce3d3d94c57f60792581a2dc (MD5) Previous issue date: 2008-10-15 / This work is the result of a study among thirteen old individuals with chronic mental disease who are residents at the Institution of Rehabilitation and Prevention in Health Indaia located in Indaiatuba city, São Paulo state. The objective of this study was to delineate the social and demographic profiles of patients who get old as interns in Psychiatric Clinics, identifying the reasons for being hospitalized and checking if they are able to understand their aging process and the family itself. The study followed the qualitative approach and its main line was the descriptive research. A bibliographical research to gather information about the patients and delineate them into their social and demographic profiles was done. Additional information was got from structured interviews made with them. These interviews were all recorded and transcribed for further analysis. The information was grouped into categories according to the delineated objectives which led us to some conclusions. The patients were between 60 to 69 years old but the average was between 62 to 63 years old. Most of them were women, making 69,2% of them. About 84,01% of them turned residents before the age of sixty. The schizophrenia and the organic psychoses were the psychiatric disease that predominated among them. In the qualitative analysis we noticed a rupture in their bibliographies because of being living far from their families and being far from the real life, so It was noticed short dialogues with no meanings and brief speeches. Nowadays many Psychiatric Institutions maintain people with chronic mental disease as residents, because themdon´t have politica, social an familiar support / Este trabalho é resultado de pesquisa realizada no Instituto de Reabilitação e Prevenção em Saúde Indaiá, na cidade de Indaiatuba, interior do Estado de São Paulo, com 13 sujeitos, idosos, doentes mentais crônicos, moradores dessa instituição. O estudo teve como objetivo traçar o perfil sociodemográfico do indivíduo que envelhece em uma instituição psiquiátrica, identificando o motivo de permanecer institucionalizado após movimento da reforma psiquiátrica, e verificar como o doente mental percebe seu processo de envelhecimento e como compreende o vínculo familiar. O estudo seguiu a abordagem qualitativa, e a linha geral que caracterizou o estudo foi a pesquisa descritiva. Para o delineamento do perfil sociodemográfico utilizou-se procedimento técnico de pesquisa bibliográfica de coleta de dados. Os demais dados foram coletados por meio de entrevista com um roteiro semi-estruturado, gravadas, com consentimento do diretor clínico da Instituição e transcritas para análise. Os dados foram agrupados em categorias, compostas a partir dos objetivos traçados. Constatou-se idade média de 62,3 anos, a maioria na faixa de 60-69 anos; 69,2% do sexo feminino, tendo a confirmação da feminização na velhice; verificou-se que 84,61% dos sujeitos foram institucionalizados antes dos 60 anos; a esquizofrenia e a psicose orgânica foram às doenças psiquiátricas de maior prevalência, com grave comprometimento cognitivo entre os sujeitos. Na análise qualitativa percebeu-se a ruptura das biografias pela falta de vínculo familiar e contato com o mundo exterior, um diálogo não seqüencial, com falas breves. Muitas instituições psiquiátricas que permaneceram em funcionamento ainda abrigam doentes mentais crônicos (são os moradores), por causa da falta de amparo político, social e familiar para essas pessoas

Made available in DSpace on 2016-03-15T19:48:50Z (GMT). No. of bitstreams: 1 Eliezer Victor Pereira Ramos.pdf: 706023 bytes, checksum: ecafbafba46d7c71ffd6cc6e68eee3f8 (MD5) Previous issue date: 2009-02-09 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This research compares the Biblical counseling developed and proposed by Jay Edward Adams and the Analytic Psychology of Carl Gustav Jung. According to Jay Adams, in order to be Biblical, the counseling must be Nouthetic, word transliterated from Greek and which is related to confrontation and exhortation. This is the main idea of Jay Adams counseling: confrontation of personal sin in the life of the person who has been counseled. As it is said by the author, there are not the words neurosis and psychosis , they are something that science created, behind all not organic disease there is a personal sin which must be confronted so as to have the repentance, or, to change the behavior. In the same way, John MacArthur Jr. developed his Biblical counseling establishing a substantial division between Psychology and Counseling, position that all Christians, compromised with the Bible, have to take. However, the life of Jung is opposed to this idea. He, who founded the field of Analytic Psychology, declares to be protestant and protector of the Christian faithfulness. Therefore, there are two positions of Christians on Psychology and, consequently, a theological and psychological analysis of Biblical Counseling in the last chapter. Thus, for the theological analysis, there are two main points: first, the Biblical counselors who follow Jay Adams thoughts and who indicate, in a way out of proportion, the God s special Revelation and with a reduction of the General Revelation importance, not taking into consideration that God gives intellectual capacity, using common recognition, for all human beings; second, the Biblical counselors state that the Bible is a counseling manual par excellence, although, It does not take some themes of mental disorders, but establishes thoughts categories so as the humanity, agreeing with the Bible, help his or her Brother. The psychological analysis indicates only one point: the definition of mental disease of the Biblical counseling, since it is the principal possibility, as a helpful device, will determine the position of someone in relation to Psychology. Jung asserts that the mental equilibrium is established in a healthy relation between conscious and unconsciousness, since it is essential to mental health in order to know and understand unconscious aspects of personality, a constructive attitude for the future. / A presente pesquisa compara o Aconselhamento Bíblico desenvolvido e proposto por Jay Edward Adams e a Psicologia Analítica de Carl Gustav Jung. Segundo Jay Adams, para ser bíblico o aconselhamento deve ser noutético, palavra transliterada do grego e que tem relação com confronto e exortação. Essa é a idéia básica do aconselhamento de Jay Adams: confronto com o pecado pessoal na vida do aconselhado. Para o autor não existem os termos neurose e psicose , isto é algo que a ciências rotula, sendo que, por trás de toda doença não orgânica encontra-se um pecado pessoal que deve ser confrontado para que ocorra o arrependimento, ou seja, a mudança de comportamento. Nesta mesma linha, John MacArthur Jr. desenvolve seu Aconselhamento Bíblico estabelecendo forte separação entre a Psicologia e o Aconselhamento, postura esta, que deve ser assumida por todos os cristãos compromissados com a Bíblia. Entretanto, a vida de Jung faz um contraponto com toda esta idéia. Ele, o criador da Psicologia Analítica, declara ser protestante e defensor da fé cristã. Estão dispostas, assim, duas posições de cristãos em relação à Psicologia e, como conseqüência, uma análise teológica e psicológica do Aconselhamento Bíblico é proposta no último capítulo. Para a análise teológica destacam-se dois pontos: primeiro, os conselheiros bíblicos seguidores da linha de pensamento de Jay Adams, ressaltam, desproporcionalmente, a Revelação Especial de Deus em detrimento da Revelação Geral, esquecendo-se de que Deus dispõe a todas as suas criaturas capacidade intelectual através da graça comum; segundo, os conselheiros bíblicos dizem que a Bíblia é um manual de aconselhamento por excelência, porém, ela própria não aborda direta e claramente algumas questões relacionadas a transtornos mentais, mas estabelece categorias de pensamento para que o homem, não contradizendo ao que está revelado na Bíblia, ajude terapeuticamente o seu próximo. A análise psicológica destaca apenas um ponto: a definição de doença mental no Aconselhamento Bíblico, por este ser o principal viés que, como ferramenta de auxílio, determinará a posição de alguém em relação à Psicologia. Jung diz que o equilíbrio mental é estabelecido numa relação sadia entre o consciente e o inconsciente, sendo fundamental para a saúde mental entrar em contato e conhecer aspectos incônscios da personalidade, numa postura construtiva diante do futuro.

The main aim of this diploma thesis is to analyze the problem of anorexia from Foucault's perspective. The first hypothesis is that this 'pathology' is rather a social construction which has its origins in social norms and standards that operate in the society to make firm distinction between the normal and the pathological, the ideal and the unacceptable. In this study we will use Foucault's theory of power and discipline, the concept of biopower and also his critics of psychiatry. At the same time, we will complete our survey with the concept of construction and deconstruction of Jacques Derrida and with the social identity theory of Judith Butler.

69 Abstract This diploma thesis deals with manifestations of a borderline type of emotionally unstable personality disorder and its influence on family members of people with this type of disease. The aim of this thesis was to present the experience of living with a person with BPD. Qualitative research, using the semi-structured type of interview, was conducted with three respondents, one man and two women. The data was evaluated using interpretative phenomenological analysis. The results show the negative effects of contact with the individual with the BPD and the psychological burden is also evident. The thesis could be beneficial for social and health workers who come into contact with people with the BPD and their loved ones within their practice. At the end of the thesis step are mentioned through which each of us can contribute to the improvement of the situation.

The diploma thesis is dedicated to the way of using and way of functioning of the coordinated rehabilitation and the multi-disciplinary team in the organization Focus in Pelhřimov which works with the people with mental disorders. The thesis is divided in the theoretical and practical part. The theoretical part describes the history and function of the coordinated rehabilitation, mental health care history, psychiatric reform and multi-disciplinary cooperation functioning. There is used the strategy of quality analysis in the research part. It was done by the questionnaire and the technique of half-structured interview. The results coming out of the interview were focused on the functioning of multi-disciplinary team in the institution and the cooperating subjects in the first part. The second part was dedicated to the basic parts of the coordinated rehabilitation provided in the organization in view of the fact that there were other participating professionals and non-formal participants during the care of the person with mental disorder. The aim of the research was to map the sectors of the coordinated rehabilitation used by the individuals with mental disorders in the organization Focus in Pelhřimov. The research team was created with the help of the method of the snow ball and basic criteria was employment of an "communication partner" in the particular organization. Their ability to evaluate their job and take part in the lead interview depended on their experience in Focus. In connection with the thesis aim there was also set the main research question: What parts of the coordinated rehabilitation are used in the organization Focus in Pelhřimov? Partial questions were devolved from that which were connected to the particular parts of the coordinated rehabilitation and the function of the multi-disciplinary team. The first contact and the next cooperation is developed by the seriousness, necessity and wishes of the client. The work with the client with mental disorder is based on the philosophy of recuperation, not recovery. In the relationship and the concentration, the work is done in all sectors of the coordinated rehabilitation. The client has the closest relationship to the key worker who provides the care in the multi-disciplinary team and other professionals in the organization. There is the conclusion from the results that there was an agreement that the coordinated rehabilitation is used in this institution and no other from the basic sectors can be omitted. The results of the diploma thesis can be used as feedback for the organization Focus in the practice where it can be useful for mapping of the sectors of coordinated rehabilitation and making clear the needs of the individuals with mental disorder. Taking into consideration the recommendation to use the feedback of the respondents about information sharing, to prefer common space of the whole team and bigger promotion.

Background: The role of the placenta in fetal programming has been recognized as a highly significant, yet often neglected area of study. We investigated placental size in relation to psychopathology, in particular attention deficit hyperactivity disorder (ADHD) symptoms, in children at 8 years of age, and later as adolescents at 16 years. Methodology/Principal Findings: Prospective data were obtained from The Northern Finland Birth Cohort (NFBC) 1986. Placental weight, surface area and birth weight were measured according to standard procedures, within 30 minutes after birth. ADHD symptoms, probable psychiatric disturbance, antisocial disorder and neurotic disorder were assessed at 8 years (n = 8101), and ADHD symptoms were assessed again at 16 years (n = 6607), by teachers and parents respectively. We used logistic regression analyses to investigate the association between placental size and mental health outcomes, and controlled for gestational age, birth weight, socio-demographic factors and medical factors, during gestation. There were significant positive associations between placental size (weight, surface area and placental-to-birth-weight ratio) and mental health problems in boys at 8 and 16 years of age. Increased placental weight was linked with overall probable psychiatric disturbance (at 8y, OR = 1.14 [95% CI = 1.04-1.25]), antisocial behavior (at 8 y, OR = 1.14 [95% CI = 1.03-1.27]) and ADHD symptoms (inattention-hyperactivity at 16y, OR = 1.19 [95% CI = 1.02-1.38]). No significant associations were detected among girls. Conclusions/Significance: Compensatory placental growth may occur in response to prenatal insults. Such overgrowth may affect fetal development, including brain development, and ultimately contribute to psychopathology.

The thesis is based on three months of participant observation in a long-term care facility in 2010 and interviews conducted during next three years. It draws from a perspectives of medical anthropology and anthropology of institutions. The focus is on an ethnography of institution for clients with chronic mental disease, dementia and substance abuse. The thesis is mapping institution's components and actors, their social life and relationships in the institution. The analyses is based upon the concept of total institution by Erving Goffman, and draws from thoughts of Josef Pieper, Martin Buber, Emanuel Lévinas and Michel Foucault. A long-term facility is an institution, which shares clients and some of problems with classical examples of total institutions, but recent reforms aimed to minimalize features of total institutions. Still it does not seem to be a vital institution and new aspects of social situation of staff and clients are recognized. Among new problems is non-existence of therapy for the inhabitants, their marginalization through poor financial situation in an institution, where lot of services are paid and little continuity to other forms of care of more community and ambulant character. Key words: total institution, long-term facility, psychiatric care, medical anthropology,...