Världen över finns idag över 58 miljoner människor som är drabbade av någon form av demenssjukdom och cirka 95% av alla med demenssjukdom uppvisar någon gång under sjukdomsförloppet beteendemässiga och psykiska symtom vid demens (BPSD). BPSD innefattar många olika symtom och några vanliga symtom är fysisk och verbal aggression, depression, oro och apati. Vårdpersonal inom hälso-och sjukvården kommer att möta och vårda dessa personer i sitt arbete och behöver därför besitta rätt kunskap för att bemöta personerna på bästa sätt. För att förstå vårdpersonalens upplevelser av att vårda personer med BPSD så behöver detta studeras. Syftet med detta examensarbete var att beskriva vårdpersonalens upplevelser av att vårda personer med BPSD. Författarna valde därför att göra en litteraturstudie där tio vetenskapliga artiklar inkluderades och analyserades med kvalitativ innehållsanalys med manifest ansats. Analysen resulterade i sex kategorier, att ofta möta våld är svårt och känslomässigt utmanande, att lära känna personen samt individanpassa mötet är viktigt, att den fysiska miljön har betydelse men det är svårt att anpassa den, att samarbeta kan vara svårt men skapar möjlighet att se hela personen, brist på vårdpersonal och tid äventyrar vården, att kunskap samt utbildning är nödvändigt och önskvärt. Vårdpersonals upplevelse av att vårda personer med BPSD visade att det kan vara tungt och utmanande därför behövs mer tid, utbildning och stöd från organisation för att kunna lära känna, bemöta samt vårda personen med BPSD. Mer forskning på hur tidsbrist och kontinuitet påverkar vårdpersonal i vården av personer med BPSD behövs.

[pt] Inicialmente, investigamos o movimento de patologização que levou a angústia a ser tomada de compromisso, definição freudiana geral para o sintoma. Entretanto, os como transtorno de ansiedade. Para isso, percorremos o histórico desse fenômeno nos manuais de classificação de doenças e transtornos – DSM e CID. Constatamos como, na clínica psiquiátrica, a angústia é equivalente a um sintoma a ser eliminado; enquanto na clínica psicanalítica o sintoma é uma expressão subjetiva que carrega uma mensagem do inconsciente a ser decifrada. As contribuições de Freud e Lacan sobre a angústia apontam que ela deve ser tomada como um afeto e não um sintoma, no sentido em que sua expressividade subjetiva não se faz ao modo da formação autores consideram que há uma relação possível entre angústia e sintoma analítico, já que o sintoma pode ser uma via de tratamento simbólico que permite desangustiar o sujeito. Neste sentido, Lacan segue a proposta freudiana de considerar a angústia em relação a um perigo fundamental, o da castração como desamparo primordial. Para tanto, após breve percurso sobre as indicações essenciais de Freud e Lacan sobre a angústia, investigaremos a proposta lacaniana da sintomatização da angústia como possibilidade para o tratamento psicanalítico. / [en] Initially, we investigate the pathologization movement that led to the anguish to be taken as an anxiety disorder. by raising the history of this phenomenon in disease and disorder classification manuals - DSM and CID. We see that in the psychiatric clinic, anguish is equivalent to a symptom to be eliminated; While in the psychoanalytic clinic the symptom is a subjective expression that carries a message from the unconscious to be deciphered. Freud and Lacan s contributions to anguish point out that it should be taken as an affection and not a symptom, in the sense that its subjective expressiveness is not made in the way of forming commitment, general definition general for the symptom. However, the authors consider that there is a possible relationship between anguish and analytical symptom, since the symptom can be a symbolic treatment that allows the decrease of the amount of anguish in the subject. In this regard, Lacan follows the Freudian proposal to consider anguish in relation to a fundamental danger, that of castration as primordial helplessness. To this end, in addition to a brief course on Freud and Lacan s essential indications of anguish, we will investigate the Lacanian proposal of the symptomatization of anguish as a possibility for psychoanalytic treatment.

The Word Memory Test (WMT) is a popular effort test that requires participants to memorize lists of paired words and repeat them back in a variety of different memory tasks. Four brain injured patients participated in two trials of the delayed recall (DR) portion of the WMT while undergoing fMRI scanning. In the first trial subjects put forth full effort, and during the second trial subjects were instructed to simulate increased memory impairment in order to represent poor effort. fMRI activation from both trials were compared in order to contrast full and simulated poor effort activation patterns during the WMT. Raw scores from full effort and simulated poor effort trials were compared to a control group to test the hypothesis that a brain injured population will score lower than a healthy population on the WMT while putting forth full effort. Raw score results showed lower WMT scores for TBI group. fMRI results showed larger between-group differences than between-condition differences, suggesting that the WMT is sensitive to TBI.

Introduction: The notion that depression is a disorder that moves along a continuum is well-established. Similarly, the belief in the continuity of mental illness is considered an important element in the stigma process. Against this background, it is the aim of this study to examine whether public continuum beliefs vary with the severity of depressive symptoms. Methods: Analyses were based on computer-assisted telephone interviews (CATIs) conducted in winter 2019/2020 in Germany (N = 1,009, response rate 46.8%). Using three vignettes representing mild, moderate, and severe depressive symptoms, beliefs regarding the continuity of symptoms, specifically a fundamental difference, were assessed with seven items. Sociodemographic characteristics and own experiences with depression (affliction and contact) were introduced as covariates. Results: Significant differences between the three groups of severity were found for the majority of the items measuring continuum beliefs or perceived fundamental difference. However, only few items showed a linear trend indicating a parallel between symptom severity and beliefs. Multivariate regression models showed that a moderate degree of depression was positively associated with stronger continuum beliefs but also with greater perceived difference compared to the mild degree, while no significant associations emerged for the severe vignette. Limitations: Although a comparison of our sample with official statistics supports the external validity, we cannot rule out a selection bias. It is arguable in how far short case vignettes convey a holistic picture of a person affected by depressive symptoms. Conclusion: Our results do not indicate a parallel between symptom severity and public continuum beliefs.

The covid-19 pandemic affected people’s health in several different ways, and government policies to address the pandemic sometimes needed to trade-off between containment of thevirus and other health aspects. This study aims to evaluate the effect of lockdown-policies on individuals’ mental wellbeing. To this end, we use a difference-in-difference method, comparing proxies for mental health before and after lockdown recommendations in 2020 relative to the same calendar months in the year preceding the pandemic. To measure mental health, we use data from Google Trends on the relative search intensity on words and classes of words associated with mental illness of various kinds. The results show that searches onmental illness increased in Sweden from March 2020, right after social distancing measures were put in place. To assess whether social isolation is a key mechanism rather than a general pandemic effect, we present hetergeneous effects by the share of single-person households atthe county level, which support social isolation as a potential channel. Given that thestate-imposed lockdown in Sweden was partial, the results can be considered a lower boundof social distance effects on mental illness. / Covid-19 pandemin påverkade människors hälsa på flera olika sätt och insatser för att hantera pandemin innebar ibland en avvägning mellan smittspridning och andra hälsoaspekter. Denna studie syftar till att utvärdera effekter av smittskyddsåtgärder på människors psykiska hälsa i Sverige. Med hjälp av en difference-in-difference metod jämförs proxyvariabler för mentalohälsa före och efter införande av restriktioner under 2020 relativt samma kalendermånader föregående år. Med data från Google Trends undersöks pandemins effekt på den relativasökintensiteten på ord och kategorier av ord förknippade med psykisk ohälsa. Resultaten visar att sökningar på ord relaterade till psykisk ohälsa ökade i Sverige från mars 2020 då de första restriktionerna om social distansering infördes. I syfte att se om social distansering ären viktig mekanism snarare än en generell pandemieffekt, utförs en heterogenitetsanalys på andel singelhushåll på länsnivå. Den visar att social distansering är en möjlig kanal. Givet att Sverige inte införde en regelrätt “lockdown” kan resultaten betraktas som ett lower bound avsocial distanserings effekt på psykisk ohälsa.

Studiens kunskapsöversikt utgår från information om grundläggande fakta om ADHD, att få diagnos, samsjuklighet, vikten av rätt diagnos samt hälso- och sjukvårdskuratorer vilket utgör studiens vetenskapliga ram. Studiens frågeställningar syftar till att dels besvara hur rådande intersektionella strukturer påverkar upplevelsen av att leva med ADHD. Dels hur behovet av stöd från sjukvården och hälso- och sjukvårdskuratorn förstås utifrån valda självbiografier. En kvalitativ ansats användes vid insamlande av studiens datamaterial där självbiografier granskades. Sedan gjordes en bearbetning och tematisering av självbiografiernas innehåll. Vidare har studien utgått från ett avgörande teoretiskt perspektiv, vilket är intersektionalitet. Inom intersektionalitet ingår begreppen: klass, kön, funktionalitet, normerande funktionalitet, normbrytande funktionalitet, ålder, maktstrukturer, konstruktion, kategorisering. Två ytterligare ansatser används, vilket är stämplingsteorin där stämplingsprocessen har en avgörande roll och det dramaturgiska perspektivet visar hur skådespeleri har en avgörande roll. Dessa tre teoretiska ansatser har därefter använts för analyserna inom varje tema. Resultaten visar på en bred bild av vilka symtom som är typiska för ADHD och vissa skillnader mellan könen framkommer. Exempelvis bär flickor på en känsla av lågt självvärde medan pojkar i en något högre utsträckning är utåtagerande. Flickor tenderar även att gömma sina problem i skolåldern och låtsas att de förstår skoluppgifter samtidigt som de egentligen inte gör det. Resultaten visade även att en hälso- och sjukvårdkurator kan komma att möta personer med odiagnostiserad ADHD och diagnostiserad ADHD i en rad olika skeenden där det viktiga i mötet handlar om att lyssna på personen och vara intresserad av att höra dennes narrativ. Studiens slutsatser visade att det är mycket viktigt för en HSK att inneha en medvetenhet om hur rådande intersektionella strukturer kan påverka till exempel möjlighet till rätt vård. Det är viktigt sett ur perspektiv där hälso- och sjukvårdskuratorn träffar en patient av andra anledningar än utredning av ADHD samt även vid utredning.

Clinical wisdom suggests that adults with histories of childhood trauma will have difficulty engaging in psychotherapy. I examined the relationship between early childhood trauma and treatment response in the form of rate of symptom decline among a group of 202 adults recruited into the longitudinal Austen Riggs Center Follow-Along Study. Participants were recruited at admission to the hospital and provided extensive demographic and clinical data at baseline, including retrospective recall of childhood traumatic experiences using the Traumatic Antecedents Interview (TAI) and narrative responses to the Relationship Anecdote Paradigm (RAP) used to generate ratings on the Social Cognition and Object Relations Scale (SCORS). Participant symptoms were assessed at baseline and again every six to eight months for up to four years using the Symptom Checklist-90-Revised (SCL-90-R). Hierarchical Linear Modeling (HLM) was used to perform growth curve modeling of the symptom change data, which demonstrated an overall linear rate of decline and significant unexplained variability. The hypothesis that degree of childhood trauma would predict rates of symptom change failed to receive support, as did other related hypotheses. Only participant age predicted differences in rates of symptom decline, with younger participants' symptoms declining more rapidly than those of older participants. The findings indicate the following: (1) symptom severity tends to decline linearly after hospital admission, (2) individual rates of symptom change vary considerably, and (3) rates of symptom decline may slow as people age. Implications for clinical research and practice are discussed.

Recent gains in understanding the effects of childhood maltreatment on the development of the brain and nervous system, combined with the revelation that nearly all psychiatric neuroimaging studies have had an unrecognized confound in childhood maltreatment, imply the possibility that psychotherapy treatment effectiveness studies have been similarly confounded by childhood maltreatment. This study examines whether treatment-seeking adults exposed to childhood maltreatment respond differently to psychotherapy than do individuals who report no history of childhood maltreatment. Response to therapy is conceptualized in this study as reduction in symptom measures pre- and post- treatment, as well as client dropout. It is hypothesized that people with a history of childhood maltreatment experience psychotherapy differently, may experience differences in symptom reduction and be more likely to drop out of treatment, than people with no history of childhood maltreatment. The current study examines psychotherapy effectiveness in symptom reduction and dropout rates of clients who experienced childhood maltreatment as compared to those with no history of childhood maltreatment.

Finding health information online continues to help patients understand new symptoms. However, incomplete information or advice that errs on the site of caution can cause distress or anxiety and prompt visits to a doctor. Cyberchondria, a new phenomenon, is defined as excessive compulsive searching for health information online that leads to distress and increase utilization of healthcare services. Grounded theory guided the conception of a mixed method study to investigate cyberchondria and symptom appraisal within Emergency Departments. A questionnaire and interviews were used to collect data from patients visiting a local Emergency Room. Results showed 63.3% of respondents looked up their symptoms online before their visit, and exhibited higher levels of cyberchondria and health anxiety than those who did not (p .001, p .004), and that health information consulted online can impact the decision to seek out immediate care. Strategies are needed to improve and promote quality online sources to benefit both seekers and services.

Alzheimer’s disease (AD) affects over 5 million individuals in the United States annually. By the year 2050, the number of individuals living with AD is projected to triple (Latest Alzheimer’s Facts and Figures, 2016). Although there is no cure for AD, there are many prescriptive pharmacologic agents used to help manage the clinical manifestations of the disease. Complementary and alternative medicines (CAM) and herbal supplements are also used in the treatment of AD, however indications for their use and effectiveness during the progression of AD have not been examined. The purpose of this study was to examine the use of herbal supplements in managing the clinical manifestations of AD. The secondary purpose was to compare a variety of herbal supplements used to treat the clinical manifestations of AD and to evaluate the most widely used and most beneficial for clinical practice. A literature review examining herbal supplements and their risks, benefits, and uses in AD was conducted from multiple online databases. Peer reviewed articles published in the English language from 1998-2016 that focused on herbal supplements used to control the clinical manifestations of mild to severe AD were included for synthesis. Results from 14 studies that used herbal supplements as a treatment for the clinical manifestations of AD were compared for effectiveness in the management of symptoms. The findings suggest Ginkgo Biloba is the most effective and widely used herbal supplement in the treatment for cognitive decline in AD. Other supplements including Saffron, Curcumin, Cistanches Herba, and Sage were found to improve memory function and activities of daily living in individuals with AD. Herbal supplements can be cost effective and easier to retrieve for many individuals in comparison with prescriptive drug therapy. Although the research demonstrated beneficial results with the use of herbal supplements, the limitations of these studies make the application of the results problematic. Therefore, further research in this area is required.