0000000000520992
AUTHOR
Päivi Köngäs-saviaro
The long-term use of psychiatric services within the Open Dialogue treatment system after first-episode psychosis
AbstractOpen Dialogue is a family-oriented early intervention model for mental health problems developed in the health district of Western Lapland, Finland. In the present study, the aim was to describe how psychiatric services were used in Western Lapland after decades of first-episode psychosis services, and to analyze how baseline characteristics were related to re-admission rates and the total duration of psychiatric treatment in geographical area where Open Dialogue approaches were developed and efforts made to systematically apply them to all psychiatric treatments. The data were obtained from the medical histories of patients who had first-episode psychosis in 1992–2005 and who lived…
Retrospective Experiences of First-Episode Psychosis Treatment Under Open Dialogue-Based Services: A Qualitative Study.
AbstractOpen Dialogue (OD) is an integrated approach to mental health care, which has demonstrated promising outcomes in the treatment of first-episode psychosis (FEP) in Finnish Western Lapland region. However, little is known how treatment under OD is retrospectively experienced by the service users themselves. To address this, twenty participants from the original Western Lapland research cohort diagnosed with psychosis (F20–F29) were asked about their treatment of FEP, initiated under OD 10–23 years previously. Thematic analysis was used to explore how the treatment was experienced. Most participants viewed network treatment meetings as an important part of their treatment, as they enab…
Protocol for a participatory survey to investigate the long-term effectiveness of adult psychiatric services (PSILEAPS) : a prospective exploratory cohort study
Mental health research and practice is currently moving beyond a focus on group-level symptom reduction models. Hence, research and treatment increasingly emphasize the real-life individual needs of service users and their social networks. One example is the Open Dialogue approach (OD), which has demonstrated promising outcomes in the Finnish Western Lapland (WL) catchment area. Nevertheless, it is unclear how OD-based services have so far been maintained in WL. It is also unclear how the experiences of multi-disciplinary care teams, service users and their social network members differ, with regard to differing approaches to mental health treatment. More generally, there is a global need f…
The family-oriented Open Dialogue approach in the treatment of first-episode psychosis : nineteen–year outcomes
Open Dialogue (OD) is a family-oriented early intervention approach which has demonstrated good outcomes in the treatment of first-episode psychosis (FEP). Nevertheless, more evidence is needed. In this register-based cohort study the long-term outcomes of OD were evaluated through a comparison with a control group over a period of approximately 19 years. We examined the mortality, the need for psychiatric treatment, and the granting of disability allowances. Data were obtained from Finnish national registers regarding all OD patients whose treatment for FEP commenced within the time of the original interventions (total N = 108). The control group consisted of all Finnish FEP patients who h…
Need adapted use of medication in the open dialogue approach for psychosis : a descriptive longitudinal cohort study
Background The open dialogue (OD) approach includes the need-adapted use of psychiatric medication in treating first-episode psychosis (FEP), but there is limited information on how psychiatric medications are actually used in OD-based services. This study aims to analyse long-term medication dispensing patterns among FEP cohort treated according to the OD. Methods The OD cohort consisted of people who received treatment for FEP in the Finnish Western Lapland catchment area at a time of OD implementation (n=61). The comparison group included people whose FEP treatment commenced outside the catchment area during the mid-1990s (n=1378). Data were gathered from national registers from onset to…
How do people talk decades later about their crisis that we call psychosis? : A qualitative study of the personal meaning-making process
Psychosis refers to a severe mental state that often significantly affects the individual’s life course. However, it remains unclear how people with the lived experiences themselves view these phenomena, as part of their life story. In order to evaluate this personal meaning-making process, we conducted in-depth life-story interviews with 20 people who had been diagnosed with non-affective psychosis 10 to 23 years previously in one catchment area. 35% of them were still receiving mental health treatment, and 55% of them were diagnosed with schizophrenia. Only a minority named their experiences as psychosis. On the basis of narrative analysis, two types of stories appeared to encompass how m…
Mitä mielenterveysongelmat ovat ja mikä mielenterveyshoidossa auttaa? : kokemuksia Länsi-Pohjan psykiatrian kyselytutkimuksen pilotoinnista
Psykiatriassa on alettu korostaa sellaisten osallistavien tutkimus- ja hoitostrategioiden merkitystä, joilla pyritään huomioimaan mielenterveyspalveluita käyttävien ja heidän läheistensä yksilöllinen avuntarve. Eräs esimerkki on Länsi-Pohjan sairaanhoitopiirin (LPSHP) alueella kehitetty avoimen dialogin hoitomalli, jolla on saavutettu lupaavia hoitotuloksia. On kuitenkin epäselvää, miten malli on juurtunut LPSHP:n psykiatrian palvelujärjestelmään kehityshankkeiden jälkeen. Lisätietoa tarvitaan myös siitä, miten sekä työntekijät että asiakkaat itse näkevät erilaiset hoitokäytännöt ja sen, mistä psykiatrisen hoidon tarve lähtökohtaisesti johtuu. Näihin kysymyksiin pyrimme vastamaan LPSHP:n ps…
Five-year cumulative exposure to antipsychotic medication after first-episode psychosis and its association with 19-year outcomes
Abstract Background: The long-term effectiveness of antipsychotic maintenance treatment after first-episode psychosis (FEP) is contested. In this real-world observational study, we examined how cumulative exposure to antipsychotics within the first 5 years from FEP was associated with the 19-year outcome. Methods: Finnish national registers were used to detect all patients who were hospitalized due to non-affective psychosis in the mid-1990s, and who were treatment naïve prior to the inclusion period (N = 1318). Generalized linear models with logit link function were used to estimate how cumulative exposure to antipsychotics within the first 5 years from onset was associated with mortality,…