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ABSTRACTS / 27TH NORDIC PSYCHIATRIC CONGRESS I
Friday 15/8, 11:00-12:30
Current concerns in nordic psychiatry: The Norwegian
perspective
Bjarte Stubhaug, President, Norwegian Psychiatric Association
no-psyk@online.no
Norway has been experiencing great changes in the structure and
legislation of psychiatry during recent years. The de-institutionali-
sation process has continued, resulting in lack of hospital beds for
the acutely ill patients. Community psychiatry is developing, and
many local psychiatric community centres have been established.
There is professional concern that this could weaken hospital
psychiatry and research, and that the specialized, research and
evidence based psychiatry is losing its position to a more com-
munity based psychosocial care.
Hospitals are run as enterprises, with demands of economic
balance.
The focus on economical issues is conflicting with professional
priorities.
There is lack of psychiatrists, and recruitment has been low.
Drug-related psychiatric disorders are increasing, creating new
needs for treatment and care.
Education and continuous professional development must meet
the need for new competence.
New health legislation has abolished the function of the psychi-
atrist as the professional leader of psychiatric services. Non-profes-
sionals may have leadership positions that include the professional
services.
The role and function of the psychiatrist is changing rapidly and
dramatically, towards the function of a medical consultant. Psychi-
atry as an integrated biopsychosocial field of medicine is being
challenged. Professional leadership issues must be resolved.
S-XXIII/3 Saturday 16/8,11:00-12:30
Current concerns in lcelandic psychiatry
Sigurður Páll Púlssun. Psychiatrist, Department of Psychiatry, University Hospital.
Reykjavík. Iceland
siggipp@centrum. is sigpp@landspitcili. is
Background: Compared to other nations the number of psychi-
atrists is high. Young doctors usually do part of their specialist train-
ing programme in Scandinavia, UK or USA. Thus, Icelandic psychi-
atry is influenced by different cultures, education, research, and ex-
Perience.
Besults:
A. Problems: 1) Increased demands for cuts in hospital beds and
use of new medication. 2) Decreasing availability of hospital-
beds. 3) Social services and primary health care have neither
resources nor experience to take over the responsibility of
our clients. 4) Two ministries are responsible for individuals
needing long-term service. 5) Prevention programmes are
still underdeveloped. 6) Need for rnore psychiatric nurses and
trained personnel. 7) Funding research 8) Strong central
administration, only one major hospital and one University.
8) Increasing knowledge of the consequences and high
prevalence of psychiatric disorders. Budgeting is in no
relation to size of the problems. The patients’ voice. Still a
fight against stigma and prejudice 9) Continued education
needs formalisation, financing and authority defined.
B. Positive aspects: Well-educated psychiatrists, many active in
research. Good availability for treatment of alcohol and drug
abuse. Concern for the individual.
Conclusions: Psychiatrists need to influence policy makers. Roles
and responsibility for different levels of service and education must
be clearer.
S-XXIII /4 Saturday 16/8,11:00-12:30
What is Swedish psychiatry concerned with?
Hans Ágren. Karolinska Institutet, Neurotec Department, Division of Psychiatry,
Huddinge University Hospital. Stockholm, Sweden. President of the Swedish
Psychiatric Association.
The old political antagonism of psychiatry-versus-psychology has
for some time been laid to rest in Sweden - a common intellectual
ground has been found in the realization that nature and nurture go
together. However, there are two areas where this harmonization is
still incomplete: the conceptualisation of ADHD and its possible
treatment with central stimulants has been under attack from socio-
logists, and certain lay mental advocate groups have managed to gel
political support in criticizing the increasing use of antidepressants
- they have confused addictive potential with discontinuation synd-
romes.
Other areas of major concern are the vast problems in Sweden
with exhaustive-depressive syndromes, where the increasing natio-
nal sick-leave rate is largely due to perceived work-place stress.
Whether exhaustion (“burn-out”) is equivalent to a depressive
disorder is unclear, as is its proper treatment. As vast a problem is
the psychiatric illness behaviour of refugee asylum seekers, where
mental problems arising during the extended waiting period before
immigrant status is granted has created a heavy burden on psychi-
atric services all over the country. Areas of debate have also inclu-
ded the use of antagonists and agonists in the continuation treat-
ment of heroine addicts, and programmes providing clean syringes
that exist in certain centres.
Psychiatric specialist education and continuing education is
under scrutiny by the Swedish Psychiatric Association, looking at
the UEMS guidelines and practices in other Nordic countries. The
new organisation of IPULS (Institute of Professional Education of
Physicians in Sweden) is an important new development, where
one single institute will judge and accredit every medical educatio-
nal activity, whether organized by academia or industry.
S-XXIII/5 Saturday 16/8, 11:00-12:30
Psychiatric care in Finland - achievements and
challenges
Raimo KK Salokangas. Professor of Psychiatry. University of Turku, Dept. of
Psychiatry. Kiinamyllynkatu 4-8,20520, Turku, Ftnland
raimo. k. r.salonkangas@lyks.fi
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