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Læknablaðið - 01.11.2015, Síða 24

Læknablaðið - 01.11.2015, Síða 24
524 LÆKNAblaðið 2015/101 Heimildir 1. Mcgrath J, Saha S, Chant D, Welham J. Schizophrenia: a concise overview of incidence, prevalence, and morta- lity. Epidemiol Rev 2008; 30: 67-76. 2. World Health Organization. The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. (2. útgáfa). Genf 2007. 3. Hausmann A, Fleischhacker WW. Differential diagnosis of depressed mood in patients with schizophrenia: a diagnostic algorithm based on a review. Acta Psychiatr Scand 2002; 106: 83-96. 4. Nordentoft M, Wahlbeck K, Hallgren J, Westman J, Osby U, Alinaghizadeh H et al. Excess mortality, causes of death and life expectancy in 270,770 patients with recent onset of mental disorders in Denmark, Finland and Sweden. PloS One 2013; 8: e55176. 5. Roick C, Fritz-Wieacker A, Matschinger H, Heider D, Schindler J, Riedel-Heller S, et al. Health habits of patients with schizophrenia. Soc Psychiatry Psychiatr Epidemiol 2007; 42: 268-76. 6. Sveinsson Ó, Þorleifsson K, Aspelund T, Kolbeinsson H. Rannsókn á áhættuþáttum hjarta- og æðasjúkdóma hjá geðklofasjúklingum á geðsviði Landspítala. Læknablaðið 2012; 98: 399-402. 7. McIntyre RS, McCann SM, Kennedy SH. Antipsychotic metabolic effects: weight gain, diabetes mellitus, and lipid abnormalities. Can J Psychiat 2001; 46: 273-81. 8. Daumit GL, Dickerson FB, Wang PN, Dalcin A, Jerome GJ, Anderso CAM et al. A behavioral weight-loss intervention in persons with serious mental illness. N Engl J Med 2013; 368: 1594-602. 9. Warburton D, Charlesworth S, Ivey A, Nettlefold L, Bredin S. A systematic review of the evidence for Canada's physi- cal activity guidelines for adults. IJBNPA 2010; 7: 1 -220. 10. Gorczynski P, Faulkner G. Exercise therapy for schizop- hrenia. Schizophr Bull 2010; 36: 665-6. 11. Pelham T, Campagna P, Ritvo P, Birnie W.The effects of exercise therapy on clients in a psychiatric rehabilitation program. Psychosoc Rehabil J 1993; 16: 75-84. 12. Tkachuk GA, Martin GL. Exercise therapy for patients with psychiatric disorders: research and clinical implica- tions. Prof Psychol Res Pr 1999; 30: 275-82. 13. Asmundson GJG, Fetzner M., DeBoer LB, Powers MB, Otto MW, Smits JAJ. Let´s get physical: a contemporary review of the anxiolytic effects of exercise for anxiety and its disorders. Depress Anxiety; 30: 362-73. 14. Faulkner G, Gorczynski P, Arbour-Nicitopoulos K. Exercise as an adjunct treatment for schizophenia. Routledge handbook of physical activity and mental health. Ekkekakis, Panteleimon 2013a; 541. 15. Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1987; 13: 261-76. 16. Lovibond PF. The structure of negative emotional states: comparison of the depression anxiety stress scales (DASS) with the Beck sepression and anxiety inventories. Behav Res Ther 1995; 33: 335-43. 17. Evans C, Connell J, Barkham M, Margison F, McGrath G, Mellor-Clark J et al. Towards a standardised brief outcome measure: psychometric properties and utility of the CORE—OM. Br J Psychiatry 2002; 180: 51-60. 18. Flanagan J. A research approach to improving our quality of life. Am J Commun Psychol 1978; 33: 138-47. 19. Rosenberg M. Society and the adolescent self-image. Princeton University Press, Princeton NJ 1965. 20. Beck ATW, Lester D, Trexler L. The measurement of pessimism: The hopelessness scale. J Consult Clin 1974; 42: 861-5. 21. Halldórsdóttir S. Vancouver-skólinn í fyrirbærafræði. Í Sigríður Halldórsdóttir og Kristján Kristjánsson, ritstj. Handbók í aðferðafræði og rannsóknum í heilbrigðis- vísindum. Háskólinn á Akureyri, Akureyri 2003: 249-66. 22. Shapiro SS, Wilk MB. An analysis of variance tests for normality (complete samples). Biometrica 1965; 52: 591- 611. 23. Lakens D. Calculating and reporting effect sizes to facili- tate cumulative science: a practical primer for t-tests and ANOVAs. Front Psychol 2013; 4: 863. 24. Beebe L, Tian L, Goodwin A, Allen S, Kuldau J. Effects of exercise on mental and physical health parameters of persons with schizophrenia. Issues Ment Health Nurs 2005; 26: 661-76. 25. Chamove AS. Positive short-term effects of activity on behaviour in chronic schizophrenic patients. Brot J Clin Psychol 1986; 25: 125-33 26. Pelham T, Campagna P. Benefits of exercise in psychiatric rehabilitation of persons with schizophrenia. Can J Reh 1991; 4: 159-68. 27. Ussher M, Doshi R, Sampuran A, West R. Cardiovascular risk factors in patients with schizophrenia receiving continuous medical care. Community Ment Health J 2011; 47: 688-93. 28. De Hert M, Detraux J, Van Winkel R, Yu W Correll CU. Metabolic and cardiovascular adverse effects asso- ciated with antipsychotic drugs. Nat Rev Endocrino 2011; 8: 114-26. 29. Daley AJ. Exercise therapy and mental health in clinical populations: Is exercise therapy a worthwhile interven- tion? Adv Psychiatr Treat 2002; 8: 262-70. 30. Faulkner G, Duncan M, Hahn M, Remington G, Cohn T. Behavioural interventions for reducing weight gain in schizophrenia. Cochrane Library 2013b; 24: 1. ENgLISH SUMMArY introduction: due to an unhealthy lifestyle, individuals with schizop- hrenia are at higher risk of morbidity compared to the general popula- tion. Studies have shown that physical activity can have positive effects on physical and mental health in these patients. The aim of the study was to evaluate the effects of a physical activity intervention on symp- toms of schizophrenia, as well as on a number of physical and mental health variables. The aim was also to gain more understanding of the participants´ experience of the intervention with interviews. Material and methods: Seventeen individuals between the ages of 21-31, diagnosed with schizophrenia participated in the study. They exercised under professional supervision for a minimum of two sessions per week for 20 weeks and attended weekly lectures on a healthy lif- estyle. The participants answered standardized questionnaires (PANSS, dASS, Rosenberg, CoRE-oM, BHS, QoLS), and physical measure- ments (weight, height, body mass index, resting blood pressure, waist circumference and resting heart rate) were taken before and after the intervention. Six participants were interviewed after the intervention and asked about their experience. Results: Negative and general psychiatric symptoms, depression, anxiety and stress scores decreased significantly whereas well-being, quality of life and physical activity increased (p<0.05). Apart from resting heart rate that decreased (p<0.05), physical measurements remained unchanged at the end of the intervention. Conclusion: The participants´ physical activity increased, their mental well-being improved, and they did not gain weight during the interven- tion period. Regular exercise under supervision and education about a healthy lifestyle are a beneficial adjunct to the primary treatment of people with schizophrenia. The effects of physical activity intervention on symptoms in schizophrenia, mental well-being and body composition in young adults kristjana Sturludóttir1,2, Sunna Gestsdóttir2, Rafn Haraldur Rafnsson1, Erlingur jóhannsson2 1Division of Psychiatry, Landspitali University Hospital2, Research Centre for Sport and Health Sciences, School of Education, University of Iceland key words: schizophrenia, physical activity, positive symptoms, negative symptoms, mental well-being, intervention. Correspondence: Erlingur Jóhannsson, erljo@hi.is R A N N S Ó K N gegn heilablóðfalli/ segareki Forvörn gegn heilablóðfalli / segareki hjá sjúklingum með gáttatif sem ekki tengist lokusjúkdómum (NVAF) ásamt einum eða fleiri áhættuþáttum. Aðeins Eliquis® tengir saman þessa kosti Veldu Eliquis®, eina Xa hemilinn sem sýnt hefur verið fram á að veiti áhrifaríkari vörn gegn heilablóðfalli/segareki með marktækt minni tíðni á meiriháttar blæðingum samanborið við warfarin2. Eliquis® (apixaban), sem ætlað er til inntöku, er beinn hemill á storkuþátt Xa og hefur eftirfarandi ábendingar: • Forvörn gegn bláæðasegareki (VTE) hjá fullorðnum sjúklingum sem hafa gengist undir valfrjáls mjaðmarliðskipti eða hnéliðskipti. • Forvörn gegn heilablóðfalli og segareki í slagæð hjá fullorðnum sjúklingum með gáttatif sem ekki tengist hjartalokusjúkdómum (non-valvular atrial fibrillation, NVAF) ásamt einum eða fleiri áhættuþáttum, svo sem sögu um heilablóðfall eða tímabundna blóðþurrð í heila (transient ischaemic attack, TIA), aldur ≥75 ára, háþrýstingi, sykursýki eða hjartabilun með einkennum (NYHA flokkur ≥II)1. • Meðferð við segamyndun í djúplægum bláæðum (DVT) og lungnasegareki (PE) og forvörn gegn endurtekinni segamyndun í djúplægum bláæðum og lungnasegareki hjá fullorðnum. Þetta lyf er undir sérstöku eftirliti til að nýjar upplýsingar um öryggi lyfsins komist fljótt og örugglega til skila. Heilbrigðisstarfsmenn eru hvattir til að tilkynna allar aukaverkanir sem grunur er um að tengist lyfinu. Sjá frekari upplýsingar um lyfið á www. lyfjastofnun.is Heimildir: 1. Samantekt á eiginleikum lyfs fyrir Eliquis. 2. Granger CB et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med 2011; 365: 981–992.2. Áhrifaríkari vörn PF151001 samanborið við warfarin2samanborið við warfarin2 Minni tíðni meiriháttar blæðinga

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