Esmatasandi auditiks valiti erinevatest ärev ushäiretest välja generaliseerunud ärevushäire ja pa... more Esmatasandi auditiks valiti erinevatest ärev ushäiretest välja generaliseerunud ärevushäire ja paanikahäire, mille kohta on 2014. aastal ilmunud perearstidele rav ijuhend. Esmatasandi spetsialistidel on vaimse tervise valdkonnas erinev ettevalmistus ning seetõttu võib diagnostiline ja terapeutiline käsitlus olla väga erinev (1). Käsitlust aitavad ühtlustada just ravijuhendid. Generaliseerunud ärevushäiret iseloomustab üldistunud ja püsiv ärevus, mis ei ole seotud kindlate keskkonnatingimustega või ei ole see tendents tugevalt väljendunud (2). Paanikahäire põhiliseks iseärasuseks on kor du v ad r a ske d ä r e v u shoo d eh k paanikahood, mis ei ole seotud k indla olukorra või muude välistingimustega ning seetõttu on subjektile ootamatud ja prognoosimatud (2). M a a i l m a Te r v i s e o r g a n i s a t s i o o n i hinnangul on ärevushäirete levimus 3,6% ning see on naistel sagedasem võrreldes meestega (4,6% vs. 2,6%) (3). Eestis on perearsti poole pöördujate hulgast üldistunud ärevushäire sümptomitega 10,2% naisi ja 5,5% mehi ning paanikahäire sümptomitega 8,0% naisi ja 5,5% mehi (4). Eesti Haigekassa andmetel diagnoosisid perearstid Eestis esmase diagnoosina generaliseerunud ärevushäiret (F41.1) 2017. aastal 310 isikul. Esmast paanikahäiret (F41.0) diagnoositi esmatasandil samal aastal 168 isikul.
as soon as possible after acceptance. Copyediting, typesetting, and review of the resulting proof... more as soon as possible after acceptance. Copyediting, typesetting, and review of the resulting proof will be undertaken on this manuscript before final publication of the Version of Record (VoR). Please note that during production and pre-press, errors may be discovered which could affect the content.
Computer Methods and Programs in Biomedicine, 2018
This is a PDF file of an unedited manuscript that has been accepted for publication. As a service... more This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Highlights EEG based measures for detection of depression Comparing linear and nonlinear EEG analysis methods' sensitivity to detect depression No single superior measure to detect depression High depression detection sensitivity by combining measures from single EEG channel
In the context of the EU’s Digital Single Market (eHealth) Strategy, the deployment of digital to... more In the context of the EU’s Digital Single Market (eHealth) Strategy, the deployment of digital tools for patients’ empowerment and person-centred care is of high demand and importance. Shifting from treatment to health promotion and disease prevention, a variety of internet-based cognitive behavioural therapy programmes have been proven to be effective for managing common mental health disorders in secondary care even hough the effectiveness and the clinical use of internet-based cognitive behavioural therapy programmes alone in primary care have not been approved yet. Additionally, such interventions are neither included in the international clinical guidelines for treating common mental health disorders nor regulated by Member States as a healthcare service. Despite that, the UK National Health Service and the Swedish National Board of Health and Welfare endorse the use of internet-based cognitive behavioural therapy as a first treatment option. The aim of this research is to inve...
Depression is a frequent psychiatric disorder, and depressive patient may be more problematic for... more Depression is a frequent psychiatric disorder, and depressive patient may be more problematic for the family doctors (FD) than a patient suffering from a somatic disease. Treatment of patients with depressive disorders is a relatively new task for Estonian FDs. The aim of our study was to find out the family doctors' attitudes to depression related problems, their readiness, motivating factors and problems in the treatment of depressive patients as well as the existence of relevant knowledge. In 2002, altogether 500 FDs in Estonia were invited to take part in a tailor-made questionnaire survey, of which 205 agreed to participate. Of the respondents 185(90%) considered management of depressive patients and their treatment to be the task of FDs. One hundred and eighty FDs (88%) were themselves ready to deal with depressed patients, and 200(98%) of them actually treated such patients. Commitment to the interests of the patients, better cooperation with successfully treated patients...
Continuity is an important aspect of cancer care that is often a challenge owing to the movement ... more Continuity is an important aspect of cancer care that is often a challenge owing to the movement of patients between family practice, cancer clinics, and hospitals. To investigate the experiences of cancer patients in relation to continuity of care. A qualitative study was conducted in a family practice setting. Semi-structured interviews were used for data collection. 10 cancer patients with a wide variation in their disease duration and experiences with medical care were interviewed. Open questions were used to encourage patients to express their personal experiences with cancer care. The interviews were recorded, transcribed and analysed by three researchers using thematic analysis. Cancer patients experienced a lack of information concerning cancer and its treatment. They also perceived that the cancer treatment made them suffer. In the patients' opinion, the family doctor has a limited role in cancer care. However, the patients felt that the family doctor should be aware of their health. The patients' satisfaction with the oncologist's care was high. They considered that their role in cancer care was to mediate an exchange of information between the oncologist and the family doctor. Cancer patients experience continuity of care in several ways: continuity in cancer care should be implemented by co-ordinating activities, such as regular check-ups, a clear timeframe and provision of adequate information. In addition, communication between the primary and secondary sector could be improved.
In a recent issue of European Journal of General Practice, in the article, ‘‘Relationship between... more In a recent issue of European Journal of General Practice, in the article, ‘‘Relationship between antidepressant and anxiolytic/hypnotic prescribing: a mixed-methods study’’ by Morrison et al., a study of 63 general practitioners’ (GP) opinions about their reasons for choosing antidepressants showed that GPs preferred to choose antidepressants, particularly selective serotonin reuptake inhibitors (SSRI), in the case of anxiety and overlap of anxiety and depression, as well as in the case of other mixed mood disorders (1). It means that the area of use of SSRIs, in the opinion of GPs, is much wider than only depression, which influences the use of traditional drugs prescribed previously in the case of other mood disorders. Morrison et al. declare that future research should continue to investigate the range of potential causes of the increase in antidepressant prescribing. Our tailor-made questionnaire-based survey of 205 family doctors (FD) aimed to find out FDs’ attitudes to mood-related problems, their readiness, motivating factors, and problems in treatment of patients with mood disorders, as well as the existence of relevant knowledge (2,3). Open questions were analysed using thematic analysis. To find out preferences for medicines, the reported preferences were summarized. For analysing preferences for medicines, all statements relating to preferences were marked, and similar preferences were further coded and categorized according to their content. The statements were analysed independently by the authors in a similar way, and any ambiguities in the analyses were discussed in order to reach consensus. In this study, the preferences and rationale of the pharmacological treatment of mood disorders including depression showed that preference of a drug was related not only to diagnosis but also to other factors depending on patient age, drug efficacy, etc. Questions concerning preferred medications in the treatment of depression, according to brand
Depressioon on uks sagedasem krooniline retsidiveeruv psuhhiaatriline haire esmatasandi arstiabi ... more Depressioon on uks sagedasem krooniline retsidiveeruv psuhhiaatriline haire esmatasandi arstiabi kasutajatel. Toos uuriti perearstide ravimieelistusi depressiooni ravimisel koos eelistuse pohjendusega ning vorreldi perearstide ja psuhhiaatrite maaratud ravimeid. Selgus, et perearstid diagnoosisid ule poole ambulatoorselt diagnoositud depressioonidest ja nad maarasid 65% antidepressantidest. Perearstid eelistasid depressiooni ravida selektiivsete serotoniini tagasihaarde inhibiitorite (SSRI) ruhma kuuluvate ravimitega, mis moodustasid 76,8% nende maaratud antidepressantidest. Perearstide ravimieelistused olid kooskolas patsiendile spetsiifilise ravimi ratsionaalse valiku teguritega. Eesti Arst 2005; 84 (7): 481–487
Depressioon on maailmas uks sagedasemaid psuuhikahaireid ja prognoositakse, et aastaks 2020 on se... more Depressioon on maailmas uks sagedasemaid psuuhikahaireid ja prognoositakse, et aastaks 2020 on see sudameveresoonkonnahaiguste jarel olulisel kohal ka toovoimetuse pohjustajana. Seetottu on oluline teada, milline on depressiooni esinemissagedus ning millised on selle hairega seostuvad pohilised tegurid. Ule-euroopalise depressiooni riskitegurite uurimisprojekti PREDICT raames Eestis tehtud uuring naitas, et depressiooni on esinenud viimase kuue kuu jooksul ligikaudu veerandil perearsti patsientidest ning viimase kuu jooksul peaaegu igal seitsmendal patsiendil. Sagedamini seostusid depressiooniga sellised tegurid nagu naissugu, tootus, pikaajaline raske haigus, majanduslik toimetulek ning negatiivsete elusundmuste olemasolu. Eesti Arst 2006; 85 (12): 811–816
Depression is a frequent psychiatric disorder, and depressive patient may be more problematic for... more Depression is a frequent psychiatric disorder, and depressive patient may be more problematic for the family doctors (FD) than a patient suffering from a somatic disease. Treatment of patients with depressive disorders is a relatively new task for Estonian FDs. The aim of our study was to find out the family doctors' attitudes to depression related problems, their readiness, motivating factors and problems in the treatment of depressive patients as well as the existence of relevant knowledge. In 2002, altogether 500 FDs in Estonia were invited to take part in a tailor-made questionnaire survey, of which 205 agreed to participate. Of the respondents 185(90%) considered management of depressive patients and their treatment to be the task of FDs. One hundred and eighty FDs (88%) were themselves ready to deal with depressed patients, and 200(98%) of them actually treated such patients. Commitment to the interests of the patients, better cooperation with successfully treated patients...
Esmatasandi auditiks valiti erinevatest ärev ushäiretest välja generaliseerunud ärevushäire ja pa... more Esmatasandi auditiks valiti erinevatest ärev ushäiretest välja generaliseerunud ärevushäire ja paanikahäire, mille kohta on 2014. aastal ilmunud perearstidele rav ijuhend. Esmatasandi spetsialistidel on vaimse tervise valdkonnas erinev ettevalmistus ning seetõttu võib diagnostiline ja terapeutiline käsitlus olla väga erinev (1). Käsitlust aitavad ühtlustada just ravijuhendid. Generaliseerunud ärevushäiret iseloomustab üldistunud ja püsiv ärevus, mis ei ole seotud kindlate keskkonnatingimustega või ei ole see tendents tugevalt väljendunud (2). Paanikahäire põhiliseks iseärasuseks on kor du v ad r a ske d ä r e v u shoo d eh k paanikahood, mis ei ole seotud k indla olukorra või muude välistingimustega ning seetõttu on subjektile ootamatud ja prognoosimatud (2). M a a i l m a Te r v i s e o r g a n i s a t s i o o n i hinnangul on ärevushäirete levimus 3,6% ning see on naistel sagedasem võrreldes meestega (4,6% vs. 2,6%) (3). Eestis on perearsti poole pöördujate hulgast üldistunud ärevushäire sümptomitega 10,2% naisi ja 5,5% mehi ning paanikahäire sümptomitega 8,0% naisi ja 5,5% mehi (4). Eesti Haigekassa andmetel diagnoosisid perearstid Eestis esmase diagnoosina generaliseerunud ärevushäiret (F41.1) 2017. aastal 310 isikul. Esmast paanikahäiret (F41.0) diagnoositi esmatasandil samal aastal 168 isikul.
as soon as possible after acceptance. Copyediting, typesetting, and review of the resulting proof... more as soon as possible after acceptance. Copyediting, typesetting, and review of the resulting proof will be undertaken on this manuscript before final publication of the Version of Record (VoR). Please note that during production and pre-press, errors may be discovered which could affect the content.
Computer Methods and Programs in Biomedicine, 2018
This is a PDF file of an unedited manuscript that has been accepted for publication. As a service... more This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Highlights EEG based measures for detection of depression Comparing linear and nonlinear EEG analysis methods' sensitivity to detect depression No single superior measure to detect depression High depression detection sensitivity by combining measures from single EEG channel
In the context of the EU’s Digital Single Market (eHealth) Strategy, the deployment of digital to... more In the context of the EU’s Digital Single Market (eHealth) Strategy, the deployment of digital tools for patients’ empowerment and person-centred care is of high demand and importance. Shifting from treatment to health promotion and disease prevention, a variety of internet-based cognitive behavioural therapy programmes have been proven to be effective for managing common mental health disorders in secondary care even hough the effectiveness and the clinical use of internet-based cognitive behavioural therapy programmes alone in primary care have not been approved yet. Additionally, such interventions are neither included in the international clinical guidelines for treating common mental health disorders nor regulated by Member States as a healthcare service. Despite that, the UK National Health Service and the Swedish National Board of Health and Welfare endorse the use of internet-based cognitive behavioural therapy as a first treatment option. The aim of this research is to inve...
Depression is a frequent psychiatric disorder, and depressive patient may be more problematic for... more Depression is a frequent psychiatric disorder, and depressive patient may be more problematic for the family doctors (FD) than a patient suffering from a somatic disease. Treatment of patients with depressive disorders is a relatively new task for Estonian FDs. The aim of our study was to find out the family doctors' attitudes to depression related problems, their readiness, motivating factors and problems in the treatment of depressive patients as well as the existence of relevant knowledge. In 2002, altogether 500 FDs in Estonia were invited to take part in a tailor-made questionnaire survey, of which 205 agreed to participate. Of the respondents 185(90%) considered management of depressive patients and their treatment to be the task of FDs. One hundred and eighty FDs (88%) were themselves ready to deal with depressed patients, and 200(98%) of them actually treated such patients. Commitment to the interests of the patients, better cooperation with successfully treated patients...
Continuity is an important aspect of cancer care that is often a challenge owing to the movement ... more Continuity is an important aspect of cancer care that is often a challenge owing to the movement of patients between family practice, cancer clinics, and hospitals. To investigate the experiences of cancer patients in relation to continuity of care. A qualitative study was conducted in a family practice setting. Semi-structured interviews were used for data collection. 10 cancer patients with a wide variation in their disease duration and experiences with medical care were interviewed. Open questions were used to encourage patients to express their personal experiences with cancer care. The interviews were recorded, transcribed and analysed by three researchers using thematic analysis. Cancer patients experienced a lack of information concerning cancer and its treatment. They also perceived that the cancer treatment made them suffer. In the patients' opinion, the family doctor has a limited role in cancer care. However, the patients felt that the family doctor should be aware of their health. The patients' satisfaction with the oncologist's care was high. They considered that their role in cancer care was to mediate an exchange of information between the oncologist and the family doctor. Cancer patients experience continuity of care in several ways: continuity in cancer care should be implemented by co-ordinating activities, such as regular check-ups, a clear timeframe and provision of adequate information. In addition, communication between the primary and secondary sector could be improved.
In a recent issue of European Journal of General Practice, in the article, ‘‘Relationship between... more In a recent issue of European Journal of General Practice, in the article, ‘‘Relationship between antidepressant and anxiolytic/hypnotic prescribing: a mixed-methods study’’ by Morrison et al., a study of 63 general practitioners’ (GP) opinions about their reasons for choosing antidepressants showed that GPs preferred to choose antidepressants, particularly selective serotonin reuptake inhibitors (SSRI), in the case of anxiety and overlap of anxiety and depression, as well as in the case of other mixed mood disorders (1). It means that the area of use of SSRIs, in the opinion of GPs, is much wider than only depression, which influences the use of traditional drugs prescribed previously in the case of other mood disorders. Morrison et al. declare that future research should continue to investigate the range of potential causes of the increase in antidepressant prescribing. Our tailor-made questionnaire-based survey of 205 family doctors (FD) aimed to find out FDs’ attitudes to mood-related problems, their readiness, motivating factors, and problems in treatment of patients with mood disorders, as well as the existence of relevant knowledge (2,3). Open questions were analysed using thematic analysis. To find out preferences for medicines, the reported preferences were summarized. For analysing preferences for medicines, all statements relating to preferences were marked, and similar preferences were further coded and categorized according to their content. The statements were analysed independently by the authors in a similar way, and any ambiguities in the analyses were discussed in order to reach consensus. In this study, the preferences and rationale of the pharmacological treatment of mood disorders including depression showed that preference of a drug was related not only to diagnosis but also to other factors depending on patient age, drug efficacy, etc. Questions concerning preferred medications in the treatment of depression, according to brand
Depressioon on uks sagedasem krooniline retsidiveeruv psuhhiaatriline haire esmatasandi arstiabi ... more Depressioon on uks sagedasem krooniline retsidiveeruv psuhhiaatriline haire esmatasandi arstiabi kasutajatel. Toos uuriti perearstide ravimieelistusi depressiooni ravimisel koos eelistuse pohjendusega ning vorreldi perearstide ja psuhhiaatrite maaratud ravimeid. Selgus, et perearstid diagnoosisid ule poole ambulatoorselt diagnoositud depressioonidest ja nad maarasid 65% antidepressantidest. Perearstid eelistasid depressiooni ravida selektiivsete serotoniini tagasihaarde inhibiitorite (SSRI) ruhma kuuluvate ravimitega, mis moodustasid 76,8% nende maaratud antidepressantidest. Perearstide ravimieelistused olid kooskolas patsiendile spetsiifilise ravimi ratsionaalse valiku teguritega. Eesti Arst 2005; 84 (7): 481–487
Depressioon on maailmas uks sagedasemaid psuuhikahaireid ja prognoositakse, et aastaks 2020 on se... more Depressioon on maailmas uks sagedasemaid psuuhikahaireid ja prognoositakse, et aastaks 2020 on see sudameveresoonkonnahaiguste jarel olulisel kohal ka toovoimetuse pohjustajana. Seetottu on oluline teada, milline on depressiooni esinemissagedus ning millised on selle hairega seostuvad pohilised tegurid. Ule-euroopalise depressiooni riskitegurite uurimisprojekti PREDICT raames Eestis tehtud uuring naitas, et depressiooni on esinenud viimase kuue kuu jooksul ligikaudu veerandil perearsti patsientidest ning viimase kuu jooksul peaaegu igal seitsmendal patsiendil. Sagedamini seostusid depressiooniga sellised tegurid nagu naissugu, tootus, pikaajaline raske haigus, majanduslik toimetulek ning negatiivsete elusundmuste olemasolu. Eesti Arst 2006; 85 (12): 811–816
Depression is a frequent psychiatric disorder, and depressive patient may be more problematic for... more Depression is a frequent psychiatric disorder, and depressive patient may be more problematic for the family doctors (FD) than a patient suffering from a somatic disease. Treatment of patients with depressive disorders is a relatively new task for Estonian FDs. The aim of our study was to find out the family doctors' attitudes to depression related problems, their readiness, motivating factors and problems in the treatment of depressive patients as well as the existence of relevant knowledge. In 2002, altogether 500 FDs in Estonia were invited to take part in a tailor-made questionnaire survey, of which 205 agreed to participate. Of the respondents 185(90%) considered management of depressive patients and their treatment to be the task of FDs. One hundred and eighty FDs (88%) were themselves ready to deal with depressed patients, and 200(98%) of them actually treated such patients. Commitment to the interests of the patients, better cooperation with successfully treated patients...
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