{"id":1179,"date":"2014-10-28T16:40:59","date_gmt":"2014-10-28T16:40:59","guid":{"rendered":"http:\/\/www.harpahreins.com\/blogg\/?p=1179"},"modified":"2014-10-28T21:59:16","modified_gmt":"2014-10-28T21:59:16","slug":"visindaleg-huglaegni-i-greiningu-thunglyndis","status":"publish","type":"post","link":"https:\/\/harpahreins.com\/blogg\/2014\/10\/28\/visindaleg-huglaegni-i-greiningu-thunglyndis\/","title":{"rendered":"V\u00edsindaleg hugl\u00e6gni \u00ed greiningu \u00feunglyndis"},"content":{"rendered":"<p>&nbsp;<\/p>\n<p><a href=\"https:\/\/i0.wp.com\/harpahreins.com\/blogg\/wp-content\/uploads\/2014\/10\/greining_thunglyndis.jpg?ssl=1\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" class=\"alignnone  wp-image-1206\" style=\"margin: 5px;\" alt=\"greining_thunglyndis\" src=\"https:\/\/i0.wp.com\/harpahreins.com\/blogg\/wp-content\/uploads\/2014\/10\/greining_thunglyndis.jpg?resize=328%2C280&#038;ssl=1\" width=\"328\" height=\"280\" srcset=\"https:\/\/i0.wp.com\/harpahreins.com\/blogg\/wp-content\/uploads\/2014\/10\/greining_thunglyndis.jpg?w=468&amp;ssl=1 468w, https:\/\/i0.wp.com\/harpahreins.com\/blogg\/wp-content\/uploads\/2014\/10\/greining_thunglyndis.jpg?resize=300%2C256&amp;ssl=1 300w\" sizes=\"auto, (max-width: 328px) 100vw, 328px\" \/><\/a><\/p>\n<p>Enn held \u00e9g \u00e1fram a\u00f0 velta fyrir m\u00e9r efni greinar um ranns\u00f3kn \u00e1 \u00feunglyndum k\u00f6rlum \u00e1 Su\u00f0urnesjum (Sigurdsson, B. o.fl. 2013), sj\u00e1 fyrri f\u00e6rslur <a title=\"\u00feunglyndi karla\" href=\"https:\/\/harpahreins.com\/blogg\/2014\/10\/13\/visindaleg-rannsokn-a-thunglyndi-karla\/\" target=\"_blank\">h\u00e9r<\/a> og <a title=\"\u00feunglyndir karlar\" href=\"https:\/\/harpahreins.com\/blogg\/2014\/10\/16\/sjo-melankoliskir-sudurnesjamenn\/\" target=\"_blank\">h\u00e9r<\/a>. \u00cd greininni birtist nefnilega \u00ed hnotskurn flest sem hefur veri\u00f0 mj\u00f6g til umr\u00e6\u00f0u \u00e1 \u00feessari \u00f6ld um starfsa\u00f0fer\u00f0ir ge\u00f0l\u00e6kna, einkum \u00feann v\u00e6gast sagt \u00f3st\u00f6\u00f0uga grunn sem \u00feunglyndisgreiningar \u00feeirra byggja \u00e1.<\/p>\n<p>\u00deessi f\u00e6rsla fjallar einkum um greiningart\u00e6ki ge\u00f0l\u00e6knanna \u00ed ranns\u00f3kninni. \u00cd framhaldsf\u00e6rslu ver\u00f0ur sko\u00f0a\u00f0 hvernig e\u00f0a hvort \u00feau n\u00fdttust til a\u00f0 greina milli \u00feunglyndra og heilbrig\u00f0ra karla \u00e1 Su\u00f0urnesjum \u00ed \u00e1rsbyrjun 2004.<\/p>\n<h3><strong>Hva\u00f0 \u00e1tti a\u00f0 rannsaka?<\/strong><\/h3>\n<p>A\u00f0al ranns\u00f3knarspurningin \u00ed Su\u00f0urnesjamannaranns\u00f3kninni var \u00a0hversu vel tveir m\u00e6likvar\u00f0ar \u00e1 \u00feunglyndi (spurningalistar) f\u00e9llu a\u00f0 ge\u00f0l\u00e6knismati sem bygg\u00f0i \u00e1 greiningarlykli DSM-IV \u00ed vi\u00f0t\u00f6lum vi\u00f0 \u00feunglynda karla.<\/p>\n<h3><strong>Greiningart\u00e6ki til a\u00f0 meta \u00feunglyndi<\/strong><\/h3>\n<p>Marga sj\u00fakd\u00f3ma m\u00e1 greina me\u00f0 n\u00e1kv\u00e6mum l\u00edffr\u00e6\u00f0ilegum pr\u00f3fum en svo er ekki me\u00f0 \u00feunglyndi. \u00cd \u00feunglyndisgreiningu er \u00fea\u00f0 fyrst og s\u00ed\u00f0ast hugl\u00e6gt mat eins manns, ge\u00f0l\u00e6knisins e\u00f0a heimilisl\u00e6knisins sem leita\u00f0 er til, sem sker \u00far um hvort einstaklingur teljist \u00feunglyndur e\u00f0a ekki, m\u00f6gulega \u00f6rf\u00e1rra sl\u00edkra l\u00e6kna ef sj\u00faklingur leitar til fleiri en eins.<\/p>\n<p>Gjarna er bent \u00e1 a\u00f0 \u201ekl\u00edn\u00edsk reynsla\u201c ge\u00f0l\u00e6kna n\u00fdtist vel \u00ed greiningu og me\u00f0h\u00f6ndlun \u00feunglyndis. \u00deetta hugtak er hugsa\u00f0 alveg eins og \u201ekennslureynsla\u201c kennara, \u201euppeldisreynsla\u201c foreldra o.fl. \u201eKl\u00edn\u00edsk reynsla\u201c er reynsla l\u00e6knis af sj\u00faklingum sem hann hefur sinnt. \u00cd sumum fr\u00e6\u00f0igreinum \u00a0vir\u00f0ast pers\u00f3nulegar sko\u00f0anir ge\u00f0l\u00e6kna sem bygg\u00f0ar eru \u00e1 kl\u00edn\u00edskri reynslu teljast t\u00e6kt m\u00e6lit\u00e6ki til a\u00f0 meta b\u00e6\u00f0i \u00feunglyndi og verkan svokalla\u00f0ra \u00feunglyndislyfja.<\/p>\n<p>Hi\u00f0 hugl\u00e6ga mat ge\u00f0l\u00e6knis, byggt \u00e1 reynslu af sj\u00faklingum sem hann hefur sinnt, er stutt greiningarlyklum l\u00e6knisins og krossapr\u00f3fasv\u00f6run sj\u00faklings. Af \u00fev\u00ed hvoru tveggja greiningarlyklarnir og krossapr\u00f3fin eru bygg\u00f0 \u00e1 hugl\u00e6gu mati \u00feeirra sem bjuggu \u00feetta til \u00e1 hva\u00f0 skuli teljast \u00feunglyndi er vafasamt a\u00f0 telja \u00feetta v\u00edsindaleg m\u00e6lit\u00e6ki.<\/p>\n<h3><strong>DSM<\/strong><\/h3>\n<p>DSM er skammst\u00f6fun fyrir riti\u00f0 <em>Diagnostic and Statistical Manual of Mental Disorders<\/em> sem Amer\u00edsku ge\u00f0l\u00e6knasamt\u00f6kin gefa \u00fat. \u00deetta er, eins og nafni\u00f0 gefur til kynna, handb\u00f3k handa ge\u00f0l\u00e6knum til a\u00f0 \u00feeir geti greint ge\u00f0r\u00e6na kvilla. Fr\u00e1 og me\u00f0 \u00fatg\u00e1fu <em>DSM-III<\/em>, \u00e1ri\u00f0 1980, hafa ge\u00f0l\u00e6knar haft fyrir satt \u00fea\u00f0 sem \u00ed ritinu stendur. \u00cd Su\u00f0urnesjamannaranns\u00f3kninni var stu\u00f0st vi\u00f0 <em>DSM-IV<\/em> en ritsins\u00a0ekki geti\u00f0 \u00ed heimildaskr\u00e1 greinarinnar (Sigurdsson, B. o.fl. 2013). \u00c9g reikna me\u00f0 a\u00f0 \u00fea\u00f0 eigi s\u00e9r svipa\u00f0ar sk\u00fdringar og ef gu\u00f0fr\u00e6\u00f0ingar s\u00e6ju ekki endilega \u00e1st\u00e6\u00f0u til a\u00f0 hafa Bibl\u00eduna me\u00f0 \u00ed heimildaskr\u00e1 greinar um gu\u00f0fr\u00e6\u00f0i. \u00de\u00f3tt h\u00e9rlendis s\u00e9 \u00ed heilbrig\u00f0ism\u00e1lum skylt a\u00f0 nota sta\u00f0al Al\u00fej\u00f3\u00f0aheilbrig\u00f0isstofnunar Sameinu\u00f0u \u00fej\u00f3\u00f0anna, ICD-10, til a\u00f0 greina og flokka sj\u00fakd\u00f3ma taka margir \u00edslenskir ge\u00f0l\u00e6knar \u00fea\u00f0 ekki til s\u00edn: \u00deeirra Bibl\u00eda er samt sem \u00e1\u00f0ur \u00feessi amer\u00edski greiningarlykill.<\/p>\n<p>\u00cd DSM er engin tilraun ger\u00f0 til a\u00f0 sk\u00fdra ors\u00f6k e\u00f0a uppruna ge\u00f0sj\u00fakd\u00f3ma heldur er talinn upp listi einkenna hvers sj\u00fakd\u00f3ms og s\u00ed\u00f0an gefi\u00f0 upp hve m\u00f6rg einkennanna sj\u00faklingur \u00feurfi a\u00f0 s\u00fdna til a\u00f0 greinast me\u00f0 \u00feennan e\u00f0a hinn ge\u00f0sj\u00fakd\u00f3minn.<\/p>\n<p>Me\u00f0 hverri \u00fatg\u00e1fu lengist \u00feessi greiningarlykill og inniheldur \u00e6 fleiri einkenni \u00ed h\u00e1tterni e\u00f0a l\u00ed\u00f0an sem teljast til marks um ge\u00f0r\u00e6nan sj\u00fakd\u00f3m \u00fe\u00f3tt almenningur hafi hinga\u00f0 til tali\u00f0 sumt \u00feessarar l\u00ed\u00f0anar e\u00f0a h\u00e1tternis nokk e\u00f0lilegt (Shorter. 2013). S\u00f6mulei\u00f0is fj\u00f6lgar ge\u00f0sj\u00fakd\u00f3mum me\u00f0 hverri n\u00fdrri \u00fatg\u00e1fu. M\u00e1 nefna sem d\u00e6mi a\u00f0 <em>DSM-III<\/em> var 495 s\u00ed\u00f0ur sem ger\u00f0i 265 sj\u00fakd\u00f3msgreiningum skil, \u00ed <em>DSM-IV<\/em>, sem kom fyrst \u00fat 1994, haf\u00f0i skilgreindum ge\u00f0sj\u00fakd\u00f3mum fj\u00f6lga\u00f0 \u00ed 297 og b\u00f3kin var or\u00f0in 886 bla\u00f0s\u00ed\u00f0ur, <em>DSM-5<\/em>, sem kom \u00fat \u00ed ma\u00ed \u00ed fyrra er 947 s\u00ed\u00f0ur en \u00e9g veit ekki t\u00f6lu sj\u00fakd\u00f3ma \u00fear.<\/p>\n<p>S\u00fdnt hefur veri\u00f0 fram \u00e1 mj\u00f6g sterk tengsl lyfjai\u00f0na\u00f0arins vi\u00f0 \u00fe\u00e1 sem semja efni\u00f0 \u00ed DSM og er \u00fea\u00f0 vatn \u00e1 myllu \u00feeirra sem halda \u00fev\u00ed fram a\u00f0 eitt markmi\u00f0 DSM s\u00e9 a\u00f0 sj\u00fakd\u00f3msv\u00e6\u00f0a sem flest til a\u00f0 auka lyfs\u00f6lu. \u00cd lj\u00f3s hefur komi\u00f0 \u00a0a\u00f0 um helmingur \u00feeirra sem s\u00f6mdu sj\u00fakd\u00f3msl\u00fdsingar\/skilgreiningarmerki sj\u00fakd\u00f3ma \u00ed\u00a0<em>DSM-IV<\/em> haf\u00f0i einhver fj\u00e1rhagsleg tengsl vi\u00f0 lyfjai\u00f0na\u00f0inn. \u00deegar um var a\u00f0 r\u00e6\u00f0a sj\u00fakd\u00f3ma \u00fear sem lyf eru yfirleitt fyrsti l\u00e6kningarkosturinn, s.s. ge\u00f0klofa e\u00f0a lyndisraskanir (en \u00feunglyndi fellur undir sl\u00edkar raskanir) voru tengslin enn sterkari: Allir \u00ed nefndunum sem s\u00f6mdu skilgreiningar og greiningarmerki fyrir \u00fe\u00e1 sj\u00fakd\u00f3ma h\u00f6f\u00f0u fj\u00e1rhagsleg tengsl vi\u00f0 lyfjai\u00f0na\u00f0inn (Cosgrove, L. o.fl. 2006)!<\/p>\n<p><em>\u00cd DSM-IV<\/em> eru greindar nokkrar sortir af \u00feunglyndi og \u00fe\u00e6r misalvarlegar. H\u00e9r ver\u00f0ur sj\u00f3num einkum beint a\u00f0 alvarlegu \u00feunglyndi. <a title=\"Greiningarlykill alvarlegs \u00feunglyndis \u00ed DSM-IV\" href=\"http:\/\/behavenet.com\/node\/21569\">Greiningarlykillinn fyrir alvarlegt \u00feunglyndi<\/a> er eins \u00ed <em>DSM-IV<\/em>, sem kom \u00fat 1994 og <em>DSM-IV-TR<\/em>, endursko\u00f0a\u00f0ri \u00fatg\u00e1fu sem kom \u00fat \u00e1ri\u00f0 2000 (Diagnostic criteria for Major Depressive Episode, \u00e1n \u00e1rtals) svo sl\u00e6leg heimildaskr\u00e1ning \u00ed grein Bjarna Sigur\u00f0ssonar og f\u00e9laga (Sigurdsson o.fl. 2013) kemur ekki eins miki\u00f0 a\u00f0 s\u00f6k. \u00deetta er fj\u00f6lbreyttur listi 9 einkenna sem snerta h\u00e1tterni og l\u00ed\u00f0an. Til \u00feess a\u00f0 sj\u00faklingur greinist me\u00f0 alvarlegt \u00feunglyndi \u00feurfa 5 \u00feeirra a\u00f0 hafa l\u00e1ti\u00f0 \u00e1 s\u00e9r kr\u00e6la \u00ed h\u00e1lfan m\u00e1nu\u00f0 samfleytt, \u00fear af ver\u00f0ur eitt einkennanna a\u00f0 vera anna\u00f0 hvort \u00feungsinni (l\u00e6kka\u00f0 ge\u00f0slag) e\u00f0a sinnuleysi (finna hvorki fyrir \u00e1huga n\u00e9 \u00e1n\u00e6gju).<\/p>\n<p>\u00cd Su\u00f0urnesjamannaranns\u00f3kninni greindu ge\u00f0l\u00e6knarnir 12 karla me\u00f0 alvarlegt \u00feunglyndi og 2 karla me\u00f0 \u00f3yndi (Dysthymic Disorder) en sj\u00e1 m\u00e1 skilmerki fyrir \u00feann sj\u00fakd\u00f3m \u00ed <em>DSM-IV-TR<\/em> <a title=\"\u00f3yndi skilgreint \u00ed DSM-IV-TR\" href=\"http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK64063\/\">ofarlega \u00e1 \u00feessari vefs\u00ed\u00f0u<\/a>\u00a0(Substance Abuse and Mental Health Services Administration. 2008). \u00cd<em> DSM-5<\/em> sem kom \u00fat \u00ed fyrra er \u00f3yndi ekki lengur talin s\u00e9rst\u00f6k lyndisr\u00f6skun (Hiller. 6\/6 2013).<\/p>\n<p>&nbsp;<\/p>\n<p><a href=\"https:\/\/i0.wp.com\/harpahreins.com\/blogg\/wp-content\/uploads\/2014\/10\/krossaval.jpg?ssl=1\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" class=\"alignnone  wp-image-1207\" style=\"margin: 5px;\" alt=\"krossaval\" src=\"https:\/\/i0.wp.com\/harpahreins.com\/blogg\/wp-content\/uploads\/2014\/10\/krossaval.jpg?resize=324%2C141&#038;ssl=1\" width=\"324\" height=\"141\" srcset=\"https:\/\/i0.wp.com\/harpahreins.com\/blogg\/wp-content\/uploads\/2014\/10\/krossaval.jpg?w=540&amp;ssl=1 540w, https:\/\/i0.wp.com\/harpahreins.com\/blogg\/wp-content\/uploads\/2014\/10\/krossaval.jpg?resize=300%2C130&amp;ssl=1 300w\" sizes=\"auto, (max-width: 324px) 100vw, 324px\" \/><\/a><\/p>\n<h3><\/h3>\n<h3><strong>\u00deunglyndiskvar\u00f0i Beck<\/strong><\/h3>\n<p>Til stu\u00f0nings hugl\u00e6gu mati \u00e1 hvort sj\u00faklingur s\u00e9 haldinn \u00feunglyndi mi\u00f0a\u00f0 vi\u00f0 upptalningu einkenna \u00ed DSM geta ge\u00f0l\u00e6knar haft til hli\u00f0sj\u00f3nar spurningalista sem eiga a\u00f0 vera m\u00e6likvar\u00f0i \u00e1 \u00feunglyndiseinkenni. Vins\u00e6lastur \u00feeirra er Beck \u00feunglyndiskvar\u00f0inn (<a title=\"\u00deunglyndiskvar\u00f0i Beck-II\" href=\"http:\/\/www.ibogaine.desk.nl\/graphics\/3639b1c_23.pdf\">Beck Depression Inventory<\/a>) , krossapr\u00f3f sem sj\u00faklingur fyllir sj\u00e1lfur \u00fat. Kr\u00e6kt er \u00ed BDI-II, \u00fatg. 1996, \u00e1 ensku, en s\u00e1 kvar\u00f0i var \u00a0v\u00e6ntanlega nota\u00f0ur \u00ed Su\u00f0urnesjamannaranns\u00f3kninni. Sj\u00e1 m\u00e1 <a title=\"Beck \u00feunglyndiskvar\u00f0inn gamli\" href=\"http:\/\/www.hirsla.lsh.is\/lsh\/bitstream\/2336\/99939\/1\/G1990-01-21-G5.pdf\">gamla \u00fatg\u00e1fu kvar\u00f0ans fr\u00e1 1979 \u00e1 \u00edslensku<\/a> (Eir\u00edkur \u00d6rn Arnarson. 1990). Beck \u00feunglyndiskvar\u00f0anum var breytt 1996 svo hann f\u00e9lli a\u00f0 breyttum greiningarskilmerkjum \u00feegar <em>DSM-IV<\/em> t\u00f3k vi\u00f0 af <em>DSM-III<\/em>.<\/p>\n<p>Stigin fyrir framan \u00fatfylltu m\u00f6guleikana eru l\u00f6g\u00f0 saman og oftast er mi\u00f0a\u00f0 vi\u00f0 a\u00f0 skor undir 14 stigum \u00fe\u00fd\u00f0i a\u00f0 \u00fatfyllari s\u00e9 laus vi\u00f0 \u00feunglyndi, 14-19 stig gefa v\u00edsbendingu um v\u00e6gt \u00feunglyndi, 20-28 stig benda til talsver\u00f0s e\u00f0a alvarlegs \u00feunglyndis, 29-63 stig \u00feykja endurspegla illv\u00edgt \u00feunglyndi.<\/p>\n<h3><strong>Gotlenski m\u00e6likvar\u00f0inn \u00e1 \u00feunglyndi karla (GMDS<\/strong>)<\/h3>\n<p>Wolfang Rutz o.fl. h\u00f6nnu\u00f0u \u00feetta krossapr\u00f3f 1999 sem mi\u00f0ar, eins og nafni\u00f0 bendir til, a\u00f0 \u00fev\u00ed a\u00f0 greina betur \u00feunglyndi karla en hinn vins\u00e6li kvar\u00f0i Beck. Kvar\u00f0inn heitir <a title=\"Gotlenski m\u00e6likvar\u00f0inn \u00e1 \u00feunglyndi karla\" href=\" http:\/\/www.cure4you.dk\/960\/Gotland%20Scale%20for%20Male%20Depression%20-%20English.pdf\" target=\"_blank\">The Gotland Male Depression Scale<\/a>, skammstafa\u00f0\u00a0GMDS. H\u00e9r er kr\u00e6kt \u00ed spurningalistann \u00e1 ensku \u00e1 vefs\u00ed\u00f0u <em>Cure4you<\/em>. Fyrsti krossam\u00f6guleiki gefur 0 stig, s\u00e1 n\u00e6sti 1 stig, s\u00e1 \u00feri\u00f0ji 2 stig og s\u00e1 fj\u00f3r\u00f0i 3 stig. Mat \u00e1 stigafj\u00f6lda er \u00fatsk\u00fdrt \u00ed sama skjali. \u00c1 s\u00ed\u00f0ari \u00e1rum hefur komi\u00f0 fram a\u00f0 kvar\u00f0inn n\u00fdtist einnig pr\u00fd\u00f0ilega til a\u00f0 greina \u00feunglyndi \u00feeirra kvenna sem ekki falla a\u00f0 uppskrift <em>DSM-IV<\/em> a\u00f0 \u00feunglyndi (M\u00f6ller-Leimk\u00fchler. 2010. Angeletti. 2013).<\/p>\n<h3><strong>\u00deunglyndiskvar\u00f0i Montgomery-\u00c5sberg<\/strong><\/h3>\n<p><a href=\"https:\/\/i0.wp.com\/harpahreins.com\/blogg\/wp-content\/uploads\/2014\/10\/krossaval_litil.jpg?ssl=1\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-1205\" style=\"margin: 7px;\" alt=\"krossaval_litil\" src=\"https:\/\/i0.wp.com\/harpahreins.com\/blogg\/wp-content\/uploads\/2014\/10\/krossaval_litil.jpg?resize=150%2C150&#038;ssl=1\" width=\"150\" height=\"150\" srcset=\"https:\/\/i0.wp.com\/harpahreins.com\/blogg\/wp-content\/uploads\/2014\/10\/krossaval_litil.jpg?resize=150%2C150&amp;ssl=1 150w, https:\/\/i0.wp.com\/harpahreins.com\/blogg\/wp-content\/uploads\/2014\/10\/krossaval_litil.jpg?resize=200%2C199&amp;ssl=1 200w, https:\/\/i0.wp.com\/harpahreins.com\/blogg\/wp-content\/uploads\/2014\/10\/krossaval_litil.jpg?zoom=2&amp;resize=150%2C150&amp;ssl=1 300w\" sizes=\"auto, (max-width: 150px) 100vw, 150px\" \/><\/a>Montgomery\u2013\u00c5sberg Depression Rating Scale (MADRS) var \u00feri\u00f0ji m\u00e6likvar\u00f0inn sem ge\u00f0l\u00e6knarnir \u00ed Su\u00f0urnesjamannaranns\u00f3kninni studdust vi\u00f0. \u00deessi m\u00e6likvar\u00f0i er \u00f3l\u00edkur \u00feeim sem taldir voru h\u00e9r a\u00f0 ofan a\u00f0 \u00fev\u00ed leyti a\u00f0 \u00fea\u00f0 er ekki sj\u00faklingur sem fyllir hann \u00fat heldur heilbrig\u00f0isstarfsma\u00f0ur (l\u00edklega einn af l\u00e6knunum fj\u00f3rum \u00ed umr\u00e6ddri ranns\u00f3kn \u00e1 Su\u00f0urnesjum). <a title=\"\u00feunglyndiskvar\u00f0i Montgomery-\u00c5sberg\" href=\"http:\/\/www.psy-world.com\/madrs.htm\" target=\"_blank\">MADRS-kvar\u00f0ann m\u00e1 sj\u00e1 h\u00e9r \u00e1 ensku<\/a> (<em>Psy-World<\/em>, \u00e1n \u00e1rtals).<\/p>\n<p>MADRS er fylltur \u00fat \u00ed samtali vi\u00f0 sj\u00fakling. \u00dea\u00f0 samtal \u00e1 a\u00f0 hefja \u00e1 opnum spurningum, skv. fyrirm\u00e6lum \u00e1 kvar\u00f0anum sj\u00e1lfum, en reyna s\u00ed\u00f0an a\u00f0 beina samtalinu a\u00f0 \u00feeim einst\u00f6ku atri\u00f0um sem krossa skal vi\u00f0 \u00e1 kvar\u00f0anum. \u00c1kve\u00f0inn sveigjanleiki er innbygg\u00f0ur \u00ed mat heilbrig\u00f0isstarfsmannsins \u00e1 sv\u00f6rum sj\u00faklingsins.<\/p>\n<p>Stigin eru s\u00ed\u00f0an l\u00f6g\u00f0 saman og yfirleitt meti\u00f0 sem svo a\u00f0 7-19 stig gefi v\u00edsbendingu um v\u00e6gt \u00feunglyndi, 20-34 stig benda til talsver\u00f0s e\u00f0a alvarlegs \u00feunglyndis, fleiri en 34 stig endurspegla l\u00edklega illv\u00edgt \u00feunglyndi.<\/p>\n<p>&nbsp;<\/p>\n<h3><strong>Heimildir<\/strong><\/h3>\n<p>Angeletti, Gloria o.fl. 2013. Short-Term Psychodynamic Psychotherapy in Patients with \u201cMale Depression\u201d Syndrome, Hopelessness, and Suicide Risk: A Pilot Study.<em> Depression Research and Treatment 2013<\/em>(408983). <a title=\"Hindawi com Journals\" href=\"http:\/\/www.hindawi.com\/journals\/drt\/2013\/408983\/\">http:\/\/www.hindawi.com\/journals\/drt\/2013\/408983\/<\/a><\/p>\n<p><a title=\"BDI-II\" href=\"http:\/\/www.ibogaine.desk.nl\/graphics\/3639b1c_23.pdf\">BDI-II<\/a>, \u00fatg. fr\u00e1 1996, birt \u00e1n \u00e1rtals e\u00f0a heimildatilv\u00edsunar \u00e1 <em>The Ibogaine Dossier.<\/em><\/p>\n<p>Cosgrove, L o.fl. 2006. Financial ties between DSM-IV panel members and the pharmaceutical industry. <em>Psychotherapy And Psychosomatics 75<\/em>(3), s. 154-160.<\/p>\n<p><a title=\"Greining alvarlegs \u00feunglyndis \u00ed DSM-IV\" href=\"http:\/\/behavenet.com\/node\/21569\">Diagnostic criteria for Major Depressive Episode<\/a> [DSM-IV-TR og DSM_IV]. <em>BehaveNet<\/em>.<\/p>\n<p>Eir\u00edkur \u00d6rn Arnarson. 1990. M\u00e6likvar\u00f0i Becks \u00e1 ge\u00f0l\u00e6g\u00f0 (Beck Depression Inventory, 1979). <em>Ge\u00f0vernd 21<\/em>(1), s. 31-33.<\/p>\n<p>Hiller, Anne. 6\/6 2013. <a title=\"Munur \u00e1 DSM-IV og DSM-5\" href=\"http:\/\/www.dsm5.org\/Documents\/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf\">Highlights of Changes from DSM-IV-TR to DSM-5<\/a>. <em>DSM-5 Developmen<\/em>t. American Psychiatric Association.<\/p>\n<p>ICD-10 Al\u00fej\u00f3\u00f0leg t\u00f6lfr\u00e6\u00f0iflokkun sj\u00fakd\u00f3ma og skyldra heilbrig\u00f0isvandam\u00e1la, a\u00f0gengileg \u00e1 <a title=\"ICD-10 greiningarlykill WHO\" href=\"http:\/\/skafl.is\/\"><em>SKAFL<\/em><\/a>. Landl\u00e6knisemb\u00e6tti\u00f0, \u00e1n \u00e1rtals.<\/p>\n<p><a title=\"MADRS skalinn\" href=\"http:\/\/www.psy-world.com\/madrs.htm\">Montgomery Asberg Depression Rating Scale<\/a>. <em>Psy-World<\/em>.<\/p>\n<p>M\u00f6ller-Leimk\u00fchler, A. M., &amp; Y\u00fccel, M. 2010. Male depression in females? <em>Journal of affective disorders 121<\/em>(1), s. 22-29.<\/p>\n<p>Shorter, Edward. 2013. <em>How Everyone Became Depressed: the Rise and Fall of the Nervous Breakdown<\/em>. New York, Oxford University Press.<\/p>\n<p>Sigurdsson, B., Palsson, S. P., Johannsson, M., Olafsdottir, M., &amp; Aevarsson, O. 2013. Saliva cortisol and male depressive syndrome in a community study. The Sudurnesjamenn study. <em>Nordic journal of psychiatry 67<\/em>(3), s. 145-152.<\/p>\n<p>Substance Abuse and Mental Health Services Administration. 2008. <a title=\"TIP nr. 48\" href=\"http:\/\/store.samhsa.gov\/shin\/content\/\/SMA13-4353\/SMA13-4353.pdf\">Managing Depressive Symptoms in Substance Abuse Clients During Early Recovery<\/a>. Treatment Improvement Protocol (TIP) Series, No. 48. Rockville, HHS Publication, s. 143-144.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; Enn held \u00e9g \u00e1fram a\u00f0 velta fyrir m\u00e9r efni greinar um ranns\u00f3kn \u00e1 \u00feunglyndum k\u00f6rlum \u00e1 Su\u00f0urnesjum (Sigurdsson, B. o.fl. 2013), sj\u00e1 fyrri f\u00e6rslur h\u00e9r og h\u00e9r. \u00cd greininni birtist nefnilega \u00ed hnotskurn flest <span class=\"ellipsis\">&hellip;<\/span> <span class=\"more-link-wrap\"><a href=\"https:\/\/harpahreins.com\/blogg\/2014\/10\/28\/visindaleg-huglaegni-i-greiningu-thunglyndis\/\" class=\"more-link\"><span>Read More &#8230;<\/span><\/a><\/span><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[9,10],"tags":[91,90,82,92,89,94,93],"class_list":["post-1179","post","type-post","status-publish","format-standard","hentry","category-gedheilsa","category-saga_gedlaekninga","tag-bdi","tag-beck-thunglyndiskvardinn","tag-gedlaeknar","tag-gmds","tag-greining-thunglyndis","tag-klinisk-reynsla","tag-madrs"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/1179","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/comments?post=1179"}],"version-history":[{"count":39,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/1179\/revisions"}],"predecessor-version":[{"id":1221,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/1179\/revisions\/1221"}],"wp:attachment":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/media?parent=1179"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/categories?post=1179"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/tags?post=1179"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}