{"id":451,"date":"2012-10-10T12:43:39","date_gmt":"2012-10-10T12:43:39","guid":{"rendered":"http:\/\/harpa.blogg.is\/2012-10-10\/kliniskar-leidbeiningar-sem-ekki-er-farid-eftir\/"},"modified":"2013-11-21T09:08:28","modified_gmt":"2013-11-21T09:08:28","slug":"kliniskar-leidbeiningar-sem-ekki-er-farid-eftir","status":"publish","type":"post","link":"https:\/\/harpahreins.com\/blogg\/2012\/10\/10\/kliniskar-leidbeiningar-sem-ekki-er-farid-eftir\/","title":{"rendered":"Kl\u00edn\u00edskar lei\u00f0beiningar sem ekki er fari\u00f0 eftir"},"content":{"rendered":"

<\/font>\u00cd Kl\u00edn\u00edskum lei\u00f0beiningum um \u00feunglyndi og kv\u00ed\u00f0a<\/a><\/i> sem Landsp\u00edtalinn gaf \u00far \u00ed \u00e1g\u00fast 2011 er \u00ed \u00f6llum tilvikum nema alvarlegu \u00feunglyndi m\u00e6lt me\u00f0 s\u00e1lfr\u00e6\u00f0ime\u00f0fer\u00f0 (hugr\u00e6nni atferlisme\u00f0fer\u00f0) sem fyrsta \u00farr\u00e6\u00f0i vi\u00f0 \u00feunglyndi og kv\u00ed\u00f0a og lyfjagj\u00f6f einungis talin forsvaranleg virki s\u00e1lfr\u00e6\u00f0ime\u00f0fer\u00f0 ekki.<\/b> Vi\u00f0 alvarlegu \u00feunglyndi er \u00ed \u00feessum lei\u00f0beiningum m\u00e6lt me\u00f0 a\u00f0 bj\u00f3\u00f0a sj\u00faklingi hugr\u00e6na atferlisme\u00f0fer\u00f0 og SSRI-lyf samt\u00edmis. Meginmarkmi\u00f0 kl\u00edn\u00edskra lei\u00f0beininga, sem byggja jafnan \u00e1 gagnreyndri l\u00e6knisfr\u00e6\u00f0i, er a\u00f0 b\u00e6ta g\u00e6\u00f0i og auka skilvirkni og jafnr\u00e6\u00f0i \u00ed heilbrig\u00f0is\u00fej\u00f3nustu. Hinar \u00edslensku Kl\u00edn\u00edsku lei\u00f0beiningar um \u00feunglyndi og kv\u00ed\u00f0a<\/i> eru sni\u00f0nar eftir kl\u00edn\u00edskum lei\u00f0beiningum NICE (National Institute for Clinical Excellence), breskrar heilbrig\u00f0isstofnunar.<\/font><\/p>\n

<\/font>\u00c1 Nor\u00f0url\u00f6ndunum m\u00e1 finna svipa\u00f0ar lei\u00f0beiningar:<\/font><\/p>\n

<\/font>\u00cd Sv\u00ed\u00fej\u00f3\u00f0 gilda Nationella riktlinjer f\u00f6r v\u00e5rd vid depression och \u00e5ngestsyndrom<\/a>. Sv\u00edar eru ofurl\u00edti\u00f0 hlynntari \u00feunglyndislyfjagj\u00f6f en sj\u00e1 m\u00e1 \u00ed \u00edslensku kl\u00edn\u00edsku lei\u00f0beiningunum.<\/font><\/p>\n

<\/font>\u00cd Danm\u00f6rku hafa ekki veri\u00f0 gefnar \u00fat kl\u00edn\u00edskar lei\u00f0beiningar um \u00feunglyndi sem \u00f6llum \u00ed heilbrig\u00f0iskerfinu\u00a0 er gert a\u00f0 fara eftir (sl\u00edkar lei\u00f0beiningar um me\u00f0h\u00f6ndlun ge\u00f0sj\u00fakd\u00f3ma eru \u00ed vinnslu) en \u00e1bendingar hafa veri\u00f0 gefnar \u00fat, Referenceprogram for unipolar depression hos voksne<\/a>. \u00deessar \u00e1bendingar\u00a0 eru svipa\u00f0ar \u00edslensku kl\u00edn\u00edsku lei\u00f0beiningunum \u00feegar kemur a\u00f0 v\u00e6gi s\u00e1lfr\u00e6\u00f0ime\u00f0fer\u00f0ar og lyfjagjafar \u00ed me\u00f0fer\u00f0 \u00feunglyndis.<\/font><\/p>\n

<\/font>\u00cd Noregi heita kl\u00edn\u00edsku lei\u00f0beiningarnar Nasjonale retningslinjer for diagnostisering og behandling av voksne med depresjon i prim\u00e6r- og spesialisthelsetjenesten<\/a>. Efnislega eru \u00fe\u00e6r samhlj\u00f3\u00f0a \u00feeim \u00edslensku, \u00fe.e. hampa s\u00e1lfr\u00e6\u00f0ime\u00f0fer\u00f0 sem fyrsta kosti vi\u00f0 l\u00e6kningu \u00feunglyndis. \u00de\u00e6r skera sig \u00far hva\u00f0 var\u00f0ar \u00e1herslu \u00e1 a\u00f0 sj\u00faklingurinn f\u00e1i \u00e6vinlega a\u00f0 velja me\u00f0fer\u00f0arkost og a\u00f0 hann s\u00e9 r\u00e6kilega uppl\u00fdstur um alla m\u00f6guleika, \u00fe.\u00e1 m. kosti og galla. Tilv\u00edsanir \u00ed heimildir og \u00edtarleg heimildaskr\u00e1 er til fyrirmyndar, miklu betri en \u00ed d\u00f6nsku og s\u00e6nsku lei\u00f0beiningunum. \u00cd \u00edslensku lei\u00f0beiningunum eru engar heimildatilv\u00edsanir.<\/font><\/p>\n

\"HAM\"<\/font>Seint \u00ed fyrra birtist greinin Gagnsemi hugr\u00e6nnar atferlisme\u00f0fer\u00f0ar vi\u00f0 lyndis- og kv\u00ed\u00f0ar\u00f6skunum hj\u00e1 fullor\u00f0num<\/a> \u00ed L\u00e6knabla\u00f0inu<\/i>. H\u00f6fundar hennar eru \u00fer\u00edr s\u00e1lfr\u00e6\u00f0ingar og einn ge\u00f0l\u00e6knir. \u00cd \u00feessari grein er \u00edtarlega fjalla\u00f0 um ranns\u00f3knir \u00e1 HAM (hugr\u00e6nni atferlisme\u00f0fer\u00f0). \u201e\u00cd greininni kemur fram a\u00f0 HAM gagnast vel vi\u00f0 \u00feunglyndi, almennri kv\u00ed\u00f0ar\u00f6skun, skelfingarkv\u00ed\u00f0a, \u00e1fallastreitur\u00f6skun, \u00e1r\u00e1ttu- og \u00fer\u00e1hyggju, f\u00e9lagsf\u00e6lni og s\u00e9rt\u00e6kri f\u00e6lni. \u00c1rangur af HAM vi\u00f0 me\u00f0fer\u00f0 \u00feessara raskana er \u00ed flestum tilfellum samb\u00e6rilegur e\u00f0a betri en \u00e1rangur lyfjame\u00f0fer\u00f0ar en a\u00f0gengi er lakara\u201c segir \u00ed \u00e1gripi greinarinnar.<\/font>
\n\u00a0<\/p>\n

<\/font>\u00der\u00e1tt fyrir afar j\u00e1kv\u00e6\u00f0a umfj\u00f6llun um HAM (hugr\u00e6na atferlisme\u00f0fer\u00f0) \u00feegar gagn hennar er bori\u00f0 saman vi\u00f0 gagn af \u00feunglyndislyfjagj\u00f6f og \u00fe\u00e6r flottu kl\u00edn\u00edsku lei\u00f0beiningar sem ge\u00f0svi\u00f0 Landsp\u00edtalans flaggar\u00a0 er \u00fea\u00f0 v\u00e6ntanlega almenn reynsla \u00feunglyndissj\u00faklinga a\u00f0 vera \u00e1v\u00edsa\u00f0 \u00feunglyndislyfi um lei\u00f0 og sj\u00fakd\u00f3msgreining f\u00e6st.\u00a0 \u00c1 \u00feeirri ge\u00f0deild sem \u00e9g hef oft legi\u00f0 er ekki bo\u00f0i\u00f0 upp \u00e1 hugr\u00e6na atferlisme\u00f0fer\u00f0, \u00fear sn\u00fdst flestallt um lyfjagj\u00f6f. \u00c1 \u00e1rum \u00e1\u00f0ur minnist \u00e9g \u00feess a\u00f0 s\u00e1lfr\u00e6\u00f0ingur kom inn \u00e1 deildina og h\u00e6gt var a\u00f0 f\u00e1 vi\u00f0tal vi\u00f0 hann, \u00fe\u00f3tt ekki v\u00e6ri bo\u00f0i\u00f0 upp \u00e1 HAM me\u00f0fer\u00f0. S\u00ed\u00f0ast \u00feegar \u00e9g l\u00e1 \u00e1 ge\u00f0deild, \u00ed sj\u00f6 vikur s\u00ed\u00f0la \u00e1rs 2010, var\u00f0 \u00e9g ekki v\u00f6r vi\u00f0 s\u00e1lfr\u00e6\u00f0ing nema \u00e1 g\u00f6ngum ge\u00f0deildarh\u00fassins. \u00der\u00e1tt fyrir f\u00f6gur or\u00f0 um fj\u00f6l\u00fe\u00e6tta me\u00f0fer\u00f0 \u00ed svolei\u00f0is m\u00f3tt\u00f6kuge\u00f0deildum<\/a>, sem sni\u00f0in s\u00e9 a\u00f0 \u00fe\u00f6rfum sj\u00faklinga og a\u00f0standenda \u00feeirra, og a\u00f0 \u00e1hersla s\u00e9 l\u00f6g\u00f0 \u00e1 a\u00f0 \u201egreina l\u00edffr\u00e6\u00f0ilega, s\u00e1lr\u00e6na og f\u00e9lagslega \u00fe\u00e6tti sem stu\u00f0la a\u00f0 veikindum og heilbrig\u00f0i\u201c er \u00fea\u00f0 m\u00edn reynsla af m\u00f6rgum innl\u00f6gnum a\u00f0 l\u00e6knisme\u00f0fer\u00f0in s\u00e9 fyrst og fremst lyfjame\u00f0fer\u00f0 e\u00f0a rafl\u00e6kningame\u00f0fer\u00f0.<\/font>
\n\u00a0<\/p>\n

<\/font>Vi\u00f0tal vi\u00f0 s\u00e1lfr\u00e6\u00f0ing \u00e1 stofu kostar a.m.k. 10-12 \u00fe\u00fasund kr\u00f3nur. Sj\u00fakrasj\u00f3\u00f0ir flestra st\u00e9ttarf\u00e9laga styrkja vi\u00f0talsme\u00f0fer\u00f0 vi\u00f0 s\u00e1lfr\u00e6\u00f0ing a\u00f0 einhverju marki en \u00fea\u00f0 gefur auga lei\u00f0 a\u00f0 \u00f6ryrkjar \u00e1 b\u00f3tum fr\u00e1 Tryggingastofnun hafa ekki efni \u00e1 svolei\u00f0is \u00fej\u00f3nustu.<\/font><\/p>\n

<\/font>\u00c1 g\u00f6ngudeild ge\u00f0svi\u00f0s Landsp\u00edtalans er h\u00e6gt a\u00f0 panta vi\u00f0tal vi\u00f0 s\u00e1lfr\u00e6\u00f0ing og s\u00fa \u00fej\u00f3nusta er ni\u00f0urgreidd af Sj\u00fakratryggingum r\u00edksins, eins og vi\u00f0t\u00f6l vi\u00f0 ge\u00f0l\u00e6kna. En \u00e1 g\u00f6ngudeildinni eru einungis \u00ferj\u00fa og h\u00e1lft st\u00f6\u00f0ugildi s\u00e1lfr\u00e6\u00f0inga svo bi\u00f0in eftir vi\u00f0tali getur or\u00f0i\u00f0 mj\u00f6g l\u00f6ng. Ge\u00f0svi\u00f0 hefur bo\u00f0i\u00f0 upp \u00e1 grunnn\u00e1mskei\u00f0 \u00ed HAM vi\u00f0 \u00feunglyndi og kv\u00ed\u00f0a \u00ed nokkur \u00e1r. \u00deau n\u00e1mskei\u00f0 eru ekki augl\u00fdst nema \u00ed Ge\u00f0deildarh\u00fasinu, t.d. er \u00feeirra ekki geti\u00f0 \u00e1 heimas\u00ed\u00f0u ge\u00f0svi\u00f0s<\/a>. (Kannski eru \u00feau augl\u00fdst \u00e1 einhverjum heilsug\u00e6slust\u00f6\u00f0vum, a.m.k. vona \u00e9g \u00fea\u00f0.) \u00c9g hef n\u00fdloki\u00f0 svona n\u00e1mskei\u00f0i og m\u00e6li eindregi\u00f0 me\u00f0 \u00fev\u00ed. Tilv\u00edsun fr\u00e1 heimilisl\u00e6kni, s\u00e1lfr\u00e6\u00f0ingi e\u00f0a ge\u00f0l\u00e6kni \u00fearf til a\u00f0 skr\u00e1 mann \u00e1 n\u00e1mskei\u00f0i\u00f0 og \u00fea\u00f0 kostar ekki miki\u00f0. Vegna manneklu \u00ed r\u00f6\u00f0um s\u00e1lfr\u00e6\u00f0inga \u00e1 g\u00f6ngudeild ge\u00f0svi\u00f0s er ekki h\u00e6gt a\u00f0 bj\u00f3\u00f0a upp \u00e1 s\u00e9rh\u00e6f\u00f0 framhaldsn\u00e1mskei\u00f0 \u00ed HAM, t.d. vi\u00f0 \u00feunglyndi e\u00f0a kv\u00ed\u00f0a.<\/font>
\n\u00a0<\/p>\n

<\/font>Ni\u00f0ursta\u00f0a m\u00edn er a\u00f0 Kl\u00edn\u00edskar lei\u00f0beiningar um \u00feunglyndi og kv\u00ed\u00f0a<\/i> s\u00e9u skynsamlegar en \u00fea\u00f0 s\u00e9 hins vegar ekkert fari\u00f0 eftir \u00feeim og \u00fe\u00e6r \u00fev\u00ed vita marklaust plagg.<\/font>
\n\u00a0<\/p>\n

<\/font>Heimildir<\/p>\n

<\/b>Fr\u00e1 Landl\u00e6knisemb\u00e6ttinu. Erlendar kl\u00edn\u00edskar lei\u00f0beiningar<\/a>. L\u00e6knabla\u00f0i\u00f0<\/i> 1. tbl. 89. \u00e1rg. 2003.<\/font><\/p>\n

<\/font>G\u00e6\u00f0i l\u00e6knis\u00fej\u00f3nustu aukin me\u00f0 vefi um kl\u00edn\u00edskar lei\u00f0beiningar<\/a>. L\u00e6knabla\u00f0i\u00f0<\/i> 5. tbl. 87 \u00e1rg. 2001.<\/font><\/p>\n

<\/font>Kl\u00edn\u00edskar lei\u00f0beiningar um \u00feunglyndi og kv\u00ed\u00f0a<\/a><\/i>. Landsp\u00edtali H\u00e1sk\u00f3lasj\u00fakrah\u00fas \u00e1g\u00fast 2011.<\/font><\/p>\n

<\/font>Magn\u00fas Bl\u00f6ndahl Sighvatsson o.fl.\u00a0 Gagnsemi hugr\u00e6nnar atferlisme\u00f0fer\u00f0ar vi\u00f0 lyndis- og kv\u00ed\u00f0ar\u00f6skunum hj\u00e1 fullor\u00f0num<\/a>. L\u00e6knabla\u00f0i\u00f0<\/i> 11. tbl. 97. \u00e1rg. 2011.<\/font><\/p>\n

<\/font>Nationella riktlinjer f\u00f6r v\u00e5rd vid depression och \u00e5ngestsyndrom<\/a><\/i>. Socialstyrelsen \u00ed Sv\u00ed\u00fej\u00f3\u00f0 2010, sj\u00e1 einkum s. 34-45.<\/font><\/p>\n

<\/font>Nasjonale retningslinjer for diagnostisering og behandling av voksne med depresjon i prim\u00e6r- og spesialisthelsetjenesten<\/a><\/i>. Helsedirektoratet \u00ed Noregi, ma\u00ed 2009. Sj\u00e1 einkum s. 50-63.<\/font><\/font><\/a><\/font><\/i><\/p>\n

<\/font>Referenceprogram for unipolar depression hos voksne<\/a><\/i>. Sundhedsstyrelsen \u00ed Danm\u00f6rku, n\u00f3vember 2007.<\/font>
\n\u00a0
\n\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"

\u00cd Kl\u00edn\u00edskum lei\u00f0beiningum um \u00feunglyndi og kv\u00ed\u00f0a sem Landsp\u00edtalinn gaf \u00far \u00ed \u00e1g\u00fast 2011 er \u00ed \u00f6llum tilvikum nema alvarlegu \u00feunglyndi m\u00e6lt me\u00f0 s\u00e1lfr\u00e6\u00f0ime\u00f0fer\u00f0 (hugr\u00e6nni atferlisme\u00f0fer\u00f0) sem fyrsta \u00farr\u00e6\u00f0i vi\u00f0 \u00feunglyndi og kv\u00ed\u00f0a og lyfjagj\u00f6f …<\/span> Read More …<\/span><\/a><\/span><\/p>\n","protected":false},"author":2,"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],"tags":[],"class_list":["post-451","post","type-post","status-publish","format-standard","hentry","category-gedheilsa"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/451","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\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/comments?post=451"}],"version-history":[{"count":1,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/451\/revisions"}],"predecessor-version":[{"id":634,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/451\/revisions\/634"}],"wp:attachment":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/media?parent=451"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/categories?post=451"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/tags?post=451"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}