These studies were carried out in collaboration with the Department of Psychiatry at the University of Tampere, the Department of Psychiatry at the University of Oulu, the Department of Psychiatry at Oulu University Hospital, and the National Institute for Health and Welfare (THL), Centre for Health and Social Economics, as part of the PERFECT (PERFormance, Effectiveness and Cost of Treatment episodes) project.
First and most profoundly I thank my supervisor Professor Esa Leinonen for encouraging me to start and successfully finish this work. He has always supported me throughout this process and given his time when needed. He once inspired me to choose my career as an old age psychiatrist. I am going to miss the conversations with him concerning research and psychiatry but I am sure that this dialogue will continue.
I am also grateful to my other supervisor Hanna-Mari Alanen MD, PhD for sharing with me her outstanding expertise in geriatric psychiatry. She has also given me lots of good practical advice on how to live between science, work and family.
I express my gratitude to the National Institute for Health and Welfare and especially to Research Professor Unto Häkkinen for the opportunity to study this extraordinary data. He also gave me valuable suggestions and comments on my studies.
I am deeply grateful to Helinä Hakko PhD, because with her advice and ultimate expertise in statistical analysis I was able reach the goal. I also wish to thank Professor emeritus Matti Isohanni for giving me guidance and inspiring ideas for my research and scientific writing. I also highly appreciate the critical conversations with Associate Professor Olli Kampman, also a member of the follow-up team, who has taught me statistics and scientific thinking. My special thanks go also to another member of follow-up team Docent Harriet Finne-Soveri. I was lucky to have excellent co-authors.
I express my appreciation to the reviewers of the manuscript of my thesis, Professor emeritus Raimo K.R. Salokangas and Professor Sirpa Hartikainen. This
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thesis is certainly of higher quality because of their constructive criticism and comments.
I want to thank Virginia Mattila MA for the important English language corrections. I admire her way of working - she always returned manuscripts sooner than expected. I also express my gratitude to Jari-Pekka Klemettilä MD and Kirsti Nurmela MD for giving their time for reading my texts and to Kirsti for her energizing friendship, as well as to other members of the scientific seminars for giving their interest to my studies. Professor emeritus Matti Joukamaa, Ritva Sundström MSc and many other people from the University of Tampere has greatly helped me in different ways, as well as Marjo Kiviniemi PhD from Oulu. Co-operation with Merja Juntunen MSc from THL was always pleasant and productive.
I am grateful for the financial support I have received from the Department of Psychiatry at Tampere University Hospital, the Department of Psychiatry at Helsinki University Central Hospital, the Uulo Arhio Foundation and the Finnish Psychiatric Association. My special thanks go to the National Graduate School of Clinical Investigation, and especially for Professor Hasse Karlsson, Docent Linnea Karlsson and the former and current coordinators Docent Jouni Lauronen and Nina Blom PhD for organizing support and the high validity seminars.
It is also my pleasure to thank many colleagues, especially Katariina Lahtinen MD, Docent Kati Juva and Jukka-Pekka Puutio MD, and other co-workers for their interest and support. Together with my wonderful every-day working team in Tikkurila Geropsychiatric Outpatient Unit I have realized why it is important to study this special research field. The heart of our group, Department Secretary Merja Taskinen, has helped me enormously in organizing my time table during these years.
I also want to thank my former and current superiors from Helsinki University Central Hospital, Department of Psychiatry, and especially Docent Björn Appelberg for his positive attitude towards the time I have spent on this project.
I wish to thank Aino, Hille, Kirsti, Leena, Outi, Pia and Tarja for long-lasting friendship ever since we were medical students and I am happy to realize that we are still planning get-together journeys.
I have a great pleasure in thanking all my good friends. With them I have shared precious moments of life, which have brought me strength and happiness.
I am indebted to my loving parents, Ritva and Erkki, who have always encouraged me to believe in myself in a realistic way. Unfortunately my father did not live to see the final results and my mother is unable to be present on the occasion of the public
95 defense of my thesis, but I know that they would proud of me. I am also grateful to my parents-in-law, Pirkko and Esko, for their love and support. Thanks go also to my brother Antti and brother-in-law Janne and their families.
Finally, I express my deepest thanks to my husband Pekka for his love, patience and never-ending confidence in me and my project. Hilla, Väinö and Eino have completed our family, for which I am enormously grateful. Their energy, joy and incisive comments have shown me what is eventually best in life.
Klaukkala, September, 2015.
Tiina Talaslahti
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