The Web is Underconstruction * We are Going to ahead for your online health services and Telemedicines as early as possible * Know more about Arsenicosis+Other Chemical Poisoning into our body Through Food Drinks-Medicine * Take Health Care from us-For more Benefit * Help ARSENICOSSIS-affected Patient for saving you + next Generation---Everyone may affected by ARSENICOSSIS from Food—Drinks-Natural sources & Medicines. Autism is a Natural CHANGE through Chromosome please take care of your Physical-Mental-Spiritual Health properly before/after Marriage. Then No Autistic Child in the World. We can take care of Autistic Children for cure. Obey Health Guideline—Introduce a Disease risk free + long live active Generation world wide by “Total Health Solution” removing ignorance +evilness.

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Tuesday, 21 June 2011 02:48

Congratulations to all of you for rebuilding PEACE +Disease-Free World

Come & Share to improve your Physical-Mental+Spiritual Health

including humankind +environment.

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e-mail : This e-mail address is being protected from spambots. You need JavaScript enabled to view it WEB : drpareshmajumder.com

Learn advices one day & follow always, you'll be better Life-long with all.

Arsenic +Other Chemical contamination into our all foods are the delivery-room

of All diseases in our body+mind+spirit, Take care of your 'triple Health' properly.

Women+Girl HealthCare is the most important HealthCare for greater interest of Mankind

& their next Generation.

Try to improve your Physical, Mental +Spiritual Health

based on "Total Health Solution" removing all ignorance +evilness

"No Diseases shall attack you"

You can adopt one or more therapy/treatment to solve the all sorts of Diseases

1. Conventional or allopathic medicines- such as regular Healthcare +medication with more

silent side effects---known +unknown.

2. Homoeopathic medicines : such as fixed time medication upto 6 months +regular Healthcare

with no side effects in future or in the long run.

3. Bio-Chemic Medicines : such as 6 months medication through 6 follow-up +regular Healthcare

with no side effects & 99.9% warranty if you follow Health Rules LIFE-long.

4. Homoeopathy+Bio-chemic: Such as 5 months medication +regular Healthcare for life-long warranty

if you follow the Health-Consciousness rule always.

5. Potentized-Herbal : Such as 6 months medication +regular Healthcare to meet the same

avoiding health-damaging causes regularly, life-long.

6. Food+Nutrient Therapy: Regular Health-Consciousness with balanced food-drinks-medicines to absorb

into your body+mind with regular Personalcare by the advices of DOCTOR.

7. "Health-Membership" for pre-marriage 'Healthcare-Insurance' at Health-Conscious Society

 

Heath is wealth, but at present time , health includes both physical & mental. Above all both physical & mental health guide by spiritual health on the basis of attention belongs to faith +emotin to understand known+unknown through merit.

 

 

Themes of World Health Days

  • 2011: Anti-microbial resistance: no action today, no cure tomorrow
  • 2010: Urbanisation and health: make cities healthier
  • 2009: Save lives, Make Hospitals Safe in Emergencies
  • 2008: Protecting health from the adverse effects of climate change
  • 2007: International health security
  • 2006: Working together for health
  • 2005: Make every mother and child count
  • 2004: Road safety
  • 2003: Shape the Future of Life: Healthy Environments for Children
  • 2002: Move for Health
  • 2001: Mental Health: Stop Exclusion, Dare to Care
  • 2000: Safe Blood Start with Me
  • 1999: Active Aging Makes the Difference
  • 1998: Safe Motherhood
  • 1997: Emerging Infectious Diseases
  • 1996: Healthy Cities for Better Life
  • 1995: Global Polio Eradication

World Health Day 2011

The theme of World Health Day 2011, marked on 7 April 2011, was "Antimicrobial resistance and its global spread" and focused on the need for governments and stakeholders to implement the policies and practices needed to prevent and counter the emergence of highly resistant microorganisms.

When infections caused by resistant microorganisms fail to respond to standard treatments, including antibiotics and other antimicrobial medicines - also known as drug resistance - this may result in prolonged illness and greater risk of death. For World Health Day 2011, WHO called for intensified global commitment to safeguard antimicrobial medicines for future generations.

On World Health Day 2011, the WHO introduced a six-point policy package to combat the spread of antimicrobial resistance:[4][5]

  1. Commit to a comprehensive, financed national plan with accountability and civil society engagement.
  2. Strengthen surveillance and laboratory capacity.
  3. Ensure uninterrupted access to essential medicines of assured quality.
  4. Regulate and promote rational use of medicines, including in animal husbandry, and ensure proper patient care; reduce use of antimicrobials in food-producing animals.
  5. Enhance infection prevention and control.
  6. Foster innovations and research and development for new tools.

Themes of previous World Health Days

2010: 1000 Cities, 1000 Lives

With the campaign "1000 cities, 1000 lives", events were organized worldwide during the week starting 7 April 2010. The global goals of the campaign were:[6]

  • 1000 cities: to open up public spaces to health, whether it be activities in parks, town hall meetings, clean-up campaigns, or closing off portions of streets to motorized vehicles.
  • 1000 lives: to collect 1000 stories of urban health champions who have taken action and had a significant impact on health in their cities.

2009: Save lives. Make hospitals safe in emergencies

World Health Day 2009 focused on the safety of health facilities and the readiness of health workers who treat those affected by emergencies. Health centres and staff are critical lifelines for vulnerable people in disasters - treating injuries, preventing illnesses and caring for people's health needs. Often, already fragile health systems are unable to keep functioning through a disaster, with immediate and future public health consequences.

For this year's World Health Day campaign, WHO and international partners underscored the importance of investing in health infrastructure that can withstand hazards and serve people in immediate need, and urged health facilities to implement systems to respond to internal emergencies, such as fires, and ensure the continuity of care.

2008: Protecting health from the adverse effects of climate change

In 2008, World Health Day focused on the need to protect health from the adverse effects of climate change and establish links between climate change and health and other development areas such as environment, food, energy, transport.

The theme “protecting health from climate change” put health at the centre of the global dialogue about climate change. WHO selected this theme in recognition that climate change is posing ever growing threats to global public health security.[7]

2007: Invest in health, build a safer future

Key messages for World Health Day 2007:

  1. Threats to health know no borders.
  2. Invest in health, build a safer future.
  3. Health leads to security; insecurity leads to poor health.
  4. Preparedness and quick response improve international health security.
  5. The World Health Organization is making the world more secure.

2006: Working together for health

In 2006, World Health Day was devoted to the health workforce crisis, or chronic shortages of health workers around the world due to decades of underinvestment in their education, training, salaries, working environment and management. The day was also meant to celebrate individual health workers - the people who provide health care to those who need it, in other words those at the heart of health systems.

The Day also marked the launch of the WHO's World Health Report 2006, which focused on the same theme. The report contained an assessment of the current crisis in the global health workforce, revealing an estimated shortage of almost 4.3 million physicians, midwives, nurses and other health care providers worldwide, and further proposed a series of actions for countries and the international community to tackle it.[8]

 

Mental Health and Global Burden of Disease

Disability-adjusted life year for neuropsychiatric conditions per 100,000 inhabitants in 2002.

no data
less than 10
10-20
20-30
30-40
40-50
50-60
60-80
80-100
100-120
120-140
140-150
more than 150

Mental, neurological, and substance use disorders make a substantial contribution to the global burden of disease (GBD).[6] This is a global measure of so-called disability-adjusted life years (DALY's) assigned to a certain disease/disorder, which is a sum of the years lived with disability and years of life lost due to this disease within the total population. Neuropsychiatric conditions account for 14 % of the global burden of disease. Among non-communicable diseases, they account for 28% of the DALY's — more than cardiovascular disease or cancer. However it is estimated that the real contribution of mental disorders to the global burden of disease is even higher, amongst others due to complex interactions and co-morbidity of physical and mental illness.

Around the world, almost one million people die due to suicide every year, and it is the third leading cause of death among young people. The most important causes of disability due to health-related conditions worldwide include unipolar depression, alcoholism, schizophrenia, bipolar depression and dementia. In low- and middle-income countries, these conditions represent a total of 19.1% of all disability related to health conditions.[7]

Treatment gap

It is estimated that one in four people in the world will be affected by mental or neurological disorders at some point in their lives.[8] Although many effective interventions for the treatment of mental disorders are known, and awareness of the need for treatment of people with mental disorders has risen, the proportion of those who need mental health care but who do not receive it remains very high. This so-called “treatment gap” is estimated to reach about 76-85% for low- and middle-income countries, and even 35-50% for high-income countries.

Despite the acknowledged need, for the most part there have not been substantial changes in mental health care delivery during the past years. Main reasons for this problem are public health priorities, lack of a mental health policy and legislation in many countries, a lack of resources – financial and human resources – as well as inefficient resource allocation.[9]

In 2011, the World Health Organization estimated a shortage of 1.18 million mental health professionals, including 55,000 psychiatrists, 628,000 nurses in mental health settings, and 493,000 psychosocial care providers needed to treat mental disorders in 144 low- and middle-income countries. The annual wage bill to remove this health workforce shortage was estimated at about US$ 4.4 billion.[10]

Interventions

Information and evidence about cost-effective interventions to provide better mental health care are available. Although most of the research (80%) has been carried out in high-income countries, there is also strong evidence from low- and middle-income countries that pharmacological and psychosocial interventions are effective ways to treat mental disorders, with the strongest evidence for depression, schizophrenia, bipolar disorder and hazardous alcohol use.

Recommendations to strengthen mental health systems around the world have been first mentioned in the WHO's World Health Report 2001[11], which focused on mental health:

  1. Provide treatment in primary care
  2. Make psychotropic drugs available
  3. Give care in the community
  4. Educate the public
  5. Involve communities, families and consumers
  6. Establish national policies, programs and legislation
  7. Develop human resources
  8. Link with other sectors
  9. Monitor community mental health
  10. Support more research

Based on the data of 12 countries, assessed by the WHO Assessment Instrument for Mental Health Systems (WHO-AIMS)[12], the costs of scaling up mental health services by providing a core treatment package for schizophrenia, bipolar affective disorder, depressive episodes and hazardous alcohol use have been estimated. Structural changes in mental health systems according to the WHO recommendations have been taken into account.

For most countries, this model suggests an initial period of investment of US$ 0.30 – 0.50 per person per year. The total expenditure on mental health would have to rise at least ten-fold in low-income countries. In those countries, additional financial resources will be needed, while in middle- and high-income countries the main challenge will be the reallocation of resources within the health system to provide better mental health service.

World Health Organization (WHO)

Two of WHO's core programmes for mental health are WHO MIND (Mental health improvements for Nations Development) and Mental Health Gap Action Programme (mhGAP).

WHO MIND focuses on 5 areas of action to ensure concrete changes in people's daily lives. These are:

  1. Action in and support to countries to improve mental health, such as the WHO Pacific Island Mental Health network (PIMHnet)
  2. Mental health policy, planning and service development
  3. Mental health human rights and legislation
  4. Mental health as a core part of human development
  5. The QualityRights Project which works to unite and empower people to improve the quality of care and promote human rights in mental health facilities and social care homes.

Mental Health Gap Action Programme (mhGAP) is WHO’s action plan to scale up services for mental, neurological and substance use disorders for countries especially with low and lower middle incomes. The aim of mhGAP is to build partnerships for collective action and to reinforce the commitment of governments, international organizations and other stakeholders.

The mhGAP Intervention Guide (mhGAP-IG) was launched in October 2010. It is is a technical tool for the management of mental, neurological and substance use disorders in non-specialist health settings. The priority conditions included are: depression, psychosis, bipolar disorders, epilepsy, developmental and behavioural disorders in children and adolescents, dementia, alcohol use disorders, drug use disorders, self-harm/suicide and other significant emotional or medically unexplained complaints.

 

 

 

 

 

Classification :

The definition and classification of mental disorders is a key issue for mental health and for users and providers of mental health services. Most international clinical documents use the term "mental disorder". There are currently two widely established systems that classify mental disorders—ICD-10 Chapter V: Mental and behavioural disorders, part of the International Classification of Diseases produced by the World Health Organization (WHO), and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) produced by the American Psychiatric Association (APA).

Both list categories of disorder and provide standardized criteria for diagnosis. They have deliberately converged their codes in recent revisions so that the manuals are often broadly comparable, although significant differences remain. Other classification schemes may be used in non-western cultures (see, for example, the Chinese Classification of Mental Disorders), and other manuals may be used by those of alternative theoretical persuasions, for example the Psychodynamic Diagnostic Manual. In general, mental disorders are classified separately to neurological disorders, learning disabilities or mental retardation.

Unlike most of the above systems, some approaches to classification do not employ distinct categories of disorder or dichotomous cut-offs intended to separate the abnormal from the normal. There is significant scientific debate about the different kinds of categorization and the relative merits of categorical versus non-categorical (or hybrid) schemes, with the latter including spectrum, continuum or dimensional systems.

Disorders: List of mental disorders as defined by the DSM and ICD

There are many different categories of mental disorder, and many different facets of human behavior and personality that can become disordered.[2][3][4][5][6]

Anxiety or fear that interferes with normal functioning may be classified as an anxiety disorder.[7] Commonly recognized categories include specific phobias, generalized anxiety disorder, social anxiety disorder, panic disorder, agoraphobia, obsessive-compulsive disorder and post-traumatic stress disorder.

Other affective (emotion/mood) processes can also become disordered. Mood disorder involving unusually intense and sustained sadness, melancholia or despair is known as Major depression or Clinical depression (milder but still prolonged depression can be diagnosed as dysthymia). Bipolar disorder (also known as manic depression) involves abnormally "high" or pressured mood states, known as mania or hypomania, alternating with normal or depressed mood. Whether unipolar and bipolar mood phenomena represent distinct categories of disorder, or whether they usually mix and merge together along a dimension or spectrum of mood, is under debate in the scientific literature.[8]

Patterns of belief, language use and perception can become disordered (e.g. delusions, thought disorder, hallucinations). Psychotic disorders in this domain include schizophrenia, and delusional disorder. Schizoaffective disorder is a category used for individuals showing aspects of both schizophrenia and affective disorders. Schizotypy is a category used for individuals showing some of the characteristics associated with schizophrenia but without meeting cut-off criteria.

Personality—the fundamental characteristics of a person that influence his or her thoughts and behaviors across situations and time—may be considered disordered if judged to be abnormally rigid and maladaptive. Categorical schemes list a number of different such personality disorders, including those sometimes classed as eccentric (e.g. paranoid, schizoid and schizotypal personality disorders), to those sometimes classed as dramatic or emotional (antisocial, borderline, histrionic or narcissistic personality disorders) or those seen as fear-related (avoidant, dependent, or obsessive-compulsive personality disorders). If an inability to sufficiently adjust to life circumstances begins within three months of a particular event or situation, and ends within six months after the stressor stops or is eliminated, it may instead be classed as an adjustment disorder. There is an emerging consensus that so-called "personality disorders", like personality traits in general, actually incorporate a mixture of acute dysfunctional behaviors that resolve in short periods, and maladaptive temperamental traits that are more stable.[9] Furthermore, there are also non-categorical schemes that rate all individuals via a profile of different dimensions of personality rather than using a cut-off from normal personality variation, for example through schemes based on the Big Five personality traits.[10]

Eating disorders involve disproportionate concern in matters of food and weight.[7] Categories of disorder in this area include anorexia nervosa, bulimia nervosa, exercise bulimia or binge eating disorder.

Sleep disorders such as insomnia involve disruption to normal sleep patterns, or a feeling of tiredness despite sleep appearing normal.

Sexual and gender identity disorders may be diagnosed, including dyspareunia, gender identity disorder and ego-dystonic homosexuality. Various kinds of paraphilia are considered mental disorders (sexual arousal to objects, situations, or individuals that are considered abnormal or harmful to the person or others).

People who are abnormally unable to resist certain urges or impulses that could be harmful to themselves or others, may be classed as having an impulse control disorder, including various kinds of tic disorders such as Tourette's syndrome, and disorders such as kleptomania (stealing) or pyromania (fire-setting). Various behavioral addictions, such as gambling addiction, may be classed as a disorder. Obsessive-compulsive disorder can sometimes involve an inability to resist certain acts but is classed separately as being primarily an anxiety disorder.

The use of drugs (legal or illegal), when it persists despite significant problems related to the use, may be defined as a mental disorder termed substance dependence or substance abuse (a broader category than drug abuse). The DSM does not currently use the common term drug addiction and the ICD simply talks about "harmful use". Disordered substance use may be due to a pattern of compulsive and repetitive use of the drug that results in tolerance to its effects and withdrawal symptoms when use is reduced or stopped.

People who suffer severe disturbances of their self-identity, memory and general awareness of themselves and their surroundings may be classed as having a dissociative identity disorder, such as depersonalization disorder or Dissociative Identity Disorder itself (which has also been called multiple personality disorder, or "split personality"). Other memory or cognitive disorders include amnesia or various kinds of old age dementia.

A range of developmental disorders that initially occur in childhood may be diagnosed, for example autism spectrum disorders, oppositional defiant disorder and conduct disorder, and attention deficit hyperactivity disorder (ADHD), which may continue into adulthood.

Conduct disorder, if continuing into adulthood, may be diagnosed as antisocial personality disorder (dissocial personality disorder in the ICD). Popularist labels such as psychopath (or sociopath) do not appear in the DSM or ICD but are linked by some to these diagnoses.

Disorders appearing to originate in the body, but thought to be mental, are known as somatoform disorders, including somatization disorder and conversion disorder. There are also disorders of the perception of the body, including body dysmorphic disorder. Neurasthenia is an old diagnosis involving somatic complaints as well as fatigue and low spirits/depression, which is officially recognized by the ICD-10 but no longer by the DSM-IV.[11]

Factitious disorders, such as Munchausen syndrome, are diagnosed where symptoms are thought to be experienced (deliberately produced) and/or reported (feigned) for personal gain.

There are attempts to introduce a category of relational disorder, where the diagnosis is of a relationship rather than on any one individual in that relationship. The relationship may be between children and their parents, between couples, or others. There already exists, under the category of psychosis, a diagnosis of shared psychotic disorder where two or more individuals share a particular delusion because of their close relationship with each other.

Various new types of mental disorder diagnosis are occasionally proposed. Among those controversially considered by the official committees of the diagnostic manuals include self-defeating personality disorder, sadistic personality disorder, passive-aggressive personality disorder and premenstrual dysphoric disorder.

Two recent unique isolated proposals are solastalgia by Glenn Albrecht and hubris syndrome by David Owen. The application of the concept of mental illness to the phenomena described by these authors has in turn been critiqued by Seamus Mac Suibhne.[12]

Causes: Causes of mental disorders

Mental disorders can arise from a combination of sources. In many cases there is no single accepted or consistent cause currently established. A common belief even to this day is that disorders result from genetic vulnerabilities exposed by environmental stressors. (see Diathesis–stress model). However, it is clear enough from a simple statistical analysis across the whole spectrum of mental health disorders at least in western cultures that there is a strong relationship between the various forms of severe and complex mental disorder in adulthood and the abuse (physical, sexual or emotional) or neglect of children during the developmental years.

An eclectic or pluralistic mix of models may be used to explain particular disorders, and the primary paradigm of contemporary mainstream Western psychiatry is said to be the biopsychosocial (BPS) model, incorporating biological, psychological and social factors, although this may not always be applied in practice. Biopsychiatry has tended to follow a biomedical model, focusing on "organic" or "hardware" pathology of the brain. Psychoanalytic theories have continued to evolve alongside congitive-behavioural and systemic-family approaches. Evolutionary psychology may be used as an overall explanatory theory, and attachment theory is another kind of evolutionary-psychological approach sometimes applied in the context of mental disorders. A distinction is sometimes made between a "medical model" or a "social model" of disorder and disability.

Studies have indicated that genes often play an important role in the development of mental disorders, although the reliable identification of connections between specific genes and specific categories of disorder has proven more difficult. Environmental events surrounding pregnancy and birth have also been implicated. Traumatic brain injury may increase the risk of developing certain mental disorders. There have been some tentative inconsistent links found to certain viral infections,[13] to substance misuse, and to general physical health.

Abnormal functioning of neurotransmitter systems has been implicated, including serotonin, norepinephrine, dopamine and glutamate systems. Differences have also been found in the size or activity of certain brain regions in some cases. Psychological mechanisms have also been implicated, such as cognitive (e.g. reason), emotional processes, personality, temperament and coping style.

Social influences have been found to be important, including abuse, bullying and other negative or stressful life experiences. The specific risks and pathways to particular disorders are less clear, however. Aspects of the wider community have also been implicated, including employment problems, socioeconomic inequality, lack of social cohesion, problems linked to migration, and features of particular societies and cultures.

Gender-specific influences

Female-specific indicators of mental illness incorporate high progesterone oral contraceptives.[citation needed]

Diagnosis

Many mental health professionals, particularly psychiatrists, seek to diagnose individuals by ascertaining their particular mental disorder. Some professionals, for example some clinical psychologists, may avoid diagnosis in favor of other assessment methods such as formulation of a client's difficulties and circumstances.[14] The majority of mental health problems are actually assessed and treated by family physicians during consultations, who may refer on for more specialist diagnosis in acute or chronic cases. Routine diagnostic practice in mental health services typically involves an interview (which may be referred to as a mental status examination), where judgments are made of the interviewee's appearance and behavior, self-reported symptoms, mental health history, and current life circumstances. The views of relatives or other third parties may be taken into account. A physical examination to check for ill health or the effects of medications or other drugs may be conducted. Psychological testing is sometimes used via paper-and-pen or computerized questionnaires, which may include algorithms based on ticking off standardized diagnostic criteria, and in rare specialist cases neuroimaging tests may be requested, but these methods are more commonly found in research studies than routine clinical practice.[15][16]

Time and budgetary constraints often limit practicing psychiatrists from conducting more thorough diagnostic evaluations.[17] It has been found that most clinicians evaluate patients using an unstructured, open-ended approach, with limited training in evidence-based assessment methods, and that inaccurate diagnosis may be common in routine practice.[18] Mental illness involving hallucinations or delusions (especially schizophrenia) are prone to misdiagnosis in developing countries due to the presence of psychotic symptoms instigated by nutritional deficiencies. Comorbidity is very common in psychiatric diagnoses, i.e. the same person given a diagnosis in more than one category of disorder.

Management : Treatment of mental disorders and Services for mental disorders

Treatment and support for mental disorders is provided in psychiatric hospitals, clinics or any of a diverse range of community mental health services. In many countries services are increasingly based on a recovery model that is meant to support each individual's independence, choice and personal journey to regain a meaningful life, although individuals may be treated against their will in a minority of cases. There are a range of different types of treatment and what is most suitable depends on the disorder and on the individual. Many things have been found to help at least some people, and a placebo effect may play a role in any intervention or medication.

Psychotherapy

A major option for many mental disorders is psychotherapy. There are several main types. Cognitive behavioral therapy (CBT) is widely used and is based on modifying the patterns of thought and behavior associated with a particular disorder. Psychoanalysis, addressing underlying psychic conflicts and defenses, has been a dominant school of psychotherapy and is still in use. Systemic therapy or family therapy is sometimes used, addressing a network of significant others as well as an individual.

Some psychotherapies are based on a humanistic approach. There are a number of specific therapies used for particular disorders, which may be offshoots or hybrids of the above types. Mental health professionals often employ an eclectic or integrative approach. Much may depend on the therapeutic relationship, and there may be problems with trust, confidentiality and engagement.

Medication

A major option for many mental disorders is psychiatric medication and there are several main groups. Antidepressants are used for the treatment of clinical depression as well as often for anxiety and other disorders. Anxiolytics are used for anxiety disorders and related problems such as insomnia. Mood stabilizers are used primarily in bipolar disorder. Antipsychotics are mainly used for psychotic disorders, notably for positive symptoms in schizophrenia. Stimulants are commonly used, notably for ADHD.

Despite the different conventional names of the drug groups, there may be considerable overlap in the disorders for which they are actually indicated, and there may also be off-label use of medications. There can be problems with adverse effects of medication and adherence to them, and there is also criticism of pharmaceutical marketing and professional conflicts of interest.

Other

Electroconvulsive therapy (ECT) is sometimes used in severe cases when other interventions for severe intractable depression have failed. Psychosurgery is considered experimental but is advocated by certain neurologists in certain rare cases.[19][20]

Counseling (professional) and co-counseling (between peers) may be used. Psychoeducation programs may provide people with the information to understand and manage their problems. Creative therapies are sometimes used, including music therapy, art therapy or drama therapy. Lifestyle adjustments and supportive measures are often used, including peer support, self-help groups for mental health and supported housing or supported employment (including social firms). Some advocate dietary supplements.[21]

[edit] Prognosis

Prognosis depends on the disorder, the individual and numerous related factors. Some disorders are transient, while others may last a lifetime. Some disorders may be very limited in their functional effects, while others may involve substantial disability and support needs. The degree of ability or disability may vary across different life domains. Continued disability has been linked to institutionalization, discrimination and social exclusion as well as to the inherent properties of disorders.

Even those disorders often considered the most serious and intractable have varied courses. Long-term international studies of schizophrenia have found that over a half of individuals recover in terms of symptoms, and around a fifth to a third in terms of symptoms and functioning, with some requiring no medication. At the same time, many have serious difficulties and support needs for many years, although "late" recovery is still possible. The World Health Organization concluded that the long-term studies' findings converged with others in "relieving patients, carers and clinicians of the chronicity paradigm which dominated thinking throughout much of the 20th century."[22][23]

Around half of people initially diagnosed with bipolar disorder achieve syndromal recovery (no longer meeting criteria for the diagnosis) within six weeks, and nearly all achieve it within two years, with nearly half regaining their prior occupational and residential status in that period. However, nearly half go on to experience a new episode of mania or major depression within the next two years.[24] Functioning has been found to vary, being poor during periods of major depression or mania but otherwise fair to good, and possibly superior during periods of hypomania in Bipolar II.[25]

Suicide, which is often attributed to some underlying mental disorder, is a leading cause of death among teenagers and adults under 35.[26][27] There are an estimated 10 to 20 million non-fatal attempted suicides every year worldwide.[28]

Despite often being characterized in purely negative terms, some mental states labeled as disorders can also involve above-average creativity, non-conformity, goal-striving, meticulousness, or empathy.[29] In addition, the public perception of the level of disability associated with mental disorders can change.[30]

Epidemiology : Prevalence of mental disorders

Mental disorders are common. World wide more than one in three people in most countries report sufficient criteria for at least one at some point in their life.[31] In the United States 46% qualifies for a mental illness at some point.[32] An ongoing survey indicates that anxiety disorders are the most common in all but one country, followed by mood disorders in all but two countries, while substance disorders and impulse-control disorders were consistently less prevalent.[33] Rates varied by region.[34]

A review of anxiety disorder surveys in different countries found average lifetime prevalence estimates of 16.6%, with women having higher rates on average.[35] A review of mood disorder surveys in different countries found lifetime rates of 6.7% for major depressive disorder (higher in some studies, and in women) and 0.8% for Bipolar I disorder.[36]

In the United States the frequency of disorder is: anxiety disorder (28.8%), mood disorder (20.8%), impulse-control disorder (24.8%) or substance use disorder (14.6%).[37][38][39]

A 2004 cross-Europe study found that approximately one in four people reported meeting criteria at some point in their life for at least one of the DSM-IV disorders assessed, which included mood disorders (13.9%), anxiety disorders (13.6%) or alcohol disorder (5.2%). Approximately one in ten met criteria within a 12-month period. Women and younger people of either gender showed more cases of disorder.[40] A 2005 review of surveys in 16 European countries found that 27% of adult Europeans are affected by at least one mental disorder in a 12 month period.[41]

An international review of studies on the prevalence of schizophrenia found an average (median) figure of 0.4% for lifetime prevalence; it was consistently lower in poorer countries.[42]

Studies of the prevalence of personality disorders (PDs) have been fewer and smaller-scale, but one broad Norwegian survey found a five-year prevalence of almost 1 in 7 (13.4%). Rates for specific disorders ranged from 0.8% to 2.8%, differing across countries, and by gender, educational level and other factors.[43] A US survey that incidentally screened for personality disorder found a rate of 14.79%.[44]

Approximately 7% of a preschool pediatric sample were given a psychiatric diagnosis in one clinical study, and approximately 10% of 1- and 2-year-olds receiving developmental screening have been assessed as having significant emotional/behavioral problems based on parent and pediatrician reports.[45]

While rates of psychological disorders are the same for men and women, women have twice the rate of depression than men.[46] Each year 73 million women are afflicted with major depression, and suicide is ranked 7th as the cause of death for women between the ages of 20-59. Depressive disorders account for close to 41.9% of the disability from neuropsychiatric disorders among women compared to 29.3% among men.[47]

 


 

 

Last Updated on Thursday, 11 August 2011 14:02