scholarly journals The epidemiological burden of major psychiatric disorders

Author(s):  
Jennifer Dykxhoorn ◽  
James B. Kirkbride

Psychiatric disorders, including common mental disorders, schizophrenia, and suicide, contribute substantially to the global burden of disease in terms of both morbidity and premature mortality, making them an important issue for public mental health. Epidemiological tools quantifying the burden of psychiatric disorders are important in furthering our understanding of psychiatric disorders and informing decision-making. In this chapter, we review major epidemiological studies from the past 30 years of psychiatric epidemiology to provide an overview of the burden of common mental disorders (depression and anxiety), psychotic disorders (schizophrenia and other psychotic disorders), and suicide. We also describe how the incidence and prevalence of these disorder vary by person and place, with a particular focus on the patterns of psychiatric disorders by ethnicity. Finally, we discuss the challenge of applying epidemiological evidence to public health, highlighting key issues facing public health professionals, researchers, and policymakers working in public mental health.

2020 ◽  
pp. 237337992092287
Author(s):  
Briana Mezuk ◽  
Belinda Needham ◽  
Kevin Joiner ◽  
Daphne Watkins ◽  
Sarah Stoddard ◽  
...  

In the past decade, the number of undergraduate public health programs has increased exponentially. This growth provides a unique opportunity to explore concepts and issues relevant to understanding the determinants of health at a population level using new pedagogical approaches. One of these issues is stigma toward mental disorders. Stigma is a concept that refers to a feature or characteristic that reduces, devalues, and disempowers a person. Given the prevalence of mental and substance use disorders among college students, undergraduate education is an important setting for attempting to address stigmatizing attitudes both for society at large and for faculty, staff, and students, including those experiencing mental health problems. This article describes an effort to develop an undergraduate course in public mental health that explicitly addresses the ways stigma shapes student understanding of this topic and discusses lessons learned from this experience.


2020 ◽  
Vol 30 (3) ◽  
pp. 503-509 ◽  
Author(s):  
Ziggi Ivan Santini ◽  
Sarah Stougaard ◽  
Ai Koyanagi ◽  
Annette Kjær Ersbøll ◽  
Line Nielsen ◽  
...  

Abstract Background Mental well-being is fundamental for a good life. Previous literature has examined the predictors of mental disorders and continuous measures of positive mental health. Very few studies have specifically focused on the predictors of different levels of mental well-being, but those that have suggest a different picture. This study aimed to compare socioeconomic and relational/recreational behaviour predictors of different levels of mental well-being as well as common mental disorders (CMDs). Methods Data from 3508 adults aged 16+ years old from the Danish Mental Health and Well-Being Survey 2016 were linked to Danish national register-based data. Mental well-being was assessed using the Warwick-Edinburgh Mental Well-being Scale, and information on CMDs was assessed using the Patient Health Questionnaire (PHQ-4). Regression analyses were conducted to estimate the predictors of low and high mental well-being compared to moderate mental well-being and also of CMDs. Results Lower socioeconomic position (education, income and employment status) was associated with increased odds of low mental well-being and the presence of CMDs, but did not significantly predict high mental well-being. Relational/recreational behaviours (informal and formal social participation, social support and recreational activity) were associated with reduced odds of low mental well-being and CMDs, and also with increased odds of high mental well-being. Conclusions Socioeconomic predictors of high mental well-being do not mirror those of low mental well-being and CMDs, whereas relational/recreational predictors of high mental well-being do mirror those of low mental well-being and CMDs. These findings have important implications for public mental health strategies.


2020 ◽  
Author(s):  
Lidia Gouveia ◽  
Kathryn Lovero ◽  
Wilza Fumo ◽  
Afonso Mazine Tiago Fumo ◽  
Palmira Dos Santos ◽  
...  

Abstract BackgroundIn Mozambique, human and financial resources for public mental health services are extremely limited. Understanding the mental health needs of those seeking healthcare can inform efficient targeting of mental health services. We examined if the frequency of mental disorders in a health facility varied based on the level of specialization of such facility, from primary care without mental health specialists (PrCMH-), to those with mental health specialists (PrCMH+) and tertiary care (TerC), where both inpatient and outpatient mental health services are available.MethodsParticipants were adults seeking health or mental health services at six facilities (2 PrCMH+, 3 PrCMH-, and 1 TerC) in the cities of Maputo and Nampula in Mozambique. Mental disorders were assessed by the MINI International Neuropsychiatric Interview (MINI) 4.0.0. We compared the sociodemographic characteristics and MINI diagnoses across the three types of health facilities. Multiple logistic regression models determined the likelihood that a person seeking services at each type of facility would have any mental disorder, common mental disorders (CMD), severe mental disorders (SMD), substance use disorders (SUD), and moderate-to-high suicide risk, adjusting for sociodemographic factors. ResultsOf the 612 total participants, 52.6% (n=322) were positive for at least one mental disorder: 37.1% were positive for CMD, 28.9% for SMD, 13.2% for SUD, and 10.5% had suicide risk. Presence of any mental disorder was highest in TerC (62.5%) and lowest in PrCMH- (48.4%). Adjusting for sociodemographic covariates, participants in PrCMH+ were significantly more likely to have SMD (OR: 1.85, 95%CI: 1.10-3.11) and SUD (OR: 2.79, 95%CI: 1.31-5.94) than participants in PrCMH-; participants in TerC were more likely to have CMD (OR: 1.70, 95%CI: 1.01-2.87) and SUD (OR: 2.57, 95%CI: 1.14-5.79) than in PrCMH-. Suicide risk was the only condition that did not differ across facility types.ConclusionsAs anticipated, people with mental disorders were more likely to be cared for at facilities with mental health specialists. However, our study suggests there is a remarkably high frequency of mental disorders across different types of facilities within the Mozambican healthcare system. These results suggest a need to increase mental health services at the primary care level.


2005 ◽  
Vol 29 (12) ◽  
pp. 455-458 ◽  
Author(s):  
Harry Petrushkin ◽  
Jed Boardman ◽  
Emilio Ovuga

Aims and MethodThe study examined the prevalence of psychiatric disorders in people with HIV/AIDS attending the AIDS Support Organisation (TASO) clinic at Mulago Hospital, Kampala, Uganda and the preparedness of AIDS counsellors to deal with mental disorders. Forty-six patients were interviewed using the Mini International Psychiatric Interview to ascertain DSM–IV diagnoses. All 15 counsellors working at the clinic were interviewed.ResultsThe total prevalence of psychiatric disorder was 82.6 (38 out of 46 patients). Depressive and anxiety disorders were common. Non-affective psychoses were present in eight patients (17.4%), bipolar affective disorder in eight (17.4%) and major depression with melancholic features in five (10.9%); 8 (13%) had current suicidal thoughts. None of the people with psychiatric disorders were receiving mental health treatment. The prevalence of disorder as estimated by the counsellors ranged from 0 to 33%. Only one counsellor had received any formal training in mental disorders and only two thought that they could deal with these if they arose. The attitudes of counsellors towards people with mental disorders were mixed, but most believed that they should be trained to provide care.Clinical ImplicationsThere is a need to provide additional mental health services to the TASO clinic through appropriate training of TASO counsellors to improve their awareness of psychiatric disorders, delivery of some psychological therapies and liaison with the psychiatric services at Mulago Hospital, in addition to public mental health education. The psychiatric disorders experienced by those attending the clinic might put them at greater risk of contracting HIV/AIDS.


2019 ◽  
pp. 106-128 ◽  
Author(s):  
Peter Ventevogel ◽  
Xavier Pereira ◽  
Sharuna Verghis ◽  
Derrick Silove

Mental health and psychosocial problems among refugees are increasingly being recognized as a priority issue. This chapter will critically examine and synthesize what is known about mental health problems among refugees. The scope will be broad, extending beyond post-traumatic stress disorder, and include brief information on other common mental disorders in refugees (such as prolonged grief, depression as well as severe mental disorders such as psychosis and bipolar disorder). The chapter briefly introduces social-ecological frameworks that assist in conceptualizing the psychosocial problems facing refugees. Emphasis is given to the need for multi-sectoral, multi-level interventions that are sensitive to culture and context, and that are evidence-informed and scalable. Key issues are: the integration of mental health into general health using brief psychological interventions; use of task shifting approaches; and interventions to strengthen self-help and family and community support in refugee settings.


Public Mental Health provides a comprehensive introduction and guide to the public health approach to mental and behavioral disorders, and to promotion of mental health. The volume’s chapter authors and coauthors are drawn from the internationally renowned faculty of the Department of Mental Health of the Johns Hopkins Bloomberg School of Public Health, a department uniquely positioned to create this important resource for researchers, students, and public health practitioners. The volume explicates the latest methodologies for studying the occurrence of mental disorders in populations, and provides estimates of burden, cultural differences, natural history, and disparities between population subgroups. It includes reviews of genetic and biological pathways as sources of risk for mental disorders, the occurrence of stresses and their timing over the life span, and crises and disasters as sources of risk. The book includes chapters on the structure and functioning of the mental health service system in the United States, and around the world, and a comprehensive review of population-based strategies of intervention to lower risk. A final chapter lays out a path for the evolution of public mental health in the future.


2009 ◽  
Vol 06 (01) ◽  
pp. 5-9 ◽  
Author(s):  
S. Aguilar-Gaxiola ◽  
J. Alonso ◽  
S. Chatterji ◽  
S. Lee ◽  
T. B. Üstün ◽  
...  

SummaryThe paper presents an overview of the WHO World Mental Health (WMH) Survey Initiative and summarizes recent WMH results regarding the prevalence and societal costs of mental disorders. The WMH surveys are representative community surveys that were carried out in 28 countries throughout the world aimed at providing information to mental health policy makers about the prevalence, burden, and unmet need for treatment of common mental disorders. Results show that mental disorders are commonly occurring in all participating countries. The inter-quartile range (IQR: 25th-75th percentiles) of lifetime DSM-IV disorder prevalence estimates (combining anxiety, mood, disruptive behavior, and substance disorders) is 18.1-36.1%. The IQR of 12-month prevalence estimates is 9.8-19.1%. Analysis of age-of-onset reports shows that many mental disorders begin in childhood-adolescence and have significant adverse effects on subsequent role transitions. Adult mental disorders are found in the WMH data to be associated with high levels of role impairment. Despite this burden, the majority of mental disorders go untreated. Although these results suggest that expansion of treatment could be cost-effective from both the employer perspective and the societal perspective, treatment effectiveness trials are needed to confirm this suspicion. The WMH results regarding impairments are being used to target several such interventions.


2018 ◽  
Vol 21 (1) ◽  
pp. 10-16 ◽  
Author(s):  
Eirenei Taua'i ◽  
Rose Richards ◽  
Jesse Kokaua

Aims: To explore associations between experiences of mental illness, migration status and languages spoken among Pacific adults living in NZ. Methods: SURVEY FREQ and SURVEY LOGISTIC procedures in SAS were applied to data from Te Rau Hinengaro: The New Zealand (NZ) Mental Health Survey, a survey of 12,992 New Zealand adults aged 16 and over in 2003/2004. Pacific people were over sampled and this paper focuses on the 2374 Pacific participants but includes, for comparison, 8160 non-Maori-non-Pacific (NMNP) participants. Results: Pacific migrant respondents had the lowest prevalence of mental disorders compared to other Pacific peoples. However, Pacific immigrants were also less likely to use mental health services, suggesting an increased likelihood of experiencing barriers to available mental health care. Those who were born in NZ and who were proficient in a Pacific language had the lowest levels of common mental disorders, suggesting a protective effect for the NZ-born population. Additionally, access to mental health services was similar between NZ-born people who spoke a Pacific language and those who did not. Conclusions: We conclude that, given the association between Pacific language and reduced mental disorder, there may be a positive role for Pacific language promotion in efforts to reduce the prevalence of mental health disorder among Pacific communities in NZ.


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