One in four individuals suffer from a psychiatric disorder at some point in their life. In October 2009, the British Medical Journal estimated the ‘economic, social and human cost of mental illness per year in the UK’ as £100 billion ($1.6 billion). It is therefore clear that humans are highly vulnerable to mental health disorders, and that these impact significantly upon our society in many different ways.
Whilst most of medicine endeavours to fix physical aberrations, psychiatrists attempt to understand a patient wi hin their context, and to alter their thoughts, behaviour, and neurobiology to help improve their quality of life. This is often a challenge, and one that is becoming more obvious as it becomes recognized that the prevalence of mental disorders worldwide is on the increase. It is often difficult for the genera public and clinicians outside psychiatry to think of mental health disorders as ‘diseases’ because it is harder to pinpoint a specific pathological cause for them. However, until recently most of medicine has been founded on this basis. For example, it was only in the late 1980s that ” Helicobacter pylori ” was linked to gastric/duodenal ulcers and gastric carcinoma. Still much of clinical medicine treats a patient’s symptoms rather than objective abnormalities.
The World Health Organization (WHO) has given the following definition of mental health: mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.
This is a helpful definition, because it clearly defines a mental disorder as a condition that disrupts this state in any way, and sets clear goals of treatment for the clinician. It identifies the fact that a disruption of an individual’s mental health impacts negatively not only upon their enjoyment and ability to cope with life, but also upon that of the wider community.
The rest of this chapter will outline the prevalence of mental health disorders worldwide, the impact that these have on both individuals and society, and the public perception of psychiatry and the effect that this has on those with mental disorders.
Worldwide prevalence of mental disorders
Psychiatric disorders are amongst the most prevalent causes of ill health in humans. One in four adults will suffer from a diagnosable mental disorder at some time in their life, and one in five has one in any given year. This is true across the globe, in both economically developed and developing countries. Table 2.1 outlines the worldwide prevalence of the major psychiatric disorders, with some common physical disorders for comparison. Depression is one of the most prevalent diseases currently seen in humans, only superseded by conditions associated with poverty and poor access to healthcare (e.g. malnutrition, iron-deficiency anaemia, low vision). Approximately 6 per cent of the population have a severe, enduring psychiatric disorder which impacts upon their functioning in the long term. Schizophrenia, bipolar disorder, and unipolar depression make up the majority of these cases. As an example of the relative prevalence of common mental health disorders seen in developed countries, Table shows epidemiological data from the USA collected in 2008. Always remember that patients frequently fit the diagnostic criteria for more than one diagnosis—for example, social phobia and major depressive disorder—and that this is especially true for the mood, anxiety, and behavioural conditions. It is unclear at the moment whether the prevalence of many disorders is increasing, or if rising figures are merely a diagnostic artefact. Time will tell.
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