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Mental health atlas 2005
- Author:
- WORLD HEALTH ORGANIZATION
- Publisher:
- World Health Organization
- Publication year:
- 2005
- Pagination:
- 540p.
- Place of publication:
- Geneva
- Edition:
- Rev. ed.
The World Health Organization Mental Health Atlas 2005 shows that global resources for people suffering from mental and neurological disorders are grossly insufficient to address the growing burden of mental health needs, and are unequally distributed around the world. The 2005 edition is an update of the first Mental Health Atlas 2001, and contains the most complete global data available on mental health resources. It shows no substantial change in global mental health resources since 2001, while there continue to be marked and growing differences in availability between high- and low-income countries. For example, while the survey of 192 countries does show a slight increase in the total number of psychiatrists from 3.96 to 4.15 per 100 000 people worldwide, distribution across regions ranges from 9.8 in Europe to just 0.04 in Africa. This disparity has increased since 2001. The Atlas notes that many countries continue to spend only a very small proportion of their total health budget on mental health. One fifth of the more than 100 countries supplying figures to the survey spend less than 1% of their health budget on mental health. This is in stark contrast to WHO's estimate that 13% of all disease burden is caused by the wide range of neuro-psychiatric disorders.
Challenging the globalisation of biomedical psychiatry
- Authors:
- THOMAS Philip, et al
- Journal article citation:
- Journal of Public Mental Health, 4(3), September 2005, pp.23-32.
- Publisher:
- Emerald
This paper briefly describes biomedical psychiatry and its origins before considering how this project is closely aligned to the interests of the pharmaceutical industry. It ends with a call for a new agenda in mental health, driven by the concerns and interests of ordinary people in local communities, and an outline of recent developments in Britain and elsewhere that illustrate this challenge to the biomedical hegemony. The authors conclude by providing details of three projects which illustrate how this can be achieved : Sharing Voices (Bradford), Evolving Minds, and PaPA.
Autistic-spectrum disorders: lessons from neuroimaging
- Authors:
- TOAL Fiona, MURPHY Declan G. M., MURPHY Kieran C.
- Journal article citation:
- British Journal of Psychiatry, 187(5), November 2005, pp.395-397.
- Publisher:
- Cambridge University Press
Autistic-spectrum disorder is approximately half as common as schizophrenia but its cause remains unknown. Recent studies have begun to clarify the underlying neuroanatomical abnormalities and brain–behaviour relationships in autism. In the past decade, great advances have been made in our understanding of the neurobiological basis of autism.
Psychiatric diagnosis and chronic fatigue syndrome: controversies and conflicts
- Author:
- SHARPE Michael
- Journal article citation:
- Journal of Mental Health, 14(3), June 2005, pp.269-276.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
This article reviews the issue of psychiatric diagnoses in patients who meet diagnostic criteria for chronic fatigue syndrome (CFS). The authors consider what is meant by a diagnosis, by a diagnosis of psychiatric disorder and by a diagnosis of CFS. The authors discuss the relationship between the different diagnoses, ask why the issue generates so much controversy, and what the useful ways forward for practice might be.
Community study of knowledge of and attitude to mental illness in Nigeria
- Authors:
- GUREJE Oye, et al
- Journal article citation:
- British Journal of Psychiatry, 186(5), May 2005, pp.436-441.
- Publisher:
- Cambridge University Press
The improvement of community tolerance of people with mental illnessis important for their integration. Little is known about the knowledge of and attitude to mental illness in sub-Saharan Africa. A multistage, clustered sample of household respondents was studied in three states in the Yoruba-speaking parts of Nigeria (representing 22% of the national population). A total of 2040 individuals participated (responserate 74.2%). Poor knowledge of causation was common.Negative views of mental illness were widespread, with as many as 96.5% (s.d.=0.5) believing that people with mental illness are dangerous because of their violent behaviour. Most would not tolerate even basic social contacts with a mentally ill person: 82.7% (s.e.=1.3) would be afraid to have a conversation with a mentally ill person and only 16.9% (s.e.=0.9) would consider marrying one. Socio-demographic predictors of both poor knowledge and intolerant attitude were generally very few. There is widespread stigmatisation of mental illness in the Nigerian community. Negative attitudes to mental illness may be fuelled by notions of causation that suggest that affected people are in some way responsible for their illness, and by fear.
Prevalence of depression in older patients consulting their general practitioner in the Netherlands
- Authors:
- LICHT-STRUNK Els, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(11), November 2005, pp.1013-1019.
- Publisher:
- Wiley
Data of The West Friesland Study were used. Five thousand, six hundred and eight-six GP attendees of 55 years and older filled in the Geriatric Depression Scale - 15 items as a screening instrument for depression (response 62%). Of those screened positive on the GDS-15, 846 (77.5%) were interviewed using the Primary Care Evaluation of Mental Disorders (PRIME-MD). A random sample of 102 patients scoring below the threshold of the GDS-15 was interviewed to estimate the proportion of false negatives. Major depression was prevalent in 13.7% and minor depression in 10.2% of the patients. Depressed patients were older, more often female and lived more often in urban districts. Patients with major depression were younger and more often female than those with a minor depression. Only 22.9% of the patients with a major depression were treated with antidepressants. Depression in older GP attendees is a very common health problem. Further research should focus on identifying those groups of patients with high risk of persistence of depression. This could help to focus the limited resources available in general practice to those patients in whom treatment is most urgently needed.
Personality and comorbidity of common psychiatric disorders
- Authors:
- KHAN Amir, et al
- Journal article citation:
- British Journal of Psychiatry, 186(3), March 2005, pp.190-196.
- Publisher:
- Cambridge University Press
We know little about the degree to which comorbidity, so commonly seen among psychiatric disorders, arises from variation in normal personality. The authors aimed to study the degree to which variation in normal personality accounts for the comorbidity of 8 common psychiatric and substance use disorders. Internalising disorders (major depression, generalised anxiety and panic disorders, phobias), externalising disorders (alcohol and drug dependence, antisocial personality and conduct disorders) and personality dimensions of neuroticism, extraversion and novelty seeking were assessed in 7,588 participants from a population-based twin registry. The proportion of comorbidity explained by each personality dimension was calculated using structural equation modelling. Neuroticism accounted for the highest proportion of comorbidity within internalising disorders (20–45%) and between internalising and externalising disorders (19–88%). Variation in neuroticism and novelty seeking each accounted for a modest proportion (10–12% and 7–14%, respectively) of the comorbidity within externalising disorders. Extraversion contributed negligibly. High neuroticism appears to be a broad vulnerability factor for comorbid psychiatric disorders. Novelty seeking is modestly important for comorbid externalising disorders.
Seminars in child and adolescent psychiatry
- Editors:
- GOWERS Simon G., (ed.)
- Publisher:
- Gaskell
- Publication year:
- 2005
- Pagination:
- 370p.
- Place of publication:
- London
- Edition:
- 2nd
This textbook for trainees in child and adolescent psychiatry has been extended, with a number of new chapters covering the major disorders and the range of service provision. From assessment to outcome, from normal development to unusual syndromes, from theoretical perspectives to treatment, the reader will find this a concise overview of the field. This new edition: provides an overview of the specialty of child and adolescent psychiatry; leads the reader from theory to clinical practice; and considers the full range of theoretical and management approaches.
Postpsychiatry
- Authors:
- BRACKEN Patrick, THOMAS Philip
- Publisher:
- Oxford University Press
- Publication year:
- 2005
- Pagination:
- 304p., bibliog.
- Place of publication:
- Oxford
The book asks, is madness best thought of as a medical condition? Psychiatrists and the drug industry maintain that psychoses are brain disorders amenable to treatment with drugs. There is no convincing evidence that the brain is disordered in psychosis, yet governments across the world are investing huge sums of money on mental health services that take for granted the idea that psychosis is an illness to be treated with medication. Although some people who use mental health services find medication helpful, many do not, and resist the idea that their experiences are symptoms of illnesses like schizophrenia. Consequently they are forced into having treatment against their wishes. The authors examine the conflicting ways in which politicians, academics, and mental health professionals appear to understand madness, and contrast this with voices and experiences that are usually excluded - those of the people who use mental health services. They then examine the power of psychiatry to shape how we understand ourselves and our emotions, before considering some of the basic limitations of psychiatry as science to make madness meaningful. In the final section of the book they draw on evidence from service users and survivors, the humanities and anthropology, to point out a new direction for mental health practice.
Clinician-patient ethnicity in psychiatric diagnosis: a pilot study with Hispanics
- Authors:
- ZAYAS Luis H., et al
- Journal article citation:
- Journal of Ethnic and Cultural Diversity in Social Work, 14(1/2), 2005, pp.93-109.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Language and ethnicity are parts of the interpersonal process that converge during psychiatric diagnosis, affecting diagnostic accuracy and concordance among clinicians. In this feasibility study, the authors videotaped two Hispanic psychiatrists conducting typical diagnostic interviews with 10 first-time Hispanic patients in a community mental health clinic. Then, two non-Hispanic psychiatrists viewed the videotapes with translator assistance. All psychiatrists rendered DSM-IV diagnoses on the patients they interviewed or whose tapes they watched. On Axis I, psychiatrists did not differ, diagnosing mostly mood disorders. On Axis II, non-Hispanic psychiatrists diagnosed personality disorders more often. On Axis IV, Hispanic psychiatrists identified more psychosocial stressors, especially family-related ones. On Axis V, Hispanic psychiatrists rated patients more functionally impaired. Although limited, the findings raise several interesting questions that can be useful to clinicians and researchers diagnosing patients from their own or a different culture. Are Axis I diagnoses less subject to cultural biases than Axis II personality disorders? Does cultural proximity between patient and clinician add sensitivity to psychosocial stressors while holding patients to higher functional standards? (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).