1 mental health and illness an epidemiological perspective
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Mental Health and Illness
An Epidemiological Perspective
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Mental Health-Everybody’s Business
• Peter Sims• Professor of Public Health
medicine• University of Papua New
Guinea• <[email protected]>
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Teaching and Learning Aims
• There is ignorance, superstition, stigma and fear around Mental Illness
• Aetiology, pathogenesis diagnosis and treatment are imperfect.
• There is a different paradigm and a less rigorous epidemiology
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Often sad,sometimes mad,occasionally bad
• The medical model is• insufficient• Diagnosis is largely • clinical and
experiential
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More of an art than a science
• Treatment is pragmatic
• Prevention is about the politics of health
• “populations,people pressures, poverty”
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Mental Health is a worldwide problem
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Mental illness is common 6 in 10 women and 4 in 10 men in Western Europe and North America will have asignificant mental illness during their lifetime
Mental illness can affect any one of us
Mental illness occurs in all societies and cultures
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We are all vulnerable
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A Holistic ApproachBODY
MIND SPIRIT
Arrow of Time
CULTURE
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Intelligence
IQ
IQ = 100
I.Q. = the Mental Age x 100 the Chronological age
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Personality
• Each human being is unique
• We all have different personalities
• My personality reflects genetic inheritance and Environment
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Behaviour
SUPER-EGO
EGO
ID
The Parent
The Adult
The Child
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The Subconscious Mind
The Conscious
The Subconscious
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A Classification• Affective Disorders• Anxiety,depression,mania,obsessional
disorders
• Schizophrenia• Simple,Hebephrenic,Catatonic,paranoid
• Organic states• Delirium,dementia
• Personality Disorder• Abnormal personality,Psychopathy
Substance abuse problemsDrugs, alcohol
Learning disordersSubnormality
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The Classification of Mental Illness:
The Neuroses
Depression, Anxiety, Mania, Obsessions and compulsions(usually the patient retains insight and orientation; they
experience deep distress and may commit suicide)
The Psychoses
Schizophrenia, puerperal psychosis(the patient is disorientated, deluded, and lacking in insight)
The Dementias
Progressive deterioration with loss of recent memory and deterioration of a normal personality,
They may be primary or more commonly secondary to another condition e.g. alcohol, stroke
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Clinical Diagnosis
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The Classification of Mental Illness
Drug Problems
Addictive drugs, (Heroin, Cocaine, Amphetamines,) alcohol and drug related illness-psychosis, delirium and dementia
Personality DisordersA personality and behaviour that is damaging to the individual and/or to society and which is not tolerated by the dominant culture
Mental subnormality/learning disorders:Problems around intelligence and ability to learn on the basis of teaching and experience
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AetiologyInheritance-Genetics/Intra-uterine environment Schizophrenia,Huntington’s
Infections-HIV,Syphilis,CJD
Drug Abuse
Alcohol,Heroin etc
Trauma/head injury Biochemistry/metabolic
Porphyria,Diabetes
Vascular-CVA
Neurological diseases
MS,Brain tumour
Upbringing
Mothering,education,parenting
Nutrition/PCM
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Treatment and Care
Hospital Care
Community Care
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Preventive NetworksChurch,Family, Home, Friends,
Work
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The Mental Health Act
Compulsory Psychiatric Treatment
Criminal responsibility
Power of attorney
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Mental Handicap/learning disability
The mind of a young child in the body of an adult
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Canst thou not minister to a mind diseased,
Pluck from the memory a rooted sorrow,
Raze out the written troubles of the brain,
And with some sweet oblivious antidote
Cleanse the stuff’d bosom of that perilous stuff
Which weighs upon the heart?
Macbeth