Mental health articles

non organic mental health disorders. Data on non-organic disorders specifically among the aged in countries of the developing world are limited. The studies reviewed below describe the burden of non-organic mental health problems among adult populations (often including the elderly) and elderly populations in the developing world.Even in adult populations, few studies are comparable because of the use of different sample types and diagnostic instruments. In a village in Lesotho,Hollifield et al. determined the prevalence of the following disorders among adults in the community:depression, 9.8%; panic disorder, 3.2%; and,generalized anxiety disorder, 4.9%. They were able tocompare results with a similar study from the UnitedStates and found higher prevalence rates in Lesotho. In Benin, Bertschy et al. documented a westernclinical pattern of depressive symptoms, albeit with ahigher frequency of somatic complaints and ideas of persecution and a lower frequency of suicidal thoughtsand guilt feelings among adults, but on the whole, the study did not lend support to the idea of'culture-bound' symptoms. One drawback of the studywas that the sample of 92 Beninese patients was more westernized than the population of the country at large because they were primarily urban and were allFrench-speaking. Gureje et al. showed a 27.8%weighted prevalence for DSM-IIIR diagnoses usingthe 12-item General Health Questionnaire (GHQ) on787 clinic attenders in a Nigerian city. Those over age60 in this population sample had the highest levels ofgeneralized anxiety disorder (13.9%) and somatoform disorders (13.1%). An epidemiological study of mental health symptomatology in Indonesia using the30-item GHQ found a 20% rate of caseness among aprobability sample of 1670 adults. The case rate waslowest among individuals belonging to communitiesthat had progressed substantially in their standard ofliving (i.e. that had shown the most socioeconomicdevelopment). Higher rates ofcaseness existed among those having little education and poor housing andliving in poverty. Based on these findings the authors conclude that rapid socioeconomic and cultural changes in the industrializing world need not universally contribute to increased mental disorder, as isoften believed, but may have a beneficial impact on mental health if they bring substantial economic progress.

non organic mental health disorders. Studies focussing exclusively on the aged are equally diverse. Neki's survey of psychiatric disorders amongthe hospitalized aged in India found 27% sufferingfrom depression. Depression seems to be acommon diagnosis in India, with prevalence ratesin primary health care settings varying from onetwentiethto between two- and three-fifths of attenders,depending on the region of the country and thediagnostic criteria used. In addition to a coreof depressive symptoms, Indians typically exhibit highlevels of somatic symptoms but low levels of psychoses. Makanjuola's study of 51 elderly Nigeriansattending a psychiatric clinic revealed that 9.8%suffered major depressive disorder while 55 % exhibitedlate onset paranoid disorders (of which 20 casesfulfilled criteria for paranoid schizophrenia). From acommunity survey of elderly black persons in twoSouth African townships, researchers reported that fully 25% of respondents were regarded as clinicallydepressed. In the more recently settled township,53% of men and 76% of women had psychiatric manifestations 'warranting further investigation', and44% of the women would have been treated for depression if seen by a psychiatrist, having shown more worry, a feeling that life is not worth living, sleep disturbance, early morning waking, headaches, cryingand anhedonia (i.e. pleasure not derived from normallypleasurable behavior) than other groups in the study. Results from the screening of a sample of 111community-dwelling elderly aged 65 years and older in$5o Paulo, Brazil with the Clinical Interview Schedule(and using ICD-9 classification criteria) showed a29.7% prevalence of psychiatric problems with thefollowing distribution: dementia, 5.5%; depression,14.3%; neuroses, 7.7%; personality disorders, 15.3%;substance abuse disorders, 3.3%; and adjustmentreactions, 6.6%. When theauthors compared these data to those from a similarsample of community-dwelling elderly from Mannheim, Germany, they observed much highersymptom rates for minor psychiatric morbidity(MPM), such as sleep disorder, irritability, anxiety,depression and lack of concentration, in the $5o Paulosample. They believe that these high symptom countsin So Paulo relative to those in Mannheim reflected"stresses associated with rapid acculturation, poverty,difficult housing conditions, and low or non-existentretirement pensions for the elderly"  In a four country study on aging in the West Pacificregion (Fiji, Malaysia, Philippines and the Republic ofKorea) using representational samples of the elderly population (60 and over), Andrews et al. reported on the presence of five symptoms of MPM: sleep difficulties, worry and anxiety, loss of interest, tiredness and forgetfulness. Their data demonstrated that, ingeneral, the level of all problems remained static orincreased with age. In Fiji, older subjects documentedloss of interest and forgetfulness more often thanyounger subjects, with no sex differences. In theRepublic of Korea, 30-50% of the study populationcomplained of sleep difficulties, worry and anxiety, lossof interest and tiredness, and these proportions changed very little with age. In Malaysia, the malepopulation showed an increase with age in thereporting of all five mental problems, and the femalepopulation showed the same trend with loss of interest,tiredness and forgetfulness.These increases were greatest for loss of interest. Eighteen percent of men and 29% of women aged60-64 years said they were not as enthusiastic about doing things they used to care about; comparable figures for those 80 years and over were 76% for menand 77% for women.

non organic mental health disorders.In the Philippines, prevalences ofall five mental health problems increased with age. Differences between youngest and oldest age groupsappeared largest for loss of interest (about 30%difference for both sexes), tiredness (29% difference for men), and forgetfulness (48% difference for men). Respondents stating that they were lonely accounted for the following percentages: 24%in Fiji, 22% in the Republic of Korea, 10% in Malaysia and 7% in the Philippines.

Tags: disorders, Health, mental, Mental health