Introduction To Public Health

Lecture 6

Magda Khutsishvili, Pharm B, MPH

Lecturer in the University of Georgia
School of Health Sciences
[email protected]
• Theme: Mental health: public health includes healthy mind
• Reading materials: Introduction to Public Health 5th Edition by
Mary-Jane Schneider (Author) chapter 19, pages: 301-311.
 Mental Health
• Mental Health definition by WHO (World Health
Organization)
“state of well-being in which the individual
realizes his or her own abilities, can cope with the
normal stresses of life, can work productively and
fruitfully and is able to make a contribution to his
or her community”.

• According to WHO:
Mental illnesses cause more disability in
developed countries than any other group of
illnesses, including cancer and heart disease.
Common Mental illnesses in Adults
Categories of Mental Disorders
• Surgeon General’s report ‘Mental Health’ in
1999 listed:
1. Anxiety
2. Psychosis
3. Disturbances of Mood
4. Disturbances of Cognition

• These categories are broad, heterogeneous,

and somewhat overlapping.
• Any particular patient may manifest symptoms
from more than one of these categories.
 Anxiety

• Anxiety is:
a vitally important physiological
response to dangerous situations
that prepares one to confront a
threat in the environment.
• Inappropriate expressions of
anxiety:
if the anxiety experienced is
disproportionate to the
circumstance or interferes with
normal functioning.
 Psychosis
• Psychosis is when people lose some contact with reality. This involves :
1. Hallucinations: seeing things that other people cannot see
2. Delusions: hear and believing things that are not actually true
• They are most characteristically associated with schizophrenia, but psychotic symptoms
can also occur in severe mood disorders.
 Disturbances of Mood
• Mood disturbance can be: sustained feelings of distress, sadness, hopelessness or
symptoms of depression and anxiety.

Mood Disturbance is related to

symptoms like:

1. Disturbances in appetite
2. Sleep difficulties
3. Low Energy level
4. Concentration problems
5. Memory problems
6. Thoughts of suicide (Most
ALERTING!)
 Disturbances of Cognition
• Disturbance of Cognition is:
when the ability to do
complex sequences of tasks,
to organize, process and
recall information is
disturbed.

• Example of diseases:
1. Alzheimer’s disease
2. Dementia
 Prevalence of Mental Disorders
• The NCS (National Comorbidity Survey) provides
data on the lifetime prevalence of mental disorders,
by different age and gender and broken down by
types of disorder:
1. Anxiety disorders
2. Mood disorders
3. Impulse-control disorders
4. Substance disorders

• Results of NCS Survey:

1. Females reported more anxiety disorders and
mood disorders than males, who have more
impulse-control disorders and substance
disorders.
2. Younger participants have a higher prevalence
than those over 60 years.
 Risk factors for Mental Disorders
• Risk factors include: individual, family and
community factors.
1. Individual may be put at risk by:
neurophysiological deficits, difficult
temperament, chronic physical illness, or below
average intelligence.
1. Family factors are:
severe marital discord, social disadvantage,
overcrowding or large family size, paternal
criminality, maternal mental disorder and
admission into foster care.
1. Community factors:
living in an area with a high rate of
disorganization and inadequate schools may
also increase risk.
 Causes and Prevention of Mental Disorders
• The exact causes of most mental
disorders are not known, but much is
known about this is that there are
some broad forces which shape them.
• The causes are viewed as a product of
the interaction between biological,
psychological and sociocultural
factors.
• Genetic factors are important in some
mental disorders, including:
1. Schizophrenia
2. Bipolar disorder
3. Autism
4. Attention deficit hyperactivity
disorder (ADHD).
 Autism in Children
• Autism is: a severe, chronic developmental disorder characterized by severely
compromised ability to engage in and by a lack of interest in social interaction.
• The prevalence in boys is about five times higher than in girls.
 Mood Disorders in Children
• Mood disorders
include: • Suicide is the second
1. Bipolar disorder leading cause of death
2. Depression among young people
age 15 to 24.
3. Suicide • Boys are 5 times as
likely to commit suicide
as girls, while girls are
more likely to report
attempting suicide,
Boys are more likely to
use deadlier methods,
such as firearms.
 Attention-Deficit Hyperactivity disorder (ADHD)
• ADHD is the most commonly
diagnosed behavior disorder of
childhood and its prevalence has
been increasing.
• Boys are more than twice as
likely to be diagnosed with
ADHD than girls.
• ADHD is treated with
psychoactive stimulants and
behavioral therapy both aims to
help a child organize tasks,
follow directions and monitor
his or her own behavior.
 Eating Disorders

• Eating Disorders: typically

appear during teen years
or young adulthood.
• They are caused by a
complex interaction of
genetic, biological,
behavioral, and
psychological factors.
• They are mental illnesses,
but they may lead to
serious physical problems.
 Anorexia Nervosa
• Anorexia Nervosa is more common in girls and
women, when they see as if they are
overweight even when they are clearly
underweight.
• They are obsessed with food, weight and
weight control and typically eats only certain
foods in very small portions.
• Anorexia Nervosa can cause:
1. Heart damage
2. Brain damage
3. Multiple organ failure
• People with anorexia are 18 times more likely
to die young as are people in the general
population of the same age.
 Bulimia Nervosa
• Bulimia Nervosa is when people are obsessed with their weight, but they lack
control over their eating.
• They eat a lot and then try to compensate by purging behaviors such as
self-induced vomiting or excessive use of laxatives or by excessive exercise.
• The are in a normal weight in reality, but develop symptoms such as:
1. Chronic sore throat
2. Tooth decay
3. Various gastrointestinal problems
4. Electrolyte imbalance.
 Binge Eating Disorder
• In binge-eating disorder, people lose control over their eating, but they do not purge.
• These people are often overweight or obese.
 Mental Health In Adulthood
• Personal Characteristics, contributing Mental Health
1. Self-esteem
2. Optimism
3. Resilience traits that are needed to deal with stressful life
events.
• The most common psychological and social stressors in adult
life include:
1. Breakup of romantic relationships,
2. Death of a family member or friend,
3. Economic hardships,
4. Racism and Discrimination,
5. Poor physical health
6. Accidental and intentional assaults on physical safety.
 Mental Health in Older Adults
• Population from 55 and older, experience specific
mental disorders that are not part of “normal”
aging, which include:
1. Depression
2. Alzheimer’s disease
3. Alcohol and drug misuse and abuse
4. Anxiety
5. Schizophrenia
• Risk factors for mental illness in the elderly:
1. General medical conditions,
2. Admission to a nursing home
3. The high number of medications taken
4. Psychosocial stressors such as bereavement or
isolation.
5. Depression after loss of a spouse.
 Treatment Of Mental Disorders
• Most people with mental
disorders do not seek
treatment, because they
do not know that there
are effective treatments.
• It is fear of the stigma of
acknowledging the
problem.
• Problem in getting the
treatment is related to the
cost of care.
• Housing is often a major
problem for people with
severe mental illness, who
often tend to be poor.
Thank You For Your Attention!