Mental Illness

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"Anti-psychiatry" first used in 1967 by David Cooper - Cooper wrote Psychiatry and Anti-Psychiatry in 1972

Psychiatry perceived as way of punishing those whose behaviour is deviant

Psychiatric diagnoses an indication of intolerance towards those we don't approve of

In Russia and China, political dissidents were often placed in psychiatric institutions

Church of Scientology - associated with advocacy group Citizens Commission on Human Rights (CCHR)

Some claims made by CCHR and other critics of psychiatry

Claim: psychiatric diagnoses are vague and based upon subjective judgements

Such judgements don't meet generally accepted scientific criteria (validity/reliability)

Over last 30 years, dramatic series of changes in way persons with serious mental illness are treated

Institutional care - reduced size/range

Use of medications to control symptoms

Postnatal Depression

Dr Taemets - director of Mother and Infant Care Unit at Belmont Private Hospital (BNE)

1 mum in 5 suffers postnatal disorder which is serious enough to require treatment

At least 10 and 20% suffer more serious postnatal disorder

As many as 45% of these women will experience depressive symptoms at end of first postnatal year

Acc. to Philip Hammond, sleep is key to curing postnatal depression

Taemets: up to 40% of fathers suffer from postnatal depression

About 40% needed education/counselling/psychotherapy to battle this

6% require treatment with antidepressant drugs

Men experience similar symptoms of tiredness, sadness and irritability after child birth

Acc. to Jim Kelly in 1999, "new British study has found male PND affects 1 in 10 dads"

Experts believe emergence of PND symptoms in men could be linked to more active role played by modern dad during and after child's delivery

For every 2 mums with PND, at least 1 dad suffers too

More than 15% of new mums are diagnosed with PND, and about 10% of new dads

PANDA estimates that 50% of parents who suffer from PND aren't ever diagnosed, and figure for men could be higher

Robert Stabler (animal behaviour consultant) says rising number of domestic animals in Aus are being sedated by antidepressants

3-6% of cats and dogs in Aus suffered from OCD - similar figure to problem found in humans

Early intervention boosts chances of animals recovering

Cause is mixture of genes and environment, with owners playing master role

DSM-I (1952)

DSM-II (1968) - homosexuality listed as mental disorder

1970, gay groups attended American Psychiatric Association (APA) Annual Meeting - also in 1971 and 1972

1973, position of APA revised - homosexuality subsequently removed from DSM-II

Homosexuality itself no longer a disorder, but diagnosis was included for homosexuals who experienced distress concerning their sexual orientation

This reformation was of major importance - mental disorder only became one if it caused distress

DSM-IIIR (1980)

DSM-IV (1994)

DSM-IVIR (2000)

DSM-5 (due May 2013)

Mental disorders defined by variety of concepts - distress, dyscontrol, disadvantage, disability, inflexibility, irrationality, syndromal pattern, aetiology, statistical deviation

Population studies

Up to 1 in 4 Australians now suffer from depression

Suicide occurs most frequently in middle-aged men who from early age have been conditioned to "tough it out"

World Mental Health Survey (Aus. administered version)

CIDI: Composite International Diagnostic Interview (III)

Structured clinical interview intended to produce DSM-IV and ICI-10 diagnoses

Australia, 2007

Persons 16-85yrs: 16 015 300 (100%)

Lifetime mental disorder: 7 286 600 (45%)

- Any 12mth mental disorder: 3 197 800 (20%)

- No 12mth mental disorder: 4 088 800 (25%)

No lifetime mental disorder: 8 728 700 (55%)

Panic Disorder

Discrete episode of intense fear/discomfort that starts abruptly and reaches peak within a few mins; last at least some mins

Symptoms: pounding heart; sweating; trembling/shaking; dry mouth - at least one of these must be present

Symptoms: difficulty breathing; feeling of choking; chest pain; nausea/abdominal distress - some of these may be present

Generalised Anxiety Disorder

Period of at least 6mths with tension, worry and apprehension about everyday events and problems

Not due to physical disorder or substance abuse

Symptoms: pounding heart; sweating; trembling/shaking; dry mouth - 1 of these must be present

Symptoms: difficulty breathing; choking feeling; chest pain; nausea - some of these may be present

Depressive Episode

Last for at least 2 weeks

Symptoms: depressed mood; loss of interest in activities; lack of energy/increased fatigue; loss of confidence; feelings of self-reproach/excessive guilt; thoughts of death/suicide; suicide attempts

Well known knowledge from population surveys in Aus

Over 1yr period, between 3-8% of pop. experience major clinical depression

Each depression possibly lasts 12-18 weeks

Lifetime pop. prevalence of major depression varies between 32-48% of pop.

Chronicity over life course isn't uncommon

Those who experience major depression possibly have many occurrences over their lifetime

Using 1 and 12mth data, estimation of 30% of men and 40% of women experience one or more episodes of major depression

Some kids as young as 5yrs are being prescribed antidepressants

Hypomania: persistent/pervasive euphoria extending for days

Environmental: trauma/substantial stress; domestic violence; living in poverty; having partner with mental illness

Biological: some forms of physical trauma (e.g. foetal brain damage; foetal alcohol syndrome; drug use with pregnancy; exposure to lead; infections in pregnancy)

Genetic: unlikely to involve single gene; many genes may each contribute (weakly) to susceptibility to mental illness; in addition to genetic effects, epigenetic factors may contribute to mental illness

Thos

Those with serious mental illness

Have higher risk factors: low exercise, higher obesity, more smoking, worse diet

Have higher rates of violent death: suicide, homocide, injuries

Many don't receive same quality of mental care

Their health may be adversely affected by their psychiatric meds

People who are in treatment for mental illness tend to have longer histories of mental illness and to experience more severe forms as well as high levels of comorbidity

General; PND; Animals

Diagnostic & Statistical Manual of Mental Disorders (DSM)

General/Stats

Panic Disorder; Anxiety Disorder; Depressive Episode

Causes