1Overview of mental disorders
Mental disorders are illnesses that affector are manifested in the brain.They mayimpact on the way a person thinks,behaves,and interacts with other people.The definition ‘mental disorder’encompasses numerous psychiatricdisorders that can vary in severity.
A mental disorder has a major impact ona person’s wellbeing.It may interferedirectly with their daily functioning (athome,work and socially) and adverselyaffect quality of life.Mental disorders arecaused by a complex and poorlyunderstood interaction between genetics,learned behaviour,personality,pastpsychological influences,physical health,present situation and coping skills.Mental disorders can have aphysiological basis and arise fromchanges in brain chemistry.Today most people who suffer from amental illness — including those thatcan be extremely debilitating,egschizophrenia — can be treatedeffectively and lead full lives.Recognised mental illnesses aredescribed and categorised in theDiagnostic and Statistical Manual ofMental Disorders,Fourth Edition (DSM-IV).This book is compiled by theAmerican Psychiatric Association and isupdated periodically (see fact sheet‘Diagnosis of mental disorders’formore information onthe DSM-IV).Mental disorders can be divided intovarious classes.
The main characteristics of thesedisorders are loss of insight and realitytesting.People with psychotic disordersexperience delusions and hallucinationsand do not understand that thesethoughts are abnormal.The main psychotic disorders areschizophrenia,schizoaffective disorderand the delusional disorders.
Schizophrenia is a serious mentaldisorder characterised by delusions,hallucinations,agitation,bluntedaffect,social withdrawal,apathy,anhedonia,and poverty of thoughtand content of speech.
In schizoaffective disorder,bothaffective illness and schizophreniasymptoms are seen.The person’spremorbid adjustment is usuallygood;there is usually a suddenonset of illness after a specificstressor.The prognosis of patientswith schizoaffective disorders isbetter than that of patientswith schizophrenia.
Delusional disorder,formerlyknown as paranoid disorder,ischaracterised by persistentnonbizarre delusions.
Mood disorders are clinical conditionscharacterised by a disturbance of moodor persistent emotional states that affecthow a person acts,thinks and perceiveshis environment.People with mooddisorders often suffer from overwhelmingfeelings of sadness (depression),whileothers suffer from alternating periods ofmania and depression (bipolar disorder).
Eating disorders are characterised by amarked disturbance in eating behaviour.The two major eating disorders areanorexia nervosa and bulimia nervosa.
These are clinical syndromes that occuras a result of using substances that acton the central nervous system (CNS).Substance abuse causes decreased workor school performance,accidents,intoxication,absenteeism,and socialconsequences include violent crime andtheft.Adolescents are the most vulnerableage group and men are more at risk ofsubstance abuse than women.Thiscategory includes disorders related toalcohol,amphetamine,cocaine,cannabisand caffeine abuse and dependency.Alcohol,a CNS depressant and intoxicant,is the most commonly abusedpsychoactive substance.Alcoholism isthe excessive use of ethanol-containingbeverages and its effects range fromalcohol intoxication to withdrawal,withdrawal delirium and hallucinosis.Alcohol abuse and dependence canlead to behavioural disorders andother persistent problems due tochronic use eg persisting amnestic
U n i p o l a r d i s o r d e r M o o d d i s o r d e r B i p o l a r I B i p o l a r I I
1 - y e a r p r e v a l e n c e ( % )
Figure 1.One year prevalence rates formood disorders