MENTAL ILLNESS.

Evaluate sociological work on Mental Illness

Evaluate sociological work on Mental Illness

Mental illness is a global term for disorders of thought, mood, affect, and behaviour that impair normal functioning, social relationships, and productivity. Worldwide, mental illnesses account for four of the ten leading causes of premature death or of disability in terms of lost years of healthy life. Major depression is the leading cause of disability worldwide, as measured by years of living with this disorder. Mental illnesses, including suicide, account for over 15 percent of disease burden, more than the burden from cancers, in established market economies such as the United States and Europe. (Wethington, 1995, Pp. 59-79)

Mental illnesses such as schizophrenia and other psychotic disorders, mood disorders, anxiety disorders, and adjustment, identity, and personality disorders, are defined by discrete, clinically meaningful clusters of behavioural symptoms. The German psychiatrist Emil Kraepelin (1856-1926) was the first to develop a unified classification of the psychoses. His emphasis on precision and objective behavioural criteria greatly influenced the current diagnostic system, the American Psychiatric Association's periodically updated and revised Diagnostic and Statistical Manual of Mental Disorders. The DSM codes are fully compatible with those in the mental disorders section of the World Health Organization's International Classification of Diseases, with worldwide applicability. Patients are assessed on five axes:

Axis I—clinical disorders and other conditions that may be a focus of clinical attention;

Axis II—personality disorders and mental retardation;

Axis III—general medical conditions;

Axis IV—psychosocial and environmental problems; and

Axis V—global assessment of functioning.

Multiaxial assessment yields multiple domains of information that indicate possible comorbidities and permit comprehensive treatment planning. Mental illnesses vary in severity, duration, and degree of incapacitation. Some specialists distinguish between acute reactive (brief nonrecurring) and chronic (long-term episodic) mental illness. The term chronic, disavowed by consumers (present and former psychiatric patients) as promoting hopelessness, has largely been replaced by “severe and persistent mental illness.” This description typically applies to persons with major Axis I disorders that manifest long-term disability. (Harding, 1988, 633-643)

Despite increasing evidence that most major mental illnesses appear to be biologically based, vulnerability and prognosis seem highly sensitive to the social environment. Epidemiologic studies indicate that major mental illnesses such as schizophrenia, depression, and bipolar or manic-depressive illness are found in all cultures throughout the world. However, there is considerable variability based on immigrant and socioeconomic status, and on urban versus rural living. Studies in Great Britain have found significantly higher prevalence rates for psychotic disorders in immigrants, city dwellers, and black and ethnic minority groups than in white British natives. (Kirkbride, 2006, 250-258)

Incidence rates for schizophrenia drawn from 158 studies of 32 countries were significantly higher for males, migrants, city dwellers, and individuals born in the winter months (McGrath 2006), the latter presumably because of greater exposure of fetuses and neonates to viral insults to developing brain structures. Internationally, female gender and income inequality are major risk factors for depression (Patel 2001). World Health Organization studies indicate that although the diagnostic criteria for schizophrenia are applicable cross-culturally, prognosis and recovery rates are significantly better in ...