MENTAL HEALTH

prof.
Amgad Ahmed Gabr
Ass. prof. of psychiatry.
 Concept
• MENTAL HEALTH is not just the absence of mental disorder

• MENTAL HEALTH is defined as a state of complete physical, mental and social well-
being.

• realizes his or her own potential

• can work productively and fruitfully

• can cope with the normal stresses of life

• and is able to make a contribution to her or his community.

CHARACTERISTICS OF A
MENTALLY HEALTHY PERSON
 Feels comfortable about her or himself

 Feels reasonably secure and adequate

 Neither underestimates nor overestimates her or his own ability

 Is able to be interested in others and to love them. She or he is able to like and
trust others.

 Is able to meet the demands of life; and is not bowled over by own
emotions of fear, anger or guilt.
What is mental health?

Mental health includes our emotional, psychological, and

social well-being. It affects how we think, feel, and act. It
also helps determine how we handle stress, relate to
others, and make choices. Mental health is important at
every stage of life, from childhood and adolescence
through adulthood.
What are the causes of mental illness?

Although the exact cause of most mental illnesses is not

known, it is becoming clear through research that many of
these conditions are caused by a combination of biological,
psychological, and environmental factors.
What Biological Factors Are Involved in Mental Illness?
Some mental illnesses have been linked to abnormal functioning of nerve cell circuits or pathways that connect
particular brain regions.

Other biological factors that may be involved in the development of mental illness include: genetics (heredity),
infections, brain defects or injury, prenatal damage, substance abuse, and other factors such as poor nutrition or
exposure to toxins
What Psychological Factors Contribute to Mental Illness?
Psychological factors that may contribute to mental illness include:
● Severe psychological trauma suffered as a child, such as emotional, physical, or sexual abuse
● An important early loss, such as the loss of a parent
● Neglect
● Poor ability to relate to others
What Environmental Factors Contribute to Mental Illness?
Certain stressors can trigger an illness in a person who is susceptible to mental illness. These stressors include:
● Death or divorce
● A dysfunctional family life
● Feelings of inadequacy, low self-esteem, anxiety, anger, or loneliness
● Changing jobs or schools
● Social or cultural expectations (For example, a society that associates beauty with thinness can be a factor in
the development of eating disorders.)
● Substance abuse by the person or the person's parents
Classification of mental disorders
The classification of mental disorders is also known as psychiatric nosology or psychiatric taxonomy. It represents a
key aspect of psychiatry and other mental health professions and is an important issue for people who may be
diagnosed. There are currently two widely established systems for classifying mental disorders:
● Chapter V of the tenth International Classification of Diseases (ICD-10) produced by the World Health
Organization (WHO);
● The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) produced by the American Psychiatric
Association (APA).
ICD-10
The International Classification of Diseases (ICD) is an international standard diagnostic
classification for a wide variety of health conditions. The ICD-10 states that mental disorder i
s "not an exact term", although is generally used "...to imply the existence of a clinically
recognisable set of symptoms or behaviours associated in most cases with distress and with
interference with personal functions." Chapter V focuses on "mental and behavioural disorders"
and consists of 10 main groups:
● F0: Organic, including symptomatic, mental disorders
● F1: Mental and behavioural disorders due to use of psychoactive substances
● F2: Schizophrenia, schizotypal and delusional disorders
● F3: Mood [affective] disorders
● F4: Neurotic, stress-related and somatoform disorders
ICD-10
● F5: Behavioural syndromes associated with physiological disturbances and physical factors
● F6: Disorders of personality and behaviour in adult persons
● F7: Mental retardation
● F8: Disorders of psychological development
● F9: Behavioural and emotional disorders with onset usually occurring in childhood and adolescence
● In addition, a group of "unspecified mental disorders".

Within each group there are more specific subcategories.

DSM-IV
The DSM-IV was originally published in 1994 and listed more than 250 mental disorders. It was produced by the
American Psychiatric Association and it characterizes mental disorder as "a clinically significant behavioral or
psychological syndrome or pattern that occurs in an individual,...is associated with present distress...or disability...or
with a significantly increased risk of suffering".

The DSM-IV-TR (Text Revision, 2000) consisted of five axes (domains) on which disorder could be assessed. The
five axes were:

● Axis I: Clinical Disorders (all mental disorders except Personality Disorders and Mental Retardation)
● Axis II: Personality Disorders and Mental Retardation
● Axis III: General Medical Conditions (must be connected to a Mental Disorder)
● Axis IV: Psychosocial and Environmental Problems (for example limited social support network)
● Axis V: Global Assessment of Functioning (Psychological, social and job-related functions are evaluated on a
continuum between mental health and extreme mental disorder)
DSM-5
The axis classification system was removed in the DSM-5 and is now mostly of historical significance. The main
categories of disorder in the DSM are:
● Disorders usually first diagnosed in infancy, childhood or adolescence.
● Delirium, dementia, and amnesia and other cognitive disorders
● Mental disorders due to a general medical condition
● Substance-related disorders
● Schizophrenia and other psychotic disorders
● Mood disorders
● Anxiety disorders
DSM-5
● Somatoform disorders
● Factitious disorders
● Dissociative disorders
● Sexual and gender dysphoria
● Eating disorders
● Sleep disorders
● Impulse control disorders not elsewhere classified
● Adjustment disorders
● Personality disorders
● Other conditions that may be a focus of clinical attention
History of Psychiatry
● Specialty in psychiatry can be traced in Ancient India.
● During the 5th century BCE, mental disorders, especially those with psychotic traits, were considered
supernatural in origin, a view which existed throughout ancient Greece and Rome.
● The beginning of psychiatry as a medical specialty is dated to the middle of the nineteenth century, although
one may trace its germination to the late eighteenth century.
History of psychiatry in the middle ages
● A number of hospitals known as bimaristans were built throughout Arab countries beginning around the early
9th century, with the first in Baghdad. They sometimes contained wards for mentally ill patients, typically those
who exhibited violence or suffered from debilitating chronic illness.
● Physicians who wrote on mental disorders and their treatment in the Medieval Islamic period included
Muhammad ibn Zakariya al-Razi (Rhazes), the Arab physician Najab ud-din Muhammad, and Abu Ali al-
Hussain ibn Abdallah ibn Sina, known in the West as Avicenna.
● Specialist hospitals were built in medieval Europe from the 13th century to treat mental disorders but were
utilized only as custodial institutions and did not provide any type of treatment.
History of psychiatry in the modern period
● The modern era of providing care for the mentally ill began in the early 19th century with a large state-led effort.
● In the early 1800s, psychiatry made advances in the diagnosis of mental illness by broadening the category of
mental disease to include mood disorders, in addition to disease level delusion or irrationality. The term
psychiatry was coined by Johann Christian Reil in 1808
● The 20th century introduced a new psychiatry into the world. Different perspectives of looking at mental
disorders began to be introduced.
History of psychiatry in the 20th century
● Following Sigmund Freud's pioneering work, ideas stemming from psychoanalytic theory also began to take
root in psychiatry.
● As evidence-based investigations in cognitive psychology led to treatments like cognitive behavioral therapy,
many of Freud's ideas appeared to be unsupported or contradicted by evidence. By the 1970s, the
psychoanalytic school of thought had become marginalized within the field.
● Biological psychiatry reemerged during this time. Psychopharmacology became an integral part of psychiatry
and now genetics are once again thought by some prominent researchers to play a large role in mental illness.
Worldwide Prevalence of mental illnesses
● It’s estimated that 970 million people worldwide had a mental or substance use disorder in 2017. The largest
number of people had an anxiety disorder, estimated at around 4 percent of the population.
● Depression stands at 3.6 percent, followed by alcohol use disorders at 1.4 percent, drug use disorders at 0.7
percent, bipolar disorder at 0.5 percent, Schizophrenia at 0.3 percent and Eating disorders 0.2 percent.
Disease burden of mental health and substance use disorders

Health impacts are often measured in terms of total numbers of deaths, but a focus on mortality means that the
burden of mental health disorders can be underestimated. Measuring the health impact by mortality alone fails to
capture the impact that mental health disorders have on an individual’s wellbeing. The ‘disease burden‘ – measured
in Disability-Adjusted Life Years (DALYs) – considers not only the mortality associated with a disorder, but also years
lived with disability or health burden.
hiatric disorders

derestimated and disabling conditions
) worldwide in 2005

Digestive

disorder (6%) Musculoskeletal

disorders (4%)
Endocrine (4%)
Other non-communicable
Respiratory

diseases (7%) disease

(8%)

Sense organ

impairment (10%) Neuropsychiatric

disorders (28%)

Cardiovascular

disease (22%)

Cancer (11%)
Thank You !