Introduction Lecture Flashcards
What is burden of disease (DALY)?
DALY = YLL (Years Life Lost) + YLD (Years Lost to Disability)
- YLD based on generic measures of quality of life and most important for the burden of mental health disorders
- YLD is an estimate of reduction quality of life
- The amount of health loss in a population caused by illness, disability, or early death
- 1 DALY is 1 year of healthy life lost to illness, disability or early death
- 0 DALY means ‘perfect health’ and no premature death
What is the difference between High prevalence vs low prevalence mental disorders?
High prevalence (2/3 all DALY’s)
- Anxiety
- Depression
- Addiction
Low prevalence (1/3 all DALY’s)
- Bipolar disease
- Schizophrenia
- Eating disorders
- Autism
What are worldwide differences within the prevalence / burden of mental health issues?
Wealthier countries and with high income inequality have higher mental health Burden
Could be because:
- Larger focus on mental health
- Have tools to diagnose mental health issues
Why could the global burden be underestimated?
- Personality disorders not included
- Indirect contributions of mental health disorders to mortality
- Suicide and self harm are grouped together
- Overlap with other disorders
- People w/ chronic pain disorders are not included
What are the stages of prevention within mental health?
- Universal: targeting the population
- Selective: target subgroups that are at risk
- Indicated: target people in the early stages who experience symptoms
(screening is a part of indicated) - Relapse prevention:
What is the difference between promotion vs prevention?
Promotion
* positive health by increasing well being, competence, resilience and creating supportive living conditions and environments
Prevention
* reduction of incidence, prevalence, recurrence of disorder
What are some issues when it comes to classification of mental health prevention?
- Indicated prevention and early treatment are hard to distinguish
- Selective and indicated prevention are hard to distinguish
- Prevention and continuing care?
- Preventing comorbid disorders?
- Preventing relapse?
- Prevention focused on relatives!
What are challenges within prevention when it comes to mental health?
- Complex (when or will the disorder occur?)
- Unknown who will develop them
- Efforts may be a waste of time for some people
- Low uptake of preventive interventions
- Experience less urgency (no motivation)
- Stigma
What are the components of the diathesis stress model?
Diathesis:
* Predisposition or vulnerability to a disorder
Stress:
* The occurrence of some severe environmental or life event
Both diathesis and stress are necessary for a disorder to develop
What are some risk factors?
- Stressful environmental or life events
- Temperamental and personality traits
- Neurobiological factors
- Cognitive processes and biases
- Genetic make-up
Causal pathways are difficult to determine
Factors interact in complex ways
What are several protective factors?
- Feelings of control
- Good interpersonal relationships
- Social support
- A high self-esteem
- A good health
(Can be the focus of preventive interventions)
Network analysis: can be used to understand the risk and protective factors
How do you identify who is at risk?
Screening
- Identify a subpopulation in which the development of the disorder is more likely to occur
- Select the relevant subset of that subpopulation to receive an unique intervention
Use predictive models
On which levels do prevention programs focus?
- Micro level - individual level
- Meso level - community
- Macro level - societal
Multiple methods can be used
- Always in conjunction with each other
- Always as one programmatic whole
What are some methods of prevention
- Policy
- Mass media campaigns
- Psycho-education
- Support and contact groups
- Hosted by professionals, groups of 8 to 12
- Providing information, teaching skills, exchange experiences
- (guided) self-help
- Books, e-health
- Accessible, cheap
- Courses or training programs
- Skills training
- etc.
School is a setting where interventions can be implemented, what are some of the main topics of this setting?
- School dropout
- Substance use
- Risky sexual behaviour
- Delinquencey
- Youth suicide
- Bullying
