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MENTAL HEALTH The Challenge of the 21st Century

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Title: MENTAL HEALTH The Challenge of the 21st Century


1
MENTAL HEALTH The Challenge of the 21st Century
  • André Haynal M.D.
  • Professor (emeritus and honorary), University of
    Geneva
  • Former visiting professor, Stanford University
  • Former member of the Swiss Academy of Medical
    Sciences
  • etc.

2
HEALTH
  • Health is a state of complete physical, mental
    and social well-being and not merely the absence
    of disease or infirmity. (Constitution of the
    World Health Organisation 1946).

3
HYGIENE
  • Hygiene includes measures to help people function
    at their full mental potential in order to cope
    with a stressful world and with a technologically
    transformed new environment.

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Effects of diabetic patients educational
programme on amputations reduction
13
Bowlby, J (1951) Maternal care and mental
hygiene, Geneva, W.H.O. Monograph
Habent sua fata libelli...
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Daniel Süss, Zürich 1997
16
  • Life Events
  • Score
  • Death of spouse 100
  • Divorce 73
  • Marital separation from mate 65
  • Detention in jail, other institution 63
  • Death of a close family member 63
  • Major personal injury or illness 53
  • Marriage 50
  • Fired from work 47
  • Marital reconciliation 45
  • Retirement 45
  • Major change in the health or behavior of a
    family member 44
  • Pregnancy 40
  • Sexual difficulties 39
  • Gaining a new family member (e.g., through
    birth, adoption, oldster moving, etc.) 39
  • Major business re-adjustment (e.g., merger,
    reorganization, bankruptcy) 39
  • Major change in financial status 38
  • Death of close friend 37

The Holmes-Rahe Scale
Holmes Rahe (1967). Holmes-Rahe life changes
scale. Journal of Psychosomatic Research. Vol.11,
pp 213-218
17
  • Death of spouse 100
  • Divorce 73
  • Marital separation from mate 65
  • Detention in jail, other institution 63
  • Death of a close family member 63
  • Major personal injury or illness 53
  • Marriage 50
  • Fired from work 47
  • Marital reconciliation 45
  • Retirement 45
  • Major change in the health or behavior of a
    family member 44

18
SCORING FOR THE HOLMES-RAHE SOCIAL READJUSTMENT
SCALE
  • Less than 150 life change units 30 chance of
    developing a stress-related illness
  • 150 - 299 life change units 50 chance of
    illness
  • Over 300 life change units 80 chance of
    illness
  • Holmes Rahe (1967). Holmes-Rahe life changes
    scale. Journal of Psychosomatic Research. Vol.11,
    pp 213-218

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DSM IV ICD-10
  • Somatization disorder
  • Undifferenciated Somatoform Disorder
  • Conversion Disorder
  • Pain Disorder
  • Hypocondriasis
  • Body Dismorphic Disorder
  • Somatoform Disorder Not Otherwise Specified
  • Somatization disorder
  • Undifferenciated Somatoform Disorder
  • Dissociative conversion disorders, (category
    with 14 items)
  • Persistent somatoform pain disorder
  • Hypochondriacal disorder
  • .
  • Somatoform disorder, unspecified

21
AIDS
  • Explosion in Central Asia and Eastern Europe of
    this illness, where more than 75 of the infected
    are younger than 30 years.

22
20th Century era of mega-death
  • an excess of 175,000,000 deaths as a result of
    deliberate, politically motivated carnage - more
    than the total killed in all previous wars, civil
    conflicts, and religious persecutions throughout
    history. (Brzezinski, Z. (1993). Out of
    Control Global Turmoil on the Eve of the 21st
    Century. New York Charles Scribner's.).

23
Forms of social violence
  • Mob verb crowd round (someone) in an unruly and
    excitable way in order to admire or attack them.
  • Stalk verb harass or persecute (someone) with
    unwanted and obsessive attention. For
    five years, she was stalked by a man who would
    taunt and threaten her
  • The NEW OXFORD Dictionary of ENGLISH

24
  • A gramme is better than a damn
  • One cubic centimetre
  • Cures ten gloomy sentiments
  • I wish I had my soma
  • Szoma ha mondom,
  • segit a gondon,
  • csak egy köbcenti,
  • helyre biccenti

Aldous Huxley (1932) Brave New World.
25
don't believe everything you think !
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