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  • 1. NUR 448 Psychiatric Epidemiology
  • 2. Prevalence
    • 28% of US population
    • Most prevalent disorders in US.:
      • Anxiety disorders
      • Depression
      • Substance Abuse
    • Associated with increased morbidity and mortality
    • Most people with mental disorders never seek treatment
  • 3. Levels of Prevention
    • Primary Prevention
      • Avoid disorder by removing risk factors
    • Secondary Prevention
      • Early detection & prompt treatment
    • Tertiary Prevention
      • Rehabilitation & limiting disability once disorder has occurred
  • 4. Risk Factors
    • Cannot be modified
      • Gender
      • Ethnicity
      • Age
      • Positive family history
    • Potentially can be modified
      • Physical health
      • Social environment
      • Physical environment
  • 5. Gender
    • Women have higher rates of affective and anxiety disorders
    • Men have higher rates of substance abuse and antisocial personality disorders
  • 6. Demographic Risk factors
    • Ethnicity
    • European American men have higher rates of depression than African American men
    • African American women have higher rates of depression than European American women
    • European Americans have higher suicide rates
  • 7. Demographic Risk Factors
    • Social class
      • Lower social class-higher rates of all psychiatric disorders especially depression, substance abuse & antisocial personality
    • Marital Status
      • Higher rates of depression
        • married women
        • recently separated, divorced, widowed
  • 8. Risk Factors
    • Physical Health Status
      • Depression-higher morbidity & mortality
        • especially in chronic illness
      • Psychiatric patients have increased mortality rates
    • Social Environment
      • Natural disasters
      • Traumatic events
  • 9. Risk Factors
    • Physical Environment
      • homelessness
      • chemical exposures
  • 10. Comorbidity
    • Two or more mental disorders over a lifetime
    • Dual diagnosis: 2 or more disorders at 1 time
    • Substance abuse often the second diagnosis
  • 11. social group ’ s sum total of learned ways of doing, thinking, feeling, past & present Culture
  • 12. Cultural Assessment
    • What do you think has caused your problem?
    • Why do you think it started when it did?
    • What do think your sickness does to you?
    • How severe is you sickness?
    • What kind of treatment do you think you should receive?
  • 13. Cultural Assessment
    • What are the most important results you hope to achieve from treatment?
    • What are the chief problems your sickness has caused?
    • What do you fear most about your sickness?
  • 14. Cultural Differences
    • Time
      • Time orientation
      • Method of structuring time
    • Involvement of extended family
    • Attitude toward change/tradition
    • Control over life events
    • Food practices
    • Role of religion