Epidemiology

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Epidemiology

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

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