'Quichua' Healers Of The Andes Diagnose Mental Illnesses

Yachactaitas (the Quichua healers of the Andes) may be identifying general psychiatric disorders in their communities, according to a study published in the May 2008 issue of the British Journal of Psychiatry.

Traditional healers' practices are widespread around the world, yet their diagnostic skills have rarely been investigated.

This exploratory study was carried out in Otavalo, in the province of Imbabura in the highlands of Ecuador. For over 18 months, 10 yachactaitas from three rural villages drew patients from the surrounding areas.

They identified 50 of these as having a condition known as llaqui. Each was referred to a Quichua-speaking physician trained in western transcultural psychiatry, and underwent the following investigations:

• A structured interview, using a Quichua questionnaire on the nature of llaqui


• A medical evaluation, including personal and medical history, and a physical examination


• Laboratory tests, including blood, faecal and urine analysis, and an X-ray


• Psychiatric evaluation and diagnosis, using established western diagnostic criteria


• An adapted Quichua version of a self-rating depression scale

94% of the people studied lived in the rural villages of the Otavalo area. Most were peasant farmers, artisans or homemakers. 56% were illiterate, and an additional 34% had not completed elementary school education. 54% were male, and 65% married.

The Quichuas themselves (and the yachactaitas in particular) identify llaqui as a cluster of four illness sub-categories comprising a symptom (sadness), the name of an illness, life events and a causal factor of illness.

The first two sub-categories are merged into one, which can be translated as 'victim of malignant spirits.' The person is under attack by natural spirits or spirits under human control that will damage the person's body or soul.

The third sub-category ('heart pain or shattered heart') results from life events and sorcery. Among the Quichuas, land disputes, family conflicts and the death of a relative are the most stressful life events. This condition also resembles the symptoms of typical anxiety or depression.

The fourth sub-category ('victim of sorcery') is believed to result from the aggression of malignant spirits under human control (usually a healer), or by a physical or visual contact with materials used in the treatment of sorcery. People can have symptoms from more than one illness sub-category at the same time.

The western clinical diagnoses of the 50 participants with llaqui showed that 82% had a depressive disorder; 44% medically unexplained symptoms (somatoform disorders); and 40% anxiety disorders. Over 80% of them also had infectious or parasitic diseases.

The researchers comment that it is surprising that the Quichua healers, using supernatural and life events notions, seem to identify people who are psychiatrically ill. Since participants were identified as ill by both the yachactaita and by the biomedically trained doctor, a remarkable overlap is apparent in the diagnostic work of both practitioners.

The findings of this study are in line with those of previous studies in different and remote parts of the world. The results highlight the contribution of yachactaitas in the provision of mental healthcare for Quichua people living in the Andes, for whom government-funded psychiatric services are non-existent, say the researchers.

The yachactaitas' diagnostic abilities could be useful in the screening of patients in psychiatric epidemiological and public health research.

"Efficacy of Quichua healers as psychiatric diagnosticians"
Incayawar M (2008)
British Journal of Psychiatry 192, 5, pages 390-391
Click here to view Abstract online

Taken from Medical News Today

Mental Illnesses Under-treated Compared With Physical Illnesses In High-, Low- And Middle-income Countries

Despite often higher disability, mental illnesses are under-treated compared with physical illnesses in high-, low- and middle-income countries, a World Health Organisation study has found.

The aims of this 15-country study, published in the May issue of the British Journal of Psychiatry, were to establish the degree and type of disability, and level of treatment, of specific mental and physical disorders.

The World Health Organisation's World Mental Health Surveys were carried out in six countries classified by the World Bank as low- and middle-income (Colombia, Lebanon, People's Republic of China, South Africa, Ukraine) and nine as high-income (Belgium, France, The Netherlands, Germany, Italy, Spain, Japan, the USA and New Zealand).

The total sample size was 73,441, with individual country samples ranging from 2372 (The Netherlands) to 12,992 (New Zealand). The average response rate was 70.3%, with country-specific rates varying from 45.9% (France) to 87.7% (Colombia).

The commonly occurring physical disorders included in the surveys included asthma, cancer, heart disease, hypertension, diabetes, arthritis, back and neck pain, chronic headaches, other chronic pain disorders and stomach ulcers.

The mental disorders studied included anxiety disorders, such as panic disorder, social phobia and post-traumatic stress disorder; mood disorders, such as depression and bipolar disorder; and impulse-control disorders, such as adult attention deficit hyperactivity disorder and intermittent explosive disorder.

The researchers measured treatment sought and received for both types of disorder, and assessed the level and type of disability attributed to them by respondents. The four disability areas explored were home management, ability to work, social life and close personal relationships.

Four key findings emerged from the analyses:

1. Respondents generally attributed more disability to their mental than to their physical disorder



2. The higher disability of mental compared with physical disorders held as strongly in low- and middle-income countries as in high-income countries



3. The higher level of disability associated with mental disorder compared with physical disorder was much more pronounced for disability in social and personal relationships than in productive roles, such as work and housework



4. The proportion of people receiving treatment at the time of interview was much lower for mental than for physical disorders in high-income countries, and even more so in low- and middle-income countries. This finding applied both to the total sample and also to participants rated as having a severely disabling disorder.

These results are consistent with previous comparative burden-of-illness studies in suggesting that musculoskeletal disorders and major depression are the most disabling disorders across the socioeconomic spectrum. Previous studies have documented this pattern only for the USA, although World Mental Health Surveys have also highlighted the importance of depression.

The researchers comment that these new results imply that mental disorders are disabling more because they create psychological barriers rather than physical barriers to functioning. Among these barriers are limitations in cognitive and motivational capacity, regulation of feelings, embarrassment and stigma.

Disability in productive role functioning, such as work and home management, was generally comparable for mental and physical disorders.

Given this greater disability of mental than physical disorders, it is disturbing to find that only a minority of people with severe mental disorders receive treatment, and that treatment is substantially more common for severe physical disorders, the researchers say.

Combined with the burden of disability that mental disorders produce, the low treatment rates call for more attention to be paid to mental disorders, they believe. Treatment effectiveness trials show that common anxiety and mood disorders can often be successfully treated, although long-term outcomes are more uncertain and further research is needed.

Despite this uncertainty, the findings of this study strongly imply that more attention should be given to the treatment of mental disorders, particularly in middle- and low- income countries.

"Disability and treatment of specific mental and physical disorders across the world."
Kessler R. C. et al (2008)
British Journal of Psychiatry 192, 5, pages 368-375
Click here to view Abstract online

Taken from Medical News Today

Mentally Unhealthy Workplaces Taking An Enormous Toll In Canada

Responding to a new survey showing workplace stress, burnout and depression are on the rise in Canada, the Canadian Mental Health Association (CMHA) is urging employers across the country to accept greater responsibility for the mental health of their employees.

"Employers must do more to promote a healthy work/life balance, otherwise they, their workers, our economy and society will suffer serious consequences," warned Dr. Taylor Alexander, CEO of the CMHA.

According to a survey commissioned by Desjardins Financial Security (DFS) and released today in advance of Mental Health Week (May 5-11), an astonishing 83 per cent of Canadians report showing up for work while sick or exhausted an average of six times in the past year. Meanwhile, 89 per cent report that instances of stress-related mental health problems have been increasing over the years.

"Stress, burnout, and depression create huge fallout in the workplace that far exceeds taking a sick day here and there. They are part of a continuum leading to serious illness," noted Dr. Alexander. "It is estimated that more than two million employees in Canada suffer mental illness at any given time. The economic, social and personal impact of mentally unhealthy workplaces is staggering."

According to the Conference Board of Canada, workers who reported a high degree of stress balancing their work and family life missed 7.2 days of work each year - double the absentee rate of those who reported very little stress.

Employees suffering clinical depression are off the job an average of 40 days, and mental health claims (particularly depression) are the fastest growing category for days lost to disability in Canada.

Many companies fail to recognize the toll this is taking. By not addressing these problems in the workplace, they are incurring increased days lost, reduced productivity, and higher disability and benefits costs.

"In addition, businesses are facing projected shortages of skilled workers in the future and they will have to use their resources in the most effective way. Part of that is ensuring that their workforce is mentally healthy," Dr. Alexander stated. As well, mentally unhealthy workplaces place another burden on an already-stressed healthcare system. Research shows that depression is linked to heart disease, diabetes, and autoimmune disorders.

"For all of these reasons, we're calling on employers to do more - to make mental health their business," said Dr. Alexander. CMHA helps employers with advice and counseling through various programs, including Mental Health Works. A similar program called the Copernicus Project is based in Alberta.

Some of the steps that employers can take include:

• Offer flexible hours


• Allow workers to work from home where possible and appropriate


• Permit those returning from a leave to gradually build up to a full- time schedule


• Train managers on how to support work/life balance


• Encourage staff to stay home with sick children or elderly relatives when needed


• Eliminate unnecessary meetings


• Communicate expectations clearly to staff


• Allow staff to control their own priorities as much as possible

About the Survey

SOM Surveys, Opinion Polls and Marketing conducted the survey on behalf of Desjardins Financial Security between February 7th and March 10th, 2008. In total, 1,594 interviews were conducted with a representative sample of Canadian adults. The data has a maximum sampling error of +2.6% at a 95 % confidence level.

About the Canadian Mental Health Association

The Canadian Mental Health Association National Office is a leading national voluntary organization within the mental health sector. For more than 90 years, it has existed to promote the mental health of all people in Canada, and to serve mental health consumers, their families and friends through education, public awareness, research, advocacy and direct services. In addition to its National office, the CMHA has 12 provincial and territorial Divisions and more than 135 Branches and Regions in communities across Canada.

About Desjardins Financial Security

Desjardins Financial Security, a subsidiary of Desjardins Group, the largest integrated cooperative financial group in Canada, specializes in group and individual life and health insurance, and savings products and services. Every day, over 5 million Canadians rely on Desjardins Financial Security to ensure their financial security. With a staff of over 3,700 employees, Desjardins Financial Security manages and administers close to $20 billion in assets from offices in major cities across the country, including Vancouver, Calgary, Winnipeg, Toronto, Ottawa, Montreal, Quebec, Levis, Halifax and St. John's.

To find more information about mental health, visit http://www.cmha.ca. To view Desjardins Financial Security's survey, visit http://www.healthiscool.ca.

The Cost of Mental Health Issues to Canadian Workplaces
Stress can be the beginning of something more serious - and most Canadian workers are feeling the pressure.

• Desjardins Financial Security's survey reveals that 89% of Canadians find that their working environment is increasingly stressful.



• The survey also found that 83% of Canadians reported to work exhausted or sick an average of six times in the past year.
  
  
• According to Statistics Canada, employees who considered most of their days to be quite a bit or extremely stressful were over 3 times more likely to suffer a major depressive episode, compared with those who reported low levels of general stress.



• A study published in the journal Chronic Diseases in Canada estimated that the Canadian economy loses $30 billion each year in direct and indirect costs related to mental health issues.



• The Conference Board of Canada found that workers who reported a high degree of stress balancing their work and family life missed 7.2 days of work each year, while those who reported very little stress only missed an average of 3.6 days.



• According to the World Health Organization, depression will be the second leading cause of disability by 2020, behind only cardiovascular disease.



• In terms of prescription drug claims, a study by Cubic Health demonstrated that mental illness represented the second most expensive therapeutic category and the second most utilized therapeutic category for employers, behind only cardiovascular drugs.



• A variety of studies have shown that for every dollar spent on a Corporate Wellness Program, the returns have been cost savings of up to $10.10 in the areas of decreased absenteeism, fewer sick days, reduced WSIB/WCB claims, lowered health and insurance costs, and improvements to employee performance and productivity.



• The Canadian Institute of Stress found that stress control programs alone can result in an 18% reduction in absences, 32% reduction in grievances, 52% reduction in disability time, 7% improvement in productivity, and 13% improvement in service quality.

Canadian Mental Health Association

Taken from Medical News Today

Autism In Children And Mental Disorders In Parents Linked

Parents of children with autism were roughly twice as likely to have been hospitalized for a mental disorder, such as schizophrenia, than parents of other children, according to an analysis of Swedish birth and hospital records by a University of North Carolina at Chapel Hill researcher and colleagues in the U.S. and Europe.

The study, "Parental psychiatric disorders associated with autism spectrum disorders in the offspring," appears in the May 5, 2008, issue of the journal Pediatrics.

"We are trying to determine whether autism is more common among families with other psychiatric disorders. Establishing an association between autism and other psychiatric disorders might enable future investigators to better focus on genetic and environmental factors that might be shared among these disorders," said study author Julie Daniels, Ph.D., an assistant professor in the UNC School of Public Health's epidemiology and maternal and child health departments.

"Earlier studies have shown a higher rate of psychiatric disorders in families of autistic children than in the general population," she said. "We wanted to see if the parents of autistic children were more likely to be diagnosed with mental disorders.

"Our research shows that mothers and fathers diagnosed with schizophrenia were about twice as likely to have a child diagnosed with autism. We also saw higher rates of depression and personality disorders among mothers, but not fathers," Daniels said.

This information will help researchers look among related diseases, such as psychiatric disorders, for causes of autism, Daniels said. "It may eventually help identify opportunities to prevent or treat the disorder."

The study examined 1,237 children born between 1977 and 2003 who were diagnosed with autism before age 10, and compared them with 30,925 control subjects matched for gender, year of birth and hospital. The large sample size enabled researchers to distinguish between psychiatric histories of mothers versus fathers in relation to autism. The association was present regardless of the timing of the parent's diagnosis relative to the child's diagnosis.

Article adapted by Medical News Today from original press release.

Coauthors of the study include Ulla Forssen, Ph.D., GlaxoSmithKline epidemiologist, Collegeville, Pa.; Christina Hultman, Ph.D., Sven Cnattingius, M.D., Ph.D. and Par Sparen, Ph.D., all of the department of medical epidemiology and biostatistics at the Karolinska Institutet, Stockholm, Sweden; David Savitz, Ph.D., director of the Center of Excellence in Epidemiology, Biostatistics and Disease Prevention, Mt. Sinai School of Medicine, New York; and Maria Feychting, Ph.D., Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.

School of Public Health contact: Ramona DuBose

Source: Patric Lane
University of North Carolina at Chapel Hill

Source : www.medicalnewstoday.com

2008 May Is Mental Health Month: Help Kids Thrive Through Better Parent-Child Communication

As Americans observe 2008 May is Mental Health Month and National Children's Mental Health Awareness Day, Mental Health America asks families to recognize and promote their children's mental health and overall development through increased communication, guidance and emotional support. The theme for this year's Mental Health Month is "Get Connected" to emphasize the important role of social relationships in protecting and improving mental health and building resiliency. Research shows that children who feel warmth and caring from their parents are more likely to be successful in school, less anxious and depressed, and have higher self-esteem than those without.

"Having supportive relationships in our lives is essential for success, happiness and, perhaps most importantly, how we deal with adversity," said David Shern, Ph.D., president & CEO of Mental Health America. "This is especially true for children. By supporting their mental and emotional needs, parents and other family members can help children think clearly, develop socially, learn new skills, build self-esteem and develop a positive mental outlook."

Here are some easy ways for families to "Get Connected" and build their children's mental health:

Give unconditional love - Children need to know that your love does not depend on their accomplishments.

Nurture confidence and self-esteem - Praise and encourage your children. Set realistic goals. Be honest about your mistakes and avoid sarcasm.

Encourage play - Play time is as important to a child's development as food. Play helps children be creative, develop problem-solving skills and self-control, and learn how to get along with others.

Enroll children in after-school activities - This is a great way for kids to stay productive, learn something new, gain self-esteem and have something to look forward to during the week. If they are home alone, check in on them after school. Children need to know that even if you're not there physically, you're thinking about them, and interested in how they spend their day.

Provide a safe and secure environment - Fear can be very real for a child. Try to find out what is frightening him or her. Be loving, patient and reassuring, not critical.

Give appropriate guidance and discipline - Be firm, but kind and realistic with your expectations. The goal is not to control the child, but to help him or her learn self-control.

Communicate - Make time each day to listen to your children and talk with them about what is happening in their lives. Share emotions and feelings with your children.

Get help - If you're concerned about your child's mental or emotional health, consult with teachers, a guidance counselor or another adult who may have information about his or her behavior. If you think there is a problem, seek professional help right away. For more information, contact your local Mental Health America affiliate, call Mental Health America at 1-800-969-6642 or visit http://www.mentalhealthamerica.net.

Mental Health America founded May is Mental Health Month 50 years ago to raise awareness about mental health conditions and the importance of mental health for all. This year's theme, "Get Connected" is focused on the important role social connectedness plays in maintaining and protecting mental health and wellness.

Mental Health America is the country's leading nonprofit dedicated to helping ALL people live mentally healthier lives. With our more than 320 affiliates nationwide, we represent a growing movement of Americans who promote mental wellness for the health and well-being of the nation - everyday and in times of crisis.

Mental Health America

Source: www.medicalnewstoday.com