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| Schizophrenia and Public Health |
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| WHO/MSA/NAM/97.6 |
| Document produced by the WHO Division of Mental Health |
| Technical Units |
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Order Number
19300144
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Price
CHF
10.00
/
US$
12.00
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Developing countries:
CHF
7.00
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English
1998
32
pages
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| Summary |
Assesses the magnitude of the global public health problem caused by schizophrenia, a major mental disorder which remains poorly understood in terms of causes, risk factors, response to various treatments, and long-term prognosis. Intended to assist in the planning of mental health services, the report evaluates the current body of scientific evidence in order to define effective strategies for reducing the burden of schizophrenia, whether on patients and their families or society at large. In view of the many uncertainties surrounding this disorder, the report makes a special effort to distinguish well-established findings from lines of evidence that remain speculative.
The report opens with a discussion of clinical issues, including current classification systems, factors that should be considered in the diagnostic approach, and symptoms that consistently form part of the clinical picture. The especially difficult problem of differential diagnosis is also briefly discussed. Section two, on epidemiology, reviews the results of several studies of incidence and prevalence and addresses the controversial question of whether incidence is decreasing. Also discussed are recent advances in understanding the patterns of clinical course and outcome, predictors of treatment outcome, and risk factors categorized as sociodemographic characteristics, predisposing factors, and precipitating factors. The frequent observation of co-morbidity with depression and substance abuse is identified as especially relevant to treatment outcome and prognosis.
Against this background, the impact of schizophrenia is considered in terms of mortality, social disability, social stigma, impact on caregivers, and social costs. Other sections review what is known about the effectiveness of various treatments, including a cautious appraisal of several new drugs, and discuss implications for service delivery. The report concludes with a call for a recovery-oriented mental health system that aims to promote recovery from mental disorders by fostering self-esteem, adjustment to disability, empowerment, and self-determination. |
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