Author: Andrew Marshall

Founder & Editor of the BootCampMilitaryFitnessInstitute.com, MilitaryGogglebox.com, and Mental-Health-Matters.org.

What is Agoraphobia?

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Introduction

Agoraphobia is a mental and behavioural disorder, specifically an anxiety disorder characterised by symptoms of anxiety in situations where the person perceives their environment to be unsafe with no easy way to escape.

These situations can include open spaces, public transit, shopping centres, or simply being outside their home. Being in these situations may result in a panic attack. Those affected will go to great lengths to avoid these situations. In severe cases people may become completely unable to leave their homes.

Agoraphobia is believed to be due to a combination of genetic and environmental factors. The condition often runs in families, and stressful or traumatic events such as the death of a parent or being attacked may be a trigger. In the DSM-5 agoraphobia is classified as a phobia along with specific phobias and social phobia. Other conditions that can produce similar symptoms include separation anxiety, post-traumatic stress disorder, and major depressive disorder. The diagnosis of agoraphobia has been shown to be comorbid with depression, substance abuse, and suicide ideation.

Without treatment it is uncommon for agoraphobia to resolve. Treatment is typically with a type of counselling called cognitive behavioural therapy (CBT). CBT results in resolution for about half of people. In some instances those with a diagnosis of agoraphobia have reported taking benzodiazepines and antipsychotics augmentation. Agoraphobia affects about 1.7% of adults. Women are affected about twice as often as men. The condition often begins in early adulthood and becomes less common in old age. It is rare in children.

Refer to Hikikomori.

Etymology

The term “agoraphobia” was coined in German in 1871 by pioneering German psychologist Carl Friedrich Otto Westphal, 1833-1890, in his article “Die Agoraphobie, eine neuropathische Erscheinung.” Archiv für Psychiatrie und Nervenkrankheiten, Berlin, 1871-1872; 3: 138-161. It is derived from Greek ἀγορά, agorā́, meaning a “place of assembly” or “market-place” and -φοβία, -phobía, meaning “fear”.

Signs and Symptoms

Agoraphobia is a condition where sufferers become anxious in unfamiliar environments or where they perceive that they have little control. Triggers for this anxiety may include wide-open spaces, crowds (social anxiety), or travelling (even short distances). Agoraphobia is often, but not always, compounded by a fear of social embarrassment, as the agoraphobic fears the onset of a panic attack and appearing distraught in public. Most of the time they avoid these areas and stay in the comfort of their haven, usually their home.

Agoraphobia is also defined as “a fear, sometimes terrifying, by those who have experienced one or more panic attacks”. In these cases, the sufferer is fearful of a particular place because they have experienced a panic attack at the same location at a previous time. Fearing the onset of another panic attack, the sufferer is fearful or even avoids a location. Some refuse to leave their homes even in medical emergencies because the fear of being outside of their comfort areas is too great.

The sufferers can sometimes go to great lengths to avoid the locations where they have experienced the onset of a panic attack. Agoraphobia, as described in this manner, is actually a symptom professionals check when making a diagnosis of panic disorder. Other syndromes like obsessive compulsive disorder or post-traumatic stress disorder can also cause agoraphobia. Essentially, any irrational fear that keeps one from going outside can cause the syndrome.

Agoraphobics may suffer from temporary separation anxiety disorder when certain other individuals of the household depart from the residence temporarily, such as a parent or spouse, or when the agoraphobic is left home alone. Such temporary conditions can result in an increase in anxiety or a panic attack or feeling the need to separate themselves from family or maybe friends.

People with agoraphobia sometimes fear waiting outside for long periods of time; that symptom can be called “macrophobia”.

Panic Attacks

Agoraphobia patients can experience sudden panic attacks when traveling to places where they fear they are out of control, help would be difficult to obtain, or they could be embarrassed. During a panic attack, epinephrine is released in large amounts, triggering the body’s natural fight-or-flight response. A panic attack typically has an abrupt onset, building to maximum intensity within 10 to 15 minutes, and rarely lasts longer than 30 minutes. Symptoms of a panic attack include palpitations, rapid heartbeat, sweating, trembling, nausea, vomiting, dizziness, tightness in the throat, and shortness of breath. Many patients report a fear of dying, fear of losing control of emotions, or fear of losing control of behaviours.

Causes

Agoraphobia is believed to be due to a combination of genetic and environmental factors. The condition often runs in families, and stressful or traumatic events such as the death of a parent or being attacked may be a trigger.

Research has uncovered a link between agoraphobia and difficulties with spatial orientation. Individuals without agoraphobia are able to maintain balance by combining information from their vestibular system, their visual system, and their proprioceptive sense. A disproportionate number of agoraphobics have weak vestibular function and consequently rely more on visual or tactile signals. They may become disoriented when visual cues are sparse (as in wide-open spaces) or overwhelming (as in crowds). Likewise, they may be confused by sloping or irregular surfaces.[20] In a virtual reality study, agoraphobics showed impaired processing of changing audiovisual data in comparison with subjects without agoraphobia.

Substance-Induced

Chronic use of tranquilisers and sleeping pills such as benzodiazepines has been linked to onset of agoraphobia. In 10 patients who had developed agoraphobia during benzodiazepine dependence, symptoms abated within the first year of assisted withdrawal. Similarly, alcohol use disorders are associated with panic with or without agoraphobia; this association may be due to the long-term effects of alcohol consumption causing a distortion in brain chemistry. Tobacco smoking has also been associated with the development and emergence of agoraphobia, often with panic disorder; it is uncertain how tobacco smoking results in anxiety-panic with or without agoraphobia symptoms, but the direct effects of nicotine dependence or the effects of tobacco smoke on breathing have been suggested as possible causes. Self-medication or a combination of factors may also explain the association between tobacco smoking and agoraphobia and panic.

Attachment Theory

Some scholars have explained agoraphobia as an attachment deficit, i.e. the temporary loss of the ability to tolerate spatial separations from a secure base. Recent empirical research has also linked attachment and spatial theories of agoraphobia.

Spatial Theory

In the social sciences, a perceived clinical bias exists in agoraphobia research. Branches of the social sciences, especially geography, have increasingly become interested in what may be thought of as a spatial phenomenon. One such approach links the development of agoraphobia with modernity. Factors considered contributing to agoraphobia within modernity are the ubiquity of cars and urbanisation. These have helped develop the expansion of public space and the contraction of private space, thus creating in the minds of agoraphobia-prone people a tense, unbridgeable gulf (a colloquialism) between the two.

Evolutionary Psychology

An evolutionary psychology view is that the more unusual primary agoraphobia without panic attacks may be due to a different mechanism from agoraphobia with panic attacks. Primary agoraphobia without panic attacks may be a specific phobia explained by it once having been evolutionarily advantageous to avoid exposed, large, open spaces without cover or concealment. Agoraphobia with panic attacks may be an avoidance response secondary to the panic attacks, due to fear of the situations in which the panic attacks occurred.

Diagnosis

Most people who present to mental health specialists develop agoraphobia after the onset of panic disorder. Agoraphobia is best understood as an adverse behavioural outcome of repeated panic attacks and subsequent anxiety and preoccupation with these attacks that leads to an avoidance of situations where a panic attack could occur. Early treatment of panic disorder can often prevent agoraphobia. Agoraphobia is typically determined when symptoms are worse than panic disorder, but also do not meet the criteria for other anxiety disorders such as depression. In rare cases where agoraphobics do not meet the criteria used to diagnose panic disorder, the formal diagnosis of agoraphobia without history of panic disorder is used (primary agoraphobia).

Treatments

Therapy

Systematic desensitisation can provide lasting relief to the majority of patients with panic disorder and agoraphobia. The disappearance of residual and sub-clinical agoraphobic avoidance, and not simply of panic attacks, should be the aim of exposure therapy. Many patients can deal with exposure easier if they are in the company of a friend on whom they can rely. Patients must remain in the situation until anxiety has abated because if they leave the situation, the phobic response will not decrease and it may even rise.

A related exposure treatment is in vivo exposure, a cognitive behavioural therapy method, that gradually exposes patients to the feared situations or objects. This treatment was largely effective with an effect size from d = 0.78 to d = 1.34, and these effects were shown to increase over time, proving that the treatment had long-term efficacy (up to 12 months after treatment).

Psychological interventions in combination with pharmaceutical treatments were overall more effective than treatments simply involving either CBT or pharmaceuticals. Further research showed there was no significant effect between using group CBT versus individual CBT.

Cognitive restructuring has also proved useful in treating agoraphobia. This treatment involves coaching a participant through a dianoetic discussion, with the intent of replacing irrational, counterproductive beliefs with more factual and beneficial ones.

Relaxation techniques are often useful skills for the agoraphobic to develop, as they can be used to stop or prevent symptoms of anxiety and panic.

Videoconferencing Psychotherapy (VCP)

Videoconferencing psychotherapy (VCP) is an emerging modality used to treat various disorders in a remote method. Similar to traditional face-to-face interventions, VCP can be used to administer CBT. The use of VCP has been shown to be equally effective as face-to-face interventions at treating panic disorder and agoraphobia (PDA) and motivating the client to continue treatment.

Medications

Antidepressant medications most commonly used to treat anxiety disorders are mainly selective serotonin reuptake inhibitors (SSRIs). Benzodiazepines, monoamine oxidase inhibitor, and tricyclic antidepressants are also sometimes prescribed for treatment of agoraphobia. Antidepressants are important because some have anxiolytic effects. Antidepressants should be used in conjunction with exposure as a form of self-help or with CBT. A combination of medication and CBT is sometimes the most effective treatment for agoraphobia.

Benzodiazepines and other anxiolytic medications such as alprazolam and clonazepam are used to treat anxiety and can also help control the symptoms of a panic attack.

Alternative Medicine

Eye movement desensitisation and reprocessing (EMDR) has been studied as a possible treatment for agoraphobia, with poor results. As such, EMDR is only recommended in cases where cognitive-behavioural approaches have proven ineffective or in cases where agoraphobia has developed following trauma.

Many people with anxiety disorders benefit from joining a self-help or support group (telephone conference-call support groups or online support groups being of particular help for completely housebound individuals). Sharing problems and achievements with others, as well as sharing various self-help tools, are common activities in these groups. In particular, stress management techniques and various kinds of meditation practices and visualisation techniques can help people with anxiety disorders calm themselves and may enhance the effects of therapy, as can service to others, which can distract from the self-absorption that tends to go with anxiety problems. Also, preliminary evidence suggests aerobic exercise may have a calming effect. Since caffeine, certain illicit drugs, and even some over-the-counter cold medications can aggravate the symptoms of anxiety disorders, they should be avoided.

Epidemiology

Agoraphobia occurs about twice as commonly among women as it does in men.

Panic disorder with or without agoraphobia affects roughly 5.1% of Americans, and about one-third (1/3) of this population with panic disorder have co-morbid agoraphobia. It is uncommon to have agoraphobia without panic attacks, with only 0.17% of people with agoraphobia not presenting panic disorders as well.

Society and Culture

Notable Cases

  • Woody Allen (b. 1935), American actor, director, musician.
  • Kim Basinger (b. 1953), American actress.
  • Earl Campbell (b. 1955), American pro football player.
  • Macaulay Culkin (b. 1980), American actor, known for his portrayal of Kevin McCallister in Home Alone and Home Alone 2: Lost in New York, said he had “self-diagnosed” agoraphobia.
  • Paula Deen (b. 1947), American chef, author, and television personality.
  • H.L. Gold (1914-1996), science fiction editor: As a result of trauma during his wartime experiences, his agoraphobia became so severe that for more than two decades he was unable to leave his apartment. Towards the end of his life, he acquired some control over the condition.
  • Daryl Hannah (b. 1960), American actress.
  • Howard Hughes (1905-1976), American aviator, industrialist, film producer and philanthropist.
  • Olivia Hussey (b. 1951), Anglo-Argentine actress.
  • Shirley Jackson (1916-1965), American writer: Her agoraphobia is considered to be a primary inspiration for the novel We Have Always Lived in the Castle.
  • Elfriede Jelinek (b. 1946), Austrian writer, Nobel Prize laureate in Literature in 2004.
  • Bolesław Prus (1847-1912), Polish journalist and novelist.
  • Peter Robinson (b. 1962), British musician known as Marilyn.
  • Brian Wilson (b. 1942), American singer and songwriter, primary songwriter of the Beach Boys, a former recluse and agoraphobic who has schizophrenia.
  • Ben Weasel, singer and songwriter.

What is the American Foundation for Suicide Prevention?

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Introduction

The American Foundation for Suicide Prevention (AFSP) is a voluntary health organisation based in New York City, with a public policy office based in Washington, D.C.

The organisation’s stated mission is to “save lives and bring hope to those affected by suicide.”

Refer to Suicide Awareness.

Brief History

Founded in 1987 as the American Suicide Foundation by Herbert Hendin M.D., AFSP is the world’s largest private funder of suicide prevention research. The founding families, alarmed by a combination of increases in death by suicide in the previous four decades and with their personal experience with loved ones dying by suicide, decided to the create AFSP in order to establish a private source of support for suicide research, education, and prevention efforts that could be sustained into the future. According to a Charity Navigator rating published in September 2018, more than 83% of the organisation’s finances went towards programme expenses (based on financial data from fiscal year 2017), receiving a perfect rating for accountability and transparency. AFSP also partners with Aetna (a US managed health care company that sells traditional and consumer directed health care insurance and related services).

For 2018, AFSP received $37 million in financial contributions from 700,000 new and returning donors.

Programmes

Programmes designed to educate the larger public about suicide and prevention best practices, such as Talk Saves Lives: An Introduction to Suicide Prevention, are offered by AFSP under the umbrella of prevention education and provide a general understanding of suicide, including its scope and what can be done to prevent it.

International Survivors of Suicide Loss Day (also known as “Survivor Day”) is one of the most prominent postvention programmes or events organised by AFSP. Originally introduced as “National Survivors of Suicide Loss Day” in 1999, when United States Senator Harry Reid – himself a survivor of suicide loss – formally introduced a resolution to the Senate, the day is officially observed annually on the Saturday before American Thanksgiving.

The Interactive Screening Programme, or ISP, is an online tool offered by AFSP first piloted at Emory University, and has since been implemented in colleges, police departments, workplaces and the NFL Players Union. Francis Levesque created this in Sept-Îles in 1973 in meeting all members of the association.

Criticism

In August 2016, AFSP formed a partnership with the National Shooting Sports Foundation, a gun industry trade association, to educate the firearm-owning community on suicide prevention through outreach at firearm retailers and shooting ranges. In December 2017, The New York Times released an opinion piece written by Erin Dunkerly, a volunteer whose father died by suicide using a firearm. The piece cites that there is a high risk of suicide from keeping firearms in the home, but claims that local AFSP staff told volunteers not to discuss the topic of gun control. The piece goes on to say that AFSP excluded from its walks violence prevention groups that promoted gun control, and that AFSP excludes the Brady Campaign to Prevent Gun Violence from donating or participating. According to a post published on digital health community The Mighty, similar accounts of gun safety groups have been reported in Wisconsin by Khary Penebaker, San Diego by Wendy Wheatcroft, and in Maine by Judi Richardson.

On This Day … 25 December

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People (Births)

  • 1875 – Francis Aveling, Canadian psychologist and priest (d. 1941).

People (Deaths)

  • 1925 – Karl Abraham, German psychoanalyst and author (b. 1877).

Francis Aveling

Francis Arthur Powell Aveling MC ComC (25 December 1875 to 06 March 1941) was a Canadian psychologist and Catholic priest. He married Ethel Dancy of Steyning, Sussex in 1925.

Life

Francis Aveling was born at St. Catharines, Ontario 25 December 1875. He went to Bishop Ridley College in Ontario and McGill University before studying at Keble College at the University of Oxford, England. Aveling was received into the Roman Catholic Church by Father Luke Rivington in 1896 and entered the Pontificio Collegio Canadese in Rome. There he earned his doctor of divinity degree. He was ordained to the priesthood in 1899, and served as a curate in Tottenham, before becoming first rector of Westminster Cathedral Choir School. He was also a chaplain at the Cathedral, and to St. Wilfrid’s Convent, Chelsea.

In 1910, Aveling obtained a doctor of philosophy degree at the age of 35 from the University of Louvain (his advisor was Albert Michotte), and in 1912 he was recipient of a doctor of science degree from the University of London, and received the Carpenter Medal following his work On the Consciousness of the Universal and the Individual: A Contribution to the Phenomenology of the Thought Process. Subsequently, Aveling received his doctor of letters degree from the University of London.

Career

Aveling taught at University College, London from 1912 as a Lecturer (Assistant Professor), under the leadership of Charles Spearman, until the First World War. During that war he served in France as a chaplain in the British Army, after which he returned to the University of London. In 1922, he transferred to King’s College, London where he was promoted to reader (associate professor), and later to professor of psychology. He was an extern examiner in philosophy at the National University of Ireland; and a lecturer in pedagogical methods for the London County Council.

Aveling authored several books. He was the doctoral advisor of Raymond Cattell From 1926 until 1929, Aveling was also a president of the British Psychological Society. Aveling was a member of the Council of the International Congresses, of the Aristotelian Society, of the council and advisory board of the National Institute of Industrial Psychology, of the council of the British Institute of Philosophical Studies and of the Child Guidance Council.

He was a contributor to the Dublin Review, The American Catholic Quarterly Review, Catholic World, The nineteenth Century, The Journal of Psychology, and the Catholic Encyclopaedia.

Karl Abraham

Karl Abraham (03 May 1877 to 25 December 1925) was an influential German psychoanalyst, and a collaborator of Sigmund Freud, who called him his ‘best pupil’.

Abraham was born in Bremen, Germany. His parents were Nathan Abraham, a Jewish religion teacher (1842-1915), and his wife (and cousin) Ida (1847-1929). His studies in medicine enabled him to take a position at the Burghölzli Swiss Mental Hospital, where Eugen Bleuler practiced. The setting of this hospital initially introduced him to the psychoanalysis of Carl Gustav Jung.

In 1907, he had his first contact with Sigmund Freud, with whom he developed a lifetime relationship. Returning to Germany, he founded the Berliner Society of Psychoanalysis in 1910. He was the president of the International Psychoanalytical Association from 1914 to 1918 and again in 1925.

Karl Abraham collaborated with Freud on the understanding of manic-depressive illness, leading to Freud’s paper on ‘Mourning and Melancholia’ in 1917. He was the analyst of Melanie Klein during the years 1924-1925, and of a number of other British psychoanalysts, including Edward Glover and Alix Strachey. He was a mentor for an influential group of German analysts, including Karen Horney, Helene Deutsch, and Franz Alexander.

Karl Abraham studied the role of infant sexuality in character development and mental illness and, like Freud, suggested that if psychosexual development is fixated at some point, mental disorders will likely emerge. He described the personality traits and psychopathology that result from the oral and anal stages of development (1921).

Abraham observed his only daughter, Hilda, reporting on her reaction to enemas and infantile masturbation by her brother. He asked that secrets be shared with him but he was careful to respect her privacy and some reports were not published until after Hilda’s death. Hilda was later to become a psychoanalyst.

In the oral stage of development, the first relationships children have with objects (caretakers) determine their subsequent relationship to reality. Oral satisfaction can result in self-assurance and optimism, whereas oral fixation can lead to pessimism and depression. Moreover, a person with an oral fixation will present a disinclination to take care of him/herself and will require others to look after him/her. This may be expressed through extreme passivity (corresponding to the oral benign suckling substage) or through a highly active oral-sadistic behaviour (corresponding to the later sadistic biting substage).

In the anal stage, when the training in cleanliness starts too early, conflicts may result between a conscious attitude of obedience and an unconscious desire for resistance. This can lead to traits such as frugality, orderliness and obstinacy, as well as to obsessional neurosis as a result of anal fixation (Abraham, 1921). In addition, Abraham based his understanding of manic-depressive illness on the study of the painter Segantini: an actual event of loss is not itself sufficient to bring the psychological disturbance involved in melancholic depression. This disturbance is linked with disappointing incidents of early childhood; in the case of men always with the mother (Abraham, 1911). This concept of the prooedipal “bad” mother was a new development in contrast to Freud’s oedipal mother and paved the way for the theories of Melanie Klein (May-Tolzmann, 1997).

Another important contribution is his work “A short study of the Development of the Libido”, where he elaborated on Freud’s “Mourning and Melancholia” (1917) and demonstrated the vicissitudes of normal and pathological object relations and reactions to object loss.

Moreover, Abraham investigated child sexual trauma and, like Freud, proposed that sexual abuse was common among psychotic and neurotic patients. Furthermore, he argued (1907) that dementia praecox is associated with child sexual trauma, based on the relationship between hysteria and child sexual trauma demonstrated by Freud.

Abraham (1920) also showed interest in cultural issues. He analysed various myths suggesting their relation to dreams (1909) and wrote an interpretation of the spiritual activities of the Egyptian monotheistic Pharaoh Amenhotep IV (1912).

Abraham died prematurely on 25 December 1925, from complications of a lung infection and may have suffered from lung cancer.

On This Day … 22 December

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People (Deaths)

  • 1902 – Richard von Krafft-Ebing, German-Austrian psychiatrist and author (b. 1840).

Richard von Kraft-Ebing

Richard Freiherr von Krafft-Ebing (full name Richard Fridolin Joseph Freiherr Krafft von Festenberg auf Frohnberg, genannt von Ebing; 1840-1902) was a German psychiatrist and author of the foundational work Psychopathia Sexualis (1886).

Krafft-Ebing was born in 1840 in Mannheim, Germany. He studied medicine at the University of Heidelberg, where he specialised in psychiatry. He later practiced in psychiatric asylums. After leaving his work in asylums, he pursued a career in psychiatry, forensics, and hypnosis.

He died in Graz in 1902. He was recognised as an authority on deviant sexual behaviour and its medicolegal aspects.

What is Pyridotriazolodiazepine?

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Introduction

A pyridotriazolodiazepine is a heterocyclic compound containing pyridine and triazole rings fused to a diazepine ring.

Background

Pyridotriazolodiazepines forms the central structure of zapizolam. Zapizolam is poorly researched, but probably it is a sedative and/or anxiolytic, like other benzodiazepine derivatives, especially triazolobenzodiazepines (such as alprazolam).

What is the World Health Organisation Collaborating Centre?

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Introduction

World Health Organisation collaborating centres are institutions that work with the World Health Organisation (WHO) in disciplines such as occupational health, food safety, and communicable disease prevention.

Overview

There are over 700 such centres across 80 countries. Collaborating centres may be research institutes, parts of universities, or academies. The participating institutions partner with WHO to perform research, provide training, or offer other services in furthering the WHO health agenda. These partners are designated by the WHO director-general as a part of a collaborative network. By using networks of established organisations, WHO is able to strengthen the scientific validity of its work and lower the costs of research.

Centres Worldwide

The WHO has established networks related to a variety of health topics. For example, WHO has put in place centres focused on organ transplants, hearing loss prevention, hepatitis, leprosy, medical ethics, and maternal health. To move the work forward, WHO has numerous designated centres in each inhabited continent. The network of centres for reference and research on influenza draws upon resources from Japan, the United States, the United Kingdom, and Australia. The network of WHO collaborating centres in occupational health is chaired by Dr. John Howard, director of the US National Institute for Occupational Safety and Health, and contains more than 60 designated organisations from across the globe.

The WHO Collaborating Centre on Global Governance of Antimicrobial Resistance has been working on the Coronavirus disease 2019 and is directed by Steven Hoffman.

What was the National Survey of Mental Health and Wellbeing?

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Introduction

The 2007 National Survey of Mental Health and Wellbeing (NSMHWB) was designed to provide lifetime prevalence estimates for mental disorders.

Purpose

To gain statistics on key mental health issues including the prevalence of mental disorders, the associated disability, and the use of services.

As such the NSMHWB was a national epidemiological survey of mental disorders that used similar methodology to the NCS. It aimed to answer three main questions:

  1. How many people meet DSM-IV and ICD-10 diagnostic criteria for the major mental disorders?
  2. How disabled are they by their mental disorders? and
  3. How many have seen a health professional for their mental disorder?

Background

Respondents were asked about experiences throughout their lifetime. In this survey, 12-month diagnoses were derived based on lifetime diagnosis and the presence of symptoms of that disorder in the 12 months prior to the survey interview. Assessment of mental disorders presented in this publication are based on the definitions and criteria of the World Health Organisation’s (WHO) International Classification of Diseases, Tenth Revision (ICD-10). Prevalence rates are presented with hierarchy rules applied (i.e. a person will not meet the criteria for particular disorders because the symptoms are believed to be accounted for by the presence of another disorder).

Results

  • Among the 16,015,300 people aged 16-85 years, 45% (or 7,286,600 people) had a lifetime mental disorder (i.e. a mental disorder at some point in their life).
  • More than half (55% or 8,728,700 people) of people had no lifetime mental disorders.
  • Of people who had a lifetime mental disorder:
    • 20% (or 3,197,800 people) had a 12-month mental disorder and had symptoms in the 12 months prior to the survey interview; and
    • 25% (or 4,088,800 people) had experienced a lifetime mental disorder but did not have symptoms in the 12 months prior to the survey interview.

Prevalence of 12-Month Mental Health Disorders

Prevalence of mental disorders is the proportion of people in a given population who met the criteria for diagnosis of a mental disorder at a point in time

  • Among the 3,197,800 people (or 20% of people) who had a 12-month mental disorder and had symptoms in the 12 months prior to interview:
    • 14.4% had a 12-month Anxiety disorder (includes Panic disorder (2.6%); Agoraphobia (2.8%); Social Phobia (4.7%); Generalised Anxiety Disorder (2.7%); Obsessive-Compulsive Disorder (1.9%); and Post-Traumatic Stress Disorder (6.4%))
    • 6.2% had a 12-month Affective disorder (includes Depressive Episode (4.1%) (includes severe, moderate and mild depressive episodes); Dysthymia (1.3%); and Bipolar Affective Disorder (1.8%)), and
    • 5.1% had a 12-month Substance Use Disorder (includes Alcohol Harmful Use (2.9%); Alcohol Dependence (1.4%); and Drug Use Disorders (includes harmful use and dependence) (1.4%)).
  • Note that a person may have had more than one mental disorder.
    • The components when added may therefore not add to the total shown.
    • Includes Severe Depressive Episode, Moderate Depressive Episode, and Mild Depressive Episode.
    • Includes Harmful Use and Dependence.

There were 3.2 million people who had a 12-month mental disorder. In total, 14.4% (2.3 million) of Australians aged 16-85 years had a 12-month Anxiety disorder, 6.2% (995,900) had a 12-month Affective disorder and 5.1% (819,800) had a 12-month Substance Use disorder.

Women experienced higher rates of 12-month mental disorders than men (22% compared with 18%). Women experienced higher rates than men of Anxiety (18% and 11% respectively) and Affective disorders (7.1% and 5.3% respectively). However, men had twice the rate of Substance Use disorders (7.0% compared with 3.3% for women).

The prevalence of 12-month mental disorders varies across age groups, with people in younger age groups experiencing higher rates of disorder. More than a quarter (26%) of people aged 16-24 years and a similar proportion (25%) of people aged 25-34 years had a 12-month mental disorder compared with 5.9% of those aged 75-85 years old.

You can read the full survey results here and a shorter analysis can be found here.

On This Day … 21 December

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People (Deaths)

  • 1948 – Władysław Witwicki, Polish psychologist, philosopher, translator, historian (of philosophy and art) and artist (b. 1878).

Wladyslaw Witwicki

Władysław Witwicki (30 April 1878 to 21 December 1948) was a Polish psychologist, philosopher, translator, historian (of philosophy and art) and artist. He is seen as one of the fathers of psychology in Poland.

Witwicki was also the creator of the theory of cratism, theory of feelings, and he dealt with the issues of the psychology of religion, and the creation of secular ethics. He was one of the initiators and co-founders of Polish Philosophical Society. He is one of the thinkers associated with the Lwów-Warsaw school.

What is the WHO Assessment Instrument for Mental Health Systems?

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Introduction

The World Health Organisation Assessment Instrument for Mental Health Systems (WHO-AIMS) is a new WHO tool for collecting essential information on the mental health system of a country or region.

Purpose

The goal of collecting this information is to improve mental health systems and to provide a baseline for monitoring the change.

What is WHO-AIMS?

WHO-AIMS is a WHO tool for collecting essential information on the mental health system of a country or region. The goal of collecting this information is to improve mental health systems and to provide a baseline for monitoring the change.

For the purpose of WHO-AIMS, a mental health system is defined as all the activities whose primary purpose is to promote, restore or maintain mental health. WHO-AIMS is primarily intended for assessing mental health systems in low and middle income countries, but is also a valuable assessment tool for high resource countries.

Note: Great care has been taken to ensure the reliability of the data presented in the WHO-AIMS country reports. Data for WHO-AIMS are collected by a team led by a focal point within the country and are, in most cases, approved by the Ministry of Health. However, since WHO is not directly responsible for the data collection, WHO cannot independently verify the accuracy of any of the data presented in these reports.

WHO-AIMS Instrument, Version 2.2

You can find country reports, sub-regional reports, and other reports here (Pan American Health Organisation (PAHO) site).