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共病 | 焦虑症 | 精神分裂症 | 精神药理学 | 躯体疾病 | 双相障碍 | 失眠 | 性问题 | 抑郁症 | 综述

没有精神健康就没有健康

【题目Title】 No health without mental health

【著者Authors】 Martin Prince, Vikram Patel, Shekhar Saxena, Mario Maj, Joanna Maselko, Michael R Phillips, Atif Rah
【来源Source】 www.thelancet.com Published online September 4, 2007 DOI:10.1016/S0140-6736(07)61238-0
【关键词Keywords】 health,mental

【摘要Abstract】 About 14% of the global burden of disease has been attributed to neuropsychiatric disorders, mostly due to the chronically disabling nature of depression and other common mental disorders, alcohol-use and substance-use disorders, and psychoses. Such estimates have drawn attention to the importance of mental disorders for public health. However, because they stress the separate contributions of mental and physical disorders to disability and mortality, they might have entrenched the alienation of mental health from mainstream efforts to improve health and reduce poverty. The burden of mental disorders is likely to have been underestimated because of inadequate appreciation of the connectedness between mental illness and other health conditions. Because these interactions are protean, there can be no health without mental health. Mental disorders increase risk for communicable and non-communicable diseases, and contribute to unintentional and intentional injury. Conversely, many health conditions increase the risk for mental disorder, and comorbidity complicates help-seeking, diagnosis, and treatment,and infl uences prognosis. Health services are not provided equitably to people with mental disorders, and the quality of care for both mental and physical health conditions for these people could be improved. We need to develop and evaluate psychosocial interventions that can be integrated into management of communicable and non-communicable diseases. Health-care systems should be strengthened to improve delivery of mental health care, by focusing on existing programmes and activities, such as those which address the prevention and treatment of HIV, tuberculosis, and malaria; gender-based violence; antenatal care; integrated management of childhood illnesses and child nutrition; and innovative management of chronic disease. An explicit mental health budget might need to be allocated for such activities. Mental health aff ects progress towards the achievement of several Millennium Development Goals, such as promotion of gender equality and empowerment of women, reduction of child mortality, improvement of maternal health, and reversal of the spread of HIV/AIDS. Mental health awareness needs to be integrated into all aspects of health and social policy, health-system planning, and delivery of primary and secondary general health care.

全球大约14%的疾病可归因为神经心理障碍，主要是由于抑郁和其它常见精神障碍、酒精滥用和物质滥用障碍和精神病的慢性致残作用。这些评估使人们认识到精神健康对公众健康的重要性。但是，因为这些评估强调了精神障碍和身体障碍对致残和死亡率的不同作用，可能强化了精神健康与改善健康和降低贫困的主流措施的异化。

因为对精神疾病与其他健康情况之间的联系了解不足，精神障碍的负担可能被低估。因为这些相互作用千变万化，没有精神健康就没有健康。精神障碍增加了传染性疾病和非传染性疾病的危险，并导致非故意伤害和故意伤害。相反，许多健康状况可增加精神障碍的危险，共患病使求助、诊断和治疗复杂化，并影响预后。精神障碍患者所接受的健康服务参差不齐，其身心治疗质量可得到改善。我们需要发展和评估可被整合到传染性疾病和非传染性疾病治疗中的心理社会干预措施。应通过聚焦于现有的项目和活动如加强HIV、肺结核和疟疾的预防和治疗，对性别暴力、产前保健及儿童疾病和营养的整合控制，以及对慢性疾病的新型疗法来强化卫生保健系统以提高精神治疗。需为这些活动分配明确的精神健康预算。精神健康会影响几项千年发展目标的进展，如促进性别平等和女性赋权，降低儿童死亡率、改善母体健康，并控制HIV/AIDS的传播。应将精神健康意识整合到以下各个方面：卫生和社会政策，保健系统计划，初级和次级卫生保健的实施。