BrightMed Session 3: Mental Health and Global Health

It's great to be back! Now I can update you on my BrightMed adventures!

This one is session 3 of this year; so we're going back a long time! I've got one more session to write about after this, and then our day trip out!

In the morning, our focus was on three mental health areas:

• Depression
• Anorexia Nervosa
• Schizophrenia

After a brief intro to mental health, we're discussing a few clinical cases, including anorexia, schizophrenia and depression.

— BrightMed BSMS (@BrightMed) January 21, 2017

First, let's take a look at the WHO's definition of mental health.

"Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community"

What do you think about this?

Some things to consider:

• How can one realise their own potential? What about viewing "beyond" your potential?
• What can we classify as "normal stresses of life"? What does this entail, and would it not differ for others?
• How do we quantify or simply productivity?
• If one doesn't make a contribution to community, do they not have a good state of mind?

Definitely food for thought!

The Thinker by Auguste Rodin

Some facts:

• 1 in 4 adults experience mental health problems every year
• Approximately 450 million people worldwide have a mental health problem
• 30% of GP consultations are for mental health

Previously, physicians used to separate the symptoms into two categories:

Neuroses → Depression, anxiety, etc
Psychoses → Hallucinations, delusions, etc

However, this is not generally used now. Now they use "DSM-V or ICD-10"

As a note, the word "Schizotypal" was brought up", which means that it doesn't necessarily indicate schizophrenia, (even though it displays similar characteristics), as it doesn't meet the full criteria.

Interesting point for further research; we came across a man named "Bryan Charnley" who documented the effects of schizophrenia as artwork.

Self-portrait by Bryan Charnley

Food for thought: perhaps exploring his artwork is a way of becoming more empathetic and understanding of mental health both for careers within medicine and in general life!

After this, we took a brief look at the "Global Burden of Disease Report", which according to the WHO:

"measures burden of disease using the disability-adjusted-life-year (DALY). This time-based measure combines years of life lost due to premature mortality and years of life lost due to time lived in states of less than full health."

 Here were the leading few conditions within Disability Adjusted Life Years:

• Lower respiratory infections
• Diarrhoeal conditions
• Unipolar depressive disorders

 I'd like to look at this DALY further, as well as a general overview of the Global Burden of Disease report - so that's being added to my to-do list!

Next, we were told about Schizophrenia in more detail.

Here's some of the information I have compiled:

• The main presenting symptoms can be:
• Hallucinations
• Ideas of conspiracies - delusions 
• Withdrawn behaviour, nervousness, flattening of mood
• Delusion of passivity - as defined by biology-online.org: a delusion in which one experiences one's feelings, impulses, thoughts, or actions as not one's own, but as being imposed on by some external force

• There is a genetic predisposition
• Folie à deux - a shared psychosis
•  1% of the population in the UK
• The typical ages for being affected are:
• Male: 20-28
• Female: 26-32
• Males are more affect than females
• It's believed to have an African origin in inner city London
• It is more likely to occur if there was a problem during childbirth 

 We then looked at Depression

On discussing the main symptoms, we found that they were:

• Anhedonia - recieving no pleasure from hobbies
• Lack of energy
• Sadness
• Loss of libido

The risk factors are:

•  Stress
• Trauma
• Family history

It occurs at a ratio of men to women at 1:2.

Treatment can be:

• Cognitive Behavioural Therapy (CBT)
• Anti-depressants (We can look at these in more detail in the future)
• SSRI (Selective serotonin reuptake inhibitor)
• SNRI (Serotonin–norepinephrine reuptake inhibitor)
• TCA (Tricyclic antidepressants)
• MAOI (Monoamine oxidase inhibitors)
• E.C.T (Electro-compulsive therapy) 

You have to assess the "capacity" of patients when treating. This involves: understanding, retaining information, weighing up the pros and cons, and communicating.

Our next topic was Anorexia.

You can recognise anorexia by behaviour like:

•  Not wanting to eat
• Feeling full
• Feeling paranoid with calories
• Having a bad body image
• Scared of food consequences 

It is more diagnosed in women - potentially due to "social image".

The most important point in my opinion is that due to underfunding, people can be refused treatment because their BMI isn't low enough, which is absolutely terrible. Not only would this bring on an even further lack of body confidence, but also, we must remember that weight is not the only area affected by eating disorders.

In fact, anorexia is the psychiatric disorder with the highest death rate.

Our afternoon session was based all around Global Health

 This can be expanded to the:

• Biomedical sciences
• Public health
• Social sciences
• Environmental sciences

 We had a little look at health inequalities, refugee health, gender equity, and climate change. Again, I could do a little write up on this topic further in the future!

 

Stay tuned for my next post, with information about my London Day Trip!

Geeker