Mental health disorders are significant disturbances affecting a person’s thinking (cognition), emotional control, or behavior. These conditions are typically linked to distress or difficulties in important areas of life. The range of mental disorders is wide, and they are also referred to as mental health conditions, a broader term encompassing mental disorders, psychosocial disabilities, and other mental states causing distress, impaired function, or self-harm risk. This article focuses on mental disorders as defined by the International Classification of Diseases 11th Revision (ICD-11).
In 2019, it was estimated that 1 in 8 people globally, or 970 million individuals, were living with a mental disorder, with anxiety and depressive disorders being the most prevalent (1). The COVID-19 pandemic in 2020 led to a significant increase in these numbers, with early estimates showing a 26% and 28% rise in anxiety and major depressive disorders, respectively, within a single year (2). Despite the availability of effective prevention and treatment options, many individuals with mental disorders lack access to appropriate care. Furthermore, stigma, discrimination, and human rights violations are common experiences for those affected.
Anxiety Disorders: A Key Part of the Mental Health Diagnosis List
Anxiety disorders are a significant category within the Mental Health Diagnosis List. In 2019, 301 million people worldwide experienced an anxiety disorder, including 58 million children and adolescents (1). These disorders are characterized by excessive fear, worry, and related behavioral issues. The symptoms are severe enough to cause significant distress or impair daily functioning. Several types of anxiety disorders are recognized in the mental health diagnosis list, including:
- Generalized Anxiety Disorder (GAD): Defined by persistent and excessive worry about various topics, events, or activities.
- Panic Disorder: Characterized by recurrent unexpected panic attacks, which are sudden periods of intense fear that may include physical symptoms like heart palpitations, sweating, and shortness of breath.
- Social Anxiety Disorder (Social Phobia): Involves intense fear and anxiety in social situations where the individual may be scrutinized by others.
- Separation Anxiety Disorder: Marked by excessive fear or anxiety regarding separation from attachment figures.
Effective psychological treatments are available for anxiety disorders, and depending on the individual’s age and the severity of the disorder, medication may also be considered as part of a comprehensive treatment plan.
Depression: Understanding a Common Mental Health Diagnosis
Depression is another prevalent condition on the mental health diagnosis list. In 2019, 280 million people globally were living with depression, including 23 million children and adolescents (1). Depression is more than just temporary sadness; it involves persistent depressed mood (feeling sad, irritable, or empty) or a significant loss of interest or pleasure in activities, lasting for most of the day, nearly every day, for at least two weeks. Additional symptoms often accompany depression and are important for a mental health diagnosis. These can include:
- Difficulty concentrating
- Feelings of guilt or low self-worth
- Hopelessness about the future
- Thoughts of death or suicide
- Sleep disturbances
- Changes in appetite or weight
- Fatigue or low energy
It’s crucial to recognize that people with depression have an increased risk of suicide. However, effective psychological treatments and medication options are available to help manage and treat depression, improving the quality of life for those affected.
Bipolar Disorder: Recognizing Mood Swings in a Mental Health Diagnosis
Bipolar disorder affected 40 million people in 2019 (1) and is an important diagnosis within the mental health diagnosis list. Individuals with bipolar disorder experience shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. These shifts cycle between depressive episodes and manic episodes. A depressive episode in bipolar disorder shares similar symptoms with major depression (as listed above). Manic episodes, on the other hand, are characterized by:
- Elevated mood, euphoria, or irritability
- Increased energy and activity levels
- Increased talkativeness
- Racing thoughts
- Inflated self-esteem
- Decreased need for sleep
- Distractibility
- Impulsive and reckless behaviors
Similar to depression, individuals with bipolar disorder also face an increased risk of suicide. Effective treatments, including psychoeducation, stress reduction, social function enhancement, and medication, are available and crucial for managing this condition.
Post-Traumatic Stress Disorder (PTSD): A Mental Health Diagnosis Following Trauma
Post-Traumatic Stress Disorder (PTSD) is a critical diagnosis in the mental health diagnosis list, particularly prevalent in conflict-affected areas (3). PTSD can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. The core symptoms of PTSD, which must persist for more than a month to warrant a diagnosis, include:
- Re-experiencing: Reliving the traumatic event through intrusive memories, flashbacks, or nightmares.
- Avoidance: Avoiding thoughts, feelings, conversations, places, activities, or people that are reminders of the trauma.
- Hyperarousal: Persistent heightened sense of current threat, exaggerated startle response, difficulty sleeping, or angry outbursts.
These symptoms cause significant distress or problems in daily functioning. Effective psychological treatments are available for PTSD and are essential for recovery.
Schizophrenia: Understanding a Complex Mental Health Diagnosis
Schizophrenia affects approximately 24 million people worldwide, or 1 in 300 individuals (1). It is a significant condition on the mental health diagnosis list, characterized by disruptions in thought processes, perception, emotional responsiveness, and behavior. Key symptoms of schizophrenia can include:
- Delusions: False beliefs not based in reality.
- Hallucinations: Sensory experiences that occur in the absence of real external stimuli, such as hearing voices.
- Disorganized Thinking (Speech): Disorganized ways of speaking that impair effective communication.
- Grossly Disorganized or Abnormal Motor Behavior: Unpredictable agitation or childlike silliness.
- Negative Symptoms: Reduced emotional expression, decreased motivation, or reduced speech.
People with schizophrenia have a significantly reduced life expectancy, 10-20 years below the general population (4). Despite its severity, a range of effective treatments exist, including medication, psychoeducation, family interventions, and psychosocial rehabilitation, which can significantly improve the lives of individuals with schizophrenia.
Eating Disorders: Addressing Food and Body Image in the Mental Health Diagnosis List
Eating disorders are serious conditions in the mental health diagnosis list; in 2019, 14 million people experienced them, including nearly 3 million children and adolescents (1). These disorders involve persistent disturbances of eating or eating-related behavior that result in altered consumption or absorption of food and that significantly impair physical health or psychosocial functioning. Common types include:
- Anorexia Nervosa: Characterized by persistent restriction of energy intake leading to significantly low body weight, intense fear of gaining weight, and disturbance in the experience of body weight or shape.
- Bulimia Nervosa: Characterized by recurrent episodes of binge eating followed by compensatory behaviors like self-induced vomiting, misuse of laxatives, fasting, or excessive exercise to prevent weight gain.
Anorexia nervosa often begins in adolescence or young adulthood and is associated with a higher risk of premature death due to medical complications or suicide. Bulimia nervosa increases the risk of substance use, suicidality, and health complications. Effective treatments, such as family-based therapy and cognitive behavioral therapy, are available.
Disruptive, Impulse-Control and Conduct Disorders: Behavioral Mental Health Diagnoses
Disruptive, impulse-control and conduct disorders are a group of conditions on the mental health diagnosis list characterized by difficulties in emotional and behavioral regulation. 40 million people, including children and adolescents, were living with conduct-dissocial disorder in 2019 (1). These disorders include:
- Conduct Disorder: Repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated.
- Oppositional Defiant Disorder (ODD): Pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures.
Onset is often during childhood. Effective psychological treatments often involve parents, caregivers, and teachers, and may include cognitive problem-solving or social skills training.
Neurodevelopmental Disorders: Diagnoses Beginning in Childhood
Neurodevelopmental disorders are conditions within the mental health diagnosis list that arise during the developmental period and involve difficulties in specific intellectual, motor, language, or social functions. These include:
- Intellectual Developmental Disorders: Characterized by deficits in intellectual and adaptive functioning.
- Autism Spectrum Disorder (ASD): Characterized by difficulties in social communication and interaction and restricted, repetitive patterns of behavior, interests, or activities.
- Attention-Deficit/Hyperactivity Disorder (ADHD): Characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.
Effective treatments include psychosocial, behavioral, occupational, and speech therapy. For some diagnoses and age groups, medication may be considered.
Risk Factors for Mental Disorders: Who is on the Mental Health Diagnosis List?
Various factors can contribute to mental health disorders. While resilience is common, people exposed to adverse circumstances like poverty, violence, disability, and inequality are at higher risk. Risk and protective factors include individual psychological and biological factors, such as emotional skills and genetics. Many of these factors are linked to changes in brain structure and function.
Health Systems and Social Support: Addressing the Needs Identified in a Mental Health Diagnosis
Health systems globally are often under-resourced and inadequately prepared to meet the needs of individuals with mental disorders. A significant treatment gap exists worldwide, and the quality of care is often lacking. For instance, only 29% of people with psychosis (5) and one-third of people with depression receive formal mental health care (6).
Beyond medical treatment, social support is crucial. This includes assistance in developing and maintaining personal, family, and social relationships, as well as support for education, employment, housing, and meaningful activities.
WHO Response: Global Action on Mental Health Diagnoses
The WHO’s Comprehensive Mental Health Action Plan 2013-2030 emphasizes mental health as essential for overall health. The plan’s four key objectives are:
- Strengthening leadership and governance for mental health.
- Providing comprehensive, integrated community-based mental health and social care services.
- Implementing promotion and prevention strategies in mental health.
- Strengthening information systems, evidence, and research for mental health.
The WHO’s Mental Health Gap Action Programme (mhGAP) aims to expand services, particularly in resource-limited settings, using evidence-based guidance, tools, and training. It focuses on priority conditions and builds capacity among non-specialized healthcare providers to integrate mental health care at all levels. The WHO mhGAP Intervention Guide 2.0 provides essential guidance for non-specialist health workers in assessing and managing mental disorders.
References
(1) Institute of Health Metrics and Evaluation. Global Health Data Exchange (GHDx), (https://vizhub.healthdata.org/gbd-results/, accessed 14 May 2022).
(2) Mental Health and COVID-19: Early evidence of the pandemic’s impact. Geneva: World Health Organization; 2022.
(3) Charlson, F., van Ommeren, M., Flaxman, A., Cornett, J., Whiteford, H., & Saxena, S. New WHO prevalence estimates of mental disorders in conflict settings: a systematic review and meta-analysis. Lancet. 2019;394,240–248.
(4) Laursen TM, Nordentoft M, Mortensen PB. Excess early mortality in schizophrenia. Annual Review of Clinical Psychology, 2014;10,425-438.
(5) Mental health atlas 2020. Geneva: World Health Organization; 2021
(6) Moitra M, Santomauro D, Collins PY, Vos T, Whiteford H, Saxena S, et al. The global gap in treatment coverage for major depressive disorder in 84 countries from 2000–2019: a systematic review and Bayesian meta-regression analysis. PLoS Med. 2022;19(2):e1003901. doi:10.1371/journal.pmed.1003901.
