Life

NEUROPSYCHIATRY Is a branch of medicine dealing with mental disorders attributable to diseases of the nervous system. It encompasses both disciplines of psychiatry and neurology, although neurology and psychiatry are practiced separately (Yudofsky and Hales, 2002). Nevertheless, neuropsychiatry has become a growing subspecialty of psychiatry and it is also closely related to the field of behavioral neurology, which is a subspecialty of neurology that addresses clinical problems of cognition and/or behavior caused by brain injury or brain disease. "Behavioral Neurology & Neuropsychiatry" fellowships are jointly accredited through the United Council for Neurologic Subspecialties (UCNS), in a manner similar to how the specialties of psychiatry and neurology in the United States have a joint board for accreditation, the American Board of Psychiatry and Neurology (ABPN). Examples of disorders classified as neuro-psychiatric illness is; unipolar depressive disorders, bipolar affective disorder, Schizophrenia, Epilepsy, Alcohol use disorders, Alzheimer and other dementias, Parkinson disease, Multiple sclerosis, Drug use disorders, Post-traumatic stress disorder, Obsessive-compulsive disorder, Panic disorder, Insomnia (primary), Migraine How common is depression in the community' With well-defined diagnostic categories and reliable operational criteria available, the frequency of depression can be measured in the community. High-risk population groups can be identified in the community and the effectiveness of various treatments and preventive measures determined. Historically, disease burden has been based on mortality statistics. However, these statistics underestimate the burden from non-fatal conditions such as neuropsychiatric disorders. The World Health Organization has introduced a new concept of measuring suffering of populations based on time lived with disability which has been described as, Disability-Adjusted Life Year (DALY). According to World Health Report 1999, in 1998, an estimated 39% of all DALYs lost in low and middle-income countries, in which most Member Countries of WHO SEAR fall, were attributable to non communicable diseases, of which, 10% of the disease burden was due to neuropsychiatric conditions. A large proportion of the burden of disease resulting from neuro-psychiatric conditions is attributable to unipolar major depression, which was the fourth leading cause of overall disease burden in 1990, while in adults aged 15-44 years, it was the leading cause of DALYs lost worldwide. The disease burden resulting from depression is estimated to be increasing both in developing and developed regions. However, establishing a diagnosis of depression versus a normal fluctuation in mood is a crucial issue in estimating the true frequency of depression in the community. This is relevant not only for doctors who must distinguish normal variations in mood from depression for the purpose of treatment, but also for health planners and policy-makers for making provisions for mental health care in the community. It is estimated that 5-10% of the population at any given time is suffering from identifiable depression needing psychiatric or psychosocial intervention. The life-time risk of developing depression is 10-20% in females and slightly less in males. Persons under 45 years are much more likely to suffer from depression than persons 45 years or older. This means that the illness is more likely to affect people during their most productive years of life. The first GBD 1990 study quantified the health effects of more than 100 diseases and injuries for eight regions of the world in 1990. It generated comprehensive and internally consistent estimates of mortality and morbidity by age, sex and region. The study also introduced a new metric – the Disability-Adjusted Life Year (DALY) – as a single measure to quantify the burden of diseases, injuries and risk factors. The DALY is based on years of life lost from premature death and years of life lived in less than full health. In the 2004 WHO report on disease burden, 59.6% of the global deaths were caused by non communicable diseases with neuropsychiatric disorders accounting for 2.1 %. Globally, DALYs estimated that neuropsychiatry accounted fkor 27% of disease burden with unipolar depressive disorders contributing 32.8%. a computation of the years lost to disability YLDs depicted neuropsychiatry as one of the major (31%) Regionally, Africa had a burden of 9.7% from neuropsychiatry Analysis by country puts the burden of neuropsychiatry in Kenya at 5.9%.