Neurological, psychiatric, and developmental disorders : meeting the challenge in the developing world / Committee on Nervous System Disorders in Developing Countries, Board on Global Health, Institute of Medicine.

Format:

Book

Author/Creator:

Institute of Medicine (U.S.). Committee on Nervous System Disorders in Developing Countries.

Language:

English

Subjects (All):

Mental health services--Developing countries.

Mental health services.

Neurobehavioral disorders--Developing countries.

Neurobehavioral disorders.

Nervous system--Diseases--Developing countries.

Nervous system.

Nervous System Diseases.

Mental Disorders.

Developmental Disabilities.

Mental Health Services.

Developing Countries.

Medical Subjects:

Nervous System Diseases.

Mental Disorders.

Developmental Disabilities.

Mental Health Services.

Developing Countries.

Physical Description:

1 online resource (458 p.)

Edition:

1st ed.

Place of Publication:

Washington, DC : National Academy Press, 2001.

Language Note:

English

Summary:

Brain disorders "neurological, psychiatric, and developmental "now affect at least 250 million people in the developing world, and this number is expected to rise as life expectancy increases. Yet public and private health systems in developing countries have paid relatively little attention to brain disorders. The negative attitudes, prejudice, and stigma that often surround many of these disorders have contributed to this neglect. Lacking proper diagnosis and treatment, millions of individual lives are lost to disability and death. Such conditions exact both personal and economic costs on families, communities, and nations. The report describes the causes and risk factors associated with brain disorders. It focuses on six representative brain disorders that are prevalent in developing countries: developmental disabilities, epilepsy, schizophrenia, bipolar disorder, depression, and stroke. The report makes detailed recommendations of ways to reduce the toll exacted by these six disorders. In broader strokes, the report also proposes six major strategies toward reducing the overall burden of brain disorders in the developing world.

Contents:

Neurological, Psychiatric, and Developmental Disorders

Copyright

REVIEWERS

Preface

Acknowledgments

Contents

Part I

Executive Summary

BACKGROUND

SCOPE

MAGNITUDE OF THE PROBLEM

FINDINGS AND FUTURE STRATEGIES

To Reduce the Burden of Brain Disorders Now

To Create Options for the Future

CONCLUSION

1 Introduction

NEUROLOGICAL, PSYCHIATRIC, AND DEVELOPMENTAL DISORDERS

CHALLENGES FOR THE CARE OF BRAIN DISORDERS

GOALS OF THE STUDY

STUDY APPROACH

ORGANIZATION OF THE REPORT

REFERENCES

2 The Magnitude of the Problem

EFFECTS ON COMMUNITIES AND NATIONS

The Disease Burden

EFFECTS ON INDIVIDUALS AND FAMILIES

Lost Productivity

Stigma and Discrimination

THE ROLES OF POVERTY AND GENDER INEQUALITY

The Role of Poverty

Poverty-Associated Risk Factors for Brain Disorders

Unsafe and Unhygienic Living Conditions

Hunger and Malnutrition

Inadequate Access to Health Care

Lack of Educational and Employment Opportunities

The Role of Gender Inequality

Postnatal Depression

Rape and Sexual Violence

HIV/AIDS

Domestic Violence

CAPACITY TO ADDRESS BRAIN DISORDERS

3 Integrating Care of Brain Disorders into Health Care Systems

THE ROLE OF PRIMARY CARE IN ADDRESSING BRAIN DISORDERS

DEVELOPING A SYSTEM OF CARE

Primary Care

The Role of Secondary and Tertiary Care

BUILDING CAPACITY THROUGH TRAINING

COLLABORATION WITH OTHER HEALTH AND NONHEALTH SECTORS

Private Physicians

Schools and Educators

Community-Based Rehabilitation Programs

Community Organizations

Traditional Healers

THE COST OF INTEGRATING SERVICES

BUILDING RESEARCH CAPACITY THROUGH COLLABORATION

POLICY IMPLICATIONS

National Policy

Local Policy

INTERNATIONAL SUPPORT FOR SYSTEMS OF PRIMARY CARE.

The Role of Professional Societies and International Organizations

Provision of Essential Drugs

NATIONAL CENTERS FOR TRAINING AND RESEARCH

4 Findings and Future Strategies

REDUCING THE DISEASE BURDEN NOW

Increasing Awareness

Utilizing Existing Health Systems

Expanding Use of Cost-Effective Interventions

CREATING OPTIONS FOR THE FUTURE

Applied Research

Capacity Strengthening

The Role of International Aid

Part II

INTRODUCTION

5 Developmental Disabilities

DEFINITION

Cognitive Disabilities

Motor Disabilities

Vision, Hearing and Speech Disabilities

Behavioral Disorders

SCOPE OF THE PROBLEM

PREVALENCE AND INCIDENCE

Prevalence of Cognitive Disabilities

Prevalence of Motor Disabilities

Prevalence of Vision Disabilities

Prevalence of Hearing and Speech Disabilities

Prevalence of Behavioral Disabilities

RISK FACTORS

Genetic

Nutritional Deficiencies

Micronutrient Deficiencies

Protein-Energy Malnutrition

Infection

Environmental Toxins

Perinatal and Neonatal

Poverty and Trauma

INTERVENTIONS

Primary and Secondary Prevention

Genetic Factors

Infections

Prenatal Care and Perinatal Services

Trauma

Secondary Prevention

Rehabilitation

Models for Rehabilitation

Barriers to Implementation

Cost Analysis

CAPACITY

Research training programs

Regional rehabilitation training programs

Clinical training programs

Special education training programs

6 Epilepsy

Treatment Gap

Infectious Diseases

Mortality Rates

Pre-, Peri- and Post-Natal

Parasitic Infections.

Bacterial Infections

Viral Infections

Head Injuries

Febrile Seizures

Prevention

Treatment

Training

Research

ANNEX 6-1

BIOLOGICAL CYCLE

EPIDEMIOLOGY

PREVENTION

TREATMENT

7 Schizophrenia

Mortality

Social and Economic Costs

Prevalence

Incidence

Environmental

Brain Pathology

Neurochemistry

Functional Neuroimaging and Cognitive Deficits

Neurodevelopmental

Associations with Age and Gender

Substance Abuse Comorbidity

Factors Affecting Course and Outcome

Early Treatment

Pharmacotherapy

The Primary Health Care Model

Family Interventions

Group Interventions Focused on the Patient

Therapeutic Communities

Role of the Hospital

8 Bipolar Disorder

Substance Abuse

Mood Stabilizers

Other Mood Stabilizers

Psychosocial Treatment

9 Depression

Suicide

Physical Illness

Gender and Reproductive Health

Neuroendocrine

Comorbidity

Associations with Age

Social and Public Health Models

Preventing Suicide

Medical interventions

Psychosocial interventions

Traditional healers

Cost Analysis.

CAPACITY

10 Stroke

INCIDENCE

Physiological

Hypertension

Diabetes

Cardiac Disease

Elevated Serum Cholesterol

Elevated Serum Homocysteine

Postpartum Cerebral Venous Thrombosis

Risk Factors for Stroke in Children

Behavioral

Cigarette Smoking

Diet

Alcohol Abuse

Physical Inactivity

Epilogue

ESTABLISHING NATIONAL AND LOCAL PRIORITIES FOR ADDRESSING BRAIN DISORDERS

THE POTENTIAL FOR PREVENTION

INCREASING THE CLINICAL AND RESEARCH PROFESSIONAL CAPACITY IN DEVELOPING COUNTRIES

COLLABORATIVE RESEARCH INTO GLOBAL HEALTH PROBLEMS

ACCESS TO AND AFFORDABILITY OF ESSENTIAL PHARMACEUTICAL PRODUCTS

AN INVESTMENT IN FUTURE OPPORTUNITIES

APPENDIX A The Study Approach

BRAIN DISORDERS AND SELECTION OF SPECIFIC DISORDERS FOR SECTION II

DEVELOPING COUNTRIES

EARLY HISTORY OF THE STUDY

CHARGE TO THE COMMITTEE

COMMISSIONED PAPERS AND TECHNICAL INPUT TO THE STUDY

WORKSHOP AND COMMITTEE MEETINGS

OTHER IOM REPORTS ON GLOBAL HEALTH

APPENDIX B Measurement Issues in Calculating the Global Burden of Disease

APPENDIX C Workshop Agenda

APPENDIX D Economic Analysis

GUIDELINES FOR ECONOMIC ANALYSIS OF COMMUNITY MENTAL HEALTH CARE PROGRAMS IN LOW-INCOME COUNTRIES

THE RATIONALE FOR AN ECONOMIC PERSPECTIVE

PRINCIPLES OF ECONOMIC ANALYSIS

PLANNING AND DESIGNING AN ECONOMIC STUDY

DATA COLLECTION

Resource Utilization

Resource Costs

Outcomes

Local Service Structures

DATA ANALYSIS AND PRESENTATION

CONTACT POINT

FURTHER READING.

MONEY MATTERS IN EPILEPSY

COST

Direct cost

Indirect cost

Intangible cost

CONSEQUENCE (BENEFIT)

PERSPECTIVE

COST OF ILLNESS STUDIES (COI)

SPECIAL PROBLEMS IN EVALUATING COST OF EPILEPSY

GENERAL TOOLS OF ECONOMIC EVALUATION

Cost Benefit Analysis

Cost Effectiveness Analysis

Cost Utility Analysis (CUA)

Cost Minimization Analysis (CMA)

PHARMACO-ECONOMIC EVALUATION OF EPILEPSY

COMPARISON OF NEWER AEDS AGAINST CONVENTIONAL AEDS

ACQUISITION COST MAY NOT REFLECT THE OVERALL COST

ECONOMIC ASPECTS OF EPILEPSY: SCENARIO IN DEVELOPING COUNTRIES

COST OF EPILEPSY CARE IN INDIA

APPENDIX E Committee and Staff Biographies

STUDY STAFF

Glossary

EPIDEMIOLOGICAL TERMS

Acronyms.

Notes:

Bibliographic Level Mode of Issuance: Monograph

Includes bibliographical references.

ISBN:

9786610185290

9780309170932

0309170931

9781280185298

1280185295

9780309570084

0309570085

OCLC:

57735144