Seek Mental Health Help in Early Stage, Experts Advise
Half of all lifetime cases of mental illness begin by age 14, and despite effective treatments, there are often long delays - sometimes decades - between first onset of symptoms and when people seek and receive treatment, according to a report in the Archives of General Psychiatry.
The study also reveals that an untreated mental disorder can lead to a more severe, more difficult to treat illness, and to the development of co-occurring mental illnesses.
The landmark study is described in four papers that document the prevalence and severity of specific mental disorders. These reports provide significant new data on the impairment, such as days lost from work, caused by specific disorders, including mood, anxiety, and substance abuse disorders.
These measures will allow researchers to determine the degree of disability and the economic burden caused by mental illness, as well as trends over time.
The collaborative study was led by Dr. Ronald Kessler and colleagues from Harvard University, the University of Michigan, and a National Institutes of Mental Health (NIMH) program.
This study is a household survey of 9,282 English-speaking persons, age 18 and older.
“These studies confirm a growing understanding about the nature of mental illness across the lifespan,” says Dr. Thomas Insel, director of the NIMH. “There are many important messages from this study, but perhaps none as important as the recognition that mental disorders are the chronic disorders of young people in the US."
Unlike most disabling physical diseases, mental illness begins very early in life. Half of all lifetime cases begin by age 14; three quarters have begun by age 24.
Thus, mental disorders are really the chronic diseases of the young, the NIMH states. For example, anxiety disorders often begin in late childhood, mood disorders in late adolescence, and substance abuse in the early 20’s.
Unlike heart disease or most cancers, young people with mental disorders suffer disability when they are in the prime of life, when they would normally be the most productive.
The risk of mental disorders is substantially lower among people who have matured out of the high-risk age range. Prevalence increases from the youngest group (age 18-29) to the next-oldest age group (age 30-44) and then declines, sometimes substantially, in the oldest group (age 60 and older).
Females have higher rates of mood and anxiety disorders. Males have higher rates of substance abuse disorders and impulse disorders.
The survey found that in the US, mental disorders are quite common; 26 percent of the general population reported that they had symptoms sufficient for diagnosing a mental disorder during the past 12 months.
However, many of these cases are mild or will resolve without formal interventions, the NIMH experts state.
The study documents the long delays between the onset of a mental disorder and the first treatment contact, as well as the accumulated burden and hazards of untreated mental disorders.
These pervasive delays in getting treatment tend to occur for nearly all mental disorders, though they vary according to specific diagnostic categories. Delay in treatment may be nearly a decade; the longest delays are 20 to 23 years for social phobia and separation anxiety disorders.
This is possibly due to the relatively early age of onset and fears of therapy that involve social interactions.
Shorter delays between onset of disorder and treatment seeking, still six to eight years, are seen for mood disorders, and are likely attributable to public awareness campaigns, the marketing of newer therapies directly to consumers, and expanded insurance coverage.
While approximately 80 percent of all people in the US with a mental disorder eventually seek treatment, there are public health implications from such long delays in treatment.
Untreated psychiatric disorders can lead to more frequent and more severe episodes, and are more likely to become resistant to treatment, the scientists report.
In addition, early-onset mental disorders that are left untreated are associated with school failure, teenage childbearing, unstable employment, early marriage, and marital instability and violence.
“The pattern appears to be that the earlier in life the disorder begins, the slower an individual is to seek therapy, and the more persistent the illness,” says Dr. Kessler, a professor of health care policy at Harvard Medical School. “It’s unfortunate that those who most need treatment are the least likely to get it.”
Treating cases early could prevent enormous disability, before the illness becomes more severe, and before co-occurring mental illnesses develop, making treatment more difficult to as additional conditions accumulate, according to the researchers.
Always consult your physician for more information.
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Green tea, already lauded for its cancer-fighting ability, may also protect against certain autoimmune diseases, according to a study reported at the Arthritis Foundation's Arthritis Research Conference, held recently.
Green teas inhibit the expression of antigens made by the body, substances that can trigger an immune response, explains study author Stephen Hsu, an associate professor in the School of Dentistry at the Medical College of Georgia in Augusta.
He focused on EGCG, a substance found in green tea known to suppress inflammation, and its effect on skin and salivary gland cells.
In one autoimmune disorder, Sjogren's syndrome, the salivary glands are affected, causing dry mouth. In another autoimmune disorder, lupus, the skin is affected.
Dr. Hsu's team isolated 130 autoantigens from cells and exposed them to EGCG. Autoantigens are molecules in the body with useful functions, according to Dr. Hsu, but changes in either their amount or their location can result in an unwanted immune response.
Of the 130 autoantigens "most were inhibited or without changes" when exposed to the EGCG, he says. "Among them, a group of key autoantigens were inhibited."
While the research is very preliminary, he says, eventually green tea might help protect cells from being attacked by the autoantigens.
In addition to applications for the dry mouth that affects those with Sjogren's, Dr. Hsu says green tea might prove useful for the skin problems found in lupus.
Dr. Hsu speculates that EGCG modulates the presence of the autoantigens, in addition to its ability to suppress inflammation.
According to Dr. Hsu, other research with green tea in animal models has shown it can reduce arthritis.
The new study is "a significant beginning," says Nihal Ahmad, an assistant professor of dermatology at the University of Wisconsin at Madison, who was part of a team in 1999 that showed that polyphenols (of which EGCG is one) in green tea could prevent induced arthritis in mice.
The Hsu research, he said, "appears to have great potential," though it "needs more work." However, "based on the cell culture study, we can only say that we can be hopeful."
Always consult your physician for more information.
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