Being Grumpy Is Good For You! - bbc online

Feeling grumpy 'is good for you'
Victor Meldrew sitcom character
An attack of the grumps can make you communicate better, it is suggested

In a bad mood? Don't worry - according to research, it's good for you.

An Australian psychology expert who has been studying emotions has found being grumpy makes us think more clearly.

In contrast to those annoying happy types, miserable people are better at decision-making and less gullible, his experiments showed.

While cheerfulness fosters creativity, gloominess breeds attentiveness and careful thinking, Professor Joe Forgas told Australian Science Magazine.

'Eeyore days'

The University of New South Wales researcher says a grumpy person can cope with more demanding situations than a happy one because of the way the brain "promotes information processing strategies".

Negative moods trigger more attentive, careful thinking, paying greater attention to the external world
Professor Joe Forgas

He asked volunteers to watch different films and dwell on positive or negative events in their life, designed to put them in either a good or bad mood.

Next he asked them to take part in a series of tasks, including judging the truth of urban myths and providing eyewitness accounts of events.

Those in a bad mood outperformed those who were jolly - they made fewer mistakes and were better communicators.

Professor Forgas said: "Whereas positive mood seems to promote creativity, flexibility, co-operation and reliance on mental shortcuts, negative moods trigger more attentive, careful thinking, paying greater attention to the external world."

The study also found that sad people were better at stating their case through written arguments, which Forgas said showed that a "mildly negative mood may actually promote a more concrete, accommodative and ultimately more successful communication style".

His earlier work shows the weather has a similar impact on us - wet, dreary days sharpened memory, while bright sunny spells make people forgetful.

We asked you for your views on this story. Please find a selection of your comments below.

Halleluiah! I intend to show this to everyone who's ever branded me with various epithets for being "negative".
Marcy Sheiner, USA

Being grumpy raises my blood pressure and I usually make wrong decisions when I am grumpy. I usually sleep on it, relax and then make a decision which is usually the correct decision. I don't like grumpy people and I usually avoid them.
Iftikharuddin Faruqui, Pakistan

Absolutely right. There is certainly no point that I can see in viewing the world through rose-coloured spectacles. Anybody who wanders through life in a continuous state of bonhomie either has no idea what's going on around them or simply doesn't care! All my close friends are similar in temperament. We would inevitably consider those who do not fit the criteria to be shallow and lacking in perception. And yes, I am still at peace within myself for all the reasons stated in the article.
Dave Gordon, Exeter, UK

I am generally a very grumpy person, but I have definitely noticed my decision making and general awareness is far higher than that of my friends who are normally much happier, jollier and generally carefree. I love being grumpy, it's clearly an advantage!
David James Keeves, Loughborough, UK

Ah! This study provides a plausible explanation of Schopenhauer's philosophical clarity and superb prose. And yet, paradoxically, the Great Grump has had a more profound influence beyond philosophy, in the realm of all those cheerful, creative artists.
Cheryl F, South Kingstown, Rhode Island, USA

I find I am happier when I am just a little grumpy. The grumpy feeling seems to aid me in concentrating on menial tasks. Maybe in this stressful modern era a touch of grumpy is all that's needed rather than anti-depressants and other drugs.
Derek Penn, Falmouth, Cornwall, UK

As a self-confessed misery, I work on the premise that "misery is the thinking man's happiness". With misery comes a distinctive humour and a more realistic outlook on life, that actually makes me a more rounded and "real" person than those around me with a painted smile on their faces. I enjoy being grumpy and wouldn't have it any other way.
Dave Woods, Coventry, UK

Could it not also be argued or proven, possibly, that making decisions while grumpy can lead one to make rash decisions? Or is that only when you're angry - since angry and grumpy are not the same thing?
Parker, Louisiana, USA

I'm often identified by friends as someone who can be pessimistic, sometimes without any real reason. I also tick the box of sceptic - which I guess goes under the category of being less gullible. I won't say any more about my intelligence for fear of immodesty!
Chris Baker, Southampton, UK

I work with the grumpiest man in the world and he doesn't seem to be any more clever than me!
Gary, Watford, UK

Being grumpy or depressed goes hand in hand with thinking. When you're continually happy you can just skim along on the surface of life and not examine anything too deeply. Which is cause and which is effect, I don't know.
Amanda, Ely, UK

PET+BLOGSPOT is the official online blog of the Malaysian Animal-Assisted Therapy for the Disabled and Elderly Association (Petpositive).

Our blog which was first established in October 2007 currently has more than 30,000 hits. Kindly take note that views expressed in this blog are not necessarily those of Petpositive.

You may also visit our Webpage by browsing: www.petpositive.com.my

Dementia and Alzheimer's - What Are They? From BBC Online

Alzheimer's and dementia

Aricept
Aricept is used to treat Alzheimer's disease
Alzheimer's disease is a progressive, degenerative and irreversible brain disorder that causes intellectual impairment, disorientation and eventually death and the most common cause of dementia.

There is no cure. It is estimated that 2-5% of people over 65 years of age and up to 20% of those over 85 years of age suffer from the disease.

What is dementia?

Dementia is an umbrella term which describes a serious deterioration in mental functions, such as memory, language, orientation and judgement.

Alzheimer's disease is one cause of dementia, but several other diseases can cause it too, including vascular disease. Alzheimer's disease is the most common cause of dementia, accounting for around two thirds of cases in the elderly.

What causes Alzheimer's?

The causes of Alzheimer's disease are not yet fully understood.

There are some very rare inherited cases caused by genetic mutations, but these account for around 1% of people with Alzheimer's.

For most cases, there is a complex interaction of many genetic, environmental and life-style risk factors, with age and genetics playing the largest part.

Some factors, such as a well-balanced diet and regular physical and mental exercise can reduce the risk of developing Alzheimer's.

Protein deposits, known as amyloid plaques and tau tangles, appear and spread in the brain, particularly in the cortex and the hippocampus.

The levels of important chemical transmitters, such as acetylcholine, are reduced. Many of the blood vessels of the brain are also damaged.

These processes are made worse by chronic inflammation in the brain and by an excess of highly reactive molecules known as free radicals, which damage brain tissue.

Gradually the connections between brain cells are lost and eventually many of the cells themselves die.

It is particularly the loss of connections between brain cells that is thought to cause the devastating symptoms of the disease.

What are the symptoms?

Alzheimer's disease has a gradual onset. The early stages of Alzheimer's disease and other dementias can be difficult to diagnose because many of the symptoms are initially subtle or common to other illnesses.

Well established features of the disease include:

* Problems with memory
* Poor or decreased judgement
* Difficulty in performing everyday tasks
* Problems with language
* Disorientation in time and place
* Problems with abstract thinking
* Change in mood and behaviour
* Change in personality
* Loss of initiative

The disease is often associated with depression, anxiety and sleep disturbance.

The rate of decline varies from patient to patient. The disease course runs anywhere from three to twenty years, with eight years being the average life span after diagnosis.

How is the disease diagnosed?

There is no single diagnostic test for Alzheimer's disease. Experts are able to observe the pattern of symptoms and perform a few simple tests over a period of time to measure any change.

Although the tests currently performed are fairly accurate, a definitive diagnosis can still only be made after death by examining the brain tissue at post mortem.

Early diagnosis is important because it helps a doctor to rule out other illnesses with similar symptoms to dementia, such as depression. It also enables new drugs to be prescribed which can improve the quality of life for both patient and carer.

Many other disease processes can mimic Alzheimer's such as thyroid imbalances, vitamin B12 deficiency, brain injuries, tumours, and severe depression.

What are memory clinics?

Specialist memory clinics operate throughout the county and offer assessment, support, information and advice to those with memory problems and their carers.

The assessment includes formal neuropsychological testing in the form of structured questions and tasks. The experts may also carry out blood tests to look for medical causes.

The staff can offer counselling and support as well as treatment.

Are there other types of dementia?

Yes. These include Dementia with Lewy bodies, which gets its name from tiny structures that develop inside nerve cells, and which trigger the degeneration of brain tissue.

Other rarer causes of dementia include progressive supranuclear palsy, Korsakoff's syndrome, Binswanger's disease, HIV and Creutzfeldt-Jakob disease (CJD).

People with multiple sclerosis, motor neurone disease, Parkinson's disease and Huntington's disease can also be at an increased risk.

What treatment is available?

Various types of therapy are used to try to stimulate Alzheimer's patients.

These include: psychological methods, art therapy, music therapy, playing with toys.

Some health professionals try to encourage patients to reminisce about past memories as a way to reduce depression without the use of drugs.

A variety of drug treatments have been shown to benefit patients. None are a cure, but they can temporarily relieve some of the symptoms in some patients:

* Cholinesterase inhibitors including donepezil (Aricept), galantamine (Reminyl) and rivastigmine (Exelon)
* NMDA receptor antagonist, namely memantine (Ebixa)
* Neuroleptics, also known as anti-psychotics or major tranquillisers - although these drugs are only used as a last resort when other methods have failed
* Antidepressants and anti-anxiety drugs

Is there controversy over availability of drugs?

Most certainly. The National Institute for Health and Clinical Excellence (NICE) says that donepezil, rivastigmine and galantamine should only be used to treat Alzheimer's once it has progressed to its moderate stages. Memantine is not recommended as an option for people with moderately severe to severe Alzheimer's disease unless it is being used as part of a clinical trial.

Campaigners argue patients in the early stages of Alzheimer's should also have access to the drugs.

This page contains basic information. If you are concerned about your health, you should consult a doctor. The Alzheimer's Society runs a helpline on 0845 300 0336 and further information is also available free from the Alzheimer's Research Trust on 01223 843899.

PET+BLOGSPOT is the official online blog of the Malaysian Animal-Assisted Therapy for the Disabled and Elderly Association (Petpositive).

Our blog which was first established in October 2007 currently has more than 30,000 hits. Kindly take note that views expressed in this blog are not necessarily those of Petpositive.

You may also visit our Webpage by browsing: www.petpositive.com.my

PETPOSITIVE ON THE MOVE

DATELINE PETALING JAYA: 

Committee Members of the Malaysian Animal-Assisted Therapy for the Disabled and Elderly Association or PETPOSITIVE had their last meeting for the year on Sunday.

Issues from getting more volunteers into the Society to obtaining a van to carry out the duties of the nation's first and only animal-assisted therapy was discussed during the two and a half hour afternoon meeting that was held at the Petpositive Therapy Centre (PTS) in Petaling Jaya, Selangor. 

In his Presidential address, Anthony SB Thanasayan thanked all the committee members for their dedication throughout 2009 but cautioned that there was much more work to be done in 2010. 

"These include building a strong force of volunteers of all ages in order to carry out our one-to-one activities and services for the disabled and handicapped community," he added.

Anthony went on to share his vision that Petpositive will engage in more volunteer-training activity as well as spearhead our counseling programmes geared towards newly disabled persons.

Anthony, who is also a councillor with the Petaling Jaya City Council (MBPJ) said that Petpositive was currently working very hard to get MBPJ to offer free dog licenses for handicapped and senior citizens. 

"A decision by the Council can be expected by the end of November. If it is positive, it will make a wonderful present for International Disabled Day which falls on December 3," he remarked. 

A van to ferry members and animals was also badly needed by for the PTC. The Committee was already working towards this goal to get a generous donor organisation to come in with this need.

"Our goal is to go out to the disabled in every home and help them improve their quality of life through successful companionship with animals," said Anthony.


Petpositive also need paid staff to run the centre and assist the President to carry out with his duties for the Society.

"The main priority now is for Petpositive to look out for funds as our reserves are slowly depleting with the monthly rental and operational costs," pointed out Dr Vijay, the Treasurer of the Society.

Antony Leopold who is Chairman of Petpositive's Fundraising Activities suggested that Committee Members approach organisations and individuals for support during the coming Christmas and Year-end season.

If you can contribute in any way to Petpositive, we would be most grateful. Donations to us are available tax exempt and the number to call is 012 220 3146. 

Thank you for reading.



PET+BLOGSPOT is the official online blog of the Malaysian Animal-Assisted Therapy for the Disabled and Elderly Association (Petpositive).

Our blog which was first established in October 2007 currently has more than 30,000 hits. Kindly take note that views expressed in this blog are not necessarily those of Petpositive.

You may also visit our Webpage by browsing: www.petpositive.com.my

Obese Struggle To Earn A Living - bbc online

Obese 'struggle to earn living'
fat man measuring his belly.
One in three adults in the UK are expected to be obese by 2012

Obese people are struggling to earn above the national average income, according to a survey.

Just under half (46%) earn more than £20,000 a year, which is the national average, while the majority earn between £10,000 and £15,000.

The survey conducted by YouGov also indicates that only 5% of people feel their weight has held them back.

But one charity said there was no doubt obesity affected work, through prejudice and health problems.

One in three adults in the UK are expected to be obese by 2012.

Negative impact

The survey questioned a representative survey of 2,056 UK adults and was commissioned by a private health business, The Hospital Group.

More than half (53%) said they were overweight or obese compared with 45% who were normal or underweight.


There is good evidence that the less control you have over your work, the more stressed you feel, and the lower income you earn, the lower your life expectancy
Dr Ian Campbell, Weight Concern

The overweight or obese said their weight had a negative impact on their ability to take part in leisure activities - 23% mentioned cycling, swimming and running and 14% said it affected their sex lives.

They also described some of the ways their weight had held them back in their careers.

One person said they could not comply with the Marine and Coastguard Agency limits for a licence.

Another admitted they had taken too many days off because of illness.

And many of them said there was a perception at work that they were lazy but the level of their output did not support that.

However, nearly a third ( 31%) said they disagreed with the idea that their weight had held them back in their careers.

Social prejudice

Dr Ian Campbell, of the charity Weight Concern, said there was no doubt that being obese made it harder for an individual to find higher paid employment due to social prejudice and medical problems.

He said: "There is good evidence that the less control you have over your work, the more stressed you feel, and the lower income you earn, the lower your life expectancy.

"People living in lower socio-economic conditions have a greater risk of obesity through less control of their environment, poorer nutrition, and less opportunity for physical activity.

"Particularly in the current recession we are seeing more people turning away from healthy, more expensive fruit and vegetables, to cheaper processed fatty foods."

'Bankrupt'

The Liberal Democrat health spokesman, Norman Lamb said: "Obesity is a massive problem in the UK and the Government has failed to address it adequately.

"NHS finances are already overstretched and unless we get more people to lead healthier lifestyles then obesity could bankrupt the health service.

"This report makes for particularly disturbing reading as it highlights the worrying link between poverty and obesity.

"Until we stop trying to dictate policy nationally and give people the freedom to tackle public health problems locally, this cycle of poverty and ill health is likely to continue."
PET+BLOGSPOT is the official online blog of the Malaysian Animal-Assisted Therapy for the Disabled and Elderly Association (Petpositive).

Our blog which was first established in October 2007 currently has more than 30,000 hits. Kindly take note that views expressed in this blog are not necessarily those of Petpositive.

You may also visit our Webpage by browsing: www.petpositive.com.my

WEEKEND VIEW: Dog Forum A Howling Success

AS a disabled activist, I’ve been privileged to have been invited to attend a number of seminars, forums and workshops.

Sometimes I’ve been asked to be speaker of such events. And on rare occasions I’ve even had the thrill of organising one or two of them.

One of those unique experiences took place only a few weeks ago.

The Canine Advisory Team (CAT) – a special monthly committee by the Petaling Jaya City Council (MBPJ) to look into animal issues – decided to have a first-ever Dog Forum organised by the local council in Petaling Jaya.

As Chairman of the group under the MBPJ’s Health Department – and a Councillor for MBPJ – it was my job to naturally assume my post as the leader of the organising team.

I was incredibly blessed to work with all of them who gave me their unflinching support.

The purpose of the forum was to bring together pet lovers and non dog owners.

This was to help both sides of the divide appreciate the role of canines – and at the same time, try to find solutions to the many genuine problems dogs present to people without canines.

The forum itself proved to be a howling success.

We managed to cover a range of issues from the responsibility of pet owners to pet rights, canine cruelty and abuse, and even animal-assisted therapy.     

However, to me these were not the only winning points as to why the forum proceeded swimmingly that day.  

The fact that people with disabilities and the elderly were also visibly present and participating in the half-day weekend forum turned the occasion into a truly meaningful one for everybody at the end of the day. 

I received feedback from some of the participants – all of them able-bodied – that they were rather surprised to see the disabled and elderly participating at the event.

Some of them admitted that when they first entered the meeting hall they thought that they were somehow in the wrong place.

The sight of several wheelchairs and people with white canes (the blind) made them wonder if they had stumbled into a “disabled association’s event.”

One pet lover who had never had a disabled friend in her life blurted out that she had no idea that pets, especially dogs, played a key role in the lives of the handicapped.

In fact, a chief issue raised at the forum was a request for free dog licenses for the disabled and the elderly from all the local councils in Selangor.

The reason for the forum’s request was so that the special waivers would serve as the local councils’ recognition of the unique therapeutic role that dogs play in the lives of vulnerable groups.

Someone with a progressive condition like Parkinson’s disease would, for instance, benefit a great deal more by taking his or her dog out for a walk in the park instead of sitting by their television set all day.

An unmotivated paralysed accident victim lying in bed 24/7 will be able to channel his mind positively on his pet rather than entertain suicidal thoughts.    

When VIPs for the occasion Selangor State Executive Councillor Ronnie Liu, forum keynote speaker Dr Chandra Muzaffar, president of the NGO JUST, and International star dance doyen Ramli Ibrahim threw their support behind the special waivers, there was a thunderous applause from all the participants.

(Currently, only Shah Alam provides free dog licenses for disabled dog owners whilst the elderly are given 50% off.)

One dog-owner who is paralysed from his neck down told me that he lives in constant fear that his local council might suddenly come to his house and confiscate his dog one day because he hasn’t got a license.

“I’ve been jobless since I became disabled and every sen now counts. Besides I have no one to go to the council to get a license for me,” he added, pointing out that his only pal now is Tiger, his mongrel.         

Two of the speakers at the Dog Forum were persons with disabilities. The souvenirs of thanks given to the VIPs and speakers were presented also by persons with disabilities.

Two of them were profoundly disabled people who are paralysed from their necks down. They were pushed by able-bodied volunteers to the stage so that they could personally present the tokens to the VIPs.

A third person who was blind was led by a sighted volunteer.

Our Cat team made sure that disabled parking nearest to the entrance was reserved for drivers with disabilities.

The security guards were also instructed to assist the handicapped when they got there.

This was in addition to some of the volunteers that were invited specially to assist the disabled.

I have no doubt in my mind at all that all of us came away having learnt something new that day.

For some it may have been about animals and our need to respect their rights and coexist with them. For others it may have been about how NGOs and local councils function.

And for others still, how a simple and small step of support can go a very long way indeed for some truly extraordinary people.   

The End

PET+BLOGSPOT is the official online blog of the Malaysian Animal-Assisted Therapy for the Disabled and Elderly Association (Petpositive).

Our blog which was first established in October 2007 currently has more than 30,000 hits. Kindly take note that views expressed in this blog are not necessarily those of Petpositive.

You may also visit our Webpage by browsing: www.petpositive.com.my

Memory Test Spots Pre-Dementia - bbc online

Memory test 'spots pre-dementia'
Worried elderly man
Dementia is a progressive disease

Memory and language tests can reliably reveal "hidden" early dementia, say UK experts.

Most dementias are missed for years as the symptoms can be elusive until considerable brain tissue is lost.

But doctors from Oxford found they were able to spot very early warning signs when they looked closely enough.

The findings in Neurology could help doctors diagnose dementia sooner, which is crucial since treatment is most effective when given early.

Over a span of 20 years, the researchers studied a group of 241 healthy elderly volunteers, giving them regular tests designed to measure their thinking or cognitive powers.

Being able to spot and measure the initial stages of dementia is a crucial challenge if we are to improve drug testing and lay the groundwork for prevention trials
Rebecca Wood of the Alzheimer's Research Trust

When they scrutinised the test results, the doctors found subtle clues that, in retrospect, hinted at ensuing impairment.

Linguistic problems

Specifically, the patients who went on to develop mild cognitive impairment or pre-dementia stumbled on tasks involving language expression, learning and recall.

For example, they had greater difficulty remembering the name for common objects or animals and explaining the meaning of a given word.

And those who were older and who scored lower on the language or memory tests tended to deteriorate more quickly.

Professor David Smith and his team say their findings fit with what we already know about dementia.

Experts have noted that the early stages of dementia are associated with linguistic problems, such as word-finding difficulties.

Early literary works by authors who have later been diagnosed with Alzheimer's show similar changes in language use - simpler narratives and a smaller vocabulary.

Risk lowered

Rebecca Wood of the Alzheimer's Research Trust said: "This significant long-term study shows how subtle, but measurable, problems with language or memory can predict when a healthy elderly person is likely to develop mild cognitive impairment, which frequently develops into dementia.

"Early intervention will be crucial for future dementia treatments. Being able to spot and measure the initial stages of dementia is a crucial challenge if we are to improve drug testing and lay the groundwork for prevention trials."

Latest work in Archives of General Psychiatry adds weight to the evidence that Alzheimer's dementia is at least partly inherited, and that being healthy in mid-life could help lower your risk of the disease.

Dutch researchers found that people with a parental history of Alzheimer's had higher blood pressure and indicators of arterial disease as well as different amounts of inflammatory proteins in their blood compared with those without a parental history of Alzheimer's.

PET+BLOGSPOT is the official online blog of the Malaysian Animal-Assisted Therapy for the Disabled and Elderly Association (Petpositive).

Our blog which was first established in October 2007 currently has more than 30,000 hits. Kindly take note that views expressed in this blog are not necessarily those of Petpositive.

You may also visit our Webpage by browsing: www.petpositive.com.my

Smoking Mums Have Problem Kids - bbc online

Smoking mums have 'problem kids'
smoking pregnant woman
Smoke toxins can pass to the foetus

Smoking during pregnancy significantly increases the risk of having a child with behavioural problems, according to UK and US researchers.

Writing in the Journal of Epidemiology and Community Health, they say the problems can be evident in children as young as three years old.

They believe smoking in pregnancy may damage the developing structure of the baby's brain.

One expert said it was another strong reason for mothers to give up smoking.

The researchers from the universities of York, Hull and Illinois looked at more than 14,000 mother and child pairs who were taking part in the Millennium Cohort Study.

This is another reason why mothers should make every effort to give up smoking - ideally before they get pregnant
Professor Alan Maryon-Davis, president of Faculty of Public Health

This covers UK children born between 2000 and 2001.

The mothers were categorised as light or heavy smokers depending on how many cigarettes they smoked every day during pregnancy.

They were asked to score their three-year-old children's behaviour using a questionnaire called Strengths and Difficulties, which focuses on behaviour problems and hyperactivity, or attention deficit disorders.

Findings

They took into account factors likely to influence the results, including the mother's age at the child's birth, her level of education and socioeconomic status, family stability and problematic parenting.

Mothers who were light smokers were 44% more likely to have boys who had problems with their conduct.

Heavy smokers were 80% more likely to have boys with these problems.

Both heavy and light smokers were also significantly more likely to have boys who were hyperactive or had attention deficit disorders.

For three-year-old girls, light and heavy smoking in pregnancy were significantly associated with conduct problems but not with hyperactivity and attention deficit behaviours.

Foetal development

Professor Kate Pickett, who lead the research, said their findings were consistent with previous research in older age groups.

She said: "Smoking in pregnancy may have direct effects on the foetal development of brain structure and functioning which has been shown in studies of rats.

"Or it may be a marker for the transmission of processes between the generations that are associated with both smoking in pregnancy and behaviour problems in children."

Professor Alan Maryon-Davis, president of the Faculty of Public Health, said: "This is another reason why mothers should make every effort to give up smoking - ideally before they get pregnant.

"There are four thousand toxic substances in cigarette smoke and many of these will pass into the brain of the foetus and it is possible that they could have an effect on how the brain chemistry works."

PET+BLOGSPOT is the official online blog of the Malaysian Animal-Assisted Therapy for the Disabled and Elderly Association (Petpositive).

Our blog which was first established in October 2007 currently has more than 30,000 hits. Kindly take note that views expressed in this blog are not necessarily those of Petpositive.

You may also visit our Webpage by browsing: www.petpositive.com.my

Mental Health Problem Under Diagnosed - bernama

Mental Health Problems Under Diagnosed

By Soraya Jamal

KUALA LUMPUR, Oct 29 (Bernama) -- About 450 million people worldwide suffer from some sort of mental illness such as depression, schizophrenia and bipolar disorder but fewer than half receive the help they need, according to World Health Organisation(WHO).

WHO also estimated that by 2020, mental illness could comprise 15 percent of global disease.

Mental health disorders are more common than you think. Last year, 400,227 patients sought psychiatric help in Malaysian government hospitals, a 15.6 percent increase from 346,196 patients in 2007.

The Third National Health and Morbidity Survey in 2006 indicated mental health disorders among teenagers as increasing.

Females are also more prone to mental health problems at 12.1 percent compared with 10.4 percent for males.

Five out of 10 leading causes of disability are related to mental illnesses. Major depression is fourth most disabling disease in the world and is expected to be the second leading cause of disability worldwide by 2020.

UNDER DIAGNOSED

Despite being a common and serious problem, mental health is still not widely accepted as critical public health problem and often under diagnosed by primary care specialists.

The ASEAN Federation for Psychiatry and Mental Health (AFPMH) president, Professor Dr Mohamad Hussain Habil said this is mainly attributed to two factors.

First is the lack of knowledge or understanding in diagnosing or treating the ailment while the second factor is directly related to the stigma associated with mental health disorders that is rife even amongst the medical practitioners.

Early detection in the community by primary care specialists can yield numerous benefits relating to costs and productivity, and in some cases preventing the problem from becoming full-blown disorder.

According to the report of the National Advisory Mental Health Council, treatment outcomes for people with even the most serious mental illness are comparable to outcomes for well-established general medical or surgical treatments for other chronic diseases.

The early treatment success rates for mental illnesses are 60-80 percent, well above the 40 to 60 percent success rates for common surgical treatments for heart disease.

For individuals who have mental health problems, not getting the help that they need can cause social distress as it can lead to isolation and cause strain on their finances as they keep on seeking medical opinions or consultations, not to mention loss of job due to reduced productivity.

Struggling with the situation also diminishes the patients' and caregivers' quality of life. Even worse, under diagnosis can end tragically if patients commit suicide.

PRIMARY CARE ROLE

AFPMH and the Malaysian Psychiatry Association (MPA) commemorated the 2009 World Mental Health Day on October 9 by addressing the important role of primary care specialists in identifying and treating psychiatric disorders.

This year's theme is "Mental Health in Primary Care; Enhancing Treatment and Promoting Mental Health".

Many people will not think of consulting a psychiatrist as most will not even consider that they have a mental health issue. And those who do are generally too embarrassed to visit a mental health specialist and often more at ease with their neighbourhood doctors.

These primary care specialists are the front liners of the public health care system and are familiar with their patients' medical history. Therefore the need to be well equipped to identify the symptoms and have the necessary knowledge in psychiatry to administer treatment," Professor Dr Mohamad Hussain said in a press conference recently.

Professor Dr Mohamad Hussain, who is also Addiction Specialist and Consultant Psychiatrist at the Department of Psychological Medicine, Universiti Malaya Medical Centre, said early detection and proper diagnosis enable patients to receive appropriate treatment.

It also prevents more debilitating disorders and ultimately enables the patient to continue with a normal life and integrate with society while undergoing treatment, he said.

ONLY 2OO PSYCHIATRISTS

Professor Dr Mohamad Hussain also said, there are only 200 psychiatrists in Malaysia while the ideal number is 2000.

"An integrated collaborative approach involving primary care specialist will lessen the burden faced by psychiatrists and provide patients, especially those from the low-income group affordable and accessible treatment.

"This approach ensures that patients do not have to travel far to get their medication from psychiatrists, which considerably reduces the burden on their caregivers," he said.

Primary care specialist must realise that psychiatric patients deserve access to the best form of treatment and at the same level of priority within the primary health care system alongside other medical disorders such as heart disease, diabetes and cancer.

Despite the fact that mental and physical health is highly interconnected, mental health issues have been treated more of social issue, he said.

STIGMA

Stigma that persists amongst the public and even primary care specialists is the greatest barrier to successful treatment leading to many psychiatric cases being undetected and untreated.

"Psychiatry has come a long way. The latest medications make mental disorders highly treatable. However many still refuse to seek professional help because they fear being labeled as 'crazy' and being discriminated if they are diagnosed with a mental illness," noted President of MPA Dr Yen Tech Hoe.

This issue is further compounded when some primary care specialists also subscribe to this misconception and consider mental health issues a less important component of the medical profession.

Many primary care specialists are unaware that most psychiatric illnesses can be presented through physical symptoms and they usually treat the pain without further examination.

This low awareness of mental health in primary care setting brought on by a lack of interest amongst primary care specialist to acquire latest knowledge and clinical skills in psychiatry, said Dr Yen.

"When patients express or exhibit psychiatric symptoms such as feeling unusually lethargic or sad, having poor concentration or loss in appetite, primary care specialist tend to disregard this signs," added Dr Yen.

MENTAL ILLNESSES CAN BE TREATED EFFECTIVELY

Mental illnesses usually occur alongside chronic disorders such as heart disease, diabetes, cancer and stroke, highlighting the significant co-morbidity of mental and physical disorders.

Research has shown that patients with severe mental illnesses are often twice as likely to have multiple physical health problems. Untreated psychiatric symptoms can worsen the pain and exacerbate psychiatric and medical outcomes as well as prolong the years of unnecessary suffering, said Dr Yen.

Many primary care specialist also believe it is difficult and time consuming to treat mental health patients who are then referred to psychiatrists.

"Many mental health can be diagnosed and treated effectively at the primary care level. Early detection and treatment can also help minimise the problem while enhancing the potential for recovery and productivity," he said.

Dr Yen said for every dollar spent on treating mental illness, the outcome is much better than any other illness especially since the treatment available is very good.

EFFECTIVE MENTAL HEALTH SERVICES

Meanwhile, Associate Professor, Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Dr Noor Zurani Md Haris Robson said a proactive and mutual commitment by the government, non-governmental organisations, families, caregivers and medical fraternity including nurses and paramedical staffs, were vital in facilitating the integration of effective mental health services in primary care environment.

"The government should develop a framework that advocates the need to incorporate primary care for mental health. Psychiatry, like other fields in medicine is constantly evolving and we need to train and educate primary care specialist in order for them to gain better understanding of mental health problems.

I believe there are many primary care specialists who are interested in treating psychiatric patients and we should offer them the opportunity to get the latest updates on the developing areas in psychiatry. These can be achieved through continuing medical education programmes," she said.

Dr Noor Zurani said primary care doctors play a central role in treating mental health disorders such as depression and anxiety.

Continuous communication between primary care specialists and psychiatrists are essential in avoiding any misunderstandings when coordinating treatment for patients with severe mental health illnesses.

The patients' well-being should be the underlying concern and both parties must be willing to share information and understand each other's role in treating patients.

-- BERNAMA

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