List of mental disorders and meanings
Schizophrenia
Schizophrenia- All topics »
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- Schizophrenia
Key facts
- Schizophrenia causes psychosis and is associated with considerable disability and may affect all areas of life including personal, family, social, educational, and occupational functioning.
- Stigma, discrimination, and violation of human rights of people with schizophrenia are common.
- More than two out of three people with psychosis in the world do not receive specialist mental health care.
- A range of effective care options for people with schizophrenia exist and at least one in three people with schizophrenia will be able to fully recover.
Schizophrenia is characterised by significant impairments in the way reality is perceived and changes in behaviour related to:
- persistent delusions: the person has fixed beliefs that something is true, despite evidence to the contrary;
- persistent hallucinations: the person may hear, smell, see, touch, or feel things that are not there;
- experiences of influence, control or passivity: the experience that one’s feelings, impulses, actions, or thoughts are not generated by oneself, are being placed in one’s mind or withdrawn from one’s mind by others, or that one’s thoughts are being broadcast to others;
- disorganized thinking, which is often observed as jumbled or irrelevant speech;
- highly disorganised behaviour e.
g. the person does things that appear bizarre or purposeless, or the person has unpredictable or inappropriate emotional responses that interfere with their ability to organise their behaviour; - “negative symptoms” such as very limited speech, restricted experience and expression of emotions, inability to experience interest or pleasure, and social withdrawal; and/or
- extreme agitation or slowing of movements, maintenance of unusual postures.
People with schizophrenia often also experience persistent difficulties with their cognitive or thinking skills, such as memory, attention, and problem-solving.
At least one third of people with schizophrenia experiences complete remission of symptoms (1). Some people with schizophrenia experience worsening and remission of symptoms periodically throughout their lives, others a gradual worsening of symptoms over time.
Magnitude and impact
Schizophrenia affects approximately 24 million people or 1 in 300 people (0.
32%) worldwide. This rate is 1 in 222 people (0.45%) among adults (2). It is not as common as many other mental disorders. Onset is most often during late adolescence and the twenties, and onset tends to happen earlier among men than among women.
Schizophrenia is frequently associated with significant distress and impairment in personal, family, social, educational, occupational, and other important areas of life.
People with schizophrenia are 2 to 3 times more likely to die early than the general population (3). This is often due to physical illnesses, such as cardiovascular, metabolic, and infectious diseases.
People with schizophrenia often experience human rights violations both inside mental health institutions and in community settings. Stigma against people with this condition is intense and widespread, causing social exclusion, and impacting their relationships with others, including family and friends. This contributes to discrimination, which in turn can limit access to general health care, education, housing, and employment.
During humanitarian and public health emergencies, extreme stress and fear, breakdown of social supports, isolation and disruption of health-care services and supply of medication can occur. These changes can have an impact on the lives of people with schizophrenia, such as exacerbation of existing symptoms. During emergencies, people with schizophrenia are more vulnerable than others to various human rights violations, including neglect, abandonment, homelessness, abuse and exclusion.
Causes of schizophreniaResearch has not identified one single cause of schizophrenia. It is thought that an interaction between genes and a range of environmental factors may cause schizophrenia. Psychosocial factors may also affect the onset and course of schizophrenia. Heavy use of cannabis is associated with an elevated risk of the disorder.
ServicesCurrently, the vast majority of people with schizophrenia around the world are not receiving mental health care.
Approximately 50% of people in mental hospitals have a schizophrenia diagnosis (4). Only 31.3% of people with psychosis receive specialist mental health care (5). Most resources for mental health services are inefficiently spent on care within mental hospitals.
There is clear evidence that mental hospitals are not effective in providing the care that people with mental health conditions need and, regularly, violate the basic human rights of persons with schizophrenia. Efforts to transfer care from mental health institutions to the community need to be expanded and accelerated. Such efforts start with the development of a range of quality community-based mental health services. Options for community-based mental health care include integration in primary health and general hospital care, community mental health centres, day centres, supported housing, and outreach services for home-based support. The engagement of the person with schizophrenia, family members and the wider community in providing support is important.
A range of effective care options for people with schizophrenia exist, and these include medication, psychoeducation, family interventions, cognitive-behavioural therapy and psychosocial rehabilitation (e.g., life skills training). Facilitated assisted living, supported housing and supported employment are essential care options that should be available for people with schizophrenia. A recovery-oriented approach – giving people agency in treatment decisions – is essential for people with schizophrenia and for their families and/or caregivers as well.
WHO responseWHO’s Comprehensive Mental Health Action Plan 2013-2030 highlights the steps required to provide appropriate services for people with mental disorders including schizophrenia. A key recommendation of the Action Plan is to shift services from institutions to the community. The WHO Special Initiative for Mental Health aims to further progress towards objectives of the Comprehensive Mental Health Action Plan 2013-2030 by ensuring 100 million more people have access to quality and affordable care for mental health conditions.
WHO's Mental Health Gap Action Programme (mhGAP) uses evidence-based technical guidance, tools and training packages to expand service in countries, especially in resource-poor settings. It focuses on a prioritized set of conditions, including psychosis, directing capacity building towards non-specialized health-care providers in an integrated approach that promotes mental health at all levels of care. Currently mhGAP is being implemented in more than 100 WHO Member States.
The WHO QualityRights Project involves improving the quality of care and human rights conditions in mental health and social care facilities and to empower organizations to advocate for the health of people with mental health conditions and psychosocial disabilities.
The WHO guidance on community mental health services and person-centred and rights-based approaches provides information and support to all stakeholders who wish to develop or transform their mental health system and services to align with international human rights standards including the UN Convention on the Rights of Persons with Disabilities.
(1) Harrison G, Hopper K, Craig T, Laska E, Siegel C, Wanderling J. Recovery from psychotic illness: a 15- and 25-year international follow-up study. Br J Psychiatry 2001;178:506-17.
(2) Institute of health Metrics and Evaluation (IHME). Global Health Data Exchange (GHDx). http://ghdx.healthdata.org/gbd-results-tool?params=gbd-api-2019-permalink/27a7644e8ad28e739382d31e77589dd7 (Accessed 25 September 2021)
(3) Laursen TM, Nordentoft M, Mortensen PB. Excess early mortality in schizophrenia. Annual Review of Clinical Psychology, 2014;10, 425-438.
(4) WHO. Mental health systems in selected low- and middle-income countries: a WHO-AIMS cross-national analysis. WHO: Geneva, 2009
(5) Jaeschke K et al. Global estimates of service coverage for severe mental disorders: findings from the WHO Mental Health Atlas 2017 Glob Ment Health 2021;8:e27.
WHO’s Comprehensive Mental Health Action Plan 2013-2030
WHO Special Initiative for Mental Health
WHO's Mental Health Gap Action Programme (mhGAP)
WHO QualityRights Project
WHO guidance on community mental health services and person-centred and rights-based approaches
More on mental health
Autism
It is estimated that worldwide about one in 100 children has autism(1).
This estimate represents an average figure, and reported prevalence varies substantially across studies. Some well-controlled studies have, however, reported figures that are substantially\r\n higher. The prevalence of autism in many low- and middle-income countries is unknown.
Causes
Available scientific evidence suggests that there are probably many factors that make a child more likely to have autism, including environmental and genetic factors.
Available epidemiological data conclude that there is no evidence of a causal association between measles, mumps and rubella vaccine, and autism. Previous studies suggesting a causal link were found to be filled with methodological flaws(2)(3).
There is also no evidence to suggest that any other childhood vaccine may increase the risk of autism. Evidence reviews of the potential association between the preservative thiomersal and aluminium adjuvants contained in inactivated vaccines and the\r\n risk of autism strongly concluded that vaccines do not increase the risk of autism.
Assessment and care
A broad range of interventions, from early childhood and across the life span, can optimize the development, health, well-being and quality of life of autistic people. Timely access to early evidence-based psychosocial interventions can improve the ability\r\n of autistic children to communicate effectively and interact socially. The monitoring of child development as part of routine maternal and child health care is recommended.
It is important that, once autism has been diagnosed, children, adolescents and adults with autism and their carers are offered relevant information, services, referrals, and practical support, in accordance with their individual and evolving needs and\r\n preferences.
The health-care needs of people with autism are complex and require a range of integrated services, that include health promotion, care and rehabilitation. Collaboration between the health sector and other sectors, particularly education, employment and\r\n social care, is important.
Interventions for people with autism and other developmental disabilities need to be designed and delivered with the participation of people living with these conditions. Care needs to be accompanied by actions at community and societal levels for greater accessibility, inclusivity and support.
Human rights
All people, including people with autism, have the right to the enjoyment of the highest attainable standard of physical and mental health.
And yet, autistic people are often subject to stigma and discrimination, including unjust deprivation of health care, education and opportunities to engage and participate in their communities.
People with autism have the same health problems as the general population. However, they may, in addition, have specific health-care needs related to autism or other co-occurring conditions. They may be more vulnerable to developing chronic noncommunicable\r\n conditions because of behavioural risk factors such as physical inactivity and poor dietary preferences, and are at greater risk of violence, injury and abuse.
People with autism require accessible health services for general health-care needs like the rest of the population, including promotive and preventive services and treatment of acute and chronic illness. Nevertheless, autistic people have higher rates\r\n of unmet health-care needs compared with the general population. They are also more vulnerable during humanitarian emergencies. A common barrier is created by health-care providers’ inadequate knowledge and understanding of autism.
WHO resolution on autism spectrum disorders
In May 2014, the Sixty-seventh World Health Assembly adopted a resolution entitled Comprehensive and coordinated efforts for the management of autism spectrum disorders,\r\n which was supported by more than 60 countries.
The resolution urges WHO to collaborate with Member States and partner agencies to strengthen national capacities to address ASD and other developmental disabilities.
WHO response
WHO and partners recognize the need to strengthen countries' abilities to promote the optimal health and well-being of all people with autism.
WHO's efforts focus on:
- increasing the commitment of governments to taking action to improve the quality of life of people with autism;
- providing guidance on policies and action plans that address autism within the broader framework of health, mental and brain health and disabilities;
- contributing to strengthening the ability of the health workforce to provide appropriate and effective care and promote optimal standards of health and well-being for people with autism; and
- promoting inclusive and enabling environments for people with autism and other developmental disabilities and providing support to their caregivers.
WHO Comprehensive mental health action plan 2013–2030 and World Health Assembly Resolution WHA73.10 for “global actions on epilepsy and other neurological disorders” calls on countries to address the current significant\r\n gaps in early detection, care, treatment and rehabilitation for mental and neurodevelopmental conditions, which include autism.
It also calls for counties to address the social, economic, educational and inclusion needs of people living with mental\r\n and neurological disorders, and their families, and to improve surveillance and relevant research.
References
(1) Global prevalence of autism: A systematic review update. Zeidan J et al. Autism Research 2022 March.
(2) Wakefield's affair: 12 years of uncertainty whereas no link between autism and MMR vaccine has been proved. Maisonneuve H, Floret D. Presse Med. 2012 Sep; French (https://www.ncbi.nlm.nih.gov/pubmed/22748860).\r\n
(3) Lancet retracts Wakefield’s MMR paper. Dyer C. BMJ 2010;340:c696. 2 February 2010 (https://pubmed.ncbi.nlm.nih.gov/20124366/)\r\n
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Dementia
dementia- Healthcare issues »
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- Dementia
Cathy Greenblat
© Photo
Dementia is a syndrome, usually chronic or progressive, in which there is a deterioration in cognitive function (ie the ability to think) to a greater extent than is expected with normal aging.
There is a degradation of memory, thinking, understanding, speech and the ability to navigate, count, learn and reason. Dementia does not affect consciousness. Cognitive dysfunction is often accompanied, and sometimes preceded, by a deterioration in emotional control, as well as a degradation in social behavior or motivation.
Dementia is caused by a variety of illnesses and injuries that primarily or secondarily cause brain damage, such as Alzheimer's disease or stroke.
Dementia is one of the leading causes of disability and addiction among older people worldwide. It can have a profound impact not only on the people who suffer it, but also on their families and caregivers. There is often a lack of awareness and understanding about dementia, leading to stigma and barriers to diagnosis and care. The impact of dementia on caregivers, families and society as a whole can be physical, psychological, social and economic.
Signs and symptoms
Dementia affects people differently, depending on the impact of the disease and on the individual before the disease.
The signs and symptoms associated with dementia go through three stages of development.
Early stage: The early stage of dementia often goes unnoticed because it develops gradually. Common symptoms include:
- forgetfulness;
- loss of track of time;
- disorientation in a familiar area.
Intermediate: As dementia progresses to the intermediate stage, the signs and symptoms become more pronounced and increasingly narrowing. They include:
- forgetting about recent events and people's names;
- disorientation at home;
- increasing difficulties in communication;
- need for help with self-care;
- behavioral difficulties, including aimless walking and asking the same questions.
Late stage: In the late stage of dementia, almost complete dependence and inactivity develops. Memory impairment becomes significant, and physical signs and symptoms become more obvious.
Symptoms include:
- disorientation in time and space;
- difficulty in recognizing relatives and friends;
- increasing need for help with self-care;
- difficulty in moving;
- behavioral changes that may be exacerbated and include aggressiveness.
Common forms of dementia
There are many forms of dementia. Alzheimer's disease is the most common form, accounting for 60-70% of all cases. Other common forms include vascular dementia, Lewy body dementia (abnormal protein inclusions that form inside nerve cells), and a group of diseases that contribute to frontotemporal dementia (degeneration of the frontal lobe of the brain). There are no clear boundaries between different forms of dementia, and mixed forms of dementia often coexist.
Dementia rates
There are about 50 million people with dementia worldwide, more than half, almost 60% of them, live in low- and middle-income countries. There are about 10 million new cases of the disease every year.
The proportion of the general population aged 60 and over with dementia at any point in time is estimated to be between 5% and 8%.
The total number of people with dementia is projected to be around 82 million in 2030 and 152 million by 2050. This growth will be driven in large part by an increase in the number of people with dementia in low- and middle-income countries.
Treatment and care
Currently there is no therapy to cure or change the course of dementia. Numerous new drugs are under investigation and are at various stages of clinical trials.
However, much can be done to support and improve the lives of people with dementia, their caregivers and their families. The main goals of medical care for dementia are:\n
- early diagnosis to ensure early and optimal management;
- optimization of physical health, cognitive abilities, activity and well-being;
- detection and treatment of associated physical illness;
- detection and treatment of behavioral and psychological symptoms;
- provide information and long-term support for carers.
Risk factors and prevention
Although age is the most important known risk factor for dementia, it is not an inevitable consequence of aging. What’s more, dementia doesn’t just affect the elderly—early onset of dementia (defined as the onset of symptoms before the age of 65) accounts for up to 9% of all cases of dementia.
Research shows that the risk of dementia can be reduced by exercising regularly, not smoking, avoiding the harmful use of alcohol, controlling your weight, eating well, and maintaining normal blood pressure, cholesterol, and blood sugar levels. Other risk factors include depression, low educational attainment, social isolation, and cognitive inactivity.
Social and economic impact
Dementia has a significant social and economic impact in terms of medical costs, social care costs and informal care. In 2015, total global public spending on dementia was estimated at US$818 billion, corresponding to 1.1% of the world's gross domestic product (GDP).
Total spending as a share of GDP ranged from 0.2% in low-income countries to 1.4% in high-income countries.
Impact on families and caregivers
Dementia can have a profound impact on the families of affected people and those who care for them. The physical, emotional and financial burden can put a lot of stress on families and caregivers, and they need support from the health, social, financial and legal systems.
Human rights
People with dementia are often denied the basic rights and freedoms that other people have. In many countries, physical means and chemicals are widely used in nursing homes and intensive care facilities to retain patients, even though there are regulations in place to protect the human rights to freedom and choice.
Providing high-quality care for people with dementia and their caregivers requires appropriate and supportive legal and regulatory frameworks based on internationally recognized human rights standards.
WHO activities
WHO recognizes dementia as a public health priority.
In May 2017, the World Health Assembly approved the Global Health Sector Action Plan for the Response to Dementia 2017-2025. The plan is a comprehensive program of action for policy makers, international, regional and national partners and WHO in the following areas:
- taking action on dementia as a public health priority; raising awareness about dementia and creating supportive environment initiatives for people with dementia; reduced risk of developing dementia;
- reduced risk of dementia; diagnosis, treatment and care;
- dementia information systems; support for carers of people with dementia; and
- research and innovation.
An international monitoring platform, the Global Dementia Observatory, has been established for policy makers and researchers to facilitate monitoring and sharing of information on dementia policy, health care, epidemiology and research. WHO is also developing a knowledge-sharing platform to facilitate the sharing of best practices in the field of dementia.
WHO has developed a dementia action plan to assist Member States in the development and operationalization of dementia action plans. This guidance is closely linked to the WHO Global Observatory on Dementia and includes relevant methodologies, such as a checklist, to guide the preparation, development and implementation of action plans for dementia. In addition, this guide can be helpful in identifying stakeholders and setting priorities.
The WHO Guidelines for Reducing the Risk of Cognitive Impairment and Dementia provide evidence-based recommendations for interventions to reduce modifiable risk factors for dementia such as physical inactivity and unhealthy diets, and to manage medical conditions associated with dementia including hypertension and diabetes.
Dementia is also a priority condition under the Mental Health Gap Action Program (mhGAP), which is an important resource for general practitioners, especially in low- and middle-income countries, to use in providing health care first line for psychiatric and neurological problems and disorders caused by the use of psychoactive substances.
WHO has developed the iSupport program to provide caregivers of people with dementia with information and skills. The iSupport web tool is available as a printed manual and is already in use in a number of countries. An online version of "iSupport" will be available soon.
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Key Facts
- Dementia is a syndrome in which memory, thinking, behavior and ability to perform daily activities deteriorate.
- Dementia mainly affects the elderly, but is not a normal condition of aging.
- There are about 50 million people with dementia worldwide, and almost 10 million new cases occur each year.
- Alzheimer's disease is the most common cause of dementia, accounting for 60-70% of all cases.
- Dementia is one of the leading causes of disability and addiction among older people worldwide.
- Dementia has a physical, psychological, social and economic impact not only on those affected, but also on their caregivers, families and society as a whole.
Dementia
Dementia is a syndrome, usually chronic or progressive, in which cognitive function (i.e. the ability to think) deteriorates to a greater extent than is expected with normal aging. There is a degradation of memory, thinking, understanding, speech and the ability to navigate, count, learn and reason. Dementia does not affect consciousness. Cognitive dysfunction is often accompanied, and sometimes preceded, by a deterioration in emotional control, as well as a degradation in social behavior or motivation.
Dementia is caused by a variety of illnesses and injuries that primarily or secondarily cause brain damage, such as Alzheimer's disease or stroke.
Dementia is one of the leading causes of disability and addiction among older people worldwide. It can have a profound impact not only on the people who suffer it, but also on their families and caregivers. There is often a lack of awareness and understanding about dementia, leading to stigma and barriers to diagnosis and care. The impact of dementia on caregivers, families and society as a whole can be physical, psychological, social and economic.
Signs and symptoms
Dementia affects people differently, depending on the impact of the disease and on the individual before the disease. The signs and symptoms associated with dementia go through three stages of development.
Early stage: The early stage of dementia often goes unnoticed because it develops gradually. Common symptoms include:
- forgetfulness;
- loss of track of time;
- disorientation in a familiar area.
Intermediate: As dementia progresses to the intermediate stage, the signs and symptoms become more pronounced and increasingly narrowing. They include:
- forgetting about recent events and people's names;
- disorientation at home;
- increasing difficulties in communication;
- need for help with self-care;
- behavioral difficulties, including aimless walking and asking the same questions.
Late stage: In the late stage of dementia, almost complete dependence and inactivity develops. Memory impairment becomes significant, and physical signs and symptoms become more obvious. Symptoms include:
- disorientation in time and space;
- difficulty in recognizing relatives and friends;
- increasing need for help with self-care;
- difficulty in moving;
- behavioral changes that may be exacerbated and include aggressiveness.
Common forms of dementia
There are many forms of dementia. Alzheimer's disease is the most common form, accounting for 60-70% of all cases. Other common forms include vascular dementia, Lewy body dementia (abnormal protein inclusions that form inside nerve cells), and a group of diseases that contribute to frontotemporal dementia (degeneration of the frontal lobe of the brain). There are no clear boundaries between different forms of dementia, and mixed forms of dementia often coexist.
Dementia rates
There are about 50 million people with dementia worldwide, more than half, almost 60% of them, live in low- and middle-income countries. There are about 10 million new cases of the disease every year.
The proportion of the general population aged 60 and over with dementia at any point in time is estimated to be between 5% and 8%.
The total number of people with dementia is projected to be around 82 million in 2030 and 152 million by 2050. This growth will be driven in large part by an increase in the number of people with dementia in low- and middle-income countries.
Treatment and care
Currently there is no therapy to cure or change the course of dementia. Numerous new drugs are under investigation and are at various stages of clinical trials.
However, much can be done to support and improve the lives of people with dementia, their caregivers and their families. The main goals of medical care for dementia are:
- early diagnosis to ensure early and optimal management;
- optimization of physical health, cognitive abilities, activity and well-being;
- detection and treatment of associated physical illness;
- detection and treatment of behavioral and psychological symptoms;
- provide information and long-term support for carers.
Risk factors and prevention
Although age is the most important known risk factor for dementia, it is not an inevitable consequence of aging. What’s more, dementia doesn’t just affect the elderly—early onset of dementia (defined as the onset of symptoms before the age of 65) accounts for up to 9% of all cases of dementia.
Research shows that the risk of dementia can be reduced by exercising regularly, not smoking, avoiding the harmful use of alcohol, controlling your weight, eating well, and maintaining normal blood pressure, cholesterol, and blood sugar levels. Other risk factors include depression, low educational attainment, social isolation, and cognitive inactivity.
Social and economic impact
Dementia has a significant social and economic impact in terms of medical costs, social care costs and informal care. In 2015, total global public spending on dementia was estimated at US$818 billion, corresponding to 1.1% of the world's gross domestic product (GDP). Total spending as a share of GDP ranged from 0.2% in low-income countries to 1.4% in high-income countries.
Impact on families and caregivers
Dementia can have a profound impact on the families of affected people and those who care for them. The physical, emotional and financial burden can put a lot of stress on families and caregivers, and they need support from the health, social, financial and legal systems.
Human rights
People with dementia are often denied the basic rights and freedoms that other people have. In many countries, physical means and chemicals are widely used in nursing homes and intensive care facilities to retain patients, even though there are regulations in place to protect the human rights to freedom and choice.
Providing high-quality care for people with dementia and their caregivers requires appropriate and supportive legal and regulatory frameworks based on internationally recognized human rights standards.
WHO activities
WHO recognizes dementia as a public health priority. In May 2017, the World Health Assembly approved the Global Health Sector Action Plan for the Response to Dementia 2017-2025. The plan is a comprehensive program of action for policy makers, international, regional and national partners and WHO in the following areas:
- taking action on dementia as a public health priority; raising awareness about dementia and creating supportive environment initiatives for people with dementia; reduced risk of developing dementia;
- reduced risk of dementia; diagnosis, treatment and care;
- dementia information systems; support for carers of people with dementia; and
- research and innovation.
An international monitoring platform, the Global Dementia Observatory, has been established for policy makers and researchers to facilitate monitoring and sharing of information on dementia policy, health care, epidemiology and research. WHO is also developing a knowledge-sharing platform to facilitate the sharing of best practices in the field of dementia.
WHO has developed a dementia action plan to assist Member States in the development and operationalization of dementia action plans. This guidance is closely linked to the WHO Global Observatory on Dementia and includes relevant methodologies, such as a checklist, to guide the preparation, development and implementation of action plans for dementia. In addition, this guide can be helpful in identifying stakeholders and setting priorities.
The WHO Guidelines for Reducing the Risk of Cognitive Impairment and Dementia provide evidence-based recommendations for interventions to reduce modifiable risk factors for dementia such as physical inactivity and unhealthy diets, and to manage medical conditions associated with dementia including hypertension and diabetes.
Dementia is also a priority condition under the Mental Health Gap Action Program (mhGAP), which is an important resource for general practitioners, especially in low- and middle-income countries, to use in providing health care first line for psychiatric and neurological problems and disorders caused by the use of psychoactive substances.
WHO has developed the iSupport program to provide caregivers of people with dementia with information and skills. The iSupport web tool is available as a printed manual and is already in use in a number of countries. An online version of "iSupport" will be available soon.
Autism
Autism- Health »
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- Autism
Key Facts
- Autism, also called autism spectrum disorder, is a diverse group of pathological conditions caused by the development of the brain.
- Signs of autism can be detected in early childhood, but it is often not diagnosed until later in life.
- Approximately 1 in 100 children have autism.
- The abilities and needs of people with autism can vary and change over time. Some people with autism are able to lead independent and productive lives, while others become severely disabled and require lifelong care and support.
- Evidence-based psychosocial interventions can improve communication skills and social behavior, which positively affects the well-being and quality of life of people with autism and their caregivers.
- Care for people with autism must be accompanied by local and community action to make physical and social environments and relationships more accessible, inclusive and supportive.
Introduction
Autism Spectrum Disorders (ASD) are a group of different conditions. All of them are characterized by certain difficulties with social interaction and communication. Other features include atypical patterns of action and behaviors, such as difficulty moving from one activity to another, focus on details, and unusual responses to external stimuli.
The abilities and needs of people with autism can vary and change over time. Some people with autism are able to live independent and productive lives, while others become severely disabled and require lifelong care and support. Autism often negatively affects educational or employment opportunities. In addition, for family members of people with autism, care and support responsibilities can often be a source of significant stress. Community attitudes and the level of support from local and national governments are important determinants of the quality of life of people with autism.
Signs of autism can be identified in early childhood, but the condition is often diagnosed at much later stages.
People with autism often have comorbid conditions and illnesses, including epilepsy, depression, anxiety, and attention deficit hyperactivity disorder, as well as behavioral problems such as sleep disturbances or self-harm. The level of intellectual abilities of people with autism varies in a wide range from severe cognitive impairment to a high level of intelligence.
Epidemiology
It is estimated that autism affects about 1 in 100 children worldwide (1). At the same time, we are talking about an average indicator, and the prevalence rates of autism recorded according to different studies vary widely. Nevertheless, according to some reputable controlled studies, the real numbers are much higher. The prevalence of autism in many low- and middle-income countries is unknown.
Causes
Available scientific evidence indicates many factors that may increase the likelihood of children developing autism, including environmental and genetic factors.
Available epidemiological data do not establish a causal relationship between autism and measles, mumps and rubella vaccination. Past studies suggesting such a causal relationship have been many methodological problems were found (2), (3).
Similarly, there is no evidence that any childhood vaccine can increase the risk of developing autism. Evidence reviews on a potential association between the preservative thiomersal and aluminum adjuvants contained in inactivated vaccines and the risk of developing autism strongly suggest that vaccines do not lead to an increase in this risk.
Needs assessment and care management
A range of interventions, from early childhood and throughout life, can contribute to the optimal development, well-being and quality of life of people with autism. Timely evidence-based psychosocial interventions at an early age can improve the ability of children with autism to communicate and interact effectively with others. It is recommended to monitor the development of children as part of the planned provision of medical care to mothers and children.
It is important that, once diagnosed, children, adolescents and adults diagnosed with autism and their caregivers have access to relevant information, referrals and practical support tailored to their individual needs. constantly changing needs and preferences.
The health care needs of people with autism are complex, requiring them to provide comprehensive services, including health promotion, care and rehabilitation services. Therefore, it is important to ensure cooperation with other sectors, in particular with the education system, employment and the social sector.
Interventions to help people with autism and other developmental disabilities should be planned and implemented with the participation of people with these conditions themselves. Caring for people with autism should be accompanied by local action. and at the level of society as a whole, in order to make the physical and social environment and relationships more accessible, inclusive and supportive.
Human rights
All people, including those with autism, have the right to the highest attainable standard of physical and mental health.
Yet people with autism often face stigma and discrimination: their health care and education rights are unfairly denied, and their opportunities to participate in society are limited.
People with autism may experience the same health problems as the rest of the population. In addition, they may have special health care needs related to autism and other related conditions. They can be are more vulnerable to chronic noncommunicable diseases associated with behavioral risk factors such as physical inactivity and poor diet, and are at greater risk of violence, injury and abuse.
People with autism, like the rest of the population, need affordable health services to meet their general health needs, including health promotion and prevention services, as well as acute and chronic disease management. However less than in the general population, the level of satisfaction of the medical needs of people with autism is at a lower level. These people are also more vulnerable in humanitarian emergencies. One of the common barriers is the insufficient level of knowledge and understanding of the specifics of autism by medical professionals.
WHO Resolution on Autism Spectrum Disorders
In May 2014, the Sixty-seventh World Health Assembly adopted a resolution on "Comprehensive and concerted efforts for the management of autism spectrum disorders", supported by over 60 countries.
The resolution calls on WHO to work with Member States and partner agencies to strengthen national capacity to address ASD and other developmental disabilities.
WHO activities
WHO and partners recognize the need to strengthen countries' capacity to promote the optimal health and well-being of all people with autism.
The main activities of WHO in this regard are:
- promoting the adoption of targeted measures by national governments to improve the quality of life of people with autism;
- develop recommendations for policies and action plans to address autism in the broader context of physical, mental, brain health and care for people with disabilities;
- help to empower healthcare professionals to provide appropriate and effective care for people with autism and achieve optimal health and well-being; and
- promote and support an inclusive and supportive environment for people with autism and other developmental disabilities.
WHO comprehensive mental health action plan 2013–2030 and World Health Assembly Resolution WHA73.10 "Global action against epilepsy and other neurological disorders" contain calling on countries to address significant gaps in the early detection, care, treatment and rehabilitation of people with mental and neurodevelopmental disorders, including and autism. The resolution also calls on countries to take action to meet the social, economic, educational and other needs of people living with mental and neurological disorders and their families, and to develop surveillance and related research activities.
References
(1) Global prevalence of autism: A systematic review update. Zeidan J et al. Autism Research 2022 March.
(2) Wakefield's affair: 12 years of uncertainty whereas no link between autism and MMR vaccine has been proven. Maisonneuve H, Floret D. Presse Med. 2012 Sep; French https://pubmed.
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