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A '''mental disorder''' or '''mental illness''' is a [[psychological]] or [[behavioral]] pattern generally associated with subjective [[suffering|distress]] or [[disability]] that occurs in an individual, and which is not a part of [[normality (behaviour)|normal]] [[developmental psychology|development]] or [[culture]]. The recognition and understanding of [[mental health]] conditions has changed over time and across cultures, and there are still variations in the definition, assessment, and [[classification of mental disorders]], although standard guideline criteria are widely accepted. A few mental disorders are diagnosed based on the harm to others, regardless of the subject's perception of distress. Over a third of people in most countries report meeting criteria for the major categories at some point in their lives.

The [[causes of mental disorders|causes]] are often explained in terms of a [[diathesis-stress model]] or [[biopsychosocial]] model. In [[biological psychiatry]], mental disorders are conceptualized as disorders of brain circuits likely caused by developmental processes shaped by a complex interplay of genetics and experience.<ref name=Insel>{{cite journal | doi = 10.1001/jama.2010.555 | last1 = Insel | first1 = T.R. | last2 = Wang | first2 = P.S. | year = 2010 | title = Rethinking mental illness | url = | journal = JAMA | volume = 303 | issue = 19| pages = 1970–1971 | pmid = 20483974 }}</ref>

[[Services for mental disorders|Services]] are based in [[psychiatric hospitals]] or in the [[community mental health services|community]]. Diagnoses are made by [[psychiatrists]] or [[clinical psychologists]] using various methods, often relying on observation and questioning in interviews. Treatments are provided by various [[mental health professionals]]. [[Psychotherapy]] and [[psychiatric medication]] are two major treatment options, as are [[social work|social]] interventions, [[peer support]] and [[self-help]]. In some cases there may be [[involuntary commitment|involuntary detention]] and [[involuntary treatment]] where legislation allows. 

[[Social stigma|Stigma]] and [[discrimination]] add to the [[suffering]] associated with the disorders, and have led to various [[social movements]] attempting to increase acceptance.
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==Classifications==
{{Main|Classification of mental disorders}}
The [[definition]] and [[wiktionary:Classification|classification]] of mental disorders is a key issue for [[mental health]] and for users and providers of mental health services. Most international clinical documents use the term "mental disorder". There are currently two widely established systems that classify mental disorders—''[[ICD-10 Chapter V: Mental and behavioural disorders]]'', part of the [[International Classification of Diseases]] produced by the [[World Health Organization]] (WHO), and the ''[[Diagnostic and Statistical Manual of Mental Disorders]]'' (DSM-IV) produced by the [[American Psychiatric Association]] (APA). 

Both list categories of disorder and provide standardized criteria for diagnosis. They have deliberately converged their codes in recent revisions so that the manuals are often broadly comparable, although significant differences remain. Other classification schemes may be used in non-western cultures (see, for example, the ''[[Chinese Classification of Mental Disorders]]''), and other manuals may be used by those of alternative theoretical persuasions, for example the ''[[Psychodynamic Diagnostic Manual]]''. In general, mental disorders are classified separately to [[neurological disorders]], [[learning disabilities]] or [[mental retardation]].

Unlike most of the above systems, some approaches to classification do not employ distinct categories of disorder or [[Dichotomy|dichotomous]] cut-offs intended to separate the abnormal from the normal. There is significant scientific debate about the different kinds of [[categorization]] and the relative merits of categorical versus non-categorical (or hybrid) schemes, with the latter including [[spectrum disorder|spectrum]], [[Continuum (theory)|continuum]] or [[dimensional]] systems.

===Disorders===
{{see also|List of mental disorders as defined by the DSM and ICD}}
There are many different categories of mental disorder, and many different facets of human behavior and personality that can become disordered.<ref name=Gazzaniga>Gazzaniga, M.S., & Heatherton, T.F. (2006). ''Psychological Science''. New York: W.W. Norton & Company, Inc.</ref><ref name=WebMDTypesIllness>WebMD Inc (2005, July 01). ''Mental Health: Types of Mental Illness''. Retrieved April 19, 2007, from http://www.webmd.com/mental-health/mental-health-types-illness</ref><ref name=USDHHS>United States Department of Health & Human Services. (1999). ''[http://www.surgeongeneral.gov/library/mentalhealth/chapter2/sec2.html Overview of Mental Illness]''. Retrieved April 19, 2007</ref><ref>NIMH (2005) [http://science-education.nih.gov/supplements/nih5/Mental/guide/info-mental-c.htm Teacher's Guide: Information about Mental Illness and the Brain] Curriculum supplement from The NIH Curriculum Supplements Series</ref><ref>{{cite web| author= Phillip W. Long M.D.|title= Disorders| url=http://www.mentalhealth.com/p20-grp.html|publisher= Internet Mental Health| date= 1995-2008| accessdate= 5 October 2009}}</ref>

[[Anxiety]] or [[fear]] that interferes with normal functioning may be classified as an [[anxiety disorder]].<ref name=webMD_types>{{cite web|url=http://www.webmd.com/mental-health/mental-health-types-illness |title=Mental Health: Types of Mental Illness |accessdate=2009-09-29 |publisher=[[WebMD]] }}</ref> Commonly recognized categories include specific [[phobia]]s, [[generalized anxiety disorder]], [[social anxiety disorder]], [[panic disorder]], [[agoraphobia]], [[obsessive-compulsive disorder]] and [[post-traumatic stress disorder]].

Other [[affective]] (emotion/mood) processes can also become disordered. [[Mood disorder]] involving unusually intense and sustained sadness, melancholia or despair is known as [[Major depression]] or Clinical depression (milder but still prolonged depression can be diagnosed as [[dysthymia]]). [[Bipolar disorder]] (also known as manic depression) involves abnormally "high" or pressured mood states, known as [[mania]] or [[hypomania]], alternating with normal or depressed mood. Whether unipolar and bipolar mood phenomena represent distinct categories of disorder, or whether they usually mix and merge together along a dimension or spectrum of mood, is under debate in the scientific literature.<ref>{{Cite journal |author=Akiskal HS, Benazzi F |title=The DSM-IV and ICD-10 categories of recurrent [major] depressive and bipolar II disorders: evidence that they lie on a dimensional spectrum |journal=J Affect Disord |volume=92 |issue=1 |pages=45–54 |date=May 2006|pmid=16488021 |doi=10.1016/j.jad.2005.12.035 }}</ref>

Patterns of belief, language use and perception can become disordered (e.g. [[delusions]], [[thought disorder]], [[hallucinations]]). [[Psychotic disorder]]s in this domain include [[schizophrenia]], and [[delusional disorder]]. [[Schizoaffective disorder]] is a category used for individuals showing aspects of both schizophrenia and affective disorders. [[Schizotypy]] is a category used for individuals showing some of the characteristics associated with schizophrenia but without meeting cut-off criteria.

[[Personality development|Personality]]—the fundamental characteristics of a person that influence his or her thoughts and behaviors across situations and time—may be considered disordered if judged to be abnormally rigid and [[maladaptive]]. Categorical schemes list a number of different such [[personality disorder]]s, including those sometimes classed as eccentric (e.g. [[paranoid personality disorder|paranoid]], [[schizoid personality disorder|schizoid]] and [[schizotypal personality disorder]]s), to those sometimes classed as dramatic or emotional ([[antisocial personality disorder|antisocial]], [[borderline personality disorder|borderline]], [[histrionic personality disorder|histrionic]] or [[narcissistic personality disorder]]s) or those seen as fear-related ([[avoidant personality disorder|avoidant]], [[dependent personality disorder|dependent]], or [[obsessive-compulsive personality disorder]]s). If an inability to sufficiently adjust to life circumstances begins within three months of a particular event or situation, and ends within six months after the stressor stops or is eliminated, it may instead be classed as an [[adjustment disorder]]. There is an emerging consensus that so-called "personality disorders", like personality traits in general, actually incorporate a mixture of acute dysfunctional behaviors that resolve in short periods, and maladaptive temperamental traits that are more stable.<ref>{{cite journal |author=Clark LA |title=Assessment and diagnosis of personality disorder: perennial issues and an emerging reconceptualization |journal=Annu Rev Psychol |volume=58 |pages=227–57 |year=2007 |pmid=16903806 |doi=10.1146/annurev.psych.57.102904.190200 |url=http://arjournals.annualreviews.org/doi/abs/10.1146/annurev.psych.57.102904.190200}}</ref> Furthermore, there are also non-categorical schemes that rate all individuals via a profile of different dimensions of personality rather than using a cut-off from normal personality variation, for example through schemes based on the [[Big Five personality traits]].<ref>{{Cite journal |author=Morey LC, Hopwood CJ, Gunderson JG, ''et al.'' |title=Comparison of alternative models for personality disorders |journal=Psychol Med |volume=37 |issue=7 |pages=983–94 |date=July 2007|pmid=17121690 |doi=10.1017/S0033291706009482 }}</ref>

[[Eating disorder]]s involve disproportionate concern in matters of food and weight.<ref name=webMD_types /> Categories of disorder in this area include [[anorexia nervosa]], [[bulimia nervosa]], [[exercise bulimia]] or [[binge eating disorder]].

[[Sleep disorder]]s such as [[insomnia]] involve disruption to normal [[sleep]] patterns, or a feeling of tiredness despite sleep appearing normal.

[[Sexual disorder|Sexual]] and gender identity disorders may be diagnosed, including [[dyspareunia]], [[gender identity disorder]] and [[egodystonic sexual orientation|ego-dystonic homosexuality]]. Various kinds of [[paraphilia]] are considered mental disorders (sexual arousal to objects, situations, or individuals that are considered abnormal or harmful to the person or others).

People who are abnormally unable to resist certain urges or impulses that could be harmful to themselves or others, may be classed as having an impulse control disorder, including various kinds of [[tic disorders]] such as [[Tourette's syndrome]], and disorders such as [[kleptomania]] (stealing) or [[pyromania]] (fire-setting). Various behavioral addictions, such as [[gambling]] addiction, may be classed as a disorder. [[Obsessive-compulsive disorder]] can sometimes involve an inability to resist certain acts but is classed separately as being primarily an anxiety disorder.

The use of drugs (legal or illegal), when it persists despite significant problems related to the use, may be defined as a mental disorder termed [[substance dependence]] or [[substance abuse]] (a broader category than [[drug abuse]]). The DSM does not currently use the common term [[drug addiction]] and the ICD simply talks about "harmful use". Disordered substance use may be due to a pattern of compulsive and repetitive use of the drug that results in tolerance to its effects and withdrawal symptoms when use is reduced or stopped.

People who suffer severe disturbances of their self-identity, memory and general awareness of themselves and their surroundings may be classed as having a [[dissociative identity disorder]], such as [[depersonalization disorder]] or Dissociative Identity Disorder itself (which has also been called multiple personality disorder, or "split personality"). Other memory or cognitive disorders include [[amnesia]] or various kinds of old age [[dementia]].

A range of [[developmental disorders]] that initially occur in childhood may be diagnosed, for example [[autism spectrum]] disorders, [[oppositional defiant disorder]] and [[conduct disorder]], and [[attention deficit hyperactivity disorder]] (ADHD), which may continue into adulthood.

Conduct disorder, if continuing into adulthood, may be diagnosed as [[antisocial personality disorder]] (dissocial personality disorder in the ICD). Popularist labels such as [[psychopath]] (or sociopath) do not appear in the DSM or ICD but are linked by some to these diagnoses.

Disorders appearing to originate in the body, but thought to be mental, are known as somatoform disorders, including [[somatization disorder]] and [[conversion disorder]]. There are also disorders of the perception of the body, including [[body dysmorphic disorder]]. [[Neurasthenia]] is an old diagnosis involving somatic complaints as well as fatigue and low spirits/depression, which is officially recognized by the ICD-10 but no longer by the DSM-IV.<ref>{{Cite journal |author=Gamma A, Angst J, Ajdacic V, Eich D, Rössler W |title=The spectra of neurasthenia and depression: course, stability and transitions |journal=Eur Arch Psychiatry Clin Neurosci |volume=257 |issue=2 |pages=120–7 |date=March 2007|pmid=17131216 |doi=10.1007/s00406-006-0699-6 }}</ref>

[[Factitious disorder]]s, such as [[Munchausen syndrome]], are diagnosed where symptoms are thought to be experienced (deliberately produced) and/or reported (feigned) for personal gain.

There are attempts to introduce a category of [[relational disorder]], where the diagnosis is of a relationship rather than on any one individual in that relationship. The relationship may be between children and their parents, between couples, or others. There already exists, under the category of psychosis, a diagnosis of [[shared psychotic disorder]] where two or more individuals share a particular delusion because of their close relationship with each other.

Various new types of mental disorder diagnosis are occasionally proposed. Among those controversially considered by the official [[committees]] of the diagnostic manuals include [[self-defeating personality disorder]], [[sadistic personality disorder]], [[passive-aggressive personality disorder]] and [[premenstrual dysphoric disorder]].

Two recent unique isolated proposals are [[solastalgia]] by [[Glenn Albrecht]] and hubris syndrome by [[David Owen]]. The application of the concept of [[mental illness]] to the phenomena described by these authors has in turn been critiqued by Seamus Mac Suibhne.<ref>{{cite journal|author=Mac Suibhne, S.|year=2009|title=What makes “a new mental illness”?: The cases of solastalgia and hubris syndrome|journal=Cosmos and History|volume=5|issue=2|pages=210–225}}</ref>

==Causes==
{{Main|Causes of mental disorders}}
Mental disorders can arise from a combination of sources. In many cases there is no single accepted or consistent cause currently established. A common belief even to this day is that disorders result from [[Genetics|genetic]] vulnerabilities exposed by [[Environment (biophysical)|environmental]] stressors. (see [[Diathesis-stress model]]). However, it is clear enough from a simple statistical analysis across the whole spectrum of mental health disorders at least in western cultures that there is a strong relationship between the various forms of severe and complex mental disorder in adulthood and the abuse (physical, sexual or emotional) or neglect of children during the developmental years. Child sexual abuse alone plays a significant role in the causation of a significant percentage of all mental disorders in adult females, most notable examples being eating disorders and borderline personality disorder.

An [[wikt:eclectic|eclectic]] or [[Scientific pluralism|pluralistic]] mix of models may be used to explain particular disorders, and the primary paradigm of contemporary mainstream Western psychiatry is said to be the [[biopsychosocial]] (BPS) model, incorporating biological, psychological and social factors, although this may not always be applied in practice. [[Biopsychiatry]] has tended to follow a [[biomedical]] model, focusing on "organic" or "hardware" pathology of the brain. [[Psychoanalytic]] theories have continued to evolve alongside congitive-behavioural and systemic-family approaches been popular but are now less so. [[Evolutionary psychology]] may be used as an overall explanatory theory, and [[attachment theory]] is another kind of evolutionary-psychological approach sometimes applied in the context of mental disorders. A distinction is sometimes made between a "[[medical model]]" or a "[[social model]]" of disorder and disability.

Studies have indicated that [[genes]] often play an important role in the development of mental disorders, although the reliable identification of connections between specific genes and specific categories of disorder has proven more difficult. Environmental events surrounding [[pregnancy]] and [[birth]] have also been implicated. [[Traumatic brain injury]] may increase the risk of developing certain mental disorders. There have been some tentative inconsistent links found to certain viral infections,<ref>{{Cite journal |author=Yolken RH, Torrey EF |title=Viruses, schizophrenia, and bipolar disorder |journal=Clin Microbiol Rev. |volume=8 |issue=1 |pages=131–45 |date=1 January 1995|pmid=7704891 |pmc=172852 |url=http://cmr.asm.org/cgi/pmidlookup?view=long&pmid=7704891 }}</ref> to [[substance abuse|substance misuse]], and to general physical health.

Abnormal functioning of [[neurotransmitter]] systems has been implicated, including serotonin, norepinephrine, dopamine and glutamate systems. Differences have also been found in the size or activity of certain brain regions in some cases. [[Psychological]] mechanisms have also been implicated, such as [[cognitive]] (e.g. [[reason]]), [[emotional]] processes, [[Personality psychology|personality]], [[temperament]] and [[Coping (psychology)|coping]] style.

Social influences have been found to be important, including [[abuse]], [[bullying]] and other negative or stressful life experiences. The specific risks and pathways to particular disorders are less clear, however. Aspects of the wider community have also been implicated, including [[employment]] problems, [[socioeconomic]] [[Economic inequality|inequality]], lack of social cohesion, problems linked to [[Human migration|migration]], and features of particular [[societies]] and [[cultures]].

===Gender-specific influences===
{{Ref improve section|date=May 2010}}
Female-specific indicators of mental illness incorporate physical or sexual abuse, stress, loss of social network, rape and domestic violence, high progesterone oral contraceptives, and mood disorders during early reproductive years.<ref>www.womenshealth.about.com</ref> It is important to note that the intersection of biological, social, and behavioral health problems may result in exacerbated mental health issues. 
An investigation carried out by the US National Camorbidity Survey (NCS) showed that 5% of woman that had been exposed to a traumatic event went onto develop [[posttramautic stress disorder]] (PTSD). It is also reported that women are the most vulnerable during the aftermath of a disaster. These circumstances increase the risk of poor physical health, anxiety, and depression which are all factors of mental health disorders. (Chandra P.S., et al. 2009).<ref>Chandra P.S., Herrman H., Fisher J., Kastrup M., Niaz U.,Rondon U.,Okasha A. 2009. ''Contemporary Topics In Woman's Health: Global perspectives In a Changing Society.'' Blackwell Publishings, UK.</ref>

==Diagnosis==
Many [[mental health professionals]], particularly [[psychiatrists]], seek to [[medical diagnosis|diagnose]] individuals by ascertaining their particular mental disorder. Some professionals, for example some [[clinical psychologists]], may avoid diagnosis in favor of other assessment methods such as formulation of a client's difficulties and circumstances.<ref>{{cite journal |author=Kinderman P, Lobban F |title=Evolving formulations: Sharing complex information with clients |journal=Behavioral and Cognitive Psychotherapy |volume=28 |issue=3 |pages=307–10 |year=2000 |doi=10.1017/S1352465800003118 }}</ref> The majority of mental health problems are actually assessed and treated by family physicians during consultations, who may refer on for more specialist diagnosis in acute or chronic cases. Routine diagnostic practice in mental health services typically involves an interview (which may be referred to as a [[mental status examination]]), where judgments are made of the interviewee's appearance and behavior, self-reported symptoms, mental health history, and current life circumstances. The views of relatives or other third parties may be taken into account. A physical examination to check for ill health or the effects of medications or other drugs may be conducted. [[Psychological testing]] is sometimes used via paper-and-pen or computerized questionnaires, which may include [[algorithms]] based on ticking off standardized diagnostic criteria, and in rare specialist cases neuroimaging tests may be requested, but these methods are more commonly found in research studies than routine clinical practice.<ref>HealthWise (2004) [http://health.yahoo.com/topic/mentalhealth/symptoms/medicaltest/healthwise/tp16780 Mental Health Assessment.] Yahoo! Health</ref><ref>{{Cite journal |author=Davies T |title=ABC of mental health. Mental health assessment |journal=BMJ |volume=314 |issue=7093 |pages=1536–9 |date=May 1997|pmid=9183204 |pmc=2126757 |url=http://www.bmj.com/cgi/content/full/314/7093/1536}}</ref> 

Time and budgetary constraints often limit practicing psychiatrists from conducting more thorough diagnostic evaluations.<ref>{{Cite journal |author=Kashner TM, Rush AJ, Surís A, ''et al.'' |title=Impact of structured clinical interviews on physicians' practices in community mental health settings |journal=Psychiatr Serv |volume=54 |issue=5 |pages=712–8 |date=May 2003|pmid=12719503 |url=http://ps.psychiatryonline.org/cgi/pmidlookup?view=long&pmid=12719503 |doi=10.1176/appi.ps.54.5.712}}</ref> It has been found that most clinicians evaluate patients using an unstructured, open-ended approach, with limited training in evidence-based assessment methods, and that inaccurate diagnosis may be common in routine practice.<ref>{{Cite journal |author=Shear MK, Greeno C, Kang J, ''et al.'' |title=Diagnosis of nonpsychotic patients in community clinics |journal=Am J Psychiatry |volume=157 |issue=4 |pages=581–7 |date=April 2000|pmid=10739417 |url=http://ajp.psychiatryonline.org/cgi/pmidlookup?view=long&pmid=10739417 |doi=10.1176/appi.ajp.157.4.581}}</ref> Mental illness involving hallucinations or delusions (especially schizophrenia) are prone to misdiagnosis in developing countries due to the presence of psychotic symptoms instigated by nutritional deficiencies. [[Comorbidity]] is very common in psychiatric diagnoses, i.e. the same person given a diagnosis in more than one category of disorder.

==Management==
{{Main|Treatment of mental disorders|Services for mental disorders}}
Treatment and support for mental disorders is provided in [[psychiatric hospitals]], [[clinics]] or any of a diverse range of [[community mental health services]]. In many countries services are increasingly based on a [[recovery model]] that is meant to support each individual's independence, choice and personal journey to regain a meaningful life, although individuals may be [[involuntary treatment|treated against their will]] in a minority of cases. There are a range of different types of treatment and what is most suitable depends on the disorder and on the individual. Many things have been found to help at least some people, and a [[placebo]] effect may play a role in any intervention or medication.

===Psychotherapy===
A major option for many mental disorders is [[psychotherapy]]. There are several main types. [[Cognitive behavioral therapy]] (CBT) is widely used and is based on modifying the patterns of thought and behavior associated with a particular disorder. [[Psychoanalysis]], addressing underlying psychic conflicts and defenses, has been a dominant school of psychotherapy and is still in use. [[Systemic therapy]] or [[family therapy]] is sometimes used, addressing a network of significant others as well as an individual. 

Some psychotherapies are based on a [[humanistic psychology|humanistic]] approach. There are a number of specific therapies used for particular disorders, which may be offshoots or hybrids of the above types. [[Mental health professionals]] often employ an [[Integrative Psychotherapy|eclectic or integrative approach]]. Much may depend on the [[therapeutic relationship]], and there may be problems with [[trust (social sciences)|trust]], [[confidentiality]] and [[engagement]].

===Medication===
A major option for many mental disorders is [[psychiatric medication]] and there are several main groups. [[Antidepressants]] are used for the treatment of [[clinical depression]] as well as often for anxiety and other disorders. [[Anxiolytics]] are used for [[anxiety disorder]]s and related problems such as insomnia. [[Mood stabilizers]] are used primarily in [[bipolar disorder]]. [[Antipsychotics]] are mainly used for [[psychosis|psychotic disorders]], notably for [[Schizophrenia#Positive and negative symptoms|positive symptoms in schizophrenia]]. [[Stimulants]] are commonly used, notably for [[ADHD]].

Despite the different conventional names of the drug groups, there may be considerable overlap in the disorders for which they are actually indicated, and there may also be [[off-label use]] of medications. There can be problems with [[adverse effects]] of medication and [[Compliance (medicine)|adherence]] to them, and there is also criticism of [[pharmaceutical marketing]] and professional [[conflicts of interest]].

===Other===
[[Electroconvulsive therapy]] (ECT) is sometimes used in severe cases when other interventions for severe intractable depression have failed. [[Psychosurgery]] is considered experimental but is advocated by certain [[neurologists]] in certain rare cases.<ref>Mind Disorders Encyclopedia [http://www.minddisorders.com/Ob-Ps/Psychosurgery.html Psychosurgery] [Retrieved on August 5th 2008]</ref><ref>{{Cite journal |author=Mashour GA, Walker EE, Martuza RL |title=Psychosurgery: past, present, and future |journal=Brain Res. Brain Res. Rev. |volume=48 |issue=3 |pages=409–19 |date=June 2005|pmid=15914249 |doi=10.1016/j.brainresrev.2004.09.002 |url=http://dura.stanford.edu/Articles/Psychosurgery.pdf|format=PDF}}</ref>

[[Counseling]] (professional) and [[co-counseling]] (between peers) may be used. [[Psychoeducation]] programs may provide people with the information to understand and manage their problems. Creative therapies are sometimes used, including [[music therapy]], [[art therapy]] or [[drama therapy]]. Lifestyle adjustments and supportive measures are often used, including [[peer support]], [[self-help groups for mental health]] and [[supported housing]] or supported [[employment]] (including [[social firms]]). Some advocate [[dietary supplements]].<ref>{{cite journal |author=Lakhan SE, Vieira KF |title=Nutritional therapies for mental disorders |journal=Nutr J |volume=7 |pages=2 |year=2008 |pmid=18208598 |pmc=2248201 |doi=10.1186/1475-2891-7-2 |url=http://www.nutritionj.com/content/7/1/2}}</ref>

==Prognosis==
Prognosis depends on the disorder, the individual and numerous related factors. Some disorders are transient, while others may last a lifetime. Some disorders may be very limited in their functional effects, while others may involve substantial [[disability]] and support needs. The degree of ability or disability may vary across different life domains. Continued disability has been linked to [[institutionalization]], discrimination and social exclusion as well as to the inherent properties of disorders.

Even those disorders often considered the most serious and intractable have varied courses. Long-term international studies of [[schizophrenia]] have found that over a half of individuals recover in terms of symptoms, and around a fifth to a third in terms of symptoms and functioning, with some requiring no medication. At the same time, many have serious difficulties and support needs for many years, although "late" recovery is still possible. The [[World Health Organization]] concluded that the long-term studies' findings converged with others in "relieving patients, carers and clinicians of the chronicity paradigm which dominated thinking throughout much of the 20th century."<ref>{{Cite journal |author=Harrison G, Hopper K, Craig T, ''et al.'' |title=Recovery from psychotic illness: a 15- and 25-year international follow-up study |journal=Br J Psychiatry |volume=178 |pages=506–17 |date=June 2001|pmid=11388966 |url=http://bjp.rcpsych.org/cgi/pmidlookup?view=long&pmid=11388966 |accessdate=2008-07-04 |doi=10.1192/bjp.178.6.506}}</ref><ref name="Jobe2005">{{Cite journal |author=Jobe TH, Harrow M |title=Long-term outcome of patients with schizophrenia: a review |journal=Canadian Journal of Psychiatry |volume=50 |issue=14 |pages=892–900 |date=December 2005|pmid=16494258 |url=http://ww1.cpa-apc.org:8080/Publications/Archives/CJP/2005/december/cjp-dec-05-Harrow-IR.pdf|format=PDF |accessdate=2008-07-05}}</ref> 

Around half of people initially diagnosed with [[bipolar disorder]] achieve syndromal recovery (no longer meeting criteria for the diagnosis) within six weeks, and nearly all achieve it within two years, with nearly half regaining their prior occupational and residential status in that period. However, nearly half go on to experience a new episode of mania or major depression within the next two years.<ref>{{Cite journal |author=Tohen M, Zarate CA, Hennen J, ''et al.'' |title=The McLean-Harvard First-Episode Mania Study: prediction of recovery and first recurrence |journal=Am J Psychiatry |volume=160 |issue=12 |pages=2099–107 |date=December 2003|pmid=14638578 |url=http://ajp.psychiatryonline.org/cgi/content/full/160/12/2099 |doi=10.1176/appi.ajp.160.12.2099}}</ref> Functioning has been found to vary, being poor during periods of [[major depression]] or [[mania]] but otherwise fair to good, and possibly superior during periods of hypomania in Bipolar II.<ref>{{Cite journal |author=Judd LL, Akiskal HS, Schettler PJ, ''et al.'' |title=Psychosocial disability in the course of bipolar I and II disorders: a prospective, comparative, longitudinal study |journal=Arch. Gen. Psychiatry |volume=62 |issue=12 |pages=1322–30 |date=December 2005|pmid=16330720 |doi=10.1001/archpsyc.62.12.1322 |url=http://archpsyc.ama-assn.org/cgi/reprint/62/12/1322.pdf|format=PDF}}</ref>

Some mental disorders are linked, on average, to increased rates of attempted and/or completed [[suicide]] or [[self-harm]].

Despite often being characterized in purely negative terms, some mental states labeled as disorders can also involve above-average creativity, non-conformity, goal-striving, meticulousness, or empathy.<ref name="Rogers&Pilgram05"/> In addition, the public perception of the level of disability associated with mental disorders can change.<ref>Ferney, V. (2003) [http://www.newyorkcityvoices.org/2003janmar/20030318.html The Hierarchy of Mental Illness: Which diagnosis is the least debilitating?] ''New York City Voices'' Jan/March</ref>

==Epidemiology==
{{Main|Prevalence of mental disorders}}
Mental disorders are common. World wide more than one in three people in most countries report sufficient criteria for at least one at some point in their life.<ref>WHO International Consortium in Psychiatric Epidemiology (2000) [http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862000000400003&lng=&nrm=iso Cross-national comparisons of the prevalences and correlates of mental disorders] ''Bulletin of the World Health Organization'' v.78 n.4</ref> In the United States 46% qualifies for a mental illness at some point.<ref>{{Cite journal |author=Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE |title=Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication |journal=Arch. Gen. Psychiatry |volume=62 |issue=6 |pages=593–602 |date=June 2005|pmid=15939837 |doi=10.1001/archpsyc.62.6.593 |url=}}</ref> An ongoing survey indicates that anxiety disorders are the most common in all but one country, followed by mood disorders in all but two countries, while substance disorders and impulse-control disorders were consistently less prevalent.<ref>{{cite web |url=http://www.hcp.med.harvard.edu/wmh/index.php |title=The World Mental Health Survey Initiative |work= |accessdate=}}</ref> Rates varied by region.<ref>{{Cite journal |author=Demyttenaere K, Bruffaerts R, Posada-Villa J, ''et al.'' |title=Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys |journal=JAMA |volume=291 |issue=21 |pages=2581–90 |date=June 2004|pmid=15173149 |doi=10.1001/jama.291.21.2581 }}</ref> Such statistics are widely believed to be underestimates, due to poor diagnosis (especially in countries without affordable access to mental health services) and low reporting rates, in part because of the predominant use of self-report data rather than semi-structured instruments.{{Citation needed|date=July 2008}} Actual lifetime prevalence rates for mental disorders are estimated to be between 65% and 85%.{{Citation needed|date=July 2008}}

A review of anxiety disorder surveys in different countries found average lifetime prevalence estimates of 16.6%, with women having higher rates on average.<ref>{{Cite journal |author=Somers JM, Goldner EM, Waraich P, Hsu L |title=Prevalence and incidence studies of anxiety disorders: a systematic review of the literature |journal=Can J Psychiatry |volume=51 |issue=2 |pages=100–13 |date=February 2006|pmid=16989109 |url=http://ww1.cpa-apc.org:8080/Publications/Archives/CJP/2004/february/waraich.asp}}</ref> A review of mood disorder surveys in different countries found lifetime rates of 6.7% for major depressive disorder (higher in some studies, and in women) and 0.8% for Bipolar I disorder.<ref>{{Cite journal |author=Waraich P, Goldner EM, Somers JM, Hsu L |title=Prevalence and incidence studies of mood disorders: a systematic review of the literature |journal=Can J Psychiatry |volume=49 |issue=2 |pages=124–38 |date=February 2004|pmid=15065747 |url=http://ww1.cpa-apc.org:8080/Publications/Archives/CJP/2004/february/waraich.asp}}</ref>

In the United States the frequency of disorder is: anxiety disorder (28.8%), mood disorder (20.8%), impulse-control disorder (24.8%) or substance use disorder (14.6%).<ref>{{Cite journal |author=Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE |title=Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication |journal=Arch. Gen. Psychiatry |volume=62 |issue=6 |pages=593–602 |date=June 2005|pmid=15939837 |doi=10.1001/archpsyc.62.6.593 }}</ref><ref>{{Cite journal |author=Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE |title=Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication |journal=Arch. Gen. Psychiatry |volume=62 |issue=6 |pages=617–27 |date=June 2005|pmid=15939839 |doi=10.1001/archpsyc.62.6.617 |pmc=2847357 }}</ref><ref>US National Institute of Mental Health (2006) [http://www.nimh.nih.gov/publicat/numbers.cfm The Numbers Count: Mental Disorders in America] Retrieved May 2007</ref>

A 2004 cross-Europe study found that approximately one in four people reported meeting criteria at some point in their life for at least one of the DSM-IV disorders assessed, which included mood disorders (13.9%), anxiety disorders (13.6%) or alcohol disorder (5.2%). Approximately one in ten met criteria within a 12-month period. Women and younger people of either gender showed more cases of disorder.<ref>{{cite journal |author=Alonso J, Angermeyer MC, Bernert S, ''et al.'' |title=Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project |journal=Acta Psychiatr Scand Suppl |volume= 109|issue=420 |pages=21–7 |year=2004 |pmid=15128384 |doi=10.1111/j.1600-0047.2004.00327.x }}</ref> A 2005 review of surveys in 16 European countries found that 27% of adult Europeans are affected by at least one mental disorder in a 12 month period.<ref>{{Cite journal |author=Wittchen HU, Jacobi F |title=Size and burden of mental disorders in Europe&mdash;a critical review and appraisal of 27 studies |journal=Eur Neuropsychopharmacol |volume=15 |issue=4 |pages=357–76 |date=August 2005|pmid=15961293 |doi=10.1016/j.euroneuro.2005.04.012}}</ref>

An international review of studies on the prevalence of schizophrenia found an average (median) figure of 0.4% for lifetime prevalence; it was consistently lower in poorer countries.<ref>{{Cite journal |author=Saha S, Chant D, Welham J, McGrath J |title=A systematic review of the prevalence of schizophrenia |journal=PLoS Med. |volume=2 |issue=5 |pages=e141 |date=May 2005|pmid=15916472 |pmc=1140952 |doi=10.1371/journal.pmed.0020141 }}</ref>

Studies of the prevalence of personality disorders (PDs) have been fewer and smaller-scale, but one broad Norwegian survey found a five-year prevalence of almost 1 in 7 (13.4%). Rates for specific disorders ranged from 0.8% to 2.8%, differing across countries, and by gender, educational level and other factors.<ref>{{Cite journal |author=Torgersen S, Kringlen E, Cramer V |title=The prevalence of personality disorders in a community sample |journal=Arch. Gen. Psychiatry |volume=58 |issue=6 |pages=590–6 |date=June 2001|pmid=11386989 |url=http://archpsyc.ama-assn.org/cgi/pmidlookup?view=long&pmid=11386989 |doi=10.1001/archpsyc.58.6.590}}</ref> A US survey that incidentally screened for personality disorder found a rate of 14.79%.<ref>{{Cite journal |author=Grant BF, Hasin DS, Stinson FS, ''et al.'' |title=Prevalence, correlates, and disability of personality disorders in the United States: results from the national epidemiologic survey on alcohol and related conditions |journal=J Clin Psychiatry |volume=65 |issue=7 |pages=948–58 |date=July 2004|pmid=15291684 |url=http://article.psychiatrist.com/?ContentType=START&ID=10000967 |doi=10.4088/JCP.v65n0711}}</ref>

Approximately 7% of a preschool pediatric sample were given a psychiatric diagnosis in one clinical study, and approximately 10% of 1- and 2-year-olds receiving developmental screening have been assessed as having significant emotional/behavioral problems based on parent and pediatrician reports.<ref>{{Cite journal |author=Carter AS, Briggs-Gowan MJ, Davis NO |title=Assessment of young children's social-emotional development and psychopathology: recent advances and recommendations for practice |journal=J Child Psychol Psychiatry |volume=45 |issue=1 |pages=109–34 |date=January 2004|pmid=14959805 |url=http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0021-9630&date=2004&volume=45&issue=1&spage=109 |doi=10.1046/j.0021-9630.2003.00316.x}}</ref>

While rates of psychological disorders are the same for men and women, women have twice the rate of depression than men.<ref>[http://www.nami.org Nami.org]</ref> Each year 73 million women are afflicted with major depression, and suicide is ranked 7th as the cause of death for women between the ages of 20-59. Depressive disorders account for close to 41.9% of the disability from neuropsychiatric disorders among women compared to 29.3% among men.<ref>[http://www.who.int/mental_health/prevention/genderwomen/en/ WHO.int]</ref>

==History==
{{Main|History of mental disorders}}
[[File:R212F1.jpeg|thumb|250px|Early color illustration of psychiatric treatment methods]]

===Ancient civilizations===
Ancient civilizations described and treated a number of mental disorders. The Greeks coined terms for [[melancholy]], [[hysteria]] and [[phobia]] and developed the [[humorism]] theory. Psychiatric theories and treatments developed in Persia, Arabia and the Muslim Empire, particularly in the [[Islamic Golden Age|medieval Islamic world]] from the 8th century, where the first [[psychiatric hospital]]s were built.

===Europe===
====Middle Ages====
Conceptions of madness in the Middle Ages in Christian Europe were a mixture of the divine, diabolical, magical and humoral, as well as more down to earth considerations. In the early modern period, some people with mental disorders may have been victims of the witch-hunts but were increasingly admitted to local workhouses and jails or sometimes to private madhouses. Many terms for mental disorder that found their way into everyday use first became popular in the 16th and 17th centuries.

====Eighteenth century====
By the end of the 17th century and into the [[Age of Enlightenment|Enlightenment]], madness was increasingly seen as an organic physical phenomenon with no connection to the soul or moral responsibility. Asylum care was often harsh and treated people like wild animals, but towards the end of the 18th century a [[moral treatment]] movement gradually developed. Clear descriptions of some syndromes may be rare prior to the 19th century.

====Nineteenth century====
[[Industrialization]] and population growth led to a massive expansion of the number and size of insane asylums in every Western country in the 19th century. Numerous different [[classification of mental disorders|classification schemes]] and diagnostic terms were developed by different authorities, and the term [[psychiatry]] was coined, though medical superintendents were still known as alienists.

====Twentieth century====
The turn of the 20th century saw the development of [[psychoanalysis]], which would later come to the fore, along with [[Kraepelin]]'s classification scheme. Asylum "inmates" were increasingly referred to as "patients", and asylums renamed as hospitals.

===Europe and the U.S.===
In the 20th century in the United States, a mental hygiene movement developed, aiming to prevent mental disorders. Clinical psychology and social work developed as professions. [[World War I]] saw a massive increase of conditions that came to be termed "[[Combat stress reaction|shell shock]]".

[[World War II]] saw the development in the U.S. of a new psychiatric manual for categorizing mental disorders, which along with existing systems for collecting census and hospital statistics led to the first [[Diagnostic and Statistical Manual of Mental Disorders]] (DSM). The [[International Classification of Diseases]] (ICD) followed suit with a section on mental disorders. The term [[stress (biological)|stress]], having emerged out of [[endocrinology]] work in the 1930s, was increasingly applied to mental disorders.
[[File:Insulin shock therapy.jpg|thumb|250px|Insulin Shock Therapy]]

[[Electroconvulsive therapy]], [[insulin shock therapy]], [[lobotomy|lobotomies]] and the "[[neuroleptic]]" [[chlorpromazine]] came to be used by mid-century. An [[antipsychiatry]] movement came to the fore in the 1960s. [[Deinstitutionalization]] gradually occurred in the West, with isolated [[psychiatric hospitals]] being closed down in favor of [[community mental health services]]. A [[consumer/survivor movement]] gained momentum. Other kinds of [[psychiatric medication]] gradually came into use, such as "[[antidepressants|psychic energizers]]" and [[lithium pharmacology|lithium]]. [[Benzodiazepines]] gained widespread use in the 1970s for anxiety and depression, until dependency problems curtailed their popularity.

Advances in [[neuroscience]] and [[genetics]] led to new research agendas. [[Cognitive behavioral therapy]] was developed. The DSM and then ICD adopted new criteria-based classifications, and the number of "official" diagnoses saw a large expansion. Through the 1990s, new SSRI [[antidepressant]]s became some of the most widely prescribed drugs in the world. Also during the 1990s, a [[recovery model]] developed.

==Society and culture==
[[Image:Self.svg|right|200px]]
Different societies or cultures and even different individuals in a culture can disagree as to what constitutes optimal versus pathological biological and psychological functioning. Research has demonstrated that cultures vary in the relative importance placed on, for example, happiness, autonomy, or social relationships for pleasure. Likewise, the fact that a behavior pattern is valued, accepted, encouraged, or even statistically normative in a culture does not necessarily mean that it is conducive to optimal psychological functioning.

People in all cultures find some behaviors bizarre or even incomprehensible. But just what they feel is bizarre or incomprehensible is ambiguous and subjective.<ref>{{Cite journal |author=Heinimaa M |title=Incomprehensibility: the role of the concept in DSM-IV definition of schizophrenic delusions |journal=Med Health Care Philos |volume=5 |issue=3 |pages=291–5 |date=October 2002|pmid=12517037 |doi=10.1023/A:1021164602485 |url=http://www.kluweronline.com/art.pdf?issn=1386-7423&volume=5&page=291}}</ref> These differences in determination can become highly contentious.

The process by which conditions and difficulties come to be defined and treated as medical conditions and problems, and thus come under the authority of doctors and other health professionals, is known as [[medicalization]] or pathologization.

In the scientific and academic literature on the definition or [[classification of mental disorder]], one extreme argues that it is entirely a matter of value judgements (including of what is [[norm (sociology)|norm]]al) while another proposes that it is or could be entirely [[objectivity (science)|objective]] and [[scientific]] (including by reference to statistical norms).<ref>{{Cite journal |author=Berrios G E |title=Classifications in psychiatry: a conceptual history |journal=Aust N Z J Psychiatry |volume=33 |issue=2 |pages=145–60 |date=April 1999|pmid=10336212 |url=http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0004-8674&date=1999&volume=33&issue=2&spage=145 |doi=10.1046/j.1440-1614.1999.00555.x}}</ref> Common hybrid views argue that the concept of mental disorder is objective but a "fuzzy [[prototype]]" that can never be precisely defined, or alternatively that it inevitably involves a mix of scientific facts and subjective value judgments.<ref>Perring, C. (2005) [http://plato.stanford.edu/entries/mental-illness/ Mental Illness] Stanford Encyclopedia of Philosophy</ref>

===Professions and fields===
{{Main|Mental health professional}}
A number of [[professions]] have developed that specialize in the treatment of mental disorders, including the [[Medicine|medical]] speciality of [[psychiatry]] (including psychiatric nursing),<ref name=AJP154Editorial>{{cite journal |author=Andreasen NC |title=What is psychiatry? |journal=Am J Psychiatry |volume=154 |issue=5 |pages=591–3 |date=1 May 1997|pmid=9137110 |url=http://ajp.psychiatryonline.org/cgi/pmidlookup?view=long&pmid=9137110 }}</ref><ref name=UM>University of Melbourne. (2005, August 19). ''What is Psychiatry?''. Retrieved April 19, 2007, from http://www.psychiatry.unimelb.edu.au/info/what_is_psych.html</ref><ref name=CPA>California Psychiatric Association. (2007, February 28). ''Frequently Asked Questions About Psychiatry & Psychiatrists''. Retrieved April 19, 2007, from http://www.calpsych.org/publications/cpa/faqs.html</ref> a subset of [[psychology]] known as [[clinical psychology]],<ref>American Psychological Association, Division 12, http://www.apa.org/divisions/div12/aboutcp.html</ref> [[social work]],<ref>Golightley, M. (2004) Social work and Mental Health Learning Matters, UK</ref> as well as mental health counselors, marriage and family therapists, [[psychotherapists]], [[Licensed Professional Counselor|counselors]] and [[public health]] professionals. Those with personal experience of using mental health services are also increasingly involved in researching and delivering mental health services and working as mental health professionals.<ref>{{Cite journal |author=Goldstrom ID, Campbell J, Rogers JA, ''et al.'' |title=National estimates for mental health mutual support groups, self-help organizations, and consumer-operated services |journal=Adm Policy Ment Health |volume=33 |issue=1 |pages=92–103 |date=January 2006|pmid=16240075 |doi=10.1007/s10488-005-0019-x |url=http://www.springerlink.com/content/u132325343qlw4r0/}}</ref><ref>The Joseph Rowntree Foundation (1998) [http://www.jrf.org.uk/knowledge/findings/socialcare/SCR488.asp The experiences of mental health service users as mental health professionals]</ref><ref>{{cite journal |author=Chamberlin J |title=User/consumer involvement in mental health service delivery |journal=Epidemiol Psichiatr Soc |volume=14 |issue=1 |pages=10–4 |year=2005 |pmid=15792289 }}</ref><ref>{{Cite journal | doi = 10.1111/j.1447-0349.2006.00432.x | author = Terence V. McCann, John Baird, Eileen Clark, Sai Lu | year = 2006 | title = Beliefs about using consumer consultants in inpatient psychiatric units | url = http://www.blackwell-synergy.com/doi/abs/10.1111/j.1447-0349.2006.00432.x | journal = International Journal of Mental Health Nursing | volume = 15 | issue = 4| pages = 258–265 | pmid = 17064322 }}</ref> The different clinical and scientific perspectives draw on diverse fields of research and theory, and different disciplines may favor differing models, explanations and goals.<ref name="Rogers&Pilgram05">{{cite book |author=Pilgrim, David; Rogers, Anne |title=A sociology of mental health and illness |publisher=Open University Press |location=[Milton Keynes] |year=2005 |isbn=0-335-21583-1 |edition=3rd}}</ref>

===Movements===
The [[consumer/survivor movement]] (also known as user/survivor movement) is made up of individuals (and organizations representing them) who are clients of mental health services or who consider themselves "survivors" of mental health services. The movement campaigns for improved mental health services and for more involvement and empowerment within mental health services, policies and wider society.<ref>{{cite journal |author=Everett B |title=Something is happening: the contemporary consumer and psychiatric survivor movement in historical context |journal=Journal of Mind and Behavior |volume=15 |issue=1-2 |pages=55–7 |year=1994 |url=http://www.umaine.edu/JMB/archives/volume15/15_1-2_1994winterspring.html#abstract4 |format=}} {{Dead link|date=March 2010}}</ref><ref>{{Cite journal |author=Rissmiller DJ, Rissmiller JH |title=Evolution of the antipsychiatry movement into mental health consumerism |journal=Psychiatr Serv |volume=57 |issue=6 |pages=863–6 |date=June 2006|pmid=16754765 |doi=10.1176/appi.ps.57.6.863 }}</ref><ref>{{Cite journal |author=Oaks D |title=The evolution of the consumer movement |journal=Psychiatr Serv |volume=57 |issue=8 |pages=1212; author reply 1216 |date=August 2006|pmid=16870979 |doi=10.1176/appi.ps.57.8.1212 |url=http://psychservices.psychiatryonline.org/cgi/content/full/57/8/1212}}</ref> [[Patient advocacy]] organizations have expanded with increasing [[deinstitutionalization]] in developed countries, working to challenge the [[stereotypes]], [[social stigma|stigma]] and exclusion associated with psychiatric conditions. An [[antipsychiatry]] movement fundamentally challenges mainstream psychiatric theory and practice, including asserting that psychiatric diagnoses of mental illnesses are neither real nor useful.<ref name=AntiPsychCoal>The Antipsychiatry Coalition. (2005, November 26). The Antipsychiatry Coalition. Retrieved April 19, 2007, from antipsychiatry.org</ref><ref>{{Cite journal |author=O'Brien AP, Woods M, Palmer C |title=The emancipation of nursing practice: applying anti-psychiatry to the therapeutic community |journal=Aust N Z J Ment Health Nurs |volume=10 |issue=1 |pages=3–9 |date=March 2001|pmid=11421968 |doi=10.1046/j.1440-0979.2001.00183.x |url=http://www.blackwell-synergy.com/doi/abs/10.1046/j.1440-0979.2001.00183.x}}</ref><ref>{{cite journal |author=Weitz D |title=Call me antipsychiatry activist&mdash;not "consumer" |journal=Ethical Hum Sci Serv |volume=5 |issue=1 |pages=71–2 |year=2003 |pmid=15279009 }}</ref>

===Intangible experiences===
[[Religious]], [[spirituality|spiritual]], or [[transpersonal]] experiences and beliefs are typically not defined as disordered, especially if widely shared, despite meeting many criteria of delusional or psychotic disorders.<ref>{{Cite journal |author=Pierre JM |title=Faith or delusion? At the crossroads of religion and psychosis |journal=J Psychiatr Pract |volume=7 |issue=3 |pages=163–72 |date=May 2001|pmid=15990520 |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=1527-4160&volume=7&issue=3&spage=163 |doi=10.1097/00131746-200105000-00004}}</ref><ref>{{cite journal |author=Johnson CV, Friedman HL |title=Enlightened or Delusional? Differentiating Religious, Spiritual, and Transpersonal Experiences from Psychopathology |journal=Journal of Humanistic Psychology |volume=48 |issue=4 |pages=505–27 |year=2008 |doi=10.1177/0022167808314174 |url=http://jhp.sagepub.com/cgi/content/abstract/48/4/505}}</ref> Even when a belief or experience can be shown to produce distress or disability—the ordinary standard for judging mental disorders—the presence of a strong cultural basis for that belief, experience, or interpretation of experience, generally disqualifies it from counting as evidence of mental disorder.

===Western bias===
Current diagnostic guidelines have been criticized as having a fundamentally Euro-American outlook. They have been widely implemented, but opponents argue that even when diagnostic criteria are accepted across different cultures, it does not mean that the underlying constructs have any validity within those cultures; even reliable application can prove only consistency, not legitimacy.<ref name=Widiger2000>{{cite journal |author=Widiger TA, Sankis LM |title=Adult psychopathology: issues and controversies |journal=Annu Rev Psychol |volume=51 |pages=377–404 |year=2000 |pmid=10751976 |doi=10.1146/annurev.psych.51.1.377 }}</ref>

Advocating a more culturally sensitive approach, critics such as [[Carl Bell (physician)|Carl Bell]] and [[Marcello Maviglia]] contend that the cultural and ethnic diversity of individuals is often discounted by researchers and service providers.<ref name=wash-post>Shankar Vedantam, [http://www.washingtonpost.com/wp-dyn/content/article/2005/06/25/AR2005062500982.html Psychiatry's Missing Diagnosis: Patients' Diversity Is Often Discounted] Washington Post: Mind and Culture, June 26</ref>

[[Cross-cultural psychiatry|Cross-cultural psychiatrist]] [[Arthur Kleinman]] contends that the Western bias is ironically illustrated in the introduction of cultural factors to the [[DSM-IV]]: that disorders or concepts from non-Western or non-mainstream cultures are described as "culture-bound", whereas standard psychiatric diagnoses are given no cultural qualification whatsoever, reveals to Kleinman an underlying assumption that Western cultural phenomena are universal.<ref>{{cite journal |author=Kleinman A |title=Triumph or pyrrhic victory? The inclusion of culture in DSM-IV |journal=Harv Rev Psychiatry |volume=4 |issue=6 |pages=343–4 |year=1997 |pmid=9385013 |doi=10.3109/10673229709030563 }}</ref> Kleinman's negative view towards the [[culture-bound syndrome]] is largely shared by other [[Cross-cultural psychiatry|cross-cultural]] critics, common responses included both disappointment over the large number of documented non-Western mental disorders still left out and frustration that even those included were often misinterpreted or misrepresented.<ref>Bhugra, D. & Munro, A. (1997) ''Troublesome Disguises: Underdiagnosed Psychiatric Syndromes'' Blackwell Science Ltd</ref>

Many mainstream psychiatrists are dissatisfied with the new culture-bound diagnoses, although for different reasons. [[Robert Spitzer (psychiatrist)|Robert Spitzer]], a lead architect of the [[DSM-III]], has hypothesized that adding cultural formulations was an attempt to appease cultural critics and stated that the formulations lack any scientific motivation or support. Spitzer also posits that the new culture-bound diagnoses are rarely used, maintaining that the standard diagnoses apply regardless of the culture involved. In general, mainstream psychiatric opinion remains that if a diagnostic category is valid, cross-cultural factors are either irrelevant or are significant only to specific symptom presentations.<ref name="Widiger2000" />

===Relationships and morality===
Clinical conceptions of mental illness also overlap with [[value (personal and cultural)|personal and cultural values]] in the domain of [[morality]], so much so that it is sometimes argued that separating the two is impossible without fundamentally redefining the essence of being a particular [[person]] in a society.<ref>{{cite journal |author=Clark LA |title=The role of moral judgment in personality disorder diagnosis |journal=J Pers Disord. |volume=20 |issue=2 |pages=184–5 |year=2006 |doi=10.1521/pedi.2006.20.2.184 }}</ref> In clinical psychiatry, persistent distress and disability indicate an internal disorder requiring treatment; but in another context, that same distress and disability can be seen as an indicator of emotional struggle and the need to address social and structural problems.<ref name="Karasz05">{{Cite journal |author=Karasz A |title=Cultural differences in conceptual models of depression |journal=Social Science in Medicine |volume=60 |issue=7 |pages=1625–35 |date=April 2005|pmid=15652693 |doi=10.1016/j.socscimed.2004.08.011}}</ref><ref>{{cite journal | doi = 10.5555/hesr.2004.13.1.54 | last1 = Tilbury | first1 = F. | last2 = Rapley | first2 = M. | year = 2004 | title = 'There are orphans in Africa still looking for my hands': African women refugees and the sources of emotional distress | url = http://www.atypon-link.com/EMP/doi/abs/10.5555/hesr.2004.13.1.54 | journal = Health Sociology Review | volume = 13 | issue = 1| pages = 54–64 }}</ref> This dichotomy has lead some academics and clinicians to advocate a [[postmodernist]] conceptualization of mental distress and well-being.<ref>{{Cite journal |author=Bracken P, Thomas P |title=Postpsychiatry: a new direction for mental health |journal=BMJ |volume=322 |issue=7288 |pages=724–7 |date=March 2001|pmid=11264215 |pmc=1119907 |url=http://bmj.com/cgi/pmidlookup?view=long&pmid=11264215 |doi=10.1136/bmj.322.7288.724}}</ref><ref>{{cite journal |author=Lewis B |title=Psychiatry and Postmodern Theory |journal=J Med Humanit |volume=21 |issue=2 |pages=71–84 |year=2000 |url=http://www.springerlink.com/link.asp?id=j75517g14h618189 |doi=10.1023/A:1009018429802}}</ref>

Such approaches, along with [[cross-cultural psychiatry|cross-cultural]] and "[[heresy|heretical]]" psychologies centered on alternative cultural and [[ethnic]] and [[Race (classification of human beings)|race-based]] identities and experiences, stand in contrast to the mainstream psychiatric community's active avoidance of any involvement with either morality or culture.<ref>{{cite journal |author=Kwate NO |title=The heresy of African-centered psychology |journal=J Med Humanit |volume=26 |issue=4 |pages=215–35 |year=2005 |pmid=16333686 |doi=10.1007/s10912-005-7698-x }}</ref> In many countries there are attempts to challenge perceived prejudice against [[minority groups]], including alleged [[institutional racism]] within psychiatric services.<ref>[http://pb.rcpsych.org/cgi/reprint/31/10/367.pdf Commentary on institutional racism in psychiatry, 2007]</ref>

===Laws and policies===
Three quarters of countries around the world have mental health legislation. Compulsory admission to mental health facilities (also known as [[involuntary commitment]] or [[sectioning]]), is a controversial topic. From some points of view it can impinge on personal liberty and the right to choose, and carry the risk of abuse for political, social and other reasons; from other points of view, it can potentially prevent harm to self and others, and assist some people in attaining their right to healthcare when unable to decide in their own interests.<ref name="WHORIGHTS">World Health Organization (2005) [http://www.who.int/mental_health/policy/who_rb_mnh_hr_leg_FINAL_11_07_05.pdf WHO Resource Book on Mental Health: Human rights and legislation] ISBN 924156282 (PDF)</ref>

All human-rights oriented mental health laws require proof of the presence of a mental disorder as defined by internationally accepted standards, but the type and severity of disorder that counts can vary in different jurisdictions. The two most often utilized grounds for involuntary admission are said to be serious likelihood of immediate or imminent danger to self or others, and the need for treatment. Applications for someone to be involuntarily admitted may usually come from a mental health practitioner, a family member, a close relative, or a guardian. Human-rights-oriented laws usually stipulate that independent medical practitioners or other accredited mental health practitioners must examine the patient separately and that there should be regular, time-bound review by an independent review body.<ref name="WHORIGHTS"/> An individual must be shown to lack the capacity to give or withhold informed consent (i.e. to understand treatment information and its implications). Legal challenges in some areas have resulted in [[supreme court]] decisions that a person does ''not'' have to agree with a psychiatrist's characterization of their issues as an "illness", nor with a psychiatrist's conviction in medication, but only recognize the issues and the information about treatment options.<ref>{{Cite journal |author=Sklar R |title=Starson v. Swayze: the Supreme Court speaks out (not all that clearly) on the question of "capacity" |journal=Can J Psychiatry |volume=52 |issue=6 |pages=390–6 |date=June 2007|pmid=17696026 }}</ref>

Proxy consent (also known as [[substituted decision-making]]) may be given to a personal representative, a family member or a legally appointed guardian, or patients may have been able to enact an [[advance directive]] as to how they wish to be treated.<ref name="WHORIGHTS"/> The right to [[supported decision-making]] may also be included in legislation.<ref>Manitoba Family Services and Housing. The Vulnerable Persons Living with a Mental Disability Act, 1996</ref> [[Involuntary treatment]] laws are increasingly extended to those living in the community, for example [[outpatient commitment]] laws (known by different names) are used in [[New Zealand]], [[Australia]], the [[United Kingdom]] and most of the United States.

The World Health Organization reports that in many instances national mental health legislation takes away the rights of persons with mental disorders rather than protecting rights, and is often outdated.<ref name="WHORIGHTS"/> In 1991, the [[United Nations]] adopted the [[Principles for the Protection of Persons with Mental Illness and the Improvement of Mental Health Care]], which established minimum human rights standards of practice in the mental health field. In 2006, the UN formally agreed the [[Convention on the Rights of Persons with Disabilities]] to protect and enhance the rights and opportunities of disabled people, including those with psychosocial disabilities.<ref>[http://www.un.org/esa/socdev/enable/ ENABLE website] UN section on disability</ref>

The term [[insanity]], sometimes used [[colloquialism|colloquially]] as a [[synonym]] for mental illness, is often used technically as a legal term. The [[insanity defense]] may be used in a legal trial (known as the [[mental disorder defence]] in some countries).

===Perception and discrimination===
;Stigma
The [[social stigma]] associated with mental disorders is a widespread problem. Some people believe those with serious mental illnesses cannot recover, or are to blame for problems.<ref>[http://www.camh.net/News_events/News_releases_and_media_advisories_and_backgrounders/torontostar_stigmaoped1204.html CAMH: Toronto Star Opinion Editorial: Ending stigma of mental illness<!-- Bot generated title -->]</ref> The US Surgeon General stated in 1999 that: "Powerful and pervasive, stigma prevents people from acknowledging their own mental health problems, much less disclosing them to others."<ref>[http://www.surgeongeneral.gov/library/mentalhealth/chapter8/sec1.html Mental Health: A Report of the Surgeon General - Chapter 8<!-- Bot generated title -->]</ref> [[Employment discrimination]] is reported to play a significant part in the high rate of [[unemployment]] among those with a diagnosis of mental illness.<ref>{{Cite journal |author=Stuart H |title=Mental illness and employment discrimination |journal=Curr Opin Psychiatry |volume=19 |issue=5 |pages=522–6 |date=September 2006|pmid=16874128 |doi=10.1097/01.yco.0000238482.27270.5d |url=http://www.medscape.com/viewarticle/542517}}</ref>

Efforts are being undertaken worldwide to eliminate the stigma of mental illness,<ref>[http://bipolarworld-net.canadawebhosting.com/Disability/Stigma/stop_stigma.htm Stop Stigma<!-- Bot generated title -->]</ref> although their methods and outcomes have sometimes been criticized.<ref>{{Cite journal |author=Read J, Haslam N, Sayce L, Davies E |title=Prejudice and schizophrenia: a review of the 'mental illness is an illness like any other' approach |journal=Acta Psychiatr Scand |volume=114 |issue=5 |pages=303–18 |date=November 2006|pmid=17022790 |doi=10.1111/j.1600-0447.2006.00824.x }}</ref>

A 2008 study by [[Baylor University]] researchers found that clergy in the US often deny or dismiss the existence of a mental illness. Of 293 Christian church members, more than 32 percent were told by their church pastor that they or their loved one did not really have a mental illness, and that the cause of their problem was solely spiritual in nature, such as a personal sin, lack of faith or demonic involvement. The researchers also found that women were more likely than men to get this response. All participants in both studies were previously diagnosed by a licensed mental health provider as having a serious mental illness.<ref>[http://newswise.com/articles/view/545316/ Study Finds Serious Mental Illness Often Dismissed by Local Church] Newswise, Retrieved on October 15, 2008.</ref> However, there is also research suggesting that people are often helped by [[extended families]] and supportive religious leaders who listen with kindness and respect, which can often contrast with usual practice in psychiatric diagnosis and medication.<ref>[http://www.timesonline.co.uk/tol/life_and_style/article6538213.ece Psychiatric diagnoses are less reliable than star signs] Times Online, June 2009</ref>

;Media and general public
{{Main|Mental disorders in art and literature}}
Media coverage of mental illness comprises predominantly negative depictions, for example, of incompetence, violence or criminality, with far less coverage of positive issues such as accomplishments or [[human rights]] issues.<ref>{{cite journal |author=Coverdate J, Nairn R, Claasen D |title= Depictions of mental illness in print media: a prospective national sample |journal=Australian and New Zealand Journal of Psychiatry |volume=36 |issue=5 |pages=697–700 |year=2001 |doi=10.1046/j.1440-1614.2002.00998.x |url=http://www.blackwell-synergy.com/doi/abs/10.1046/j.1440-1614.2002.00998.x |pmid=12225457}}</ref><ref>Edney, RD. (2004) [http://www.ontario.cmha.ca/content/about_mental_illness/mass_media.asp Mass Media and Mental Illness: A Literature Review] Canadian Mental Health Association</ref><ref>{{cite journal |author=Diefenbach DL |title=The portrayal of mental illness on prime-time television |journal=Journal of Community Psychology |volume=25 |issue=3 |pages=289–302 |year=1998 |doi=10.1002/(SICI)1520-6629(199705)25:3<289::AID-JCOP5>3.0.CO;2-R |url=http://www3.interscience.wiley.com/cgi-bin/abstract/46099/ABSTRACT?CRETRY=1&SRETRY=0}}</ref> Such negative depictions, including in children's cartoons, are thought to contribute to [[social stigma|stigma]] and negative attitudes in the public and in those with mental health problems themselves, although more sensitive or serious cinematic portrayals have increased in prevalence.<ref>{{cite journal |author=Sieff, E |title=Media frames of mental illnesses: The potential impact of negative frames |journal=Journal of Mental Health |volume=12 |issue=3 |pages=259–69 |year=2003 |url=http://www.ingentaconnect.com/content/routledg/cjmh/2003/00000012/00000003/art00006 |doi=10.1080/0963823031000118249 |format=}} {{Dead link|date=March 2010}}</ref><ref>{{cite journal |author=Wahl, O.F. |title=News Media Portrayal of Mental Illness: Implications for Public Policy |journal=American Behavioral Scientist |volume=46 |issue=12 |pages=1594–600 |year=2003 |doi=10.1177/0002764203254615 |url=http://abs.sagepub.com/cgi/content/abstract/46/12/1594 }}</ref>

In the United States, the [[Carter Center]] has created fellowships for journalists in [[South Africa]], the U.S., and [[Romania]], to enable reporters to research and write stories on mental health topics.<ref name="Fellows">{{Cite web |author= The Carter Center |title=The Carter Center Awards 2008-2009 Rosalynn Carter Fellowships for Mental Health Journalism |date=2008-07-18 |url=http://www.cartercenter.com/news/pr/mental_health_fellows_2008_2009.html |accessdate=2008-07-21}}</ref> Former [[First Lady of the United States|US First Lady]] [[Rosalynn Carter]] began the fellowships not only to train reporters in how to sensitively and accurately discuss mental health and mental illness, but also to increase the number of stories on these topics in the news media.<ref name="RCFellows">{{Cite web |author=The Carter Center |title=The Rosalynn Carter Fellowships For Mental Health JournalisM |url=http://www.cartercenter.com/health/mental_health/fellowships/index.html |accessdate=2008-07-21}}</ref><ref name="RCadvoc">{{Cite web |author=The Carter Center |title=Rosalynn Carter's Advocacy in Mental Health |url=http://www.cartercenter.com/health/mental_health/rc_advocacy.html |accessdate=2008-07-21}}</ref> There is a [[World Mental Health Day]], which the US and Canada subsume under a [[Mental Illness Awareness Week]].

The general public have been found to hold a strong stereotype of dangerousness and desire for social distance from individuals described as mentally ill.<ref>{{Cite journal |author=Link BG, Phelan JC, Bresnahan M, Stueve A, Pescosolido BA |title=Public conceptions of mental illness: labels, causes, dangerousness, and social distance |journal=Am J Public Health |volume=89 |issue=9 |pages=1328–33 |date=September 1999|pmid=10474548 |pmc=1508784 |url=http://www.ajph.org/cgi/pmidlookup?view=long&pmid=10474548 |doi=10.2105/AJPH.89.9.1328}}</ref> A US national survey found that a higher percentage of people rate individuals described as displaying the characteristics of a mental disorder as "likely to do something violent to others", compared to the percentage of people who are rating individuals described as being "troubled".<ref>{{Cite journal |author=Pescosolido BA, Monahan J, Link BG, Stueve A, Kikuzawa S |title=The public's view of the competence, dangerousness, and need for legal coercion of persons with mental health problems |journal=Am J Public Health |volume=89 |issue=9 |pages=1339–45 |date=September 1999|pmid=10474550 |pmc=1508769 |url=http://www.ajph.org/cgi/pmidlookup?view=long&pmid=10474550 |doi=10.2105/AJPH.89.9.1339}}</ref>

;Violence
Despite public or media opinion, national studies have indicated that severe mental illness does not independently predict future violent behavior, on average, and is not a leading cause of violence in society. There is a statistical association with various factors that do relate to violence (in anyone), such as [[substance abuse]] and various personal, social and economic factors.<ref name="pmid19188537">{{Cite journal |author=Elbogen EB, Johnson SC |title=The intricate link between violence and mental disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions |journal=Arch. Gen. Psychiatry |volume=66 |issue=2 |pages=152–61 |date=February 2009|pmid=19188537 |doi=10.1001/archgenpsychiatry.2008.537}}</ref>

In fact, findings consistently indicate that it is many times more likely that people diagnosed with a serious mental illness living in the community will be the victims rather than the perpetrators of violence.<ref name="Stuart03"/><ref>{{Cite journal |author=Brekke JS, Prindle C, Bae SW, Long JD |title=Risks for individuals with schizophrenia who are living in the community |journal=Psychiatr Serv |volume=52 |issue=10 |pages=1358–66 |date=October 2001|pmid=11585953 |url=http://ps.psychiatryonline.org/cgi/pmidlookup?view=long&pmid=11585953 |doi=10.1176/appi.ps.52.10.1358}}</ref> In a study of individuals diagnosed with "severe mental illness" living in a US inner-city area, a quarter were found to have been [[Victimology|victims]] of at least one violent crime over the course of a year, a proportion eleven times higher than the inner-city average, and higher in every category of crime including violent assaults and theft.<ref>Linda A. Teplin, PhD; Gary M. McClelland, PhD; Karen M. Abram, PhD; Dana A. Weiner, PhD (2005) [http://archpsyc.ama-assn.org/cgi/content/abstract/62/8/911 Crime Victimization in Adults With Severe Mental Illness: Comparison With the National Crime Victimization Survey] Arch Gen Psychiatry. 62(8):911-921.</ref> People with a diagnosis may find it more difficult to secure prosecutions, however, due in part to prejudice and being seen as less credible.<ref>Petersilia, J.R. (2001) [http://cjb.sagepub.com/cgi/content/abstract/28/6/655?ijkey=3a7777608a8a96498b90a1bd867e7c6efb2a6121&keytype2=tf_ipsecsha Crime Victims With Developmental Disabilities: A Review Essay] Criminal Justice and Behavior, Vol. 28, No. 6, 655-694 (2001)</ref>

However, there are some specific diagnoses, such as childhood [[conduct disorder]] or adult [[antisocial personality disorder]] or [[psychopathy]], which are defined by or inherently associated with conduct problems and violence. There are conflicting findings about the extent to which certain specific symptoms, notably some kinds of [[psychosis]] (hallucinations or delusions) that can occur in disorders such as [[schizophrenia]], [[delusional disorder]] or [[mood disorder]], are linked to an increased risk of serious violence on average. The [[Mediation (statistics)|mediating]] factors of violent acts, however, are most consistently found to be mainly socio-demographic and socio-economic factors such as being young, [[male]], of lower [[socioeconomic status]] and, in particular, [[substance abuse]] (including [[alcoholism]]) to which some people may be particularly vulnerable.<ref name="Rogers&Pilgram05"/><ref name="Stuart03">{{Cite journal |author=Stuart H |title=Violence and mental illness: an overview |journal=World Psychiatry |volume=2 |issue=2 |pages=121–124 |date=June 2003|pmid=16946914 |pmc=1525086}}</ref><ref>Steadman HJ, Mulvey EP, Monahan J, Robbins PC, Appelbaum PS, Grisso T, Roth LH, Silver E. (1998) [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Retrieve&list_uids=9596041 Violence by people discharged from acute psychiatric inpatient facilities and by others in the same neighborhoods.] ''Archives of General Psychiatry.'' May;55(5):393-401.</ref><ref name="pmid19668362">{{Cite journal |author=Fazel S, Gulati G, Linsell L, Geddes JR, Grann M |title=Schizophrenia and violence: systematic review and meta-analysis |journal=PLoS Med. |volume=6 |issue=8 |pages=e1000120 |date=August 2009|pmid=19668362 |pmc=2718581 |doi=10.1371/journal.pmed.1000120}}</ref>

High-profile cases have led to fears that serious crimes, such as homicide, have increased due to [[deinstitutionalization]], but the evidence does not support this conclusion.<ref name="pmid19668362"/><ref>Taylor, P.J., Gunn, J. (1999) [http://bjp.rcpsych.org/cgi/content/abstract/174/1/9 Homicides by people with mental illness: Myth and reality] British Journal of Psychiatry Volume 174, Issue JAN., 1999, Pages 9-14</ref> Violence that does occur in relation to mental disorder (against the mentally ill or by the mentally ill) typically occurs in the context of complex social interactions, often in a family setting rather than between strangers.<ref>{{Cite journal | doi = 10.1177/1524838004272464 | pmid = 15574672 | author = Solomon, PL., Cavanaugh, MM., Gelles, RJ. | year = 2005 | title = Family Violence among Adults with Severe Mental Illness | url = http://tva.sagepub.com/cgi/content/abstract/6/1/40 | journal = Trauma, Violence, & Abuse | volume = 6 | issue = 1| pages = 40–54 }}</ref> It is also an issue in health care settings<ref>{{Cite journal |author=Chou KR, Lu RB, Chang M |title=Assaultive behavior by psychiatric in-patients and its related factors |journal=J Nurs Res |volume=9 |issue=5 |pages=139–51 |date=December 2001|pmid=11779087 }}</ref> and the wider community.<ref>{{Cite journal | doi = 10.1111/j.1600-0047.2004.00322.x/abs/ | author = B. Lögdberg, L.-L. Nilsson, M. T. Levander, S. Levander | year = 2004 | title = Schizophrenia, neighborhood, and crime | url = http://www.blackwell-synergy.com/links/doi/10.1111/j.1600-0047.2004.00322.x/abs/ | journal = [[Acta Psychiatrica Scandinavica]] | volume = 110 | issue = 2| page = 92 }}</ref>

==In animals==
[[Psychopathology]] in non-human [[primates]] has been studied since the mid-20th century. Over 20 behavioral patterns in captive chimpanzees have been documented as (statistically) abnormal for their frequency, severity or oddness—some of which have also been observed in the wild. Captive [[great apes]] show gross behavioral abnormalities such as [[stereotypy]] of movements, [[self-mutilation]], disturbed emotional reactions (mainly fear or aggression) towards companions, lack of species-typical communications, and generalized [[learned helplessness]]. In some cases such behaviors are hypothesized to be equivalent to symptoms associated with psychiatric disorders in humans such as depression, anxiety disorders, eating disorders and post-traumatic stress disorder. Concepts of antisocial, borderline and schizoid personality disorders have also been applied to non-human great apes.<ref name="Brune2006">{{cite journal |author=Brüne M, Brüne-Cohrs U, McGrew WC, Preuschoft S |title=Psychopathology in great apes: concepts, treatment options and possible homologies to human psychiatric disorders |journal=Neurosci Biobehav Rev |volume=30 |issue=8 |pages=1246–59 |year=2006 |pmid=17141312 |doi=10.1016/j.neubiorev.2006.09.002 }}</ref>

The risk of [[anthropomorphism]] is often raised with regard to such comparisons, and assessment of non-human animals cannot incorporate evidence from linguistic communication. However, available evidence may range from nonverbal behaviors—including physiological responses and homologous facial displays and acoustic utterances—to neurochemical studies. It is pointed out that human psychiatric classification is often based on statistical description and judgement of behaviors (especially when speech or language is impaired) and that the use of verbal self-report is itself problematic and unreliable.<ref name="Brune2006"/><ref name="Fabrega2006">{{cite journal |author=Fabrega H |title=Making sense of behavioral irregularities of great apes |journal=Neurosci Biobehav Rev |volume=30 |issue=8 |pages=1260–73; discussion 1274–7 |year=2006 |pmid=17079015 |doi=10.1016/j.neubiorev.2006.09.004 }}</ref>

Psychopathology has generally been traced, at least in captivity, to adverse rearing conditions such as early separation of infants from mothers; early sensory deprivation; and extended periods of social isolation. Studies have also indicated individual variation in temperament, such as sociability or impulsiveness. Particular causes of problems in captivity have included integration of strangers into existing groups and a lack of individual space, in which context some pathological behaviors have also been seen as coping mechanisms. Remedial interventions have included careful individually tailored re-socialization programs, [[behavior therapy]], environment enrichment, and on rare occasions psychiatric drugs. Socialization has been found to work 90% of the time in disturbed chimpanzees, although restoration of functional sexuality and care-giving is often not achieved.<ref name="Brune2006"/><ref name="Lilienfeld1999">{{Cite journal |author=Lilienfeld SO, Gershon J, Duke M, Marino L, de Waal FB |title=A preliminary investigation of the construct of psychopathic personality (psychopathy) in chimpanzees (Pan troglodytes) |journal=J Comp Psychol |volume=113 |issue=4 |pages=365–75 |date=December 1999|pmid=10608560 |url=http://content.apa.org/journals/com/113/4/365 |doi=10.1037/0735-7036.113.4.365}}</ref>

Laboratory researchers sometimes try to develop [[animal models]] of human mental disorders, including by inducing or treating symptoms in animals through genetic, neurological, chemical or behavioral manipulation,<ref>{{cite journal |author=Moran M |title=Animals Can Model Psychiatric Symptoms |journal=Psychiatric News |volume=38 |issue=12 |pages=20 |date=June 20, 2003 |url=http://pn.psychiatryonline.org/cgi/content/full/38/12/20 }}</ref><ref>{{cite journal |author=Sánchez MM, Ladd CO, Plotsky PM |title=Early adverse experience as a developmental risk factor for later psychopathology: evidence from rodent and primate models |journal=Dev. Psychopathol. |volume=13 |issue=3 |pages=419–49 |year=2001 |pmid=11523842 |doi= 10.1017/S0954579401003029|url=http://journals.cambridge.org/action/displayAbstract?aid=82066}}</ref> but this has been criticized on [[empirical]] grounds<ref name="pmid15925695">{{cite journal |author=Matthews K, Christmas D, Swan J, Sorrell E |title=Animal models of depression: navigating through the clinical fog |journal=Neurosci Biobehav Rev |volume=29 |issue=4-5 |pages=503–13 |year=2005 |pmid=15925695 |doi=10.1016/j.neubiorev.2005.03.005 |url=}}</ref> and opposed on [[animal rights]] grounds.

==References==

<references/>

==Further reading==
* Atkinson, J. (2006) ''Private and Public Protection: Civil Mental Health Legislation'', Edinburgh, Dunedin Academic Press ISBN 1903765617
* {{Cite book | author=Hockenbury, Don and Sandy | title=Discovering Psychology | publisher=Worth Publishers | year=2004 | isbn=0-7167-5704-4}}
* {{Cite book | author=Fried, Yehuda and Joseph Agassi, | title=Paranoia: A Study in Diagnosis| publisher=Boston Studies in the Philosophy of Science, 50 | year=1976 | isbn=90-277-0704-9}}
* {{Cite book | author=Fried, Yehuda and Joseph Agassi, | title=Psychiatry as Medicine | publisher=The HAgue, Nijhoff| year=1983 | isbn=90-247-2837-1}}
* {{Cite book |author=[[Roy Porter|Porter, Roy]] |title=Madness: a brief history |publisher=Oxford University Press |location=Oxford [Oxfordshire] |year=2002 |isbn=0-19-280266-6 }}
* Weller M.P.I. and Eysenck M. The Scientific Basis of Psychiatry, W.B. Saunders, London, Philadelphia, Toronto etc. 1992
* Wiencke, Markus (2006) ''Schizophrenie als Ergebnis von Wechselwirkungen: Georg Simmels Individualitätskonzept in der Klinischen Psychologie''. In David Kim (ed.), ''Georg Simmel in Translation: Interdisciplinary Border-Crossings in Culture and Modernity'' (pp.&nbsp;123–155). Cambridge Scholars Press, Cambridge, ISBN 1-84718-060-5

==External links==
{{Spoken Wikipedia|Mental_illness.ogg|2005-08-20}}
* [http://www.nimh.nih.gov/ NIMH.NIH.gov] - 'Working to improve mental health through biomedical research on mind, brain, and behavior', [[National Institute of Mental Health]] (United States)
* [http://www.nimhe.csip.org.uk/ NIMHE] - 'Responsible for supporting the implementation of positive change in mental health and mental health services', [[National Institute for Mental Health]] ([[United Kingdom]])
* [http://www.cartercenter.com/health/mental_health/intl_women.html International Committee of Women Leaders on Mental Health] – an international body of women political leaders founded by the World Mental Health Federation to produce positive change for citizens who struggle with mental illnesses.
* [http://www.brokenplate.biz/mental-disorder-in-old-age.html Mental Disorder In Old Age]
* [http://dictionary-psychology.com Psychology Dictionary]
* [http://www.psychiatrist.com/ Journal of Clinical Psychiatry]
* [http://www.miwatch.org/ Mental Illness Watch]
* [http://metapsychology.mentalhelp.net/poc/center_index.php?id=390&cn=390 ''Metapsychology Online Reviews'': Medications & Psychiatry]

{{Medical conditions}}
{{Mental illness (alphabetical list)}}
{{Mental and behavioural disorders}}

{{DEFAULTSORT:Mental Disorder}}
[[Category:Disability]]
[[Category:Medical ethics]]
[[Category:Mental illness diagnosis by DSM and ICD]]
[[Category:Psychiatry]]
[[Category:Sociology]]
[[Category:Abnormal psychology]]