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Abstract
Pearson, 1992), another kind of punishment was acupuncture with an electric current It uses electrically controlled acupuncture needles. (Munro, 2006), and also medications are sometimes forcefully administered through nasogastric tubes to torture and punish practitioners for not cooperating with the authorities (Lu et al., 2002).
Psychiatry and declaration of ethics
Looking back, the issue of soviet political abuse of psychiatry had a lasting impact on world psychiatry as well as on the World Psychiatric Association. The most positive conclusion is that the issue triggered the discussions on medical ethics and the professional responsibilities of physicians (including psychiatrists), resulting in the Declaration of Hawaii (Van Voren, 2009).
The Declaration of Hawaii, adopted by the World Psychiatric Association (WPA) in 1977, was a significant event, it explicates the ethical principles of respect for autonomy and of beneficence, by formulating the components of informed consent, by calling to mind the obligation of confidentiality, by stating rules for forensic evaluation and compulsory interventions, by demanding the possibility of independent proof of compulsory measures and by obliging psychiatrists not to misuse their professional possibilities and particularly to abstain from any compulsory intervention in the absence of a mental disorder (Okasha, 2003).
Furthermore, on the 26th of August 1996 the General Assembly of the WPA approved the Madrid Declaration which is an update of the Hawaii Declaration, Seven general guidelines focus on the aim of Psychiatry as to treat the mentally ill patients, to prevent mental illness, promote mental health and provide care and rehabilitation for mental patients. The Declaration ensures the duties of the psychiatrists, prohibiting any abuse and that no treatment should be provided against the patient’s will unless it is necessary for the welfare and safety of the patient and others (WPA, 1996).
The removal of homosexuality from the psychiatric manual
The first attack by homosexual activists against the APA began in 1970 when this organization held its convention in San Francisco. Homosexual activists decided to disrupt the conference by interrupting speakers and shouting down and ridiculing psychiatrists who viewed homosexuality as a mental disorder (Bayer, 1981), after much political pressure, a committee of the APA met behind closed doors in 1973 and voted to remove homosexuality as a mental disorder from the DSM-II (Satinover, 1996).
Stress and psychiatric disorders derived from political decisions and conflicts
A number of factors have been identified as having an impact on the mental health of populations affected by disasters, Man-made disasters often cause more frequent and more persistent psychiatric symptoms and distress than natural disasters (Norris et al., 2002), Man-made disasters with a high degree of community destruction, and those in developing countries, are associated with the worst outcomes (Davidson et al., 2006). Post-traumatic mental disorders include depression, anxiety, post-traumatic stress disorder, phobias, medically unexplained symptoms, substance misuse, and personality change.
Immigrants and refugees
Apart from physical wounds or starvation, a large percentage of refugees develop symptoms of mental disorders. These long-term mental problems can severely impede the functionality of the person in everyday situations. It makes matters even worse for displaced persons who are confronted with a new environment and challenging situations.
The following factors appear to have been most strongly and consistently linked to elevated rates of mental disorder among migrant and refugee populations: traumatic experiences or prolonged stress prior to immigration, separation from family and community, isolation from people of similar ethnic/cultural background, unemployment and underemployment, DROP in socioeconomic status, negative public attitudes towards, and rejection of, immigrants and refugees generally and/or some groups specifically (Ellis et al., 1997).
Terrorism and war victims
War has been an enduring aspect of human existence, History has shown that the experience of deployment to war can have legacies that manifest themselves in a variety of physical and psychological health problems. It is widely recognised that exposure to combat and other wartime experiences can have both short-term and long-term psychological effects (Zalihic et al., 2009). Research over the past years has also examined the psychological impact of terrorist Estimates of the prevalence of PTSD after terrorist attacks range from 7.5% to 50% in the year after the event depending on the degree of victimization. Studies of individuals incurring physical injuries should also be considered in addressing the long-term consequences of traumatic events (Verger et al., 2004).
Survivors of torture
Torture can have devastating consequences on the victim’s physical, mental, and social well-being. For example, an individual who was severely beaten may frequently experience musculoskeletal pain. The recurring pain may trigger significant psychological symptoms, such as intrusive thoughts of the trauma (Kaplan and Sadock, 2009).
Psychiatric disorders derived from political conflicts
Anxiety disorders
Anxiety disorders are blanket terms covering several different forms of abnormal and pathological fear and anxiety which only came under the aegis of psychiatry at the very end of the 19th century (Berrios, 1999) Current psychiatric diagnostic criteria recognize a wide variety of anxiety disorders. Recent surveys have found that as many as 18% of Americans may be affected by one or more of them (Kesseler et al., 2005), Post traumatic stress disorder (PTSD) is an anxiety disorder comprising three clusters of symptoms that can develop following person’s exposure to a traumatic event.
PTSD is unusual among the syndromes listed in the text revision of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. (DSM-IV-TR) in that one of its criteria specifies an etiological event: Exposure to a traumatic stressor. Unlike the other anxiety disorders, whose focus of concern is threats looming in the future (e.g., impending heart attack in panic disorder; concern about embarrassment during a forth coming speech for social anxiety disorder). The central focus in PTSD concerns preoccupation with threats that occurred in the past. Hence, PTSD is a disorder driven by pathogenic memories of past danger (Kaplan, 2009).
Mood disorder:
While major depressive disorder can arise without any precipitating stressors, stress and interpersonal losses certainly increase risk. Psychodynamic formulations find that significant losses in early life predispose to major depressive disorder over the lifespan of the individual, as does trauma, either transient or chronic (Ravinder et al., 2010). The relationship between stressful life events and social support has been a matter of some debate. The lack of social support may increase the likelihood that life stress will lead to depression, or the absence of social support may constitute a form of strain that leads to depression directly (Vilhjalmsson, 1993). Cost of depression in Europe in 2004 est. €118 billion – doubled in last 10 years (Ponser, 2008).
Comorbidity between mood and anxiety disorders
Comorbidity between mood disorders and anxiety disorders has been found to be associated with greater severity of the psychopathology, higher rates of chronicity, lower response to treatment, and poorer prognosis. When patients have coexisting depressive and anxiety symptoms, social and occupational impairment and reliance on healthcare resources are increased (Haroun, 2009).
The relationship between PTSD and major depression is beginning to be clarified, especially how exposure to trauma is related to the disorders jointly and separately. The National Co-morbidity Survey (Kessler et al., 1995) found that, based on retrospective data, PTSD was usually the primary disorder (temporally) when examining the two together. Other studies have shown that MDD is a risk factor for the later development of PTSD. Several investigators looking more closely at this association have found that PTSD and MDD most likely represent a joint vulnerability with regard to trauma exposure, and are not therefore independent in trauma survivors (Breslau et al., 2000).
Racism, ethnic minorities and mental health
Specific attention is given to the topic of racism-related stress by Harrell (2000). According to her research, there are six types of racism-related stress that have the potential to affect the well-being of an individual: racism-related life events, vicarious racism experiences, daily racism micro stressors, chronic-contextual stress, collective experiences, and trans-generational transmission (Harrell, 2000).
Racism-related stress complicates the lives of non-whites in a number of very serious ways. In addition to creating the widely discussed social inequalities, racism has been shown to have a negative impact on one’s psychological and physiological well-being. The psychological distress caused by racism-related stress can be debilitating and may increase the potential that one will adopt negative coping strategies in an effort to alleviate their depression, anxiety, frustration, and anger. Negative coping strategies, such as substance abuse and poor eating habits, affect one’s physiological and social well-being and do not serve to eliminate one’s problems (Crocker, 2007).
However, The fourth National survey of ethnic minorities provided United Kingdom (UK) evidence of cross-sectional association between interpersonal racism and mental health, a nationally representative of 5196 persons of asian, caribbean and african origins were asked about racial discrimination in the preceding years, those who suffered from verbal abuse were 3 times more likely to develop depression or psychosis and those who suffered from racist attack were 3 times more likely to develop depression and 5 times to develop psychosis, and finally those who said that their employees were racist were 1.6 more likely to develop psychosis (Chakraborty et al., 2002).
When political decisions affects economic status and subsequently mental health
The link between poverty and mental health is well known. Arguments regarding the causality of the relationship continue, but it seems likely that it is bi-directional, those with low incomes are more likely to suffer from poor mental health and poverty effectively causing or contributing to poor mental health (MHE, 2010).
Poverty, acting through economic stressors such as unemployment and lack of affordable housing, is more likely to precede mental illnesses such as depression and anxiety, thus making it an important risk factor for mental illness (Kuruvilla et al., 2007).
Poor people stress the anxiety and fear they experience because they feel insecure and vulnerable when their conditions worsen. Security is defined as stability and continuation of livelihood, predictability of relationships, feeling safe and belonging to a social group (Narayan et al., 2000). There is evidence of the association between insecurity of income flow and common mental disorders, Araya et al found a strong relationship between acute income DROP in the previous six months and the risk of mental disorders (Araya et al., 2003).