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Rates of psychiatric disorder in the community
To determine what psychiatric services are required for a community, it is necessary to know the frequency of mental disorder in the population and the needs for treatment of the people with the disorders identified in this way. Policy decisions have then to be made about the division of care between primary and specialist medical services, between medical and social services, and between people with different kinds of mental disorder. In the National Health Service, priority is given to people with serious mental illness. It is difficult to determine the exact frequency of mental disorders in a community (for methods of epidemiological research), but approximate estimates are usually sufficient for service planning. The higher figure for anxiety disorders in the US survey is balanced by the figure for non-specific neurotic disorder in the UK survey. The other differences may relate to variations in the methods used in the two surveys rather than any major differences in the true population rates. These and other surveys indicate that psychiatric disorders are common. Amongst persons at risk, about one in five experience one of these disorders in the course of one year. However, many of the conditions are brief anxiety and depressive disorders arising in reaction to stressful circumstances. Anxiety disorders are most frequent, followed by misuse of drugs or alcohol. Mood disorders come next in frequency. Obsession disorders and schizophrenia are much less frequent.
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