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The second phase introduces procedures to reduce dietary restraint and increase the regularity of eating. The last phase involves teaching people relapse-prevention strategies to help them prepare for possible setbacks. A course of individual CBT for bulimia nervosa usually involves 16 to 20 hour-long sessions over a period of 4 to 5 months. It is offered on an individual, group, or self-managed basis. The goals of CBT are designed to interrupt the proposed bulimic cycle that is perpetuated by low self-esteem, extreme concerns about shape and weight, and extreme means of weight control.
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Dialectical Behavior Therapy (DBT):
A type of behavioral therapy that views emotional deregulation as the core problem in bulimia nervosa. It involves teaching people with bulimia nervosa new skills to regulate negative emotions and replace dysfunctional behavior. A typical course of treatment is 20 group sessions lasting 2 hours once a week (see Behavioral Therapy). Term used to describe any atypical eating behavior. Behaviors that include any or all of the following: replacing food consumption with excessive alcohol consumption; consuming food along with sufficient amounts of alcohol to induce vomiting as a method of purging and numbing feelings.
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[Ed. Note: this is not a recognized medical term, but rather one popularized in the lay media.] The fifth (and most current as of 2014) edition of the Diagnostic and Statistical Manual for Mental Disorders V published by the American Psychiatric Association (APA). This manual lists mental diseases, conditions, and disorders, and also lists the criteria established by APA to diagnose them. Several newly created eating disorders diagnoses are listed in this edition, including Avoidant/Restrictive Food Intake Disorder (see ARFID).
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This diagnosis has been discontinued under the DSM-V. Eating Disorder Inventory (EDI):
A self-report test that clinicians use with patients to diagnose specific eating disorders and determine the severity of a patient’s condition. Eating Disorder Inventory-2 (EDI-2):
Second edition of the EDI. (slang) Eating disorder. Acronym for eating disorder.
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Guided imagery is sometimes called visualization. Sometimes music is used as background noise during the imagery session (see Alternative Therapy). Health Insurance Portability and Accountability Act (HIPAA):
A federal law enacted in 1996 with a number of provisions intended to ensure certain consumer health insurance protections for working Americans and their families and standards for electronic health information and protect privacy of individuals’ health information. HIPAA applies to three types of health insurance coverage: group health plans, individual health insurance, and comparable coverage through a high-risk pool. HIPAA may lower a person’s chance of losing existing coverage, ease the ability to switch health plans, and/or help a person buy coverage on his/her own if a person loses employer coverage and has no other coverage available.
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Health Insurance Reform for Consumers:
Federal law has provided to consumers some valuable–though limited–protections when obtaining, changing, or continuing health insurance. Understanding these protections, as well as laws in the state in which one resides, can help with making more informed choices when work situations change or when changing health coverage or accessing care. Three important federal laws that can affect coverage and access to care for people with eating disorders are listed below:
• Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA)
• Health Insurance Portability and Accountability Act of 1996 (HIPAA)
• Mental Health Parity Act of 1996 (MHPA)
• Patient Protection and Accountable Care Act of 2010 (aka Obamacare)
Health Maintenance Organization (HMO):
A health plan that employs or contracts with primary care physicians to write referrals for all care that covered patients obtain from specialists in a network of healthcare providers with whom the HMO contracts. The patient’s choice of treatment providers is usually limited. The vomiting of blood.
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Services include therapeutic group homes, super- vised apartment living, monitoring the person’s compliance with prescribed mental and medical treatment plans, and job placement. Intake Screening An interview conducted by health service providers when a patient is admitted to a hospital or treatment program. International Classification of Diseases (ICD-10):
The World Health Organization lists international standards used to diagnose and classify diseases. The listing is used by the healthcare system so clinicians can assign an ICD code to submit claims to insurers for reimbursement for services for treating various medical and mental health conditions in patients. The code is periodically updated to reflect changes in classifications of disease or to add new disorders.
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Intake Screening An interview conducted by health service providers when a patient is admitted to a hospital or treatment program. International Classification of Diseases (ICD-10):
The World Health Organization lists international standards used to diagnose and classify diseases. The listing is used by the healthcare system so clinicians can assign an ICD code to submit claims to insurers for reimbursement for services for treating various medical and mental health conditions in patients. The code is periodically updated to reflect changes in classifications of disease or to add new disorders. Interpersonal Therapy (IPT):
Also called interpersonal psychotherapy, IPT is designed to help people identify and address their interpersonal problems, specifically those involving grief, interpersonal role conflicts, role transitions, and interpersonal deficits.
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In this therapy, no emphasis is placed directly on modifying eating habits. Instead, the expectation is that the therapy will enable people to change as their interpersonal functioning improves. IPT usually involves 16 to 20 hour-long, one-on-one treatment sessions over a period of 4 to 5 months. Ketosis A condition characterized by an abnormally elevated concentration of ketones in the body tissues and fluids, which can be caused by starvation. It is a complication of diabetes, starvation, and alcoholism.
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Mealtime Support Therapy:
Treatment program developed to help patients with eating disorders eat healthfully and with less emotional upset. Mental Health Parity Laws:
Federal and State laws that require health insurers to provide the same level of healthcare benefits for mental disorders and conditions as they do for medical disorders and conditions. For example, the federal Mental Health Parity Act of 1996 (MHPA) may prevent a group health plan from placing annual or lifetime dollar limits on mental health benefits that are lower, or less favorable, than annual or lifetime dollar limits for medical and surgical benefits offered under the plan. (slang) For bulimia or bulimic. Modified Cyclic Antidepressants:
A class of medications used to treat depression.
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The term “cure” signifies that the treated condition or disorder is permanently gone, never to return in the individual who received treatment. Services delivered in a structured resi- dence other than the hospital or a client’s home. Residential Treatment Center:
A 24-hour residential environ- ment outside the home that includes 24-hour provision or access to support personnel capable of meeting the client’s needs. Selective Serotonin Re-uptake Inhibitors (SSRI):
A class of antidepressants used to treat depression, anxiety disorders, and some personality disorders. These drugs are designed to elevate the level of serotonin, a neurotransmitter .
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Many states have issued mandates pertaining to coverage of mental health benefits and specific disorders the state requires insurers to cover. Use of a mood or behavior-altering substance in a maladaptive pattern resulting in significant impairment or distress of the user. Substance Use Disorders:
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) defines a substance use disorder as a maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period: (1) recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home; (2) recurrent substance use in situations in which it is physically hazardous; and (3) recurrent substance-related legal, social, and/ or interpersonal problems. Sub-threshold Eating Disorder:
Condition in which a person exhibits disordered eating but not to the extent that it fulfills all the criteria for diagnosis of an eating disorder. Supportive Residential Services:
(see Residential Treatment Center)
Psychotherapy that focuses on the management and resolution of current difficulties and life decisions using the patient’s strengths and available resources.
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Posttraumatic stress disorder[note 1] (PTSD) is a severe anxiety disorder that can develop after exposure to any event that results in psychological trauma. This event may involve the threat of death to oneself or to someone else, or to one's own or someone else's physical, sexual, or psychological integrity, overwhelming the individual's ability to cope. As an effect of psychological trauma, PTSD is less frequent and more enduring than the more commonly seen acute stress response.
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As an effect of psychological trauma, PTSD is less frequent and more enduring than the more commonly seen acute stress response. Diagnostic symptoms for PTSD include re-experiencing the original trauma(s) through flashbacks or nightmares, avoidance of stimuli associated with the trauma, and increased arousal— such as difficulty falling or staying asleep, anger, and hypervigilance. Formal diagnostic criteria (both DSM-IV-TR and ICD-10) require that the symptoms last more than one month and cause significant impairment in social, occupational, or other important areas of functioning. Psychological trauma PTSD is believed to be caused by experiencing any of a wide range of events which produces intense negative feelings of "fear, helplessness or horror" in the observer or participant. Sources of such feelings may include (but are not limited to): experiencing or witnessing childhood or adult physical, emotional, or sexual abuse; experiencing or witnessing physical assault, adult experiences of sexual assault, accidents, drug addiction, illnesses, medical complications; employment in occupations exposed to war (such as soldiers) or disaster (such as emergency service workers); or getting a diagnosis of a life-threatening illness.
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Parents with violence-related PTSD may, for example, inadvertently expose their children to developmentally inappropriate violent media due to their need to manage their own emotional dysregulation. Clinical findings indicate that a failure to provide adequate treatment to children after they suffer a traumatic experience, depending on their vulnerability and the severity of the trauma, will ultimately lead to PTSD symptoms in adulthood. DSM-5 proposed diagnostic criteria changes In preparation for the May 2013 release of the DSM-5, the fifth version of the American Psychiatric Association's diagnostic manual, draft diagnostic criteria was released for public comment, followed by a two-year period of field testing. Proposed changes to the criteria (subject to ongoing review and research) include the following: Criterion A (prior exposure to traumatic events) is more specifically stated, and evaluation of an individual's emotional response at the time (current criterion A2) is dropped. Several items in Criterion B (intrusion symptoms) are rewritten to add or augment certain distinctions now considered important.
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Criterion F (formerly "E") still requires duration of symptoms to have been at least one month. Criterion G (formerly "F") stipulates symptom impact ("disturbance") in the same way as before. The "acute" vs "delayed" distinction is dropped; the "delayed" specifier is considered appropriate if clinical symptom onset is no sooner than 6 months after the traumatic event(s).
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Injuries become severe and life-threatening when they fall outside the range of human tissue tolerance. William Haddon in the 1960s first came up with the idea that trauma is a public health issue. He came up with three phases of trauma: 1) pre-event; 2) event; and 3) post-event. He invented the “Haddon Matrix”, which identified pre-event occurrences like avoidance of alcohol and the use of proper restraint. Speed limits are also a part of that.
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Epidemiology of Trauma in the US
Injuries account for a quarter of all deaths in the US per year in all age groups. It is the leading cause of death in children. About 150,000 people die per year as a result of an injury. This is about 54 people out of 100,000 individuals in the US. There are 400 injury deaths per day and 50 of these deaths occur in kids.
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Research into infection, hemorrhage, and trauma will eventually reduce the number of deaths, especially delayed deaths from trauma. Deaths are only part of the injury burden. More than 1.5 million trauma victims are hospitalized in the US each year. These patients survive to the point of discharge from the hospital. About 28 million people are treated and eventually discharged from emergency rooms or urgent care centers.
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More than 1.5 million trauma victims are hospitalized in the US each year. These patients survive to the point of discharge from the hospital. About 28 million people are treated and eventually discharged from emergency rooms or urgent care centers. Injuries make up 6 percent of all discharges from the hospital and 30 percent of all emergency department visits per year. These injuries are far more than they look because they lead to things like disability and a decreased quality of life.
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These patients survive to the point of discharge from the hospital. About 28 million people are treated and eventually discharged from emergency rooms or urgent care centers. Injuries make up 6 percent of all discharges from the hospital and 30 percent of all emergency department visits per year. These injuries are far more than they look because they lead to things like disability and a decreased quality of life. In dollar amounts, the cost of fatal and nonfatal accidents in any given year is about 406 billion dollars to the overall economy.
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Injuries make up 6 percent of all discharges from the hospital and 30 percent of all emergency department visits per year. These injuries are far more than they look because they lead to things like disability and a decreased quality of life. In dollar amounts, the cost of fatal and nonfatal accidents in any given year is about 406 billion dollars to the overall economy. The costs related to deaths account for a disproportionate share of the costs spent on injury care. Deaths account for only 1 percent of injuries but account for 30 percent of the total costs incurred.
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In dollar amounts, the cost of fatal and nonfatal accidents in any given year is about 406 billion dollars to the overall economy. The costs related to deaths account for a disproportionate share of the costs spent on injury care. Deaths account for only 1 percent of injuries but account for 30 percent of the total costs incurred. The rest, about 70 percent, are related to the treatment of nonfatal injuries. These include hospital costs and the other costs related to healthcare as part of the injury.
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The costs related to deaths account for a disproportionate share of the costs spent on injury care. Deaths account for only 1 percent of injuries but account for 30 percent of the total costs incurred. The rest, about 70 percent, are related to the treatment of nonfatal injuries. These include hospital costs and the other costs related to healthcare as part of the injury. A total of 41 percent of the costs are from permanent and temporary disability.
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The rest, about 70 percent, are related to the treatment of nonfatal injuries. These include hospital costs and the other costs related to healthcare as part of the injury. A total of 41 percent of the costs are from permanent and temporary disability. This doesn’t take into account the losses spent by family and loved ones as part of the ongoing trauma-related expenses. Injuries and deaths from trauma are most likely a problem of young males and older individuals.
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Injuries and deaths from trauma are most likely a problem of young males and older individuals. Seventy percent of deaths and half of all injuries not leading to death are seen in males. In all age groups, except for the age of 0-9, the rate of injury in males is more than twice that of females. In non-fatal injuries, males are only 1.3 times more likely to be affected. This trend reverses in the elderly, where females have a 1.3 times incidence of nonfatal injury when compared to men.
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In all age groups, except for the age of 0-9, the rate of injury in males is more than twice that of females. In non-fatal injuries, males are only 1.3 times more likely to be affected. This trend reverses in the elderly, where females have a 1.3 times incidence of nonfatal injury when compared to men. The peak of death is from 16-40 and from the over 65 group where trauma is concerned. People under the age of 45 have 53 percent of all fatalities from injuries and half of all hospitalizations.
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In non-fatal injuries, males are only 1.3 times more likely to be affected. This trend reverses in the elderly, where females have a 1.3 times incidence of nonfatal injury when compared to men. The peak of death is from 16-40 and from the over 65 group where trauma is concerned. People under the age of 45 have 53 percent of all fatalities from injuries and half of all hospitalizations. They accounted for about 80 percent of emergency department visits.
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This trend reverses in the elderly, where females have a 1.3 times incidence of nonfatal injury when compared to men. The peak of death is from 16-40 and from the over 65 group where trauma is concerned. People under the age of 45 have 53 percent of all fatalities from injuries and half of all hospitalizations. They accounted for about 80 percent of emergency department visits. Hospitalizations and nonfatal injuries follow this same bimodal pattern, especially when it comes to males.
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Burns account for two percent of injury-related deaths and 1.4 percent of nonfatal events reported to the Centers for Disease Control. In 2004, alone, there were 167,000 deaths due to trauma. There were 1.9 million hospital discharges from the hospital secondary to trauma. There were 3.1 million visits to the emergency room due to injuries. And there were 35 million initial visits to private physician clinics because of injury-related events.
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In 2004, alone, there were 167,000 deaths due to trauma. There were 1.9 million hospital discharges from the hospital secondary to trauma. There were 3.1 million visits to the emergency room due to injuries. And there were 35 million initial visits to private physician clinics because of injury-related events. Statistics show that 93 percent of nonfatal injuries were unintentional, whereas 68 percent of fatal injuries were unintentional.
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There were 1.9 million hospital discharges from the hospital secondary to trauma. There were 3.1 million visits to the emergency room due to injuries. And there were 35 million initial visits to private physician clinics because of injury-related events. Statistics show that 93 percent of nonfatal injuries were unintentional, whereas 68 percent of fatal injuries were unintentional. Thirty percent of deaths due to injury were related to violence.
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There were 3.1 million visits to the emergency room due to injuries. And there were 35 million initial visits to private physician clinics because of injury-related events. Statistics show that 93 percent of nonfatal injuries were unintentional, whereas 68 percent of fatal injuries were unintentional. Thirty percent of deaths due to injury were related to violence. In 2007 alone, about 18,000 people were killed because of homicide.
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This accounted for 66 percent of all violent deaths. Injury in the workplace is common. About 5000 fatalities were reported in 2008 as a result of injuries sustained at the workplace. This means that there were 3.6 per million full time workers per year. Transportation-related deaths accounted for 40 percent of all workplace deaths.
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Injury in the workplace is common. About 5000 fatalities were reported in 2008 as a result of injuries sustained at the workplace. This means that there were 3.6 per million full time workers per year. Transportation-related deaths accounted for 40 percent of all workplace deaths. Assaults and violence accounted for 16 percent of all fatalities, whereas 18 percent of fatalities were because of contact with equipment.
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About 5000 fatalities were reported in 2008 as a result of injuries sustained at the workplace. This means that there were 3.6 per million full time workers per year. Transportation-related deaths accounted for 40 percent of all workplace deaths. Assaults and violence accounted for 16 percent of all fatalities, whereas 18 percent of fatalities were because of contact with equipment. Falls accounted for 13 percent.
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Five percent of all workplace deaths were self-inflicted. The Division of Labor Statistics reported about 4.6 million nonfatal work-related injuries. This amounts to 3.6 people out of 100 workers. A total of 71 percent of these injuries were in the service industry. Half of all injuries produced some kind of disability.
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The Division of Labor Statistics reported about 4.6 million nonfatal work-related injuries. This amounts to 3.6 people out of 100 workers. A total of 71 percent of these injuries were in the service industry. Half of all injuries produced some kind of disability. Distribution of Injuries
It is important to catalog injuries by severity and nature.
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Distribution of Injuries
It is important to catalog injuries by severity and nature. There are several systems available for cataloguing injuries by nature and severity. ICD-10 codes are important in cataloguing the various injuries and their nature. Death certificate data is the best way to identify injury-related deaths. There can be variations in the way that these injuries are presented.
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Traumatic brain injuries account for many deaths and a great deal of disability when it comes to injury. Traumatic brain injury can be mild or severe, and many of the mild cases are missed. There are about 1.7 million visits to the emergency room, deaths and hospitalizations directly related to traumatic brain injury. Traumatic brain injury accounts for 1/3 of all injury-related deaths or about 52,000 deaths per year. The distribution of nonfatal injuries and fatal injuries is different from one another.
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Traumatic brain injury can be mild or severe, and many of the mild cases are missed. There are about 1.7 million visits to the emergency room, deaths and hospitalizations directly related to traumatic brain injury. Traumatic brain injury accounts for 1/3 of all injury-related deaths or about 52,000 deaths per year. The distribution of nonfatal injuries and fatal injuries is different from one another. There are many injuries associated with body areas that are not considered lethal.
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The distribution of nonfatal injuries and fatal injuries is different from one another. There are many injuries associated with body areas that are not considered lethal. Even among nonfatal hospitalized injuries, only a fourth have Abbreviated Injury Scores of 3 or more on a scale of 0-6. Injuries to the upper and lower extremities involve the leading cause of emergency department visits and hospitalizations among injured people. They account for over half of all non-fatal injuries and 47 percent of hospitalizations because of injuries.
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Even among nonfatal hospitalized injuries, only a fourth have Abbreviated Injury Scores of 3 or more on a scale of 0-6. Injuries to the upper and lower extremities involve the leading cause of emergency department visits and hospitalizations among injured people. They account for over half of all non-fatal injuries and 47 percent of hospitalizations because of injuries. More than a third of all moderately severe or severe injuries are for injuries with an Abbreviated Injury Scores of 3 or more. Recovery can take a long time and can be costly.
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Injuries to the upper and lower extremities involve the leading cause of emergency department visits and hospitalizations among injured people. They account for over half of all non-fatal injuries and 47 percent of hospitalizations because of injuries. More than a third of all moderately severe or severe injuries are for injuries with an Abbreviated Injury Scores of 3 or more. Recovery can take a long time and can be costly. The best of treatment can result in disability and permanent impairment of the individual.
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The best of treatment can result in disability and permanent impairment of the individual. The second most common type of nonfatal injuries that are hospitalized are due to head injuries. It accounts for 10-15 percent of all hospitalizations because of injuries. Mild head injuries are usually treated as an outpatient. The make up 2-5 percent of all trips to the emergency room visits.
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It accounts for 10-15 percent of all hospitalizations because of injuries. Mild head injuries are usually treated as an outpatient. The make up 2-5 percent of all trips to the emergency room visits. About 80 percent of these patients are treated and released from the emergency department. The actual number of head injuries may be under-represented due to the large number of them treated at outpatient centers and urgent care facilities.
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Mild head injuries are usually treated as an outpatient. The make up 2-5 percent of all trips to the emergency room visits. About 80 percent of these patients are treated and released from the emergency department. The actual number of head injuries may be under-represented due to the large number of them treated at outpatient centers and urgent care facilities. The total estimate of head injuries ranges from 152 to 367 people out of 100,000 individuals.
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About 80 percent of these patients are treated and released from the emergency department. The actual number of head injuries may be under-represented due to the large number of them treated at outpatient centers and urgent care facilities. The total estimate of head injuries ranges from 152 to 367 people out of 100,000 individuals. Most head injuries are mild but about 70,000 to 90,000 are classified as severe and can result in long term disability. Head injuries from recreational activities are not uncommon, accounting for 300,000 injuries per year.
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The actual number of head injuries may be under-represented due to the large number of them treated at outpatient centers and urgent care facilities. The total estimate of head injuries ranges from 152 to 367 people out of 100,000 individuals. Most head injuries are mild but about 70,000 to 90,000 are classified as severe and can result in long term disability. Head injuries from recreational activities are not uncommon, accounting for 300,000 injuries per year. Spinal cord injuries represent a small proportion of injuries from trauma.
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The total estimate of head injuries ranges from 152 to 367 people out of 100,000 individuals. Most head injuries are mild but about 70,000 to 90,000 are classified as severe and can result in long term disability. Head injuries from recreational activities are not uncommon, accounting for 300,000 injuries per year. Spinal cord injuries represent a small proportion of injuries from trauma. They account for 10,000 to 15,000 hospitalizations per year.
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Head injuries from recreational activities are not uncommon, accounting for 300,000 injuries per year. Spinal cord injuries represent a small proportion of injuries from trauma. They account for 10,000 to 15,000 hospitalizations per year. Motor vehicle injuries make up 30-60 percent of all spinal cord injuries. Falls account for 20-30 percent of spinal cord injuries.
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Spinal cord injuries represent a small proportion of injuries from trauma. They account for 10,000 to 15,000 hospitalizations per year. Motor vehicle injuries make up 30-60 percent of all spinal cord injuries. Falls account for 20-30 percent of spinal cord injuries. About 5-10 percent of all spinal cord injuries are from diving accidents.
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They account for 10,000 to 15,000 hospitalizations per year. Motor vehicle injuries make up 30-60 percent of all spinal cord injuries. Falls account for 20-30 percent of spinal cord injuries. About 5-10 percent of all spinal cord injuries are from diving accidents. There is a huge financial cost incurred as a result of spinal cord injuries, many of which are nonfatal but result in major disability.
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Motor vehicle injuries make up 30-60 percent of all spinal cord injuries. Falls account for 20-30 percent of spinal cord injuries. About 5-10 percent of all spinal cord injuries are from diving accidents. There is a huge financial cost incurred as a result of spinal cord injuries, many of which are nonfatal but result in major disability. Distribution of Injuries as related to Geographic Location
There is a varying amount of injuries as stratified across different areas of the country and between rural and urban areas.
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There is a lot of data missing regarding pre-hospital care and post-hospital care of injuries, including rehabilitation. There have been many pre-hospital databases developed over the years. Only 26 states supply data to the NEMSIS program, the “National Emergency Medical Services Information System” database. At least 12 states are considering legislation to have the states contribute to this system, which will help make the data more accurate. Many professional organizations are pushing for change that allows EMS systems to provide data that is NEMSIS-compliant.
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There have been many pre-hospital databases developed over the years. Only 26 states supply data to the NEMSIS program, the “National Emergency Medical Services Information System” database. At least 12 states are considering legislation to have the states contribute to this system, which will help make the data more accurate. Many professional organizations are pushing for change that allows EMS systems to provide data that is NEMSIS-compliant. Long term care data is essential when it comes to recognizing the long term financial implications of trauma.
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Elderly women make up the vast majority of hospitalizations from injuries sustained. Teens and young adults make up the majority of emergency department visits, with most injuries occurring around the home. There has been a slight reduction in injury related deaths when comparing 1985 to 2004. Some causes of death are increasing while others are decreasing. Injury morbidity has dropped in every population except for the elderly.
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Accurate data continues to be the focus of agencies trying to determine who gets injured and how to prevent these injuries from occurring. We’re members of the Million Dollar Advocates Forum. Ca;; us anytime for free, friendly advice at 916-921-6400 in Sacramento or 800-404-5400 Elsewhere in California.
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Health Status: Mental Health
In recognition of the need to highlight issues of quality of life and rights of people with mental disorders, in 1992 the National Mental Health Strategy was developed and in 1996 mental health was designated as a National Health Priority Area. Types of mental health disorders
The prevalence of mental disorder was similar for men and women (17% and 18% respectively). However, there were differences in the prevalence of mental disorders of different types among men and women and at different ages.
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Health Status: Mental Health
In recognition of the need to highlight issues of quality of life and rights of people with mental disorders, in 1992 the National Mental Health Strategy was developed and in 1996 mental health was designated as a National Health Priority Area. Types of mental health disorders
The prevalence of mental disorder was similar for men and women (17% and 18% respectively). However, there were differences in the prevalence of mental disorders of different types among men and women and at different ages. Women were more likely to have experienced anxiety disorders (12% for women compared to 7% for men) and affective disorders (7% compared to 4%).
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Types of mental health disorders
The prevalence of mental disorder was similar for men and women (17% and 18% respectively). However, there were differences in the prevalence of mental disorders of different types among men and women and at different ages. Women were more likely to have experienced anxiety disorders (12% for women compared to 7% for men) and affective disorders (7% compared to 4%). On the other hand, men were more than twice as likely as women to have had a substance use disorder (11% compared to 4%). The prevalence of anxiety disorders for women aged 18-44 ranged between 12% to 15%.
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However, there were differences in the prevalence of mental disorders of different types among men and women and at different ages. Women were more likely to have experienced anxiety disorders (12% for women compared to 7% for men) and affective disorders (7% compared to 4%). On the other hand, men were more than twice as likely as women to have had a substance use disorder (11% compared to 4%). The prevalence of anxiety disorders for women aged 18-44 ranged between 12% to 15%. Women aged 45-54 had the highest rate of anxiety disorders, 16%, which steadily declined in older age groups to 5% for those aged over 64.
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Women were more likely to have experienced anxiety disorders (12% for women compared to 7% for men) and affective disorders (7% compared to 4%). On the other hand, men were more than twice as likely as women to have had a substance use disorder (11% compared to 4%). The prevalence of anxiety disorders for women aged 18-44 ranged between 12% to 15%. Women aged 45-54 had the highest rate of anxiety disorders, 16%, which steadily declined in older age groups to 5% for those aged over 64. For men, the prevalence of anxiety disorders varied little with age until age 55, after which it declined.
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On the other hand, men were more than twice as likely as women to have had a substance use disorder (11% compared to 4%). The prevalence of anxiety disorders for women aged 18-44 ranged between 12% to 15%. Women aged 45-54 had the highest rate of anxiety disorders, 16%, which steadily declined in older age groups to 5% for those aged over 64. For men, the prevalence of anxiety disorders varied little with age until age 55, after which it declined. The prevalence of affective disorders was highest at 11% for women aged 18-24, more than three times the rate for men of this age.
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The prevalence of anxiety disorders for women aged 18-44 ranged between 12% to 15%. Women aged 45-54 had the highest rate of anxiety disorders, 16%, which steadily declined in older age groups to 5% for those aged over 64. For men, the prevalence of anxiety disorders varied little with age until age 55, after which it declined. The prevalence of affective disorders was highest at 11% for women aged 18-24, more than three times the rate for men of this age. For women, the prevalence of affective disorders generally declined with age, while for men, rates increased in the middle years before declining after age 55.
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Women aged 45-54 had the highest rate of anxiety disorders, 16%, which steadily declined in older age groups to 5% for those aged over 64. For men, the prevalence of anxiety disorders varied little with age until age 55, after which it declined. The prevalence of affective disorders was highest at 11% for women aged 18-24, more than three times the rate for men of this age. For women, the prevalence of affective disorders generally declined with age, while for men, rates increased in the middle years before declining after age 55. Men aged 18-24 had the highest rate of substance use disorders, particularly from excessive alcohol intake, with more than one in five being affected (22%).
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For men, the prevalence of anxiety disorders varied little with age until age 55, after which it declined. The prevalence of affective disorders was highest at 11% for women aged 18-24, more than three times the rate for men of this age. For women, the prevalence of affective disorders generally declined with age, while for men, rates increased in the middle years before declining after age 55. Men aged 18-24 had the highest rate of substance use disorders, particularly from excessive alcohol intake, with more than one in five being affected (22%). The equivalent rate for women in this age group was half this (11%).
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The prevalence of affective disorders was highest at 11% for women aged 18-24, more than three times the rate for men of this age. For women, the prevalence of affective disorders generally declined with age, while for men, rates increased in the middle years before declining after age 55. Men aged 18-24 had the highest rate of substance use disorders, particularly from excessive alcohol intake, with more than one in five being affected (22%). The equivalent rate for women in this age group was half this (11%). For men and women, the prevalence of substance use disorders declined steadily with age.
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For women, the prevalence of affective disorders generally declined with age, while for men, rates increased in the middle years before declining after age 55. Men aged 18-24 had the highest rate of substance use disorders, particularly from excessive alcohol intake, with more than one in five being affected (22%). The equivalent rate for women in this age group was half this (11%). For men and women, the prevalence of substance use disorders declined steadily with age. Alcohol use disorders were about three times more common than any other substance use disorder (7% compared to 2%).
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The equivalent rate for women in this age group was half this (11%). For men and women, the prevalence of substance use disorders declined steadily with age. Alcohol use disorders were about three times more common than any other substance use disorder (7% compared to 2%). The presence of a mental disorder may predispose individuals to other disorders. For example, people who experience social phobia may also experience depression and alcohol dependence.
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For example, people who experience social phobia may also experience depression and alcohol dependence. People with an affective disorder were the most likely to have more than one mental disorder. Of those with an affective disorder, 61% also had an anxiety or substance use disorder. In comparison, 43% of those with an anxiety disorder also had an affective or substance use disorder and 31% of those with a substance use disorder had an affective or anxiety disorder. PREVALENCE OF MENTAL DISORDERS(a), 1997
(a) During the 12 months prior to interview.
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People with an affective disorder were the most likely to have more than one mental disorder. Of those with an affective disorder, 61% also had an anxiety or substance use disorder. In comparison, 43% of those with an anxiety disorder also had an affective or substance use disorder and 31% of those with a substance use disorder had an affective or anxiety disorder. PREVALENCE OF MENTAL DISORDERS(a), 1997
(a) During the 12 months prior to interview. Source: Mental Health and Wellbeing Profile of Adults, Australia 1997 (cat.
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Of those with an affective disorder, 61% also had an anxiety or substance use disorder. In comparison, 43% of those with an anxiety disorder also had an affective or substance use disorder and 31% of those with a substance use disorder had an affective or anxiety disorder. PREVALENCE OF MENTAL DISORDERS(a), 1997
(a) During the 12 months prior to interview. Source: Mental Health and Wellbeing Profile of Adults, Australia 1997 (cat. no.
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Source: Mental Health and Wellbeing Profile of Adults, Australia 1997 (cat. no. 4326.0). Impact on daily life
People with a mental disorder (or physical condition) are not necessarily restricted in their day to day activities. However, the presence of mental and/or physical conditions in combination often increases the likelihood of disability, compounding the difficulties that these people face.
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The BDQ asks participants whether they are limited in a number of activities, and whether they have cut down or stopped activities they were expected to do as part of their routine. Participants were then allocated a score characterising them as having a mild, moderate or severe disability, or none. People who reported physical conditions only were more likely to have a disability than those who reported mental disorders only (55% compared to 30%). This may partly reflect the emphasis the BDQ places on the physical rather than the mental aspects of disability. Even so, adults with mental disorders, were on average more likely to be disabled than adults in general (44% compared to 34%).
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People who reported physical conditions only were more likely to have a disability than those who reported mental disorders only (55% compared to 30%). This may partly reflect the emphasis the BDQ places on the physical rather than the mental aspects of disability. Even so, adults with mental disorders, were on average more likely to be disabled than adults in general (44% compared to 34%). MENTAL DISORDERS AND PHYSICAL CONDITIONS(a) BY DISABILITY STATUS(b), 1997
(b) During the four weeks prior to interview, according to the Brief Disability Questionnaire. Source: Mental Health and Wellbeing Profile of Adults, Australia, 1997 (cat.
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Source: Mental Health and Wellbeing Profile of Adults, Australia, 1997 (cat. no. 4326.0). Health service use
Some people experience a mental disorder once and fully recover. For others, it recurs throughout their lives or in episodes.
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For others, it recurs throughout their lives or in episodes. The vast majority of mental illnesses are able to be treated if they have access to appropriate care and services2. Of those with mental disorders in 1997, 38% used a health service for their mental health problems in the previous 12 months. Women were more likely than men to use health services (46% of women compared to 29% of men). The most commonly used health service for both men and women was consulting a general practitioner (22% and 37% respectively).
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The vast majority of mental illnesses are able to be treated if they have access to appropriate care and services2. Of those with mental disorders in 1997, 38% used a health service for their mental health problems in the previous 12 months. Women were more likely than men to use health services (46% of women compared to 29% of men). The most commonly used health service for both men and women was consulting a general practitioner (22% and 37% respectively). The likelihood of using health services for a mental health problem was closely related to the type of mental disorder.
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Of those with mental disorders in 1997, 38% used a health service for their mental health problems in the previous 12 months. Women were more likely than men to use health services (46% of women compared to 29% of men). The most commonly used health service for both men and women was consulting a general practitioner (22% and 37% respectively). The likelihood of using health services for a mental health problem was closely related to the type of mental disorder. Of those with affective disorders only, 56% used health services, compared to 28% of those with anxiety only and 14% of those with substance use disorders only.
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The most commonly used health service for both men and women was consulting a general practitioner (22% and 37% respectively). The likelihood of using health services for a mental health problem was closely related to the type of mental disorder. Of those with affective disorders only, 56% used health services, compared to 28% of those with anxiety only and 14% of those with substance use disorders only. Those with combinations of mental disorders were the most likely to use services for mental health problems (66%). For those with a disability, service use for mental disorders increased with the severity of the disability.
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The likelihood of using health services for a mental health problem was closely related to the type of mental disorder. Of those with affective disorders only, 56% used health services, compared to 28% of those with anxiety only and 14% of those with substance use disorders only. Those with combinations of mental disorders were the most likely to use services for mental health problems (66%). For those with a disability, service use for mental disorders increased with the severity of the disability. A small proportion of people with no mental disorders also used services for mental health problems (5%).
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Those with combinations of mental disorders were the most likely to use services for mental health problems (66%). For those with a disability, service use for mental disorders increased with the severity of the disability. A small proportion of people with no mental disorders also used services for mental health problems (5%). These people may have consulted a health professional for a sub-clinical mental disorder such as stress, or for a mental disorder not included in the analysis of the National Survey of Mental Health and Wellbeing. Overall, the proportion of people with a mental disorder decreased as the number of people living in the household increased.
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After adjusting for age, the prevalence of mental disorder was highest for both men and women living alone. This was the case for anxiety, affective and substance use disorders individually. Age standardised rates were higher among people who were separated or divorced (24% of men and 27% of women) compared to people who were married, widowed or never married. In particular, people who were separated or divorced had higher rates of anxiety or affective disorders (18% and 12% respectively) than the other groups. People who had never married also had higher rates of mental disorder than those who were married.
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This was the case for anxiety, affective and substance use disorders individually. Age standardised rates were higher among people who were separated or divorced (24% of men and 27% of women) compared to people who were married, widowed or never married. In particular, people who were separated or divorced had higher rates of anxiety or affective disorders (18% and 12% respectively) than the other groups. People who had never married also had higher rates of mental disorder than those who were married. In particular, this group, had higher rates of substance use disorders (14%).
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In particular, people who were separated or divorced had higher rates of anxiety or affective disorders (18% and 12% respectively) than the other groups. People who had never married also had higher rates of mental disorder than those who were married. In particular, this group, had higher rates of substance use disorders (14%). People with mental disorders not only find it more difficult to obtain jobs (see Australian Social Trends 1997, Employment of people with a handicap), but unemployment may also contribute to their disorder. Higher unemployment rates among people with mental disorders could be the result of a combination of factors including the disabling effects of mental disorders, lack of training and negative employer attitudes.
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Higher unemployment rates among people with mental disorders could be the result of a combination of factors including the disabling effects of mental disorders, lack of training and negative employer attitudes. After adjusting for age, rates of mental disorders were highest for men and women who were unemployed or not in the labour force. In particular, unemployed people had relatively high rates of substance use disorders (19% of men and 11% of women) compared to employed people and people not in the labour force. It is unclear whether substance use predisposes people to unemployment, unemployment predisposes people to substance use, or both. Unemployed women also had relatively high rates of anxiety disorders (20%) compared to employed women and women not in the labour force.
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In particular, unemployed people had relatively high rates of substance use disorders (19% of men and 11% of women) compared to employed people and people not in the labour force. It is unclear whether substance use predisposes people to unemployment, unemployment predisposes people to substance use, or both. Unemployed women also had relatively high rates of anxiety disorders (20%) compared to employed women and women not in the labour force. PROPORTION OF PEOPLE WITH A MENTAL DISORDER(a) BY LABOUR FORCE STATUS, 1997
Source: Mental Health and Wellbeing Profile of Adults, Australia 1997, (cat. no.
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PROPORTION OF PEOPLE WITH A MENTAL DISORDER(a) BY LABOUR FORCE STATUS, 1997
Source: Mental Health and Wellbeing Profile of Adults, Australia 1997, (cat. no. 4326.0). Suicide is thought to be higher among people with mental disorders. However, the incidence of suicide among people with mental disorders is not known.
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However, the incidence of suicide among people with mental disorders is not known. Results from the 1997 Survey of Mental Health and Wellbeing indicate that people with a mental disorder were nearly four times as likely to have thought about suicide since the age of 18 as people without a mental disorder (37% compared to 9%). Furthermore, they were nearly 7 times more likely to have attempted suicide (10% compared to 1.5%). 1 World Health Organisation (WHO) 1992, The ICD-10 Classification of Mental and Behavioural Disorders, Clinical Descriptions and Diagnostic Guidelines, WHO, Geneva. 2 National Mental Health Strategy brochure 1997, Mental illness - facts, AGPS, Canberra.
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Results from the 1997 Survey of Mental Health and Wellbeing indicate that people with a mental disorder were nearly four times as likely to have thought about suicide since the age of 18 as people without a mental disorder (37% compared to 9%). Furthermore, they were nearly 7 times more likely to have attempted suicide (10% compared to 1.5%). 1 World Health Organisation (WHO) 1992, The ICD-10 Classification of Mental and Behavioural Disorders, Clinical Descriptions and Diagnostic Guidelines, WHO, Geneva. 2 National Mental Health Strategy brochure 1997, Mental illness - facts, AGPS, Canberra.
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Furthermore, they were nearly 7 times more likely to have attempted suicide (10% compared to 1.5%). 1 World Health Organisation (WHO) 1992, The ICD-10 Classification of Mental and Behavioural Disorders, Clinical Descriptions and Diagnostic Guidelines, WHO, Geneva. 2 National Mental Health Strategy brochure 1997, Mental illness - facts, AGPS, Canberra.
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|Classification and external resources|
|ICD-9||307.42, 307.41, 327.0, 780.51, 780.52|
Insomnia, or sleeplessness, is a sleep disorder in which there is an inability to fall asleep or to stay asleep as long as desired. While the term is sometimes used to describe a disorder demonstrated by polysomnographic or actigraphic evidence of disturbed sleep, this sleep disorder is often practically defined as a positive response to either of two questions: "Do you experience difficulty sleeping?" or "Do you have difficulty falling or staying asleep?"
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Insomnia is typically followed by functional impairment while awake. Insomnia can occur at any age, but it is particularly common in the elderly. Insomnia can be short term (up to three weeks) or long term (above 3–4 weeks); it can lead to memory problems, depression, irritability and an increased risk of heart disease and automobile related accidents. Those who are having trouble sleeping sometimes turn to sleeping pills, which can help when used occasionally but may lead to substance dependency or addiction if used regularly for an extended period. Insomnia can be grouped into primary and secondary, or comorbid, insomnia.
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It is described as a complaint of prolonged sleep onset latency, disturbance of sleep maintenance, or the experience of non-refreshing sleep. A complete diagnosis will differentiate between free-standing primary insomnia, insomnia as secondary to another condition, and primary insomnia co-morbid with one or more conditions. - 1 Classification
- 2 Causes and comorbidity
- 3 Diagnosis
- 4.1 Non-pharmacological
- 4.2 Medications
- 4.3 Alternative medicine
- 5 Epidemiology
- 6 Society
- 7 See also
- 8 References
- 9 Bibliography
DSM-5 criteria for insomnia
The DSM-5 criteria for insomnia include the following:
Predominant complaint of dissatisfaction with sleep quantity or quality, associated with one (or more) of the following symptoms:
- Difficulty initiating sleep. (In children, this may manifest as difficulty initiating sleep without caregiver intervention.) - Difficulty maintaining sleep, characterized by frequent awakenings or problems returning to sleep after awakenings.
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- Early-morning awakening with inability to return to sleep. - The sleep disturbance causes clinically significant distress or impairment in social, occupational, educational, academic, behavioral, or other important areas of functioning. - The sleep difficulty occurs at least 3 nights per week. - The sleep difficulty is present for at least 3 months. - The sleep difficulty occurs despite adequate opportunity for sleep.
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- The sleep disturbance causes clinically significant distress or impairment in social, occupational, educational, academic, behavioral, or other important areas of functioning. - The sleep difficulty occurs at least 3 nights per week. - The sleep difficulty is present for at least 3 months. - The sleep difficulty occurs despite adequate opportunity for sleep. - The insomnia is not better explained by and does not occur exclusively during the course of another sleep-wake disorder (e.g., narcolepsy, a breathing-related sleep disorder, a circadian rhythm sleep-wake disorder, a parasomnia).
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- The insomnia is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication). - Coexisting mental disorders and medical conditions do not adequately explain the predominant complaint of insomnia. note: The DSM-5 criteria for insomnia is intended for use by general mental health and medical clinicians (those caring for adult, geriatric, and pediatric patients). Types of insomnia
Insomnia can be classified as transient, acute, or chronic. - Transient insomnia lasts for less than a week.
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It is common for patients who have difficulty falling asleep to also have nocturnal awakenings with difficulty returning to sleep. Two thirds of these patients wake up in middle of the night, with more than half having trouble falling back to sleep after a middle of the night awakening. Early morning awakening is an awakening occurring earlier (more than 30 minutes) than desired with an inability to go back to sleep, and before total sleep time reaches 6.5 hours. Early morning awakening is often a characteristic of depression. Poor sleep quality
Poor sleep quality can occur as a result of, for example, restless legs, sleep apnea or major depression.
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Early morning awakening is often a characteristic of depression. Poor sleep quality
Poor sleep quality can occur as a result of, for example, restless legs, sleep apnea or major depression. Poor sleep quality is caused by the individual not reaching stage 3 or delta sleep which has restorative properties. Some cases of insomnia are not really insomnia in the traditional sense. People experiencing sleep state misperception often sleep for normal durations, yet severely overestimate the time taken to fall asleep.
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