The mental health of Australians 2

Glossary

Page last updated: May 2009

12-month prevalence
Affective disorders
Agoraphobia
Anxiety disorders
Bipolar affective disorder
Care-giving
Chronic condition
Chronic physical conditions
Class of mental disorder
Comorbidity
Composite International Diagnostic Interview (CIDI)
Contact (with family/ friends)
Days out of role
Dependence
Depressive episode
Diagnostic criteria
Dysthymia
Generalized anxiety disorder (GAD)
Harmful use
Health professional
Interference with life
Kessler 10 scale (K10)
Lifetime prevalence
Mental disorders
Mental health problems
Mental health professional
National Health Priority Areas (NHPAs)
Obsessive-compulsive disorder (OCD)
Other mental health professional
Other health professional
Panic disorder
Posttraumatic stress disorder (PTSD)
Prevalence of mental disorders
Psychological distress
Service use
Service provider
Severity
Sheehan Disability scale
Social phobia
Substance use disorders
Suicidal ideation
Suicidality
World Mental Health survey Initiative Composite International Diagnostic Interview (WMH-CIDI)

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12-month prevalence

Meeting diagnostic criteria for a mental disorder at any point in the respondent's lifetime and having symptoms of the disorder in the 12 months prior to interview.

This publication reports data using ICD-10.

Survey data is also available for DSM-IV.

Affective disorders

Affective disorders is a class of mental disorders. The affective disorders included in the survey were episodes of depression (mild, moderate and severe), dysthymia and bipolar affective disorder. A key feature of these mental disorders is mood disturbance.

See chapter 4 for further information.

Agoraphobia

Agoraphobia is an anxiety disorder. The anxiety arises from fear of being in places or situations from which it is difficult to escape should a panic attack occur. Avoidance of these types of places or situations may be prominent.

Anxiety disorders

Anxiety disorders is a class of mental disorders. This class of mental disorder involves the experience of intense and debilitating anxiety. The anxiety disorders covered in the survey were panic disorder, social phobia, agoraphobia, generalized anxiety disorder (GAD), posttraumatic stress disorder (PTSD) and obsessive compulsive disorder (OCD). Specific phobias were not included in the survey. This is the same set as in 1997.

See chapter 5 for further information.

Bipolar affective disorder

Bipolar affective disorder is an affective disorder characterised by periods of elevated or irritable mood. In many cases these fluctuate with periods of low mood. Bipolar affective disorder has previously been termed 'manic depressive disorder'.

Caregiving

Caregiving was defined, for the purpose of the survey, as the provision of care to relatives who have long term physical or mental conditions, such as cancer, serious heart problems, serious memory problems, an intellectual disability, a physical disability, chronic physical illness, alcohol or drug problems, depression, anxiety, schizophrenia or psychosis, bipolar affective disorder or other chronic mental problems.

Provision of care included emotional and financial support and assistance with tasks of daily living, such as self-care, cooking and paperwork.

See chapter 10 for further information.

Chronic condition

A health condition or disorder that has lasted, or is expected to last, for six months or more.

Chronic physical conditions

Chronic physical conditions were defined for the survey as the five physical conditions identified as National Health Priority Areas in Australia. These are arthritis and musculoskeletal conditions, asthma, cancer, cardiovascular health and diabetes.
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Class of mental disorder

Mental disorders are grouped into classes of disorder that share common features. Three classes of mental disorders were included in the survey. These were affective disorders, anxiety disorders and substance use disorders. The common feature of a disorder class is not exclusive to disorders within the class, for example mood disturbance is a key feature of affective disorders and is also required for a diagnosis of schizoaffective disorder, which is generally grouped with psychotic disorders.

Comorbidity

The occurrence of more than one disorder at the same time.
It may refer to co-occurring mental disorders and also co-occurring mental disorders and physical conditions.

See chapter 7 for further information.

Composite International Diagnostic Interview (CIDI)

See World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (WMH-CIDI).

Contact (with family/ friends)

For the purposes of the survey, contact was defined as including visits, phone calls, letters, or electronic mail messages.

Days out of role

This measure captures the impact of mental disorders and physical conditions on people's ability to function in their day-to-day activities.
Respondents were asked two separate questions about the 30 days prior to interview:
  • the number of days that they were 'unable' to work or carry out normal activities because of their health and
  • the number of days they had to 'cut down' on what they did because of their health.
The answers to these questions are then totalled, with days cut back given half the weight of days unable to work.

Dependence

Dependence is a substance use disorder and was measured in relation to alcohol and four separate categories of drugs (cannabis, stimulants, sedatives and opioids). It is characterised by tolerance to the effects of the substance, withdrawal symptoms if use of the substance is stopped or cut back and by difficulty controlling consumption of the substance despite associated physical and psychological problems.

Depressive episode

Depressive episode is an affective disorder. Mild, moderate and severe depressive episode were assessed in the survey. It is characterised by periods of low mood with significant impairment due to symptoms required to meet diagnostic criteria. Symptoms include loss of interest and enjoyment, reduced energy and concentration and changes in sleep and appetite.

Diagnostic criteria

The survey was designed to estimate the prevalence of common mental disorders defined according to clinical diagnostic criteria, as directed by both the International Classification of Diseases 10th Revision (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV).

Diagnostic criteria for a disorder usually involve specification of:
  • the nature, number and combination of symptoms
  • a time period over which the symptoms have been continuously experienced
  • the level of distress or impairment experienced and
  • circumstances for exclusion of a diagnosis, such as it being due to a general medical condition or the symptoms being associated with another mental disorder.
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Dysthymia

Dysthymia is an affective disorder characterised by chronic low mood lasting for two years or more.

Generalized anxiety disorder (GAD)

Generalized anxiety disorder is an anxiety disorder characterised by long periods of uncontrollable worry about everyday issues or events. The worry is typically accompanied by feelings of fatigue, restlessness or difficulty concentrating.

Harmful use

Harmful use is a substance use disorder. It was measured in relation to alcohol and to four separate categories of drugs (cannabis, stimulants, sedatives and opioids). It is defined by levels of use associated with either physical or psychological harm.

Health professional

Health professional is defined to include the following:
  • general practitioner
  • psychiatrist
  • psychologist
  • mental health nurse
  • other professionals providing specialist mental health services
  • other specialist doctor or surgeon
  • other professional providing general services, such as social worker, occupational therapist and counsellor and
  • complementary and alternative medicine therapist.
These health professionals have been grouped in a number of ways for the purposes of reporting.

See definitions for Mental health professionals, Other mental health professionals and Other health professionals.

Interference with life

Interference with life was assessed for each type of mental disorder using the Sheehan Disability Scale.
The scale assesses impairment in the four domains of household maintenance, work or study, close relationships and social life for the worst month in the 12 months prior to interview. Interference for each domain is self-rated from 0 or no interference to 10 or very severe interference.

Kessler 10 scale (K10)

See psychological distress.

Lifetime prevalence

Meeting diagnostic criteria for a mental disorder at any point in the respondent's lifetime.
This publication reports data using ICD-10.

Survey data is also available for DSM-IV.

Mental disorders

Mental disorders are defined according to the detailed diagnostic criteria within classification systems.

This publication reports data for ICD-10

Survey data is also available for mental disorders as defined by DSM-IV.
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Mental health problems

This includes, but is not restricted to, such things as stress, anxiety, depression, or dependence on alcohol or drugs. Individuals with mental health problems may never meet the diagnostic threshold for a mental disorder.

Mental health professional

Defined in the survey as psychiatrists, psychologists and other mental health professionals, including mental health nurses and other health professionals working in specialised mental health settings.

National Health Priority Areas (NHPAs)

These are seven conditions identified at the Australian national level as National Health Priority Areas due to their high social and/or financial costs to Australian society or 'burden of disease'. The conditions are arthritis and musculoskeletal conditions, asthma, cancer, cardiovascular health, diabetes, injury and mental disorders.

The survey collected data on the first five to enable examination of the associations between mental disorders and chronic physical conditions.

Obsessive-compulsive disorder (OCD)

Obsessive-compulsive disorder is an anxiety disorder characterised by repeated thoughts, images or impulses that the person feels are inappropriate, and repetitive behaviours, such as hand-washing, designed to reduce the anxiety generated by the thoughts.

Other mental health professional

Defined in the survey as mental health nurses and other health professionals working in specialised mental health settings.

Other health professional

Defined in the survey as including social workers, occupational therapists and counsellors providing general services; medical doctors other than psychiatrists or general practitioners, and practitioners of complementary and alternative medicines.

Panic disorder

Panic disorder is an anxiety disorder. It involves experiencing sudden bursts of extreme anxiety that are accompanied by symptoms like a pounding heart, shortness of breath and nausea.

Posttraumatic stress disorder (PTSD)

Posttraumatic stress disorder is an anxiety disorder. It is characterised by symptoms that occur as a result of a previous traumatic event. These symptoms include recurrent and intrusive memories of the trauma, feelings of emotional numbing and detachment, and increases in emotional arousal such as irritability and disturbed sleep.

Prevalence of mental disorders

The proportion of people in a given population who meet diagnostic criteria for any mental disorder in a given time frame.

This publication reports data using ICD-10.

Survey data is also available for DSM-IV.

See also 12-month prevalence and lifetime prevalence.
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Psychological distress

Psychological distress is measured by the Kessler Psychological Distress Scale (K10). This is a widely used scale designed to detect the differing levels of psychological distress in the general population. While high levels of distress are often associated with mental illness, it is not uncommon for some people to experience psychological distress but not meet criteria for a mental disorder.
The K10 is based on 10 questions about negative emotional states in the 30 days prior to interview. It is scored from 10 to 50, with higher scores indicating higher levels of distress. In this report, scores are grouped as follows:
  • 10-15 Low levels of psychological distress
  • 16-21 Moderate levels of psychological distress
  • 22-29 High levels of psychological distress and
  • 30-50 Very high levels of psychological distress.

Service use

Service use includes consultations with health professionals and hospital admissions. People defined as having used services for mental health problems are those who identified having at least one consultation with a health professional or hospital admission in relation to mental health problems in the 12 months prior to interview.

See also Health professional.

Service provider

See definition for Health professional.

Severity

Severity was measured using the World Mental Health Survey Initiative severity measure (modified for recent changes in the survey instrument). For each individual with a 12-month mental disorder the measure summarises the impact of all the mental disorders experienced in the previous 12 months into a mild, moderate or severe category:
  • To be classified as severe, in addition to having a 12-month mental disorder, one of the following must have occurred in the previous 12 months: an episode of mania; attempted suicide; or experienced severe role impairment on at least two domains of the disorder specific Sheehan Disability Scales or overall functional impairment at a level equivalent to a Global Assessment of Functioning score of 50 or less.

  • A classification as moderate requires a 12-month mental disorder and moderate role impairment in one domain on the Sheehan Disability Scales.

  • The remaining people with a 12-month mental disorder were categorised as mild.
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Sheehan Disability scale

See Interference with life.

Social phobia

Social phobia is an anxiety disorder. It is characterised by a strong fear of social interaction or performance situations. People with social phobia avoid social situations in case of embarrassment or humiliation.

Substance use disorders

Substance use disorders is a class of mental disorders relating to problems arising from the use of alcohol and drugs.

The survey provided separate diagnoses of harmful use and dependence for alcohol, cannabis, sedatives, stimulants and opioids.

See chapter 6 for further information.

Suicidal ideation

Suicidal ideation is defined as serious thoughts about taking one's own life.

Suicidality

The term suicidality covers suicidal ideation (serious thoughts about taking one's own life), suicide plans and suicide attempts.

See chapter 8 for further information.

World Mental Health survey Initiative Composite International Diagnostic Interview (WMH-CIDI)

The WMH-CIDI is an extensive survey instrument designed for the collection of data on mental disorders and associated factors. In its current form (Version 3.0), the WMH-CIDI provides estimates of lifetime and 12-month prevalence of mental disorders, the impact of these disorders on functioning and types and frequency of service use.
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