WHO issues new guidebook to support diagnosis of mental disorders

The World Health Organisation (WHO) has published a new diagnostic manual for mental, behavioural, and neurodevelopmental disorders.

The manual offers guidance to clinicians on how to diagnose disorders that have been recently added to the WHO’s ICD-11 handbook. These include complex post-traumatic stress disorder, gaming disorder and prolonged grief disorder. The aim is to offer better support to health professionals to enable them to recognise distinct clinical features of these disorders, which may previously have been undiagnosed and untreated.

It takes a lifespan approach to mental, behavioural and neurological disorders, including information about how disorders appear in childhood, adolescence, and older adults. The manual also includes culture-related guidance for each disorder, including how disorder presentations may differ according to cultural background.

Dévora Kestel, director of the WHO’s mental health and substance use department, said: “An accurate diagnosis is often the first critical step towards receiving appropriate care and treatment. By supporting clinicians to identify and diagnose mental, behavioural and neurodevelopmental disorders, this new ICD-11 diagnostic manual will ensure more people are able to access the quality care and treatment they need.”

More mental health visits to GPs since pandemic

The publication of the manual coincides with more evidence of a widespread increase in mental health problems. International research, published in the Lancet, has found that mental health visits to primary care practitioners went up after the Covid-19 pandemic. The researchers carried out an interrupted time series analysis in nine countries to examine changes in rates of monthly mental health visits to primary care settings from January 1st, 2018, to December 31st, 2021.

They found that mental health visit rates increased after the onset of the pandemic in most countries, largely as a result of people reporting anxiety or depression. The researchers say that their work “demonstrated the immediacy of the pandemic influence, with most countries experiencing an immediate rapid increase in mental health visit rates following the onset. This initial surge could be attributed to the heightened stressors, anxiety, and uncertainty induced by the pandemic and underscores the acute need for mental health care services during crises of this magnitude.”

UK is the second unhappiest country

While the Lancet research showed an increase in mental health problems across a number of different countries, another study has apparently shown that the UK is the second-most miserable nation in the world.

The Mental State of the World report, produced by an American non-profit organisation called Sapien Labs, is based on an index measuring mental well-being. Using data from 500,000 respondents in 71 countries, the index measures how people’s “inner state impacts their ability to function within their life context”. The idea is to measure people’s mental well-being relative to the environment they live in.

The top five-rated countries for mental well-being were the Dominican Republic, Sri Lanka, Tanzania, Panama and Malaysia. The UK is ranked 70, with only one country – Uzbekistan – ranking lower.

Western nations as a whole fare badly, with none making it into the top 10. “Greater wealth and economic development do not necessarily lead to greater mental wellbeing,” the researchers write.

Like the authors of the Lancet study, however, the researchers note a widespread drop in mental well-being since the pandemic. “Mental wellbeing remained at its post-pandemic low with yet again no sign of movement towards pre-pandemic levels,” they write, adding: “This raises important questions about the lasting impact of the pandemic, and how shifts in the way we live and work and the amplification of existing habits (e.g. remote working, online communication, consumption of ultra-processed food, use of single-use plastics) have cumulatively pushed us into a space of poorer mental wellbeing.”