At what point do certain emotions, thinking patterns or personality traits become mental disorders? The lines drawn between normal mental processes and illness have changed significantly over the years, and continue to do so.
In a new study, an international team of researchers looked into which mental conditions people consider to be illnesses and which they do not. The findings show a significant difference between the opinions of mental health professionals and the public.
A questionnaire was distributed to 6,200 individuals, of whom 3,000 were Finns chosen randomly from the Population Register. The rest included 1,500 physicians — a number of psychiatrists and other specialists — 1,500 nurses and, in addition, all of the 200 members of the Finnish Parliament. The researchers received 3,259 responses (53%).
The respondents were asked whether they would define the following conditions as diseases: attention-deficit/hyperactivity disorder (ADHD), alcoholism, anorexia, autism, bulimia, premature ejaculation, homosexuality, drug addiction, depression, panic disorder, gambling addiction, personality disorder, absence of sexual desire, schizophrenia, social anxiety disorder, grief, transsexualism, work exhaustion, insomnia and generalized anxiety disorder.
At least 75 percent of respondents in all groups considered schizophrenia and autism illnesses, while a corresponding share did not consider homosexuality and grief illnesses.
In all groups, ADHD, anorexia, bulimia, depression, panic disorder, personality disorder and generalized anxiety disorder were classified as diseases by 50-75% of respondents. The same number of respondents did not classify premature ejaculation, absence of sexual desire and transsexualism as diseases.
The widest range of views concerned alcoholism, drug and gambling addiction, social anxiety disorder, insomnia and work exhaustion.
“It’s difficult to draw a definite line between normal and abnormal behaviour, or to know when mental symptoms should be called a disease. For instance, grief and anxiety can be normal reactions to a difficult stage in life, but they may also underlie severe depression or an anxiety disorder,” said Dr. Kari Tikkinen, the principal author of a research article on this topic who is an Academy of Finland clinical researcher and adjunct professor at the University of Helsinki.
Psychiatrists were most inclined to classify the conditions included in the questionnaire as diseases, followed by other physicians, nurses, members of parliament and laypeople.
“In other words, the more psychiatric training you had, the more likely you were to consider the conditions diseases. The difference between psychiatrists and laypeople was substantial,” Tikkinen said.
People’s ideas of what is and is not a disorder is very important in the discourse on mental health and human behavior. These notions also influence the allocation of society’s resources and the stigmatization of various groups of people.
“Society’s attitude towards alcoholics and drug addicts largely depends on whether substance abuse is considered an illness or a life choice,” Tikkinen pointed out.
“The medicalization of various problems is not a positive trend either; it may result in non-medical causes being overlooked, solving problems with an approach that is too reliant on pharmaceuticals.”
Source: University of Helsinki