The most common mental disorders in young people and middle-aged people in the modern world

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The most common mental disorders in young people and middle-aged people in the modern world

Liana Spytska

Ліана Вікторівна Спицька

INTRODUCTION

In today's world, maintaining a person's psychological and mental health is an important task. It is also no secret that young and middle-aged people are the foundation and future of any society. Therefore, the mental disorders they suffer from have a significant impact on the functioning of society and therefore require more attention. The relevance of the stated problem lies in the harmful impact of mental disorders on the social and professional activities of young and middle-aged people, which has significant consequences for both the patients themselves and society as a whole, and the need to combat them.

S.N. Shapse (2008) argues that mental disorders are now being studied as behavioural and psychological syndromes that arise in a person as a response to stress or other negative experiences, and not just as a normal reaction to a particular event. Mental disorders are considered in descriptive and behavioural definitions. The scientist also draws attention to the fact that the symptoms of mental disorders can be a rather blurred phenomenon, as people with the same disorder may have very few behavioural traits in common, although they minimally meet the defining features of a particular disorder. A group of researchers,point out that in the 21^st century, mental disorders are quite common around the world. One in three people is at risk of developing a mental disorder in their lifetime. Although most disorders now have effective treatments, the presence of a mental disorder can be quite a significant problem for a person. Researchers attribute this to the fact that certain behavioural and physical manifestations of disorders can alienate other people from the patient, preventing them from fully functioning as a member of society. M. Subramaniam et al. (2020) conducted a study that showed that one in seven Singaporeans experience mental disorders in their lifetime (the most common were anxiety, mood disorders, and obsessive-compulsive disorder). It was also noted that young people are one of the most vulnerable groups in the population, and researchers suggest creating treatment centres targeted at them. That is why it is worth paying attention to why young and middle-aged people are the most vulnerable groups to mental disorders. J. Firth et al. (2020) conducted a study on the impact of lifestyle on the risk of these disorders, namely: sports, quantity and quality of sleep, nutrition, bad habits, stress at work and in personal life. As a result, the researchers concluded that sufficient physical activity and a healthy diet not only reduce the risk of mental disorders, but can also be used as a treatment method in some cases. There was also a link between tobacco, alcohol, and drug use and the risk of both mild and severe mental disorders. R. von der Warth et al. (2022) found that major depressive disorder, anxiety disorder (including social anxiety disorder), adjustment disorder, and a number of personality disorders are the most common disorders among young and middle-aged people, given the factors that trigger their onset (Conway et al., 2023). Therefore, the purpose of the study is to examine mental disorders common among young and middle-aged people, their classification, diagnosis, and treatment.

MATERIALS AND METHODS

The following methods were used in the study: analysis (to study the peculiarities of the development of mental disorders); comparison, generalization (to systematize the theoretical material related to the object of study); description (to present the results); comparative (to compare approaches and materials for studying the most common mental disorders among young and middle-aged people); classification (to distinguish between types of mental disorders, methods of their diagnosis and treatment). The study was conducted in Kyiv, Ukraine. The sample consisted of 1018 people, including 543 women and 475 men aged 16 to 50 years. The group of “youth” was defined as 16-30 years old, and “middle-aged people” as 30-50 years old. The assessment of psychological state and causes of mental disorders was carried out using standardized questionnaires (compiled by the author), psychodiagnostic methods and tests (GMHAT/PC - Global Mental Health Assessment Tool - Primary Care, developed by Cheshire and Wirral NHS Trust in collaboration with the University of Liverpool, UK (Sharma et al., 2004). All procedures carried out in participatory research complied with ethical standards, did not violate the honour and dignity of respondents, considered the age characteristics of the respondents and were conducted with the anonymity of the results. In the course of the survey, the interviewer followed the recommendations of the American Sociological Association's Code of Ethics (1997).

The method of analysis was used to theoretically collect and describe existing approaches in psychology, psychiatry, and medicine to the issue of current mental disorders among young and middle-aged people in the modern world; information from books, electronic articles, monographs, conferences, dissertations, which deeply and comprehensively reveal aspects and manifestations of mental disorders common among young people, was considered. The method of comparison helped to reveal the relevance of this issue based on the study of works devoted to this problem, its features, characteristics, and approaches to explanation; to show the causes of the development of mental disorders and to identify the most appropriate definition for this phenomenon. The classification was also used to identify the types of mental disorders, provide brief overviews of research by scientists, and identify unexplored issues. The method of analysis was used to determine the most effective ways and methods of diagnosing and subsequent treatment of mental disorders based on the use of certified medications and psychotherapy. Empirical methods were used to identify the main mental disorders that are most common among young and middle-aged people. Various factors that directly or indirectly influence their occurrence were considered separately. The method of induction was used to examine negative trends and the prevalence of disorders among young and middle-aged people during Russia's military invasion of Ukraine and subsequent hostilities, which helped to diagnose common factors and symptoms of the most common mental disorders among the described population groups. Using the methods of generalization and description, the author substantiates the aspects of the psychological research work carried out; the conclusions obtained during the writing of the research paper are systematized. In addition, with the help of various theoretical methods (the method of comparing approaches and classification), the data obtained during the work were classified and compared with other scientific and theoretical works of scientists; theoretical and practical conclusions and results of the study were substantiated. The comparison method was used to compare studies and approaches aimed at a detailed study of the problem of the prevalence of mental disorders among young and middle-aged people; the main approaches and standards for classifying mental disorders were shown.

RESULTS

Mental disorders, their types, and causes

Before moving on to the issue of the most pressing mental disorders among young and middle-aged people in the modern world, it is worth considering in more detail the concept of “mental disorder” and its types. A mental disorder is a disorder whose manifestations are mainly signs or symptoms of a psychological (emotional and/or behavioural) nature (Spitzer & Endicott, 2018). According to another definition, it is a behaviour determined by certain mental factors that leads to significant stress and negatively affects a person's performance (Bolton, 2008). Mental disorders affect a person's ability to cognition, emotions and behavioural control, and significantly interfere with the ability to function adequately both independently and with others. The symptoms can be permanent, recurrent or occur as individual episodes, and they also vary significantly between individual disorders. It is worth noting that mental disorders can only be diagnosed by specialized doctors, i.e. psychologists or psychiatrists. In modern psychology and psychiatry, there are two points of view on the classification of mental disorders: the ICD (International Classification of Diseases) and the DSM (Diagnostic and Statistical Manual of Mental Disorders). The ICD is an international classification of diseases, in which a separate section is devoted to mental disorders, and it is used when registering mental diagnoses in those medical institutions that provide official statistics. The DSM is an American classification of mental disorders, but it is widely used in other countries as well, as it has a number of advantages over the ICD. Despite some differences, the classification of mental disorders in them is somewhat similar. Therefore, mental disorders can be divided into the following groups: organic mental disorders; substance-related disorders (alcohol, tobacco, drugs, and caffeine); schizophrenia and schizotypal disorders (schizoaffective disorder, brief psychotic disorder); mood disorders (depressive disorders, anxiety); stress disorders; disorders related to the patient's physical health; personality and behavioural disorders; disorders affecting the patient's psychological development; behavioural and emotional disorders diagnosed in childhood and adolescence; unspecified mental disorders (Tyrer, 2014).

When it comes to the causes of mental disorders, there are quite a few, and some of them are quite unclear. The most common are genetic causes, environmental influences, and the person's psychological state. There is a spectrum of certain mental disorders related to family composition (depression, anxiety, narcissistic personality disorder). There is also a high chance that twins will develop the same disorders (Torgersen et al., 2000). It is also worth noting that gender also affects the risk of mental disorders: Men are more likely to develop attention deficit hyperactivity disorder and autism; women have a higher risk of major depressive disorder and anxiety (Jamison et al., 2006). Environmental factors play a key role during pregnancy and at birth. For example, the use of alcohol or psychoactive substances during pregnancy or the lack of it can provoke mental disorders in the child. Complications during childbirth can have the same effect, and inadequate care in the first months of life can lead to cognitive impairment (Fu- magalli et al., 2007). The impact of drug use is also worth mentioning. In particular, cannabis and alcohol can lead to anxiety disorders, depression and bipolar personality disorder, while cocaine and amphetamines can lead to schizophrenia and psychosis (Khan & Akella, 2009). Psychological and social factors include childhood abuse by parents and peers, childhood trauma, and negative life experiences in general. In adulthood, mental disorders can lead to problems in personal life or at work, as well as employment and career problems. Stress associated with difficult life situations (discrimination by society, forced migration, war, disasters) also contributes to the onset of mental disorders (Hiday, 1995). Thus, the causes of mental disorders can be diverse: both congenital and acquired as a result of various environmental influences (stress, exposure to various chemicals, social conditions, etc.).

The most common mental disorders among young people and middle-aged people

The mental and psychological stability of young and middle-aged people is an extremely important component of maintaining stability and well-being in society, as they are its foundation. In the 21^st century, these populations are affected by numerous harmful factors that lead to mental illness and disorders. These factors can be both psychological and social. In this context, it seems important to identify the mental disorders that are most common among young and middle-aged people. Based on the analysis of the survey results, it was concluded that there is a certain distribution between age groups, gender and mental disorders that occur in representatives of these groups.

Taking into account the results of the study, it is worth considering in detail each of the disorders that are common among young and middle-aged people. Many factors cause depressive disorders. For young people, one of the most significant is unemployment. It has been proven that depression is three times more common among unemployed young people. Other influential factors include satisfaction with their financial situation, place in society, relationships with the opposite sex, and the level of well-being in general.

Importantly, all of these factors are also relevant for middle-aged people (Bartelink et al., 2019). Anxiety disorder is characterized by exaggerated feelings of anxiety and fear, sometimes panic. On the physical level, it manifests itself through trembling and increased heart rate. The causes of this disorder can be divided into psychological, genetic and external factors. People who suffered from parental violence (physical and/or psychological) in childhood, have a difficult financial situation, or have relatives who suffered from a certain disease are more likely to develop anxiety disorders. Numerous studies have also shown that unemployed young people, those with higher education, and those who are single are at higher risk of developing the condition (Goodwin et al., 2020). Social anxiety disorder, also known as social phobia, is a mental disorder that affects a person's ability to function in society. The main causes of this disorder are negative psychological experiences in childhood. Most often, this is associated with bullying by peers, bullying, unsuccessful public speaking experiences, etc. As a result, a person develops a fear of any social activity (whether it is public speaking or just communicating with people) (Mohamma- di et al., 2020). An adjustment disorder is a mental disorder that occurs during periods of adaptation to major changes in a person's life and is characterized by significant stress and emotional fluctuations that interfere with a person's normal functioning. It can be caused by various life situations that require a person to adapt. For example, the death of loved ones, forced migration, financial instability, uncertainty in professional activities, family problems and serious illnesses that force a change in lifestyle. An interesting fact is that among young and middle-aged people, women are twice as likely to develop this disorder (Dragan et al., 2021). PTSD is a serious mental condition that occurs as a result of events that have an extremely powerful negative impact on the human psyche. Hostilities and constant missile attacks lead to a massive spread of this disorder. Particularly noteworthy is the fact that the main risk group for PTSD in wartime is young military personnel (18-30 years old). For them, the factors of influence are: the use of weapons; death of comrades-in-arms and loved ones; and hard life in the field.

Diagnosis and treatment of mental disorders

In order to treat a mental disorder effectively, it must first be correctly diagnosed. Much attention began to be paid to this problem about twenty years ago, when the extraordinary diversity of mental disorders led to the realization that they could not be treated in the same way. This was the impetus for the development and further use of the DSM.

The DSM-IV provided recommendations for the diagnosis of mental disorders in patients along several “axes”:

1. Axis 1 - the presence or absence of a mental illness. Its use allows for the diagnosis of serious disorders, such as schizophrenia and post-traumatic stress disorder.

2. Axis 2 - the presence or absence of background psychopathy. It is used to diagnose personality and developmental disorders. Such disorders are diagnosed when personality traits lose their functionality and adaptability.

3. Axis 3 - the presence or absence of somatic diseases. It reveals physical conditions that can directly affect psychological health.

4. Axis 4 - psychosocial factors. It helps to assess the severity of psychological and social stressors that may have contributed to the onset or exacerbation of the disorder.

5. Axis 5 - general level of patient adaptation. It characterizes the general level of psychological, social and professional functioning of a person (Shapse, 2008).

However, DSM-IV was replaced by an updated version - DSM-5, which stands out from its predecessor by the presence of the so-called spatial approach. The spatial approach is an approach to the classification of mental disorders that, instead of categorizing them, quantifies the patient's symptoms and represents them using numerical values on one or more scales. As physicians are now often faced with patients who have symptoms of two or more different mental disorders (e.g., panic attacks in a depressed patient), this leads to two concurrent diagnoses. It is in this situation that the new approach can provide the necessary assistance, as it assesses the magnitude of individual symptoms. The spatial model helps to assess and map the course of a mental disorder. This makes it possible to separate normal from abnormal behaviour (Vahia, 2013). It is important to note that effective treatment is provided only by specialists in psychology and psychiatry. The main ways to treat mental disorders are psychotherapy and the use of certified medications. Regular exercise, proper and healthy diet, and support from the environment can be additional treatments that do not require the intervention of a doctor.

Psychotherapy is a way of helping people with a variety of mental illnesses and emotional difficulties. Talk therapy is used to eliminate or control anxiety symptoms. Its goal is to improve a person's functioning and well-being (Karlsson, 2011).

There are several types of psychotherapy:

1. Cognitive behavioural therapy (CBT). It allows identifying and getting rid of habits that provoke the onset of mental disorders. It is especially effective for depression.

2. Interpersonal therapy (IPT). It allows learning how to express one's own emotions and communicate with other people.

3. Dialectical behavioural therapy. It involves the formation of new habits that allow the patient to feel responsible for dealing with a mental disorder. It is usually used to treat patients with suicidal tendencies.

4. Psychodynamic therapy. It consists in working through and subsequently getting rid of childhood traumas that caused the disorder.

5. Psychoanalysis. It is a more intensive form of psychodynamic therapy.

6. Supportive therapy. A type of psychotherapy that helps patients improve their self-esteem, reduce anxiety and develop coping mechanisms (Wiswede, 2014).

As already mentioned, the second most effective way of treating mental disorders is through the use of special medications prescribed by a psychiatrist or family doctor. They can be classified as follows: Antidepressants used for major depressive disorder; anxiolytics prescribed to combat anxiety disorder); mood stabilizers, which are useful in the treatment of bipolar personality disorder; antipsychotics used in the treatment of schizophrenia; stimulants prescribed for patients with attention deficit hyperactivity disorder (Cipriani et al., 2018). In summary, it is worth saying that the mental disorders have been successfully identified that are most common among young and middle-aged people and are also relevant for these populations.

DISCUSSION

Considering the problem of mental disorders among young people, it is worth paying attention to the work of M. Vasileva et al. (2021). It presents the results of a study of the prevalence of mental disorders among certain population groups and compares them with other works on this topic. The researchers concluded that the most common mental disorders observed among young people were oppositional defiant disorder and anxiety disorders of various types. However, given that the study was based on data from psychiatric institutions, the researchers suggest that the results may not be sufficiently representative of the general population. The researchers' conclusions that anxiety disorders are common among young people coincide with the results of this article. As for the methods of treatment of mental disorders, it is worth considering the article by K.R. Meri- kangas et al. (2013). In this article, the researchers investigated the way mental illnesses are treated among American youth. After interviewing 123 people aged 13-18, they concluded that 14.2% of respondents with existing mental disorders were treated with certified psychotropic drugs. There was also a certain correlation between the types of drugs and the types of disorders that patients had. For example, patients with mood disorders used antidepressants; stimulants were used by patients with attention deficit/hy- peractivity disorder; antipsychotics were observed among people with serious developmental disorders. Scientists found it interesting that even people without diagnosed mental disorders were taking psychotropic drugs to combat psychological stress and anxiety, which, if not controlled, can lead to serious consequences for mental health and the body as a whole. The opinions of researchers regarding the use of antidepressants for depressive and mood disorders coincide with the results of this study. In continuation of this topic, it is worth considering the work of M. Solmi et al. (2022). In it, the researchers concluded that young people are at risk for such mental disorders as depressive disorder, anxiety disorder, and various psychotic disorders. In the context of combating them, it was concluded that regular exercise can have a positive impact on the course of depressive disorders and anxiety disorders. The researchers also noted that improving social relations in schools and higher education institutions can reduce the risk of mental disorders among young people. The conclusions of scientists that young people are at risk for depression and anxiety disorders and the findings of this study have a common basis.

in their study on new factors influencing the onset of mental disorders, note that climate change-related problems can create new psychological conditions that will negatively affect both young people with pre-existing mental disorders and the risks of developing them in healthy people. Scientists also point out that natural disasters, such as hurricanes, floods, and forest fires, can be the cause of depression, anxiety, and post-traumatic stress disorders. Although the study presented here looks at the problem of mental disorders among young people from an unusual perspective that differs from the one presented in this paper, it is worthy of attention. Given that stress at work is a fairly common cause of mental disorders among middle-aged people, it is worth having a closer look at the research on this topic. The article by E.C. Schreibau- er et al. (2020) is just such a work. In it, the researchers call workplace stress one of the biggest threats to employees' psychological health. They define it as stress that occurs when the needs of the job exceed the resources and capabilities of employees to cope with them. The main social and psychological factors that provoke stress at work are: The intensity of work; the social environment of employees; and the availability of support from the environment (colleagues, friends, family). The present study of stress at work as a factor that increases the risk of mental disorders examines the stated problem from a perspective not considered in this paper. When considering the treatment of anxiety disorders among young people, it is worth paying attention to the work of C. Creswell et al. (2020). They draw attention to the fact that anxiety disorders among young people are not given enough attention, and even more so, some doctors do not recognize them as a serious problem. As a result, many young people do not receive the necessary treatment and continue to suffer from the inability to function fully in society. This becomes even more relevant as research in the US shows that many young adults (14%) and middle-aged people (7%) complained of increased anxiety. The largest jump in the number of diagnosed anxiety disorders was observed among young people aged 1825. The results of the presented work on the large number of young people suffering from anxiety disorders coincide with the results of this study.

Since post-traumatic stress disorder has become a significant issue among Ukrainians, it is advisable to refer to article by G. Dyomina (2022). She considers PTSD as a type of neurosis that occurs as a response of the human psyche to traumatic events. As hostilities continue on the territory of Ukraine, war crimes are being committed in the occupied territories, and terrorist missile attacks on civilian infrastructure are taking place in the rear cities, PTSD is becoming more widespread. The researcher notes that the most at-risk populations are young military personnel, internally displaced persons and refugees, residents of frontline and occupied territories, and civilians directly or indirectly affected by the war. Similar to this work, G. Dyomina (2022) notes the urgency of the problem of PTSD among Ukrainians and draws attention to the fact that young military personnel are at risk. Considering the problem of depressive disorder among young and middle-aged people, it is worth mentioning the work of M.A. Villarroel and E.P. Terlizzi (2020). They define depression as a condition in which a person feels sad, empty, becomes more irritable, and certain physical and cognitive changes occur. For this condition to be called depression, it must last for at least two weeks. After conducting a survey, the researchers learned that in the two weeks preceding the experiment, 18.5% of respondents experienced symptoms of depressive disorder, which is a significant figure. Most often, symptoms occurred in young people (21%) and middle-aged people (16.8%). Thus, the findings of M.A. Villarroel and E.P. Terlizzi (2020) on the prevalence of depressive disorder among young and middle-aged people coincide with the results of this study. Continuing the study of mental disorders among young people, it is worth noting the work of G. Beaudry et al. (2021). The researchers analysed the results of 47 scientific papers on mental disorders among young people. It was determined that behavioural disorders, attention deficit disorder, and depressive disorder are the most common among men. Among females, symptoms of depressive disorder and post-traumatic stress disorder were more common. Analysing the information provided, it is possible to learn that the conclusions of this research paper regarding the prevalence of depressive and anxiety disorders among young people are correct.

CONCLUSIONS

After conducting the study, it is worth concluding that mental disorders are an urgent problem in the modern world. They can arise under the influence of stressful, psycho-emotional factors or in the presence of a genetic (hereditary) predisposition. Without professional treatment, disorders can only worsen, so timely and high-quality diagnosis is important. This is of particular importance for young and middle-aged people, for whom full functioning in society is very important. The paper examines in detail the concept of mental disorders, describes their types and the difference in classifications. The article also describes various genetic, psychological and sociological factors that can trigger the onset of mental disorders. It is concluded that the most common mental disorders among young and middle-aged people are the following: depressive disorder; anxiety disorder; adjustment disorder; social phobia; and PTSD. In addition, the criteria for diagnosing mental disorders are defined. The difference between psychotherapeutic treatment and medication is described. The materials of the article may be relevant for psychologists, students of psychological faculties, sociologists, psychiatrists, social workers, who need to be aware of the aspects and stages of development of mental disorders in order to prevent their occurrence. The results of the study will also be informative for the scientific community, as it will expand the aspects of studying the problem of psychological health of modern youth and middle-aged people in the face of negative external influences. It is worth continuing the study and deepening it, revealing the problem of the spread of mental disorders among young and middle-aged people based on psychological and medical methods and approaches. This study does not exhaust all aspects of this psychosocial problem, as it is worth studying such issues as: the connection of one disorder with the emergence of others; the impact of the Russian-Ukrainian war on the risk of mental disorders; creating the right conditions for working with patients with mental disorders.

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