Mental Illness in the Orthodox Jewish Community. Nachas Ruach 14 November 2010 Kate Miriam Loewenthal. Topics. Needs – psychiatric illnesses and minor disorders - stress Barriers to help-seeking What types of support are likely to be sought?
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14 November 2010
Kate Miriam Loewenthal
Prevalences of psychiatric disorders(where known) correspond roughly to prevalence in the general urban population. Where they differ, this can usually be related to life-style factors.
Childhood disorders may be relatively low among young children, with stable families as a likely contributory factor (98% living with both parents) (Lindsey et al, 2003). Hyperactivity and attention disorders may be raised among adolescent boys, possibly due to poor sports facilities in the (very under-resourced) charedischools ) and possibly traditional teaching styles(Frosh et al, 2005)
Relatively low prevalence compared with other urban populations. Protective factors include religious factors, stable families, good community support (Loewenthal et al, 1995, 2000). Depression (MDD) may be as prevalent among men as among women (unusual!) partly due to low use of alcohol by orthodox Jews for coping (Ball & Clare, 1990; Loewenthal et al, 2003)
GAD: subclinical GAD (Generalised Anxiety Disorder) may be high among women probably due to eventfulness of life caring for large family (Loewenthal et al, 1997).
OCD: Uncertain whether OCD more prevalent among Jews than among other groups. Zohar et al (1992).
High prevalence among Israeli adolescents: app 4% compared to <2% general population.
Bernstein (1997) suggests OCD may be over-diagnosed among SOJs due to misinterpretation of religious behaviour as “symptoms”.
Religious factors are thought not to be causal, but do influence the shaping of symptoms (Greenberg & Witztum, 2001)
PTSD: Many survivors of holocaust and other anti-semitic persecutions: PTSD and other symptoms among survivors (Yehuda et al, 1998), but not their descendants (Levav, 2010). No epidemiological studies in the UK
Bipolar disorder: there is still uncertainty about whether this is more prevalent among (Ashkenazi) Jews than among other groups (Fallin et al, 2003).
Schizophrenia: probably similar prevalence as in other groups, though possible genetic susceptibility is under investigation.
Some cultural effects on symptoms (Littlewood & Lipsedge, 1997)
Personality disorders: little/no clear information.
Needs for psychiatric and clinical psychological services are at least as great as in other groups. Statutory service providers would be helped by knowledge of cultural and religious factors. Presentation may have culture-specific features.
Stress (339 interviews, approximately equal numbers of women and men, traditionally and strictly orthodox: Loewenthal et al 1994).% of difficulties requiring actual or potential social service support (over 90% were using statutory or voluntary services; about 20% of these were judged to require specialised appropriate cultural/religious knowledge)
These are chiefly:
% strictly orthodox Jews saying they would use the following forms of support for health, relationship or other difficulties, if appropriate (n=210)
e.g. “I am being punished for things I have done wrong”
“G-d is angry with me” (Pargament, 2002).
Also, poorer mental health goes with
Religious activity, cognitions and affect: a model involving some components of religious faith (items of belief) (Loewenthal et al 2000)
All for G-d Spiritual (religious)
the best control support
Raises Lowers distress