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Early Detection and Management of Mental Disorders

A common theme in the recent literature on most mental disorders is that
they often remain undetected and untreated for quite a long time, not rarely
for several years, after the occurrence of their first manifestations. For some
disorders – namely bipolar disorder, schizophrenia and some anxiety
disorders – clinical research has directly documented the average interval
between their onset and the time of their diagnosis and the start of
appropriate treatment. For depressive disorders, a different way to
document the same phenomenon has been the finding that a high
proportion of cases are missed by general practitioners, although part of
them are recognized in subsequent consultations. For other conditions –
especially eating disorders and some anxiety disorders – the main focus has
been on the multiple barriers to help seeking, which often delay recognition
and treatment. In the case of Alzheimer’s disease, neuropsychological and
biological research has been decisive in documenting the latency between
the first manifestations of the disease and the clinical diagnosis.

The argument underlying this vast and diverse body of literature has
been that an early diagnosis and management of the various disorders may
be essential in improving their course and outcome and in reducing or even
preventing their social consequences. This hypothesis has received up to
now only a partial empirical support for most of the above-mentioned
disorders, but represents a major focus of research for virtually all of them.
Moreover, it has been repeatedly pointed out that the reconstruction of the
early phases of development of mental disorders may contribute significantly
to the elucidation of their etiopathogenesis and, in the case of some of
them, may allow devising prevention programmes.
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