World Health Organization (WHO) has defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”1 In 1974, a WHO expert committee on the organization of mental health services in developing countries, urged governments to recognize mental disorders as a problem of high priority for the individual, the community, and national development. The International Conference on Primary Health Care, which was held in Alma-Atta, USSR, 6-12 September 1978, strongly reaffirmed that health is a fundamental human right.2
The relationship between the body and mind is an organic relationship. In fact, it is that of oneness. The body affects the mind resulting in what is known as organic mental disorders and vice versa. The mind affects the body leading to psychosomatic disorders. The implication of this soma-psyche concept is immense; it entails a holistic approach to patients’ assessment and management. The ultimate objective will be a patient-oriented rather than disease-oriented attitude towards our patients. This objective is only achievable through teamwork and a multidisciplinary approach. A bio-psychosocial model in dealing with our patients is a prerequisite. To this triad, a spiritual dimension has recently been added.
The most common approach to contemporary psychiatry is derived from the mind-body concept and interaction between mental processes and physical processes. This is the essence of psychosomatic medicine, and neuropsychiatry. Non-specific symptoms that have no immediate organic explanation are extremely frequent in the general population.34 Somatization is the most widely used general term.
The papers published in this particular issue of the journal are in a way, a reflection of these fundamental issues and concepts.
Adherence to drugs may be simply defined as: ‘the extent to which the patient's behavior coincides with the clinical prescription.5 Children seldom require medication for psychiatric problems. Parental attitudes towards prescribing drugs in general are sometimes unsupportive or even negative. Both patients and relations are fearful or even suspicious of the prescription of psychotropic drugs. Worries about the sedative effect of psychotropic drugs and possible dependency have to be dealt with in psychotherapeutic settings.
Like adult disorders most child psychiatric problems are now regarded as multifactorially determined; both genetic and environmental factors playing a role in their development.
Khat is primarily a social drug and its mild stimulant effects appear to promote social interaction. But its socio-economic hazards are enormous.
1. Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on7 April 1948
2. . Declaration of Alma-Atta WHO. 1978
3. Kleinmann A. Depression, somatization and the ‘new cross-cultural Psychiatry.’ Social Science and Medicine. 1977;11:3–10
4. Goldberg DP, Bridges K. Somatic presentations of psychiatric illness in primary care Journal of Psychosomatic Research. 1988;32:137–44
5. Haynes RB, Taylor DW, Sackett DL Compliance in health care. 1979 Baltimore Johns Hopkins University Press