Mental Disorders and Economic Change -- the Example of Hungary

By Bitter, Istvan | Bulletin of the World Health Organization, April 2000 | Go to article overview

Mental Disorders and Economic Change -- the Example of Hungary


Bitter, Istvan, Bulletin of the World Health Organization


As the notes on WHO's agenda for mental health point out, disability-adjusted life years are a useful way of measuring some aspects of mental health, but other ways are needed too (1). Socioeconomic indicators also directly affect epidemiology. The political, economic and social changes since 1989 in Hungary have had a major impact on health care (2). Suicides and disability contribute significantly to the burden of mental disorders. In this paper we would like to highlight recent changes in suicide rates and disability rates in Hungary, which is a good example of a country making the transition from communism to a market economy. We will look first at the correlation between decreasing suicide rates and improved treatment of depression, then at social and occupational dysfunctions in relation to changing market forces.

Depression and suicide rates in Hungary

Epidemiological data on depression and suicide before and after the major political changes in Hungary show an increase in depression (see Fig. 1), a decrease in suicide and an increase in the use of antidepressants (3-5).

[Figure 1 ILLUSTRATION OMITTED]

The improvement in the treatment of depression has been a result of changes in the Hungarian health care system. General practitioners have been motivated by privatization and capitation to provide better services. Several antidepressants were marketed in Hungary, and until July 1999 they enjoyed 100% reimbursement. A nationwide educational campaign for the general public, general practitioners and psychiatrists began in 1990, and contributed to better recognition and treatment of depression.

The continuing decrease in suicide rates and increase in the use of antidepressants (Fig. 2) supports the hypothesis of Rihmer, that recognition and treatment of depression strongly influence suicide rates (4).

[Figure 2 ILLUSTRATION OMITTED]

Employment and disability rates

Since the collapse of communism, the cost of making the transition to a market economy has been overwhelming: after 1989 the volume of gross domestic product decreased by one quarter and in 1998 still had not reached the level of 1989. Big state factories with accommodation for their workers were shut down, and this resulted in a wave of unemployed and homeless people. Psychiatric patients were among the first to be hit by unemployment and homelessness. There was increasing competition for employment, and government and health workers lost their control over employment and housing.

The communist governments left behind them a weak social support network and no self-help groups. Unemployment was zero from 1950 to the end of the 1980s, and stood at 8-12% in the 1990s. A 47-fold increase was registered in the unemployment rate in 1992 as compared to 1989, and there has been an 80-150% increase in the number of disability pension applications since 1989. The number of approved disability pension claims also had a transitory increase (Table 1). Of the newly disabled, 15-16% have mental disorders, which is the second largest group after patients suffering from cardiovascular disorders. Many data, such as those missing in Table 1 and approved disability claims in different diagnostic categories, could not be obtained, because the Hungarian insurance system was not computerized until recently.

Table 1. Selected data on unemployment and disability, Hungary

Year     Population     Number of    Number of
       (x [10.sup.6])   registered     new
                        unemployed   disabled

1989      10.5886         14 200         -
1990      10. … 

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Mental Disorders and Economic Change -- the Example of Hungary
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.