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Tijdschrift voor Psychiatrie 43 (2001) 4, 245 - 257

Review article

Determinants of mental ill-health: implications for research and policy

J. Ormel, J. Neeleman, D. Wiersma

background Mental ill-health is an important public health problem. Effective public mental health policies will benefit from good knowledge about the determinants of mental illness and mental health . aims Drawing from our background study 'Mental (ill-)health: determinants and effects of interventions', we present an overview of current knowledge in the Netherlands and abroad concerning determinants of mental illness/health.
method Determinants are ordered according to the dynamic stress-vulnerability model. They are summarised concisely, largely in tabular form. An attempt has been made to quantify the strength of their association with mental illness/health and the consistency of the evidence of the association. results Genetic and environmental factors play a role in almost all types of mental illness, but their respective contribution varies strongly dependent on the various disorders. The direction of the associations is often not clear. Some generic determinants of psychiatric illness which are linked with several disorders can be defined.
conclusion Efficient and rational prevention of psychiatric illness crucially hinges on knowledge of how various determinants of mental illness interact. It is particularly at this point that knowledge is lacking.

keywords determinants, mental illness, prevention, stress, vulnerability