We searched Medline, Embase, PsycINFO, PSYNDEXplus, PsycCritiques, PsycEXTRA, and the Cochrane Database of Systematic Reviews for reports published in any language between Jan 1, 2005, and March 10, 2011. We used the search terms “hearing disorders”, “deafness”, “deaf-blind disorders”, “hearing loss-functional”, “hearing loss-sensorineural”, “cochlear implants”, “sign language”, and “interpreters” in combination with specific terms for mental health or health services. We transformed all these
ReviewMental health of deaf people
Introduction
Hearing loss affects about 15–26% of the world's population, with the highest prevalence in low-income countries.1, 2, 3 This Review focuses on individuals with severe to profound deafness, with onset before language has been established. Roughly seven per 10 000 people in the general population are in this group.4, 5 The population covered by this report includes all deaf individuals who prefer to communicate via a signed language and many others who do not use sign language yet who cannot use the sense of hearing alone for effective communication.
Deafness is associated with large heterogeneity in cognitive, social, and emotional development.6 Availability and frequency of medical interventions, worldwide variations in access to deaf education, societal attitudes, and opportunities for deaf people contribute to these differences. Communities, known as Deaf communities, are made up of individuals with severe deafness who prefer to use sign language and whose social intercourse defines a distinctive culture referred to in some reports.7, 8 These Deaf communities are essential to their members; nevertheless, they are difficult for hearing individuals, including medical professionals, to access. This isolation might be one reason why very few studies of prevalence rates of mental disorders in large deaf population samples have been done. Available studies show high rates of mental health problems in deaf adults (table).9, 10, 11, 12 Rates of emotional and behavioural problems in deaf children are about two times higher than they are for hearing children.13, 14, 15, 16, 17, 18
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Factors affecting mental health of deaf people
Some perinatal infections (eg, rubella) and syndromal causes of deafness are associated with other disabilities and poor mental health.17, 19 After 1990, rates of hearing impairment associated with rubella and unknown causes declined.20 In a 2011 population-based Dutch study,21 a hereditary cause for permanent childhood hearing impairment was recorded in 39% of participants, an acquired cause in 30%, miscellaneous causes in 7%, and unknown causes in 24%. An acquired cause—mostly through
Specific mental health disorders in deaf people
Although no reports exist of incidence rates of specific mental illnesses in large adult deaf population samples based on usual epidemiological methods, published work suggests that deaf people do not have a specific psychopathology and that mental health problems in deaf populations are mostly common mental disorders. In a study of the Austrian deaf community,11 individuals had raised scores on all the symptom scales, with scores for anxiety and somatisation higher in women than in men (table
Management and treatment
Deaf patients report fear, mistrust, and frustration in health-care settings.70 They appreciate efforts from care providers to improve communication (panel 1), provision of medically skilled interpreter services, and especially providers who know sign language.70, 71 Enhanced communication with deaf patients results in improved patient compliance with medical recommendation.72 Possible limitations in access to health information for members of the Deaf community should be taken into account.73
Implications
Despite a shortage of epidemiological and service-effectiveness studies of mental health and deafness, there is ample evidence for higher rates of mental health problems in people who are deaf than in hearing individuals. Research into associated factors emphasises the heterogeneity of mental health problems in deaf people and helps clinicians to understand the individual patient. These findings can also guide preventive measures. Newborn hearing screening must be used to allow parents and
Search strategy and selection criteria
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2024, Medicine (United States)Exploring automatic text-to-sign translation in a healthcare setting
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