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Paracetamol (acetaminophen) poisoning

1998; BMJ; Volume: 317; Issue: 7173 Linguagem: Inglês

10.1136/bmj.317.7173.1609

0959-8138

Philip A. Routledge, Allister Vale, D. Nicholas Bateman, G. D. Johnston, Alison L Jones, Albert M. Judd, Simon H. L. Thomas, G N Volans, L. F. Prescott, A. T. Proudfoot,

Liver Disease and Transplantation

the Robin Hood index, a well validated measure of income differentials.Income differentials vary over time and from place to place, 7 suggesting that they are not just a fact of life.It could be argued that wide income differentials are an economic manifestation of people taking advantage of each other, and that it is the latter that causes premature mortality-through the emotional distress it generates.Solutions to apparently intractable public health problems like inequalities in health and unhealthy lifestyles may therefore lie in research into emotional wellbeing.A broad range of studies is needed to test the hypothesis that emotional distress creates susceptibility to physical illness and a further range is to research interventions which can prevent emotional distress and promote mental and social health.Two of the most promising approaches depend on a further body of research which shows that unresolved emotional distress in childhood is an important cause of emotional distress in adulthood. 13 14These approaches are parenting programmes and mental health promotion programmes in schools.The evidence showing that parenting programmes can both reverse emotional and behavioural problems 15 and prevent their emergence 16 is robust.Several school mental health promotion programmes have been subject to controlled trials which show a positive impact on emotional wellbeing. 17Through developing empathy and respect, both types of programmes improve self esteem in children and parents and increase their ability to give and receive social and emotional support.Long term follow up studies are needed to test the hypothesis that these programmes affect adult physical and mental health, but the epidemiological evidence suggesting that they could is strong.Successful implementation of the agenda defined in Our Healthier Nation will depend on research and development of such programmes.For this to happen doctors, and others who determine the allocation of NHS funds, will need to believe that emotional and social wellbeing are at least as important for health as physical wellbeing and invest both development and research funds accordingly.