introduction to psychiatry pdf - د.الهام

Fifth stage

Psychiatry

Lec-1

الهام

الجماس

9/10/2016

Introduction to Psychiatry

History Concepts

 How were mentally ill treated prior to1790’s?

• Banishment

• Confinement

• What were attitudes toward them?

• Possessed by the devil

• Lacked basic human qualities

• Period of Enlightenment begins in 1790’s

• Concept of “Asylum” (sanctuary):

 If we treat patients humanely and

respectfully, they will improve.

 Mental illness worsens with stress

• First mental hospitals (“asylums”) in US in 1820’s

Era of Psychotropic Drugs

 Medications first available in 1950s, i.e. chlorpromazine (Thorazine) for

Schizophrenia, Lithium for Mania

 Hope for previously “incurable” mental illnesses and enhanced quality

of life.

WHAT IS HEALTH

World Health Organization's Definition

"A state of complete physical, mental, social and spiritual well-being and

not merely the absence of disease or infirmity'

WHAT IS MENTAL HEALTH?

DIVERSE OPINIONS EXIST

The most acceptable concept nowadays

person who is:



Able to cope/function normal



Meets the responsibilities.



Expressed balanced attitude towards day to day challenges/problems.

MENTAL HEALTH IN THE WORLD

1. MORE THAN TWO FIFTHS OF THE TOTAL DISABILITIES ARE DUE TO MENTAL ILLNESSES

(WORLD HEALTH REPORT, 2001)

2. EXISTING DATA SUGGEST:



Schizophrenia 45million

(above the age of 18).



Depression. 340million

Both disorders cause 60% of Suicide across the globe.

MENTAL HEALTH IN THE WORLD



Mental Retardation 4.6%

(total psychiatric diagnoses)



Alcohol Dependence 140 million

(Nations for Mental WHO.2001)



Alzheimer's disease 11 million



Epilepsy 45 million

(Murray L and Lopes A 1996)

DISEASES IN 2020



Ischemic Heart Disease



Depression



Road Traffic Accident



Cerebrovascular diseases



Chest diseases

(Murray L and Lopes A 1996)

MYTHS



Violent



Aggressive



Irrational



Untreatable



Unreliable



Dependent



Chronic

AETIOLOGY



Genetics



Biological Factors



Psychological Factors



Social Factors

GENETIC



Twins Studies



Family Studies



Adoptions Studies



Mode of Inheritance



Molecular Genetics

BIOCHEMICAL



Postmortem Studies



Brain Biochemistry & Imaging



Peripheral Measures

PSYCHOLOGICAL FACTORS

 Parental Deprivation

 Relationship with Parents

 Life Events

 Effect of Physical illness

 High Express Emotion

SOCIAL FACTORS

 Place of Residence

 Occupation and Social Class

 Culture

 Migration

 Social Isolation

CLASSIFICATIONS

1. International Classification of Diseases (ICD-10)

2. Diagnostic and Statistical manual (DSM-IV)

ORGANIC MENTAL DISORDERS

 Delirium

 Dementia

 Amnestic Disorders

 Personality and Behavioral disorders due to brain disease, damage and dysfunction

PSYCHIATRIC DISORDER

 Psychotic Disorders

 Non Psychotic Disorders

 Personality Disorders

PSYCHIOTIC DISORDERS

 Schizophrenia

 Drug Induced Psychosis

 Schizoaffective

 Postnatal Psychosis

MOOD DISORDER

 Bipolar Affective Disorder

 Major Depression

 Post Natal Depression

PERSONALITY DISORDERS

 CLUSTER A

 Paranoid Schizoid, Schizotypal

 CLUSTER B

 Antisocial, Border line, histrionic, narcissistic

 CLUSTER C

 Avoidant, Dependent, Obsessive Compulsive

ANXIETY DISORDERS

 Generalized -Anxiety Disorder

 Panic Disorder

 Phobic Disorders

 Obsessive compulsive disorder

 Post-Traumatic Stress Disorder (PTSD)

 Hypochondrical Disorder

Substance Abuse Disorders

 Intoxication

 Abuse

 Dependence

 Withdrawal

 Psychotic Disorders

 Amnestic Disorders

 Mood Disorders

 Anxiety Disorders

 Sexual dysfunction

 Sleep Disorder

CLASSIFICATION OF SUBSTANCE ABUSE DRUGS

 Alcohol

 Caffeine

 Opioids

 inhalants

 Nicotine

 Cannabis

 Sedatives / Hypnotics

 Multiple drug use

PSYCHIATRIC DISORDERS WITH SOMATIC SYMPTOMS

 Stress & Adjustment Disorders

 Mood Disorders

 Anxiety Disorders

 Somatoform Disorder:



Dissociative / Conversion Disorders



Hypochondriacal syndrome



Pain syndrome

SEXUAL DYSFUNCTION

AROUSAL

RESPONSE

MALE

Erectile impotence

Premature ejaculation
Retarded ejaculation

FEMALE

Lubrication failure

Anorgasmia

PSYCHOSEXUAL DISORDER

CHILDHOOD PSYCHIATRIC DISORDERS

- Problems of Preschool Children

- Specific Developmental Disorders

- Pervasive Developmental Disorders

Gender identity Gender role

SEXUAL
PREFERENCE

DRIVE AND
RESPONSEVENESS

RELATIONSHIP
BEHAVIOR

Principal Psychiatric Disorders

• Hyperkinetic Disorders

• Conduct Disorders

• Juvenile Delinquency

• Anxiety Disorders

• Somatization Disorders

• Depressive Disorders

• School Refusal

• Functional Enuresis

• Stammering

• Schizophrenia

• Gender Identity Disorders

• Abuse

- Physical

- Sexual

- Emotional

SPECIFIC DEVELOPMENTAL DISORDER

• Specific Reading Disorder

• Mathematical Learning Disorders

• Communication Disorders

TYPES OF MENTAL RETARDATION

- Mild (IQ 50-70)

- Moderate (IQ 35-49)

- Severe (IQ 20-34)

- Profound (IQ below 20)

PSYCHIATRIC DISORDERS AMONG THE MENTAL RETARD

 Schizophrenia

 Mood Disorders

 Emotional Disorders

 Eating Disorders

 Personality Disorders

 Cognitive Psychiatric Disorders

 Behavioral disorders.

EFFECTS OF MENTAL RETARDATION ON THE FAMILY

- Initially Shock

- Depression

- Guilt

- Sham

- Anger

- Inability to cope with practical and financial problems