Introduction to psychiatry


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Introduction to psychiatry

  1. 1. Prof. Dr. Haroon Rashid Chaudhry DPP (UK), FACHARZT (PSYCH. & NEUROLOGY) FACP (USA) MRCPsych (London) FRCP (Ireland) <ul><li>Head of the Department of Psychiatry </li></ul><ul><li>Fatima Jinnah Medical College </li></ul><ul><li>Zonal Representative World Psychiatric Association (WPA) </li></ul><ul><ul><li>(Western & Central Asia) </li></ul></ul><ul><li>Honorary Executive Director </li></ul><ul><li>Fountain House, Lahore </li></ul>INTRODUCTION TO PSYCHIATRY
  2. 2. 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”
  3. 3. WHAT IS MENTAL HEALTH? DIVERSE OPINIONS EXIST The most acceptable concept now –a – days A person who is: <ul><li>Able to to cope/function normally </li></ul><ul><li>Meets the responsibilities </li></ul><ul><li>Expresses balanced attitude towards day to day challenges/ problems </li></ul>
  5. 5. MENTAL HEALTH IN THE WORLD EXISTING DATA SUGGESTS: Schizophrenia (above the age of 18): 45million Depression: 340million Both disorders cause 60% Suicide across the globe. (Desjarlais R et al 1995 WORLD HEALTH REPORT, 2001)
  6. 6. MENTAL HEALTH IN THE WORLD Mental Retardation 4.6% (total psychiatric diagnoses) Alcohol Dependence 140 million (Nations for Mental Health, WHO, 2001)
  7. 7. MENTAL HEALTH IN THE WORLD Alzheimer’s disease: 11 million Epilepsy: 45 million (Murray L and Lopez A 1996)
  8. 8. DISEASES IN 2020 <ul><li>Ischaemic Heart Disease </li></ul><ul><li>Depression </li></ul><ul><li>Road Traffic Accident </li></ul><ul><li>Cerebrovascular Diseases </li></ul><ul><li>Chest Diseases </li></ul><ul><li>(Murray L. And Lopez A., 1996) </li></ul>
  9. 9. MYTHS <ul><li>Violent </li></ul><ul><li>Aggressive </li></ul><ul><li>Irrational </li></ul><ul><li>Untreatable </li></ul><ul><li>Unreliable </li></ul><ul><li>Dependent </li></ul><ul><li>Chronic </li></ul>
  10. 10. PREJUDICE Every Patient Deserves a Clinician And a Healer who is not Prejudiced
  11. 12. AETIOLOGY <ul><li>Genetics </li></ul><ul><li>Biological Factors </li></ul><ul><li>Psychological Factors </li></ul><ul><li>Social Factors </li></ul>
  12. 13. Bio Psycho Social Model Psychosocial Factors Genetics Biological Factors
  13. 14. GENETICS <ul><li>Twins Studies </li></ul><ul><li>Family Studies </li></ul><ul><li>Adoptions Studies </li></ul><ul><li>Mode of Inheritance </li></ul><ul><li>Molecular Genetics </li></ul>
  14. 15. BIOCHEMICAL <ul><li>Postmortem Studies </li></ul><ul><li>Brain Biochemistry & Imaging </li></ul><ul><li>Peripheral Measures </li></ul>
  15. 16. PSYCHOLOGICAL FACTORS <ul><li>Parental Deprivation </li></ul><ul><li>Relationship with Parents </li></ul><ul><li>Life Events </li></ul><ul><li>Effect of Physical illness </li></ul><ul><li>High Express Emotion </li></ul>
  16. 17. <ul><li>ANGER </li></ul><ul><li>QUARRELS </li></ul><ul><li>SPELLS OF CRYING </li></ul>EMOTIONAL REACTIONS EVERY DAY OCCURANCE IN SOCIETY
  17. 18. SOCIAL FACTORS <ul><li>Place of Residence </li></ul><ul><li>Occupation and Social Class </li></ul><ul><li>Culture </li></ul><ul><li>Migration </li></ul><ul><li>Social isolation </li></ul>
  18. 19. National Seminar on Post Earthquake Mental Health Activities
  19. 20. CLASSIFICATIONS <ul><li>International Classification of Diseases (ICD-10) </li></ul><ul><li>The Diagnostic and Statistical Manual (DSM-IV) </li></ul>
  20. 21. ORGANIC MENTAL DISORDERS <ul><li>Delirium </li></ul><ul><li>Dementia </li></ul><ul><li>Amnestic Disorders </li></ul><ul><li>Personality and Behavioural disorders due to brain disease damage and dysfunction </li></ul>
  21. 22. PSYCHIATRIC DISORDERS <ul><li>Psychotic Disorders </li></ul><ul><li>Non Psychotic Disorders </li></ul><ul><li>Personality Disorders </li></ul>
  22. 23. PSYCHIOTIC DISORDERS <ul><li>Schizophrenia </li></ul><ul><li>Drug Induced Psychosis </li></ul><ul><li>Schizoaffective </li></ul><ul><li>Postnatal Psychosis </li></ul>
  23. 24. MOOD DISORDERS <ul><li>Bipolar Affective Disorder </li></ul><ul><li>Major Depression </li></ul><ul><li>Post Natal Depression </li></ul>
  24. 25. PERSONALITY DISORDERS <ul><li>CLUSTER A </li></ul><ul><li>Paranoid Schizoid, Schizotypal </li></ul><ul><li>CLUSTER B </li></ul><ul><li>Antisocial, Border line, histrionic, narcissistic </li></ul><ul><li>CLUSTER C </li></ul><ul><li>Avoidant, Dependant, Obsessive Compulsive </li></ul>
  25. 26. ANXIETY DISORDERS <ul><li>Generalized Anxiety Disorder </li></ul><ul><li>Panic Disorder </li></ul><ul><li>Phobic Disorders </li></ul><ul><li>Obsessive Compulsive Disorder </li></ul><ul><li>Post Traumatic Stress Disorder (PTSD) </li></ul><ul><li>Hypochondriacal Disorder </li></ul>
  26. 27. Substance Abuse Disorders <ul><li>Intoxication </li></ul><ul><li>Abuse </li></ul><ul><li>Dependence </li></ul><ul><li>Withdrawal </li></ul><ul><li>Psychotic Disorders </li></ul><ul><li>Amnestics Disorders </li></ul><ul><li>Mood Disorders </li></ul><ul><li>Anxiety Disorders </li></ul><ul><li>Sexual Dysfunctions </li></ul><ul><li>Sleep Disorders </li></ul>
  27. 28. CLASSES OF SUBSTANCE ABUSE DRUGS <ul><li>Alcohol </li></ul><ul><li>Caffeine </li></ul><ul><li>Opioids </li></ul><ul><li>Inhalents </li></ul><ul><li>Nicotine </li></ul><ul><li>Cannabis </li></ul><ul><li>Sedatives / Hypnotics </li></ul><ul><li>Multiple Drugs Use </li></ul>
  28. 29. PSYCHIATRIC DISORDERS, WITH SOMATIC SYMPTOMS <ul><li>Stress & Adjustment Disorders </li></ul><ul><li>Mood Disorders </li></ul><ul><li>Anxiety Disorders </li></ul><ul><li>Somatoform Disorders </li></ul><ul><ul><li>Dissociative / Conversion Disorders </li></ul></ul><ul><ul><li>Hypochondriacal syndrome </li></ul></ul><ul><ul><li>Psychogenic autononinc dysfunction </li></ul></ul><ul><ul><li>Pain syndrome </li></ul></ul>
  29. 30. SEXUAL DYSFUCNTIONS Anorgasmia Lubrication Failure FEMALE Premature Ejaculation Retarded Ejaculation Erectile impotence MALE RESPONSE AROUSAL
  30. 31. PSYCHOSEXUAL DISORDERS Gender identity Gender Role Drive and Responsiveness Sexual Preferences Relationship behaviour
  31. 33. CHILDHOOD PSYCHIATRIC DISORDERS <ul><li>Problems of Preschool Children </li></ul><ul><li>Specific Developmental Disorders </li></ul><ul><li>Pervasive Developmental Disorders </li></ul>
  32. 34. CONTD….. <ul><li>Principal Psychiatric Disorders </li></ul><ul><ul><li>Hyperkinetic Disorders </li></ul></ul><ul><ul><li>Conduct Disorders </li></ul></ul><ul><ul><li>Juvenile Delinquency </li></ul></ul><ul><ul><li>Anxiety Disorders </li></ul></ul><ul><ul><li>Somatization Disorders </li></ul></ul><ul><ul><li>Depressive Disorders </li></ul></ul><ul><ul><li>School Refusal </li></ul></ul>
  33. 35. <ul><li>Functional Enuresis </li></ul><ul><li>Stammering </li></ul><ul><li>Schizophrenia </li></ul><ul><li>Gender Identity Disorders </li></ul><ul><li>Child Abuse </li></ul><ul><li>– Physical </li></ul><ul><li>– Sexual </li></ul><ul><li>– Emotional </li></ul>CONTD…..
  34. 36. <ul><li>SPECIFIC DEVELOPMENTAL DISORDERS </li></ul><ul><li>Specific Reading Disorders </li></ul><ul><li>Mathematical Learning Disorders </li></ul><ul><li>Communication Disorders </li></ul>CONTD…..
  35. 37. Types Of Mental Retardation <ul><li>Mild (IQ 50 - 70) </li></ul><ul><li>Moderate (IQ 35 – 49) </li></ul><ul><li>Severe (IQ 20 - 34) </li></ul><ul><li>Profound (IQ below 20) </li></ul>
  36. 38. PHYSICAL DISORDERS AMONG THE MENTAL RETARDED <ul><li>Sensory Disorders </li></ul><ul><li>Motor Disorders </li></ul><ul><li>Epilepsy </li></ul><ul><li>Incontinence </li></ul>
  37. 39. <ul><li>Schizophrenia </li></ul><ul><li>Mood Disorders </li></ul><ul><li>Emotional Disorders </li></ul><ul><li>Eating Disorders </li></ul><ul><li>Personality Disorders </li></ul><ul><li>Cognitive Psychiatric Disorders </li></ul><ul><li>Behaviour Disorders </li></ul>PSYCHIATRIC DISORDERS AMONG THE MENTAL RETARDED
  38. 40. EFFECTS OF MENTAL RETARDATION ON THE FAMILY <ul><li>Initially Shock </li></ul><ul><li>Depression </li></ul><ul><li>Guilt </li></ul><ul><li>Shame </li></ul><ul><li>Anger </li></ul><ul><li>Inability to cope with practical and financial problems </li></ul>
  39. 41. THANK YOU !