Culture and Psychiatry
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Culture plays an important role in psychiatry by influencing what is considered normal or abnormal behavior, how psychiatric symptoms are expressed, and the meanings given to symptoms. Culture determines what is normal versus abnormal, how symptoms are expressed, and help-seeking behaviors. Certain disorders or symptoms are more frequent in some cultures, and some syndromes are unique to specific geographical and cultural groups. When assessing and treating patients, psychiatrists must consider the cultural factors that influence the individual's cognition, symptoms, and attitudes towards mental illness.
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Schizophrenia Presentation
Disorganized schizophrenia is a severe subtype of schizophrenia characterized by incoherent and illogical thoughts and behaviors that prevent daily functioning. Signs include disorganized thinking and speech, inappropriate behavior, lack of emotion, and delusions or hallucinations. It is diagnosed using criteria from the DSM including evidence of disorganized speech, behavior, blunted emotions, and emotions inappropriate for situations. The causes are likely genetic and environmental factors combined with imbalances in neurotransmitters like dopamine.
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The document provides an overview of schizophrenia including its symptoms, diagnosis, misconceptions, potential causes, and treatment options. It discusses the positive and negative symptoms as well as psychomotor symptoms used to diagnose schizophrenia based on the DSM-IV criteria. Potential causes mentioned include genetics, environment, biochemical abnormalities, and abnormal brain structure. The best treatment approach is described as using antipsychotic medications in conjunction with psychotherapy, group therapy, family therapy, and self-help methods.
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Schizophrenia is a psychotic disorder that affects about 1% of people worldwide, deteriorating personal, social, and occupational functioning through strange perceptions, disturbed thought processes, unusual emotions, and motor abnormalities. It causes symptoms like auditory hallucinations, disorganized thinking, paranoia, delusions, and disorganized speech. Schizophrenia is diagnosed based on symptoms and can be of five main types, and both biological and psychological factors may contribute to its causes and treatment may involve medications and therapy.
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Schizophrenia is a chronic mental illness that causes changes in thinking, perception, emotions, language, sense of self and behavior. Common symptoms include hallucinations, delusions, disorganized speech and behavior, lack of motivation and impaired cognitive skills. It is diagnosed through medical exams, history, lab tests and ruling out other potential causes. While the causes are not fully understood, genetics and environmental factors like stress, drug use and complications during birth are thought to play a role.
Presentation schizophrenia
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- Common delusions include persecution, reference, exalted birth, special mission, bodily change or jealousy. Auditory hallucinations may threaten the patient or command them, or be non-verbal noises. Other rare hallucinations can involve smell, taste, or bodily sensations. Visual hallucinations can also occur but are not predominant.
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A comprehensive slide on topic: schizophrenia. Compiled based on Newcastle University and NUMed Stage 5 learning outcomes in Mental Health module. Suitable for medical students and housemen who wish to revisit the topic. (Disclaimer: The diagnostic criteria ae based on ICD-10, so please check the latest version)
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Disorganized schizophrenia is a severe subtype of schizophrenia characterized by incoherent and illogical thoughts and behaviors that prevent daily functioning. Signs include disorganized thinking and speech, inappropriate behavior, lack of emotion, and delusions or hallucinations. It is diagnosed using criteria from the DSM including evidence of disorganized speech, behavior, blunted emotions, and emotions inappropriate for situations. The causes are likely genetic and environmental factors combined with imbalances in neurotransmitters like dopamine.
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Schizophrenia is a psychotic disorder that affects about 1% of people worldwide, deteriorating personal, social, and occupational functioning through strange perceptions, disturbed thought processes, unusual emotions, and motor abnormalities. It causes symptoms like auditory hallucinations, disorganized thinking, paranoia, delusions, and disorganized speech. Schizophrenia is diagnosed based on symptoms and can be of five main types, and both biological and psychological factors may contribute to its causes and treatment may involve medications and therapy.
Schizophrenia
Schizophrenia is a chronic mental illness that causes changes in thinking, perception, emotions, language, sense of self and behavior. Common symptoms include hallucinations, delusions, disorganized speech and behavior, lack of motivation and impaired cognitive skills. It is diagnosed through medical exams, history, lab tests and ruling out other potential causes. While the causes are not fully understood, genetics and environmental factors like stress, drug use and complications during birth are thought to play a role.
Presentation schizophrenia
- Paranoid schizophrenia is the most common type worldwide, characterized by stable delusions like paranoia, often accompanied by auditory hallucinations and perceptual disturbances. Symptoms like disturbed affect, volition, speech and catatonia are not prominent.
- Common delusions include persecution, reference, exalted birth, special mission, bodily change or jealousy. Auditory hallucinations may threaten the patient or command them, or be non-verbal noises. Other rare hallucinations can involve smell, taste, or bodily sensations. Visual hallucinations can also occur but are not predominant.
Schizophrenia
Schizophrenia is a mental disorder characterized by abnormal social behavior and failure to recognize what is real. It is believed to be caused by a combination of genetic and environmental factors. Common symptoms include false beliefs, unclear thinking, hearing voices, reduced social engagement, and lack of motivation. Diagnosis is based on observed behavior and reported experiences, and involves meeting criteria in diagnostic manuals. Treatment primarily involves antipsychotic medication, which can help reduce positive symptoms within weeks but has limited impact on negative symptoms and cognitive dysfunction.
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This document summarizes the case history of a 50-year-old married woman with a 10-year history of schizophrenia. She exhibits symptoms like depression, irritability, suspiciousness, insomnia, hallucinations, and social withdrawal. A mental status examination found coherent thought with visual hallucinations and phobias. She has good memory and intelligence but poor judgment. The patient displays signs of delusions of persecution, jealousy, and grandiosity as well as hallucinatory voices.
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Schizophrenia is a severe mental disorder characterized by disordered thoughts, abnormal behaviors, and difficulties perceiving reality. It is prevalent worldwide and genetic and environmental factors likely contribute to its development. Symptoms include hallucinations, delusions, disorganized speech and behavior, negative symptoms like apathy, and impaired social and occupational functioning. Treatment involves antipsychotic medications and psychotherapy. Nurses monitor symptoms, assess functioning, and aim to promote health, self-care, and appropriate thought processes through therapeutic interventions.
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Role of Mukta Pishti in the Management of Hyperthyroidism
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Culture and Psychiatry
- 2. CULTURE The way of life, especially the general customs and beliefs, of a particular group of people at a particular time Meanings, values, behavioural norms learned and transmitted in the society Influences cognitions, feelings and self concept
- 3. CULTURE AND PSYCHIATRY Culture decides What is normal and what is abnormal What and how psychiatric symptoms are expressed Meanings given to the symptoms Help seeking behavior / interaction between patient and system
- 4. WHAT IS NORMAL / ABNORMAL Homosexuality Anorexia nervosa Assertiveness
- 5. MORE FREQUENT OCCURRENCE Substance misuse Self harm and suicide
- 6. HOW SYMPTOMS ARE EXPRESSED More somatic symptoms in Eastern cultures Content of the delusions and hallucinations Content of obsessions, phobias and negative thoughts Less first rank symptoms, less religious delusions, more catatonic symptoms, more visual hallucinations of schizophrenia
- 7. CULTURE BOUND SYNDROME Name Geographical localization/populations Amok Indonesia; Malaysia Dhat syndrome (dhātu) India; Sri Lanka Koro, suk yeong, jinjin bemar South-east Asia, India, China Latah Indonesia; Malaysia Nervios, nerfiza, nerves, nevra Egypt; Greece; northern Europe; Mexico, Central and South Pa-leng (frigophobia) Taiwan; south-east Asia Pibloktoq (Arctic hysteria) Inuit l Susto, espanto Mexico, Central and South America Taijin kyofusho, shinkeishitsu (anthropophobia) Japan Ufufuyane, saka Kenya; southern Africa Uqamairineq Inuit Windigo Indigenous people of north-east America
- 8. MEANINGS GIVEN TO SYMPTOMS Astrological beliefs Karma Supernatural beliefs
- 9. HELP SEEKING BEHAVIORS No help sought Religious rituals Traditional healing methods Stigma Medication or psychotherapy Compliance with medication
- 10. PROGNOSIS Better prognosis of Schizophrenia in countries like Sri Lanka and India
- 11. WHAT SHOULD WE DO? Assessment Treatment