This document discusses the classification and diagnosis of mental disorders. It provides an overview of how mental illnesses are classified, including using systems like the ICD-10. It then discusses the diagnosis process, which involves taking a patient history and conducting a mental status examination. The document analyzes a case study of a patient experiencing alcohol withdrawal and provides a multi-axial analysis of the patient's diagnoses and disabilities according to the ICD-10.
Basic principles, interview style, various components and their significance, how to take history of present illness, past history,family and personal history, substance history, premorbid personality
Psychotherapeutic medications have been used to treat mental illness for centuries. In the 1940s-1950s, early treatments included marijuana, amphetamines, insulin shock therapy, and electroshock therapy. In 1949, lithium was discovered and became one of the first psychotropic drugs used long-term to treat bipolar disorder. Chlorpromazine, first used in the 1950s, significantly reduced hospitalizations and led to deinstitutionalization, though this had some unintended consequences. Today, the most commonly prescribed medications are antidepressants and anti-anxiety drugs, which provide relief for most patients.
There are two main types of thought disorders - delusions and overvalued ideas. Delusions are defined as false beliefs that are firmly held despite evidence to the contrary. Three main criteria define delusions: certainty, incorrigibility, and impossibility of content. Primary delusions cannot be explained by other symptoms, whereas secondary delusions are derived from other abnormalities like hallucinations. Grandiose, paranoid, and delusions of guilt are some common types of delusional content. Disorders of the prefrontal and temporal lobes may underlie generation of delusions.
Diagnosis and management of major depressive disorderNeurologyKota
This document provides information on major depressive disorder and dysthymic disorder, including their symptoms, classifications, prevalence, risk factors, pathophysiology, diagnostic criteria, sleep abnormalities seen in depression, and treatment options. It discusses antidepressant medications like TCAs, MAOIs, SSRIs, SNRIs, augmentation therapies, psychosocial therapies, and ECT in the treatment of depressive disorders.
information regarding psychopharmacology especially for nursing students and community. covers all group like anti psychotic, anti anxiety, antidepressants, mood stabilizing agents etc.
This document defines and describes several somatoform disorders and related conditions, including: somatization disorder, pain disorder, conversion disorder, hypochondriasis, body dysmorphic disorder, factitious disorder, and malingering. These conditions are characterized by physical symptoms that cannot be fully explained by medical factors, and appear to be influenced by psychological issues. They involve preoccupations with health, pain experiences, or imagined physical defects that are distressing and disruptive to the individual.
Basic principles, interview style, various components and their significance, how to take history of present illness, past history,family and personal history, substance history, premorbid personality
Psychotherapeutic medications have been used to treat mental illness for centuries. In the 1940s-1950s, early treatments included marijuana, amphetamines, insulin shock therapy, and electroshock therapy. In 1949, lithium was discovered and became one of the first psychotropic drugs used long-term to treat bipolar disorder. Chlorpromazine, first used in the 1950s, significantly reduced hospitalizations and led to deinstitutionalization, though this had some unintended consequences. Today, the most commonly prescribed medications are antidepressants and anti-anxiety drugs, which provide relief for most patients.
There are two main types of thought disorders - delusions and overvalued ideas. Delusions are defined as false beliefs that are firmly held despite evidence to the contrary. Three main criteria define delusions: certainty, incorrigibility, and impossibility of content. Primary delusions cannot be explained by other symptoms, whereas secondary delusions are derived from other abnormalities like hallucinations. Grandiose, paranoid, and delusions of guilt are some common types of delusional content. Disorders of the prefrontal and temporal lobes may underlie generation of delusions.
Diagnosis and management of major depressive disorderNeurologyKota
This document provides information on major depressive disorder and dysthymic disorder, including their symptoms, classifications, prevalence, risk factors, pathophysiology, diagnostic criteria, sleep abnormalities seen in depression, and treatment options. It discusses antidepressant medications like TCAs, MAOIs, SSRIs, SNRIs, augmentation therapies, psychosocial therapies, and ECT in the treatment of depressive disorders.
information regarding psychopharmacology especially for nursing students and community. covers all group like anti psychotic, anti anxiety, antidepressants, mood stabilizing agents etc.
This document defines and describes several somatoform disorders and related conditions, including: somatization disorder, pain disorder, conversion disorder, hypochondriasis, body dysmorphic disorder, factitious disorder, and malingering. These conditions are characterized by physical symptoms that cannot be fully explained by medical factors, and appear to be influenced by psychological issues. They involve preoccupations with health, pain experiences, or imagined physical defects that are distressing and disruptive to the individual.
The document discusses substance-related disorders and their classification. It notes that psychoactive substances have been used in many cultures throughout history and can affect the brain. Substance-related disorders include substance use disorders like dependence and abuse, as well as substance-induced disorders like intoxication and withdrawal. The prevalence of substance-related disorders is highest between ages 18-24 and diagnoses are more common in men generally.
The document provides guidelines for assessing and evaluating disabilities in India. It describes the following:
1. Authorities in India that are responsible for providing disability certificates according to the Persons with Disabilities Act of 1995.
2. The Indian Disability Evaluation and Assessment Scale (IDEAS) which was developed to measure and quantify disability in mental disorders.
3. How the IDEAS evaluates four areas - self-care, interpersonal activities, communication and understanding, and work - to determine the level of global disability on a scale from 0-100%.
This is characterized by recurrent episodes of mania and depression in the same patient.
Bipolar mood disorder is further classified into two according to DSM IV.
Bipolar I disorder
Bipolar II disorder
This document provides an overview of long-acting injectable antipsychotics (LAIs). It discusses the benefits of LAIs including consistent drug delivery and improved compliance. It then describes the pharmacology of first-generation LAIs such as fluphenazine, haloperidol, and zuclopenthixol. Second-generation LAIs including risperidone, paliperidone, and olanzapine are also reviewed in terms of their absorption, metabolism, and indications. The advantages and disadvantages of different LAIs are compared.
The document discusses delusions from a psychiatric perspective. It provides background on how delusions were historically defined and categorized. It describes the key characteristics of delusions as being firmly held false beliefs that are resistant to evidence. It discusses different types of delusional content and potential neurological underpinnings. The document also examines theories about how delusions may develop from abnormal perceptions, emotions, memories or thought processes and considers case examples.
1. Said Mohammad, an 18-year-old male from Peshawar, presented with suspiciousness, aggression, insomnia, lack of appetite, and social withdrawal over the past month.
2. His symptoms began one month ago when he started socially withdrawing and expressing beliefs that his family was plotting to kill him. Over the past three days, he became aggressive, refused to eat or sleep, and believed his family would poison him.
3. He was brought to the hospital by his family after attempts to treat him with spiritual healers were unsuccessful. His symptoms appeared to develop after recently relocating with his family due to security concerns.
This document provides an overview of dissociative disorders, including:
- Their classification in both ICD-10 and DSM-5 systems.
- Epidemiological findings that dissociative symptoms are common in the general population.
- Etiological theories including information processing theories and the discrete behavioral state model.
- A history of conceptualizations from ancient theories to modern understandings of dissociation and dissociative disorders.
This document provides an overview of disorders of thought, including their classification and specific disorders. It discusses disorders of intelligence, thinking, stream of thought, content of thought, and form of thought. Specific disorders covered include learning disabilities, dementia, schizophrenia deterioration, amentia, flight of ideas, inhibition/slowing of thinking, circumstantiality, perseveration, thought blocking, obsessions, compulsions, thought alienation, and formal thought disorder. Theories from Bleuler, Cameron, Goldstein, Chapman, Payne, and Schneider regarding thought disorders are also summarized.
Mood disorders include depressive disorders like major depressive disorder and bipolar disorders. Major depressive disorder involves one or more major depressive episodes without a history of mania. Bipolar I disorder involves one or more manic or mixed episodes. Etiology may include genetics, neurotransmitter imbalances, stress, negative thought patterns, and interpersonal problems. Treatment involves psychotherapy like cognitive behavioral therapy and interpersonal therapy as well as medication like SSRIs, tricyclics, lithium, and ECT.
This document provides an overview of psychiatry case taking and examination, including history taking and mental status examination (MSE). It discusses the purpose and general principles of history taking, as well as how to structure the interview room and questions. It then describes how to obtain information on a patient's identifying data, chief complaints, history of present illness, past history, family history, personal history, and pre-morbid personality. Finally, it outlines the components of the MSE including general appearance, psychomotor activity, speech, mood, thought, perception, and cognitive functions.
This case presentation discusses a 50-year-old African American female patient admitted to the hospital for schizoaffective disorder, manic episode. The patient has a history of schizoaffective disorder and has been living in a nursing home. The goals of hospitalization are to decrease restlessness, irritability, worry, anxiety and increase self-control and medication compliance. Interventions include medication management with Lamictal and Invega, nursing care, social work support, and education. The presentation provides context on schizoaffective disorder, symptoms, course, and treatment goals for managing the manic episode.
1) Bipolar disorder causes greater disability during depressive episodes, as patients spend more time depressed than manic. Selecting treatment requires considering a patient's preferences as well as efficacy and side effects.
2) Treatment for bipolar depression involves collaborative care between doctors and patients to establish a treatment plan through shared decision making. The urgency of a patient's symptoms must be weighed against concerns about side effects.
3) Lurasidone is approved to treat bipolar I depression and has shown efficacy with tolerability. Proper diagnosis and treatment of bipolar depression is important to prevent disability, suicide risk, and switching between mood states.
A presentation about depressive disorder. The presentation composed of the definition, causes, types, clinical feature, diagnosis, prognosis, treatment and prevention of depression
This document provides an overview of several topics in child and adolescent psychiatry. It discusses the tiers of child and adolescent mental health services (CAMHS), ranging from primary care providers (Tier 1) to highly specialized services (Tier 4). It also summarizes several common disorders seen in youth, including conduct disorder, oppositional defiant disorder, attention deficit hyperactivity disorder, enuresis, encopresis, learning disabilities, anxiety disorders like separation anxiety disorder and generalized anxiety disorder, and panic disorder. For each topic, it covers characteristics, causes, symptoms, comorbidities, and management approaches.
This document discusses psychotropic drug categories and antipsychotic drugs. It summarizes that antipsychotic drugs work by blocking dopamine receptors and are used to treat symptoms of psychosis. It lists common antipsychotic drugs and their dosages and side effects, which include extrapyramidal symptoms like acute dystonia, pseudoparkinsonism, akathisia, and tardive dyskinesia. It provides information on treating side effects and educating clients on antipsychotic medication management.
Mental status examination in Psychiatryvaibhav dua
This document provides an overview of the components of a mental status examination (MSE). It describes in detail how to evaluate a patient's appearance and behavior, psychomotor activity, speech, mood, affect, perception, thought process and content, attention, memory, intelligence, judgment, and insight. Key areas of examination include facial expression, posture, grooming, speech patterns, thought organization and content, presence of hallucinations or delusions, and level of insight. The document provides definitions and criteria for abnormal findings in each area to guide the examiner.
Bipolar disorder is a chronic illness that causes major shifts in mood and energy, impairing various areas of life. While not curable, effective treatment exists to control symptoms and the course of the disorder. Treatment may include hospitalization if the person is a danger to self or others or unable to function. Pharmacotherapy focuses on acute symptom suppression, continuation treatment to prevent symptom return, and maintenance treatment to prevent recurrence. Treatment options include mood stabilizers, antipsychotics, antidepressants, anticonvulsants, and combination drugs. Prognosis depends on factors like episode duration, age of onset, and substance abuse history. Psychotherapy and support groups can also help manage the disorder.
Psychotic disorders involve hallucinations and/or delusions where the person loses contact with reality. Schizophrenia is a type of psychosis characterized by disturbances in thought, emotion and behavior. It affects about 1% of the population and usually develops in early adulthood. Symptoms include delusions, hallucinations, disorganized speech and behavior. Treatment involves antipsychotic medications and psychosocial support. Prognosis depends on several factors but schizophrenia generally involves long-term impairment.
This document discusses motor disorders and their classification. It covers disorders of adaptive movements including expressive, reactive, and goal directed movements. Disorders of non-adaptive movements like stereotypies, parakinesia, tics, tremors, chorea, athetosis, and spasmodic torticollis are described. Motor speech disturbances, disorders of posture, abnormal complex patterns of behavior like stupor and excitement, and drug-induced movement disorders are also summarized.
Depression is the leading cause of disability world wide and is a major contributor to the overall global burden of diseases .At its worst depression can cause suicide .
There are effective psychological and pharmacological treatments for depression
This document discusses different approaches to classifying mental disorders, including categorical and dimensional approaches. Categorical approaches like the DSM and ICD organize disorders into distinct categories based on symptoms. Dimensional approaches classify disorders on continuous scales based on severity of symptoms. Both approaches have strengths like organization, but also limitations like not capturing the complexity of some disorders. The document provides examples of how depression may be classified under each approach.
The document discusses substance-related disorders and their classification. It notes that psychoactive substances have been used in many cultures throughout history and can affect the brain. Substance-related disorders include substance use disorders like dependence and abuse, as well as substance-induced disorders like intoxication and withdrawal. The prevalence of substance-related disorders is highest between ages 18-24 and diagnoses are more common in men generally.
The document provides guidelines for assessing and evaluating disabilities in India. It describes the following:
1. Authorities in India that are responsible for providing disability certificates according to the Persons with Disabilities Act of 1995.
2. The Indian Disability Evaluation and Assessment Scale (IDEAS) which was developed to measure and quantify disability in mental disorders.
3. How the IDEAS evaluates four areas - self-care, interpersonal activities, communication and understanding, and work - to determine the level of global disability on a scale from 0-100%.
This is characterized by recurrent episodes of mania and depression in the same patient.
Bipolar mood disorder is further classified into two according to DSM IV.
Bipolar I disorder
Bipolar II disorder
This document provides an overview of long-acting injectable antipsychotics (LAIs). It discusses the benefits of LAIs including consistent drug delivery and improved compliance. It then describes the pharmacology of first-generation LAIs such as fluphenazine, haloperidol, and zuclopenthixol. Second-generation LAIs including risperidone, paliperidone, and olanzapine are also reviewed in terms of their absorption, metabolism, and indications. The advantages and disadvantages of different LAIs are compared.
The document discusses delusions from a psychiatric perspective. It provides background on how delusions were historically defined and categorized. It describes the key characteristics of delusions as being firmly held false beliefs that are resistant to evidence. It discusses different types of delusional content and potential neurological underpinnings. The document also examines theories about how delusions may develop from abnormal perceptions, emotions, memories or thought processes and considers case examples.
1. Said Mohammad, an 18-year-old male from Peshawar, presented with suspiciousness, aggression, insomnia, lack of appetite, and social withdrawal over the past month.
2. His symptoms began one month ago when he started socially withdrawing and expressing beliefs that his family was plotting to kill him. Over the past three days, he became aggressive, refused to eat or sleep, and believed his family would poison him.
3. He was brought to the hospital by his family after attempts to treat him with spiritual healers were unsuccessful. His symptoms appeared to develop after recently relocating with his family due to security concerns.
This document provides an overview of dissociative disorders, including:
- Their classification in both ICD-10 and DSM-5 systems.
- Epidemiological findings that dissociative symptoms are common in the general population.
- Etiological theories including information processing theories and the discrete behavioral state model.
- A history of conceptualizations from ancient theories to modern understandings of dissociation and dissociative disorders.
This document provides an overview of disorders of thought, including their classification and specific disorders. It discusses disorders of intelligence, thinking, stream of thought, content of thought, and form of thought. Specific disorders covered include learning disabilities, dementia, schizophrenia deterioration, amentia, flight of ideas, inhibition/slowing of thinking, circumstantiality, perseveration, thought blocking, obsessions, compulsions, thought alienation, and formal thought disorder. Theories from Bleuler, Cameron, Goldstein, Chapman, Payne, and Schneider regarding thought disorders are also summarized.
Mood disorders include depressive disorders like major depressive disorder and bipolar disorders. Major depressive disorder involves one or more major depressive episodes without a history of mania. Bipolar I disorder involves one or more manic or mixed episodes. Etiology may include genetics, neurotransmitter imbalances, stress, negative thought patterns, and interpersonal problems. Treatment involves psychotherapy like cognitive behavioral therapy and interpersonal therapy as well as medication like SSRIs, tricyclics, lithium, and ECT.
This document provides an overview of psychiatry case taking and examination, including history taking and mental status examination (MSE). It discusses the purpose and general principles of history taking, as well as how to structure the interview room and questions. It then describes how to obtain information on a patient's identifying data, chief complaints, history of present illness, past history, family history, personal history, and pre-morbid personality. Finally, it outlines the components of the MSE including general appearance, psychomotor activity, speech, mood, thought, perception, and cognitive functions.
This case presentation discusses a 50-year-old African American female patient admitted to the hospital for schizoaffective disorder, manic episode. The patient has a history of schizoaffective disorder and has been living in a nursing home. The goals of hospitalization are to decrease restlessness, irritability, worry, anxiety and increase self-control and medication compliance. Interventions include medication management with Lamictal and Invega, nursing care, social work support, and education. The presentation provides context on schizoaffective disorder, symptoms, course, and treatment goals for managing the manic episode.
1) Bipolar disorder causes greater disability during depressive episodes, as patients spend more time depressed than manic. Selecting treatment requires considering a patient's preferences as well as efficacy and side effects.
2) Treatment for bipolar depression involves collaborative care between doctors and patients to establish a treatment plan through shared decision making. The urgency of a patient's symptoms must be weighed against concerns about side effects.
3) Lurasidone is approved to treat bipolar I depression and has shown efficacy with tolerability. Proper diagnosis and treatment of bipolar depression is important to prevent disability, suicide risk, and switching between mood states.
A presentation about depressive disorder. The presentation composed of the definition, causes, types, clinical feature, diagnosis, prognosis, treatment and prevention of depression
This document provides an overview of several topics in child and adolescent psychiatry. It discusses the tiers of child and adolescent mental health services (CAMHS), ranging from primary care providers (Tier 1) to highly specialized services (Tier 4). It also summarizes several common disorders seen in youth, including conduct disorder, oppositional defiant disorder, attention deficit hyperactivity disorder, enuresis, encopresis, learning disabilities, anxiety disorders like separation anxiety disorder and generalized anxiety disorder, and panic disorder. For each topic, it covers characteristics, causes, symptoms, comorbidities, and management approaches.
This document discusses psychotropic drug categories and antipsychotic drugs. It summarizes that antipsychotic drugs work by blocking dopamine receptors and are used to treat symptoms of psychosis. It lists common antipsychotic drugs and their dosages and side effects, which include extrapyramidal symptoms like acute dystonia, pseudoparkinsonism, akathisia, and tardive dyskinesia. It provides information on treating side effects and educating clients on antipsychotic medication management.
Mental status examination in Psychiatryvaibhav dua
This document provides an overview of the components of a mental status examination (MSE). It describes in detail how to evaluate a patient's appearance and behavior, psychomotor activity, speech, mood, affect, perception, thought process and content, attention, memory, intelligence, judgment, and insight. Key areas of examination include facial expression, posture, grooming, speech patterns, thought organization and content, presence of hallucinations or delusions, and level of insight. The document provides definitions and criteria for abnormal findings in each area to guide the examiner.
Bipolar disorder is a chronic illness that causes major shifts in mood and energy, impairing various areas of life. While not curable, effective treatment exists to control symptoms and the course of the disorder. Treatment may include hospitalization if the person is a danger to self or others or unable to function. Pharmacotherapy focuses on acute symptom suppression, continuation treatment to prevent symptom return, and maintenance treatment to prevent recurrence. Treatment options include mood stabilizers, antipsychotics, antidepressants, anticonvulsants, and combination drugs. Prognosis depends on factors like episode duration, age of onset, and substance abuse history. Psychotherapy and support groups can also help manage the disorder.
Psychotic disorders involve hallucinations and/or delusions where the person loses contact with reality. Schizophrenia is a type of psychosis characterized by disturbances in thought, emotion and behavior. It affects about 1% of the population and usually develops in early adulthood. Symptoms include delusions, hallucinations, disorganized speech and behavior. Treatment involves antipsychotic medications and psychosocial support. Prognosis depends on several factors but schizophrenia generally involves long-term impairment.
This document discusses motor disorders and their classification. It covers disorders of adaptive movements including expressive, reactive, and goal directed movements. Disorders of non-adaptive movements like stereotypies, parakinesia, tics, tremors, chorea, athetosis, and spasmodic torticollis are described. Motor speech disturbances, disorders of posture, abnormal complex patterns of behavior like stupor and excitement, and drug-induced movement disorders are also summarized.
Depression is the leading cause of disability world wide and is a major contributor to the overall global burden of diseases .At its worst depression can cause suicide .
There are effective psychological and pharmacological treatments for depression
This document discusses different approaches to classifying mental disorders, including categorical and dimensional approaches. Categorical approaches like the DSM and ICD organize disorders into distinct categories based on symptoms. Dimensional approaches classify disorders on continuous scales based on severity of symptoms. Both approaches have strengths like organization, but also limitations like not capturing the complexity of some disorders. The document provides examples of how depression may be classified under each approach.
The document discusses the classification of mental disorders according to two major systems - ICD-10 and DSM-IV. ICD-10 is the World Health Organization's classification system that codes psychiatric disorders from F00 to F99. DSM-IV is the diagnostic manual published by the American Psychiatric Association that uses a multi-axial system with five axes to evaluate patients. Some key differences between the two systems are that ICD-10 is intended for clinical work, research, and primary care globally while DSM-IV is in English only and includes social consequences in its diagnostic criteria.
This document provides an overview of signs and symptoms of mental disorders from three approaches: phenomenological, psychodynamic, and experimental. It then categorizes and describes in detail disorders of perception, thinking, mood, behavior, motor signs, body image, memory, consciousness, attention, and insight. Key points include descriptions of hallucinations, thought disorders, types of delusions and obsessions, mood changes, phobias, derealization, memory disorders, levels of consciousness, and assessing insight. The document aims to comprehensively cover abnormalities in mental functioning and experiences that are evaluated and diagnosed in psychiatry.
The document provides information about various mental disorders categorized into anxiety disorders, affective disorders, psychotic disorders, impulse disorders, somatoform disorders, and personality disorders. It defines key terms like anxiety, depression, apathy, and stigma. It describes the symptoms and examples of different disorders like panic disorder, phobias, obsessive compulsive disorder, post traumatic stress disorder, depression, schizophrenia, and more. It also discusses available treatment options and resources for mental health disorders.
Chapter 20: Mental Health and Mental IllnessMarleneDJ
This document discusses characteristics of mental health and causes of mental illness. People who are mentally healthy can get along with others, adapt to situations, care for themselves and others, give and accept love, use healthy coping mechanisms, take responsibility for their actions and decisions, and behave appropriately with impulse control. The four main causes of mental illness are physical problems, emotional trauma or a poor family environment, heredity, and stress. The document also discusses communicating respectfully with mentally ill patients, common defense mechanisms, specific mental illnesses like anxiety and depression, and treatments for mental illness.
This document discusses common sexually transmitted diseases (STDs), including chlamydia, hepatitis B, syphilis, and HIV. It provides information on how each disease is transmitted and describes common symptoms. Chlamydia can infect the genitals, rectum, or throat and cause burning during urination. Hepatitis B can be transmitted sexually or from mother to child and cause liver damage. Syphilis, if untreated, can lead to serious complications but is treatable with antibiotics. HIV is transmitted via unprotected sex or needle sharing and may cause flu-like symptoms early on.
Family Life Education - Human SexualityAdam Thompson
This document outlines an agenda and goals for a workshop on understanding human sexuality today. The agenda includes sessions on messaging, implementing sexuality education guidelines, a sexual health model, sexually healthy adolescents, and comprehensive sexuality education. The goals are to increase knowledge and comfort discussing sexuality issues, and identify appropriate classroom content on sexuality for middle and high school students.
This document provides an overview of human sexuality and sexual health. It discusses key concepts like sexual orientation, sexual behaviors, and how sexuality is influenced by society and culture. It also describes the male and female anatomy involved in sexual activity and the female sexual response cycle. Additionally, it addresses factors that can affect sexual function and notes some of the joys and challenges of sexuality.
This document discusses psychiatric emergencies commonly encountered in prehospital care. It begins by defining psychiatric disorders and outlining the DSM-IV-TR system for categorizing mental disorders. It then provides case studies demonstrating schizophrenia, mood disorders like depression and bipolar disorder, anxiety disorders, and other conditions. It aims to familiarize emergency personnel with identifying and assessing patients experiencing psychiatric crises.
The document discusses various topics related to human sexuality and sexual health. It addresses human sexual response, gender identity, sexual orientation, and factors that can influence sexuality such as physical and mental illnesses. The document also examines several sexual disorders based on the DSM classification system, including gender identity disorder and paraphilias. Finally, the document outlines issues related to infertility treatment, including diagnostic testing, medical therapies, and assisted reproductive technologies.
Teaching students with general learning disabilities Emma Grice
The document outlines a lecture on teaching students with general learning disabilities. It discusses:
- Categorizing students based on IQ scores and identifying different types of learning disabilities
- Barriers to learning students with GLD may face
- Eight principles of effective instruction for students with GLD, including using multi-sensory teaching, structuring lessons in a graded sequence, and providing feedback.
This document discusses the assessment and management of patients experiencing psychiatric and behavioral emergencies. It covers topics such as normal versus abnormal behavior, pathophysiology of common disorders, performing a mental status exam, diagnosing specific conditions like schizophrenia and depression, safely restraining violent patients, and general strategies for de-escalation and transport. The goal is to provide emergency personnel with knowledge and skills for responding effectively to mental health crises.
The document provides an overview of human sexuality from various perspectives including biological, psychological, social and cultural. It defines key terms like sexuality, sexology and discusses frameworks like the circles of sexuality. It also covers topics like sexual response, ethics, problems after spinal cord injuries and concludes advocating for comprehensive sex education.
The document is from a PowerPoint presentation on human sexuality that covers several topics:
- It defines human sexuality and discusses how it is studied from various academic perspectives.
- It explores how values and critical thinking influence attitudes toward sexuality.
- It presents various historical, biological, evolutionary, sociological, and psychological perspectives on understanding human sexuality.
- It discusses perspectives from feminism, queer theory, and how multiple perspectives provide a richer understanding of human sexuality.
The document discusses definitions and classifications of mental health disorders. It describes how the World Health Organization (WHO) defines health and mental health. Mental illness can occur when the brain is not functioning well, disrupting thinking, perception, emotion, behavior, physical functioning or signaling. The document also discusses the differences between neurosis (minor mental disorders) and psychosis (major personality disorders), and how psychiatric disorders are classified based on symptoms and etiology. It provides a brief history of classification systems and describes the International Classification of Diseases (ICD) published by WHO and the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association.
This document provides an overview of mental health and psychiatry. It discusses what constitutes a mental disorder and how psychiatry has evolved from biological to psychological to social models. It also covers the history of psychiatry, classification systems for mental disorders, assessment approaches, the roles of various professionals in mental health teams, and the importance of doctor-patient relationships and confidentiality in mental healthcare.
Quick Clinical Review of AntipsychoticsShah Parind
This document discusses antipsychotic medications, including their history, types, uses, efficacy, and side effects. It covers both typical and atypical antipsychotics, noting that atypicals are now more commonly used due to lower risk of side effects like tardive dyskinesia. Atypicals are effective for positive and negative schizophrenia symptoms as well as mood disorders but can cause metabolic issues. Proper dosing and maintenance treatment are important to prevent relapse.
The document discusses several components of human sexuality including definitions of terms related to sex, gender, and sexual identity. It also describes types of sexual stimulation such as physical and psychological stimulation. Different stages of the human sexual response are outlined as well as types of sexual orientation and disorders of sexual functioning.
This document discusses the classification of psychiatric disorders. It defines classification as the process of grouping things based on similarities. In psychiatry, classification aims to enable patient care, communication between professionals, and research, though ideally it would be based on etiology. Major classifications include ICD-10 from WHO and DSM-IV from APA. These take categorical approaches but some argue for dimensional/spectrum models. Classification seeks to group syndromes, disorders, and illnesses while acknowledging limitations due to incomplete understanding of causes.
Examining the history, classification, causes and treatment of psychological ...Pubrica
What do we think? What do we feel? How do we react to a particular situation?
How do we define it?
How To Examine Whether Someone Is A Patient Of Mental Illness Or Not?
How To Do A Patient’s History Examined Systematically?
The main classes of mental illness :
Cause and Treatment of psychological disorder:
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Nursing Case Study Paranaoid Schizophreniapinoy nurze
The document describes paranoid schizophrenia. Key points include:
- Paranoid schizophrenia is characterized by stable delusions and auditory hallucinations.
- Symptoms include suspiciousness and paranoia. The condition is lifelong but can be managed with treatment.
- The case study involves a 40-year-old male patient who was admitted after stabbing his cousin, experiencing auditory hallucinations and paranoid delusions.
Schizophrenia is a significant mental disorder in which people interpret reality abnormally & it may result in some combination of hallucinations, delusions, and extremely disordered thinking and behavior that impairs daily functioning. Through this period Anti psychotic & Psycho social treatment improve the condition.
This document discusses the field of psychiatry. It begins by defining psychiatry as the study of the causes, mechanisms, symptoms, prognosis, diagnosis and treatment of mental illnesses. It then discusses the broad scope of conditions studied in psychiatry, from severe psychoses to neuroses and personality disorders. The document also outlines various branches and classifications of psychiatry, diagnostic criteria for mental disorders, and the biological, psychological and social factors that can contribute to psychiatric illnesses.
The document discusses psychological disorders and provides information about several types of disorders:
1) It describes obsessive-compulsive disorder and gives an example of someone diagnosed with it.
2) It discusses different approaches to understanding psychological disorders such as the medical model and biopsychosocial approach.
3) It summarizes several types of psychological disorders including anxiety disorders, somatoform disorders, dissociative disorders, and mood disorders.
Schizophrenia and other psychotic disorders involve distortions in perception of reality and impairments in thinking, behavior, and emotion. The term schizophrenia was coined in 1908 and refers to a "split mind." Common types include paranoid schizophrenia, characterized by delusions and auditory hallucinations, and disorganized schizophrenia with loose and disordered thinking. Positive symptoms add characteristics like delusions and hallucinations, while negative symptoms remove characteristics and result in flattened affect and lack of motivation. Biological and environmental factors may contribute to the development of psychotic disorders.
Classification systems for mental disorders aim to improve treatment and prevention by grouping disorders with shared characteristics. The current system consists of specific mental disorders in various classes based on phenomenology. Reliability, validity, utility, and meeting diverse user needs are important criteria in evaluating classification systems. Challenges include the subjective and unstable nature of symptoms, lack of biological markers, and conceptual ambiguities. The systems have evolved over time based on various approaches.
This document discusses intellectual disability (ID), including its prevalence, diagnostic criteria, and causes. It notes that ID is characterized by limitations in intellectual functioning and adaptive behavior that onset before age 18. The document outlines diagnostic classifications from ICD-10 and DSM-IV-TR and describes features of mild, moderate, severe, and profound ID. Common causes are discussed as prenatal, natal, postnatal, and unknown. Elements of clinical evaluation for patients with ID are summarized, including history taking, psychiatric interviewing, physical and neurological exams, and psychological assessment. Common syndromes associated with ID and psychiatric disorders among those with ID are also briefly mentioned.
The document discusses schizophrenia, a type of psychosis characterized by distortions in thinking, perception, emotions, language, sense of self and behavior. It defines schizophrenia and describes its subtypes according to the ICD-10 classification system. The causes are thought to involve genetic and environmental factors. Signs and symptoms include positive symptoms like hallucinations and delusions as well as negative symptoms such as reduced emotional expression. Diagnosis involves evaluating symptoms, and treatment includes antipsychotic medication, psychotherapy and social/vocational support.
Mental health is defined as a state of complete physical, mental, and social well-being, not just the absence of disease. Around 20% of the world's children and adolescents have a mental disorder. Mental health involves realizing one's abilities and coping with stress while contributing productively to the community. Historically, the mentally ill were mistreated but psychiatry has advanced scientifically. Common mental illnesses include depression, schizophrenia, substance use disorders, and neuroses. Genetics, environment, life stressors, and lack of needs fulfillment can all contribute to poor mental health. Community mental health services aim to prevent and treat illness through education, early intervention, and rehabilitation.
Mental health is defined as a state of complete physical, mental and social well-being. The WHO emphasizes the positive dimension of mental health. Depression is a leading cause of disability worldwide, and about half of all mental disorders begin before age 14. Mental health involves realizing one's own potential and being able to cope with stress and contribute productively to the community. Historically, the mentally ill were seen as possessed, but psychiatry has advanced scientifically. Factors like heredity, social environment, life events, and physical health can all impact mental health. Community programs aim to prevent issues through education, early diagnosis, and treatment.
Mental health is defined as a state of complete physical, mental and social well-being. The WHO emphasizes the positive dimension of mental health. Depression is a leading cause of disability worldwide, and about half of all mental disorders begin before age 14. Mental health involves realizing one's own potential and being able to cope with stress and contribute productively to the community. Historically, the mentally ill were seen as possessed, but psychiatry has advanced scientifically. Factors like heredity, social environment, life events, and physical health can all impact mental health. Community programs aim to prevent issues through education, early diagnosis, and treatment.
This document provides an introduction to the field of psychiatry. It begins with definitions of key terms like psychiatry, psychology, psychotherapy and psychoanalysis. It then discusses the history of psychiatry, from early views of mental disorders as supernatural to modern biological perspectives. Famous figures in the field like Sigmund Freud, Anna Freud, Jean Piaget are mentioned. The document outlines concepts in phenomenology like delusions, hallucinations and classification systems like ICD-10 and DSM-5. It describes various sub-specialties within psychiatry such as addiction, biological, child and adolescent psychiatry.
This document provides an introduction and background information on a study examining startle response and pre-pulse inhibition in adolescent rats from three groups: 1) rats that received neonatal lesions of the ventral hippocampus, 2) rats that were prenatally stressed, and 3) control rats. The study found that rats with neonatal lesions had significantly higher startle amplitudes compared to controls and prenatally stressed rats. Prenatally stressed rats had significantly lower startle responses compared to both other groups. Both experimental groups showed higher pre-pulse inhibition compared to controls. The document discusses etiological factors in schizophrenia like genetics, prenatal factors, and neurochemical dysfunction. It provides context on animal models using stress, lesions, and pre-pulse inhibition
1. The document discusses psychological disorders, including definitions, classifications, symptoms, theories of causation, and prevalence rates.
2. It describes several psychological disorders like obsessive-compulsive disorder, schizophrenia, anxiety disorders, mood disorders, dissociative identity disorder, and personality disorders.
3. It analyzes risk factors like genetics, brain abnormalities, childhood trauma, and socioeconomic status that may contribute to psychological disorders.
Interdisciplinary Perspectives On Aging(2)vjthemetalhead
1. The document discusses several topics related to aging including cognitive changes, learning and memory, mental disorders like dementia and depression, and theories of adult development.
2. Key aspects of aging discussed include declines in fluid intelligence but stability of crystallized intelligence, changes in learning and memory processes, and increased risk of dementia, Parkinson's disease, and depression in older adults.
3. Theories of adult development addressed stage theories by Erik Erikson and Daniel Levinson that describe transitions in identity and personality across the adult lifespan.
Similar to Classification assesment and diagnosis of mental disorders (asw) new (20)
Classification assesment and diagnosis of mental disorders (asw) new
1. Classification and
Diagnosis of Mental
Disorders
Helen Crimlisk
Consultant Psychiatrist
Eastglade Sector Team (Oct 12)
2. Plan of Talk
Classification
Classification in general
Classification of mental illness
ICD 10
Case example
Break
Diagnosis
Diagnosis
Assessment
History
Mental State Examination
Common Mental Illnesses
Case examples
4. Classification
Why?
Aids recognition - improves communication
Economic - simplification “cognitive economy”
Predictive - “heuristic” - leads to ability to test
hypotheses
Reflect natural processes ( i.e. implies better
understanding e.g. Darwin )
13. Classification
Problems
Categorisationmeans defining thresholds
which may be and indeed often are arbitrary
depression / dysthymia / fed up
obese / well built / chubby / slender
16. Terms previously acceptable now gone out of usage
because of negative connotations
cretin hypothyroid
mongol Down’s syndrome
mentally retarded
imbecile mentally handicapped Intellectually
challenged
moron
learning disabled
autism
idiot savant pervasive developmental
disorder
cerebral palsy
spastic
insane psychopathic
lunatic schizophrenia integrative
disorder??
17. Classification
Problems
Economy of thought may lead to
oversimplification and inhumane action
18. Categorisation of people
makes it “easier” to engage
in inhumane behaviour
Jews
Polish Gypsies
Dissidents Homosexuals
19. What are the benefits of using
classification in mental health?
to facilitate reporting and inform public health issues
to provide a framework for research
to encourage communication among health workers and
between them and health care providers /government
Promote a feeling of being understood (“we’ve seen this
before – your problems are not unique”)
Some ability to predict treatment options and natural
history
21. Classification in Mental Health
severity severe / moderate / mild
depression
characteristics hebephrenic / paranoid /
schizophrenia
aetiology endogenous / exogenous
depression
prognosis “treatment resistant”
personality disorders /
depression
age young onset / older onset
dementia
treatability personality disorders /
schizophrenia
22. History 1
Cullen (18th Century)
Neurosis
“dysfunction of nervous system in the absence of fever”
Freud (19th Century)
Psychoneurosis
“A neurosis that is psychological in origin”
Kraepelin (19th Century)
Distinguished between:
Dementia Praecox (schizophrenia) and Manic Depressive Psychosis
(bipolar disorder)
ICD -European / DSM -American (20th Century)
23. History 2
1938
FirstInternational classification to include mental
disorders
International Classifications of Disease 5 (previously
“death”)
a. mental deficiency
b. schizophrenia
c. manic depressive psychosis
d. other mental diseases
24. History 3
1992
http://www3.who.int/icd/currentversion/fr-icd.htm
ICD 10 published by World Health Organisation
increased number of disorders listed
diagnostic guidelines given
subsections for different professions:
medical / clerical / educational / research personnel
version for primary care
multi-axial classification introduced
25. Aims of ICD 10 Chapter V
To facilitate medical practice and public health
action by providing a common language to all
concerned.
To enable mental health workers, public health
decision makers, statisticians and professionals
in disciplines relevant to psychiatry:
to understand one another
to share results of research
to improve and unify training strategies
to allow all disciplines to record areas specific to them
as fully as they wish to
26. Developed simultaneously in
many languages
Arabic
Chinese
English
French
German
Japanese
Portuguese
Russian
Spanish
Translated into 30+ other languages
27. Features of ICD 10 Chapter V
based on consensus
based on field trials
developed in collaboration between a Governmental
Organization (WHO) and non-Governmental
Organizations (WPA, WFN, AD, etc.)
developed simultaneously in many languages
compatible with national classifications
developed in collaboration with a network of centres
around the world participating in relevant research,
undertaking translation and providing training and
support to users
28. ICD 10 Classification
22 chapters I – XXII
covering all ailments/conditions/abnormalities etc
Chapter V: Mental and Behavioural Disorders
F0 Organic mental disorders
F1 Disorders due to psychoactive substance misuse
F2 Schizophrenia, schizotypal and delusional disorders
F3 Mood disorders
F4 Neurotic, stress related and somatoform disorders
F5 Behavioural syndromes associated with psychological
disturbances
F6 Disorders of adult personality disorder and behaviour
F7 Mental retardation
F8 Disorders of psychological development
F9 Behavioural and emotional disorders with onset usually
occurring in childhood and adolescence.
29. ICD 10 Classification
Each chapter has subsections with
clinical descriptions
F2 Schizophrenia, schizotypal and delusional
disorders
F20 schizophrenia
F21 schizotypal disorder
F22 persistent delusional disorder
F23 Acute and transient psychotic disorder
F24 Induced delusional disorder
F25 schizoaffective disorder
F28 Other non organic psychotic disorders
F29 Unspecified non organic psychosis
30. Multi-axial presentation of
ICD-10
Axis I clinical diagnoses
mental disorders
physical disorders
personality disorders
Axis II disability
personal care
occupation
family and household
functioning in broader social context
Axis III contextual factors
environmental and life style factors relevant to
pathogenesis and course of patient's illness
31. Case History 1
Mr X, a 35-year old Asian factory worker, married, with 3
children, was admitted to hospital, having broken his leg
by falling down stairs.
On the third day of admission, he grew increasingly
nervous and started to tremble. He could not sleep,
talked incoherently and was obviously very anxious.
According to his wife, Mr X drank large quantities of beer
each night until falling asleep, for the last 3 years. This
had caused a rift in the relationship.
32. Case History 2
He had been unhappy at work and was the only Asian.
During the past year he had missed work several times
and had been threatened with dismissal. He had been in
the country for 9 years, arriving as a asylum seeker.
On examination Mr X spoke incoherently. He was
disoriented in time, place, and at times also in person.
He picked at bugs that he could see on his blanket. He
trembled and sweated profusely. He was agitated, tried
constantly to get out of bed and seemed unaware that
his right leg was in plaster.
33. Axis I: Clinical diagnoses
Mr X had a long history of heavy alcohol use and
developed severe withdrawal symptoms when he could
not get alcohol.
He presented with the characteristic symptoms of a
delirium: clouding of consciousness, global disturbance
of cognition, psychomotor agitation, disturbance of the
sleep-wake cycle, rapid onset and fluctuation of the
symptoms.
There were no convulsions.
F10.40 Alcohol withdrawal state with delirium,
without convulsions.
34. Axis I: Clinical diagnoses
The information provided by his wife gives
evidence pointing to an additional diagnosis of
alcohol dependence syndrome: continuous
heavy use during the last 3 years, difficulties in
controlling the drinking and the presence of a
withdrawal state.
F10.24 Alcohol dependence syndrome,
currently using the substance
35. Axis II: Disabilities
Because of the situation described, it is possible
for an assessment to be made of the disabilities
suffered by Mr X on a scale defined in ICD 10:
A. Personal care =0
B. Occupation =1
C. Family and household =2
D. Broader social context =2
36. Axis III: Contextual factors
It is thought by the assessor that the following
contextual factors were important to consider in
Mr X:
• Z55.0 illiteracy and low-level literacy
• Z56.4 discord with boss and workmates
• Z60.5 target of perceived adverse discrimination and
persecution
• Z60.3 acculturation difficulty (Migration & Social
transplantation)
• Z63.0 problems in relationship with spouse or partner
38. Diagnosis
How do we make diagnoses
Man in the street’s terminology
mad / depressed / drunkard
Patients own diagnosis
depression / hyperactivity / “ME”
Rating Scales
Beck Depression Inventory / Aspberger questionnaire
Standardised Clinical Assessment
E.g. SCAN interview ( set questions asked)
History and Mental State Examination “clinical”
39. Aims of assessment – not only
diagnosis!
make a provisional diagnosis
elicit the aetiology of the illness
identify maintaining factors
clarify the risks – to patient / to others
set out a management strategy
40. Psychiatric Assessment
reason for referral
history of presenting complaint
past psychiatric history
family history
personal history
past medical history
use of medication/drugs/alcohol
forensic history
mental state examination
including cognitive examination
physical examination
risk assessment
management plan
41. History of presenting complaint
what are the current symptoms?
how long have they been present?
what precipitated them?
do the symptoms fluctuate?
does anything help or make things worse?
42. Open Ended Questions
“Can you tell me a bit about what the
problem is?”
“I’d like to ask you a few questions in a
minute but perhaps you can start by
telling me in your own words what has
been happening to you?”
43. Clarifying and closed
questioning
“Can I stop you there and just check a few
details - When exactly did this start? –
How long did that feeling last?”
“Have you ever had anything like this
before?”
“What exactly brought you into hospital
today?
44. Past Psychiatric History
“Have you ever had anything like this
before?”
“Did you ever seek help for this in the
past?”
“Have you ever been in hospital for this
before”
“What treatments have you tried in the
past?”
45. Family History
“Has anyone else in the family had anything
similar to this?”
“Has anyone in the family had problems with
their nerves?”
“Has anyone in the family seen a psychiatrist
that you know about?”
“Tell me a bit more about your family – are
your parents alive? What did they do for a
living? What’s your relationship like with
them? – has it always been like that?”
46. Personal History
birth
early development
school - social / academic
home environment
qualifications
relationships and children
work
47. Personal History -clarifications
“Did you complete the training course?
Why not – were you finding it difficult or
did you have problems with the boss?”
“Why did you leave that job after just 3
months?”
“Why did you have so much time off
school as a child?”
48. Past Medical History
medical conditions
admissions
surgical procedures
head injuries ?accidents
deliberate self harm
49. Medication, Drugs & Alcohol
current medication
allergies
illicit drug use
how much?
why?
alcohol consumption
how much?
why?
how long?
50. Drug and Alcohol - clarifications
“What age were you when you first started
using drugs?”
“Have you ever injected?
Which veins do you use?”
“So what do you actually mean by social
drinking?”
“What time do you usually start drinking in the
morning?”
“Do you drink every day?”
51. Forensic History
juvenile crime
court appearances
convictions
length of sentence
against person / property
experience of prison
52. Mental State Examination
what you objectively observe
can be done even where no history
available
56. Mental State Examination 4
Mood (subjective)
depressed
elated
anxious
biological features
suicidal thoughts or plans
Affect (objective)
congruent
appropriate
57. Mental State Examination 5
Thoughts
slowed or racing thoughts
ruminative or intrusive thoughts
thought disorder “loosened associations”
preoccupations
delusions
58. Mental State Examination 6
Perceptions
Hallucinations2nd or 3rd person?
“Do the voices talk to you (2nd) or about you
(3rd)?”
Command hallucinations
“Have you ever heard sounds or voices that
no one else can hear?”
“Have you ever had any unusual
experiences?”
59. Mental State Examination 7
Cognitive
orientation in time, place & person
registration, attention
memory
naming
following instructions
writing
copying
60. Insight
how does the patient see their problems?
do they recognise that there is a problem?
Do they recognise problems as relating to
mental health?
Are they willing to accept help?
how do they feel about what should be
done now?
61. Physical Examination
aetiological factors
e.g.thyroid abnormalities
head injuries
co morbid factors
diabetes
asthma
side effects
interferon for MS
Antiviral treatment in HIV / hepatitis
62. Risk Assessment
risk to self through suicidal behaviour
risk to self through neglect / dangerous
behaviour
risk to others
63. Delusions 1
a disorder of thought
a belief that is
• firmly held
• not affected by rational argument or evidence
to the contrary
• not a conventional belief (not within
educational and cultural background)
• usually false but not always so
64. Delusions 2
must differentiate from
• normal “eccentric” ideas
• overvalued ideas - an isolated belief which
can dominate a person’s life for years
- often within cultural background
- may be swayed by reason, not held with utter
conviction
65. Delusions 3
Persecutory :
patient believes a person or organization
are trying to harm him
“They're out to get me”
Grandiose :
beliefs of inflated self-importance, celebrity,
supernaturalness
“I am the true Queen of England”
66. Delusions 4
Delusions of reference :
certain objects/ events/ actions take on
special significance for the patient
“When I hear them talking about pedophiles on
the TV, I know they really mean me”
Nihilistic delusions :
belief that everything is negated or absent
“I don't have any bowels, they’ve been eaten
away”
67. Unusual types of delusions
erotomanic (De Clerambault’s syndrome)
patientdevelops a delusion that a man often of
higher social standing is in love with her (cf stalking)
morbid jealousy (Othello syndrome)
patientdevelops a delusion that a sexual partner is
being unfaithful NB high risk of violence
delusional misidentification (Capgras syndrome)
delusionthat a close relative has been replaced by
an impersonator (a number of variants possible)
infestation (Ekbom’s syndrome)
folie a deux “induced psychosis”
68. Hallucinatons 1
Disorder of perception
a percept
• experienced in the absence of an external
stimulus
• similar quality to that of a real perception
• experienced as originating in the outside
world (objective space) not in own mind
(subjective space)
69. Hallucinations 2
It is important to differentiate between
hallucination and illusion
illusion : misperceptions of external (real)
stimulus
affect driven
anxious child who sees a coat hanging on a door
and thinks it is a robber
seeing a map of England in a crack on the ceiling
71. Auditory hallucinations
2nd person
“you are an evil person, you deserve to die”
“you are the most important person in the world”
3rd person
running commentary “now he’s picking up the
knife and he’s going to ….”
repeating patients thoughts
several voices discussing patient “ I think he’s one
of the most wonderful people I’ve ever met” “Yes –
he is the true Messiah….”
72. Passivity phenomena
Disorder of both thought and perception
The feeling that one’s actions/ thoughts/ feelings
are not their own but controlled by an external
agency
!!!
External
agency
Controls own
thoughts
73. Thought alienation
Disorder of thought
The feeling that one’s thoughts are being
interfered with in some way
thought broadcast
thought insertion
broadcast
thought withdrawal
insertion withdrawal
75. Depression
disorder of mood
three core symptoms:
pervasive, persistent low mood
loss of pleasure (anhedonia)
loss of energy (anergia)
psychotic phenomena
mood congruent
hallucinations 2nd person
76. Symptoms of depression
Biological symptoms Cognitive symptoms
sleep disturbance poor concentration
appetite disturbance hopelessness
diurnal mood variation worthlessness
weight loss guilt
loss of libido loss of confidence
77. Mania (also hypomania)
disorder of mood
three core features
elevated or irritable mood
increased energy/activity
reduced need for sleep/rest
psychotic phenomena
grandiosity, paranoia
hallucinations 2nd person
78. Symptoms of mania
elevated mood
feelings of well being, infective affect
poor concentration and attention
increased energy, drive, sexual energy
irritability, boorish behaviour or conceit
r educed need for sleep
loss of social inhibitions
grandiosity, inflated self esteem
over spending, rash decisions
promiscuity
79. Anxiety
can be a symptom of many disorders e.g.
psychosis, depression, alcohol
dependence
also prominent in the neurotic disorders :
• generalized anxiety disorder
• panic disorder
• phobias
80. Symptoms of anxiety
Physical Psychological
palpitations sense of impending
hyperventilation doom
chest pain poor concentration
dry mouth irritability
parasthesiae restlessness
headache initial insomnia
tremor
urinary frequency
81. Schizophrenia
Pragmatic definition
A severe psychotic illness with onset in early
adulthood, characterised by bizarre
delusions, auditory hallucinations, thought
disorder strange behaviour and progressive
deterioration in personal, domestic, social
and occupational competence all occurring in
clear consciousness
82. Schizophrenia
Schneiderian First Rank symptoms
Symptoms which if present give weight to a
diagnosis of schizophrenia
delusional perception
audible thoughts
voices heard arguing
voices giving a running commentary
made actions/impulses/feelings
somatic passivity
thought insertion/broadcast/withdrawal
83. Diagnoses
full assessment needed to be certain
diagnosis may need to be revised
not static
remember this is only axis I of the classification
system
consider also
disability
contextural aspects
84. Case A (1)
A 34 yr old man presents in A+E saying
he is having a heart attack. He is sweaty,
shaky, breathless and experiencing
palpitations. Investigations rule out
“medical” causes.
What would you thinking of?
85. Case A (2)
On further questioning he tells you that he
has been drinking 1 bottle of vodka and
£30 worth of cannabis per day
What else would you think about?
86. Case A (3)
After he has calmed down, he tells you
that he uses the alcohol and cannabis to
“drown out” the voices. They talk about
him and control his thoughts and actions.
What now?
87. Case B (1)
A 19yr old male is brought in by the police
swearing and shouting. He says he is
responding to all the people calling him a
“bastard”. He believes that the police and
Army are involved in a conspiracy to kill
him.
What are your immediate thoughts?
88. Case B (2)
He is admitted to the ward and settles
down very quickly. A urine drug screen is
positive for amphetamines.
What now?
89. Case B (3)
A few days later he absconds from the
ward and returns drowsy and confused.
He says he has taken Ecstasy and
alcohol. You check his bloods and his
LFTs are very high.
What now?