The presentation was created amidst Pandemic. Feel free to use if it helps your cause. It was meant for Final year medical students at a medical college.

1. Introduction to Psychiatry
Dr Usman Amin Hotiana
MBBS, FCPS (Psych)
Head of Psychiatry Department
Rashid Latif Medical College

2. Ancient Treatments of Mental Illness
• 10000 BS onwards: Trepanation
• 1500 BC Ebers Pyparus (Egyptians): Described illness like Dementia,
Depression and Schizophrenia
• 1400 BC Atharva Veda ( ancient Indian test)
• 1000 BC The Yellow Emperor Classic of Internal Medicine
• 450 BC Hippocratic Test: Moved away from supernatural to rational
explanation of causation (quoted depression, mania, hysteria and
dementia)
• 280 BC Theophrastus : 28 types of personalities or temperaments
• 270 BC First psychiatric hospital (Baghdad)
• 1247 Bethlam hospital funded (First psych patient in 1930)

3. Psychiatry Timeline
• 1637 Descartes: Discourse de la Methode body is different from mind
• 1650-1950 The Asylum Era
• 1667 Thomas Willis
• 1792 Philippe Pinel (improving asylums and classications). William
Tuke took these ideas to the Uk York treat
• 1845 Lunacy Act in the Asylum Era, replacing private madhouse
• 1852 Moral (France) makes reference to Dementia Praecox
• 1863 Kahlbaum described hebephrenia
• 1869 Beard described Neuroasthenia
• 1895 Freud and Breuer published Studies on Hysteria

8. Psychiatry Timeline
• 1899 Emil Kraepelin established nosology which dominates 19th
• 1907 Alzheimer’s
• Eugene Bleuler’s group of schizophrenia
• Karl Jasper General Psychopathology
• 1914-1918 WWI Shell Shock Syndrome
• 1880 Johann Christian Reil quoted the term Psychiatry
• 1841 Association of Medical Officers for Asylums and Hospital for the
insane
• 1866 Medical Psychological Associations
• 1971 became the RCPsych

9. Asylum the Good Bad and Ugly
POSITIVE NEGATIVE
Public Safety Stagnant, cut off from the world
Food, Shelter and clothes Internal abuse, neglect scandals
Diagnostics, Research ,
classifications
Institutionalization
Occupations activities Failure of Moral Therapy
Recognition of Mental Illness Distant , stigmatization
Financial social commitments Oversized, underfunded

11. Publications on Psychiatry
1843 Annales Medico psychologiques
1844 Americal Journal of Insanity
1848-1854 Journal of Psychological Medicine and mental pathology
1853 Asylum Journal
1858-1962 Journal of Mental Science
1963 British Journal of Psychiatry
1970 Psychological Medicine
1977 Psychiatric Bulletin ( The Psychiatrists)

12. Publications in Psychiatry
1808 Act for Better Maintenance and Care of the Lunatic
1844-45 Lunatics and Asylum Acts (Statutory duty to provide asylum)
1890 Lunacy Act
1913 Mental Deficiency Act –Board of Control to supervise Asylum
1930 Mental Treatment Act – outpatients and involuntary admissions allowed
1959 Mental Health Act, ending of magistrate’s courts and board control.
Mental Health Tribunals
1983 Mental Health Act- Introduced consent, Approved SW and Mental
Health Act Commission
1995 Patients in the community act- Supervised discharged
2007 Revised Mental Health Act

13. The road to modern Psychopharmacology
1855 Von Bibra 17 types of mind altering
plants
1955 Rerserpine and meprobamate
1884 Adrenaline indentified 1956 Methylphenidate
1898 Mescal 1957 Chlordiazepoxide
1901 Adrenaline marketed 57-60 TCA
1926 Henrry Dale 1959 Diazepam marketed
1929 Amphetamine 197 Lab testing for Fluoxetine
1943 Hofmanns’s LSD 1987 Fluoxetine
1950 Chlorpromazine

14. Publications in Psychiaty (Pakistan)
• Mental Health Act 2001
• Mental Health Act 2014
• Punjab Mental Health Authority
• Federal Mental Health Authority
• PIMH & Board of Certifications

16. Psychiatric History in the Cinema

19. Phenomenology
• Description of nature of inner life of the patient
• Delusion
• Hallucination
• Illusion

20. Phenomenology
• Delusion-types
• Persecution
• Infidelity
• Love
• Grandiose
• Nihilistic

21. Phenomenology
• Hallucination
• Auditory
• Visual
• Gustatory
• Tactile
• Visceral
• Hypnogogic Hypnopompic ( Falling/Waking)

22. Phenomenology
• Affect
• Mood
• Euthymia
• Elevated Mood
• Ecstasy

23. Phenomenology
• Thought insertion/Withdrawal/Broadcasting
• Made feeling/ Impulses/ Acts
• Obsession
• Compulsion

24. Phenomenology
• Fear
• Anxiety
• Panic
• Phobia

25. Phenomenology
• Déjà vu
• Jamais vu
• Confabulation
• Insight

26. Classification in Psychiatry
• Ideally should be based on Aetiology
• Until then , What can we do???
• Pragmatic/ Practical Approach