Classification in Psychiatry
The concept, reliability, validity, advantages and disadvantages of different classification systems, controversies in psychiatry classification
DISORDER CONTENTOF THOUGHT -DELUSION
BY DR.WASIM
UNDER GUIDANCE OF
DR.SANJAY.JAIN
Definition of delusion:
Delusions are categorized into four different groups
THERE ARE 2 TYPES OF DISORDERS OF THOUGHT CONTENT
1.DELUSION
2.OVERVALUED IDEAS
DISTINGUISED
DELUSION
OTHER MEMBERS OF THE CULTURE DONOT SHARE THE BELIEF.
NEED NOT BE ASSOCIATED WITH AFFECT.
FIRMLY SUSTAINED BELIEF.
CONVINCED THAT DELUSION IS REAL.
RECOGNIZED AS ABSURED.
CANNOT BE ACCEPTED.
OCCUR IN MENTALLY ILL PATIENTS.
OVERVALUED IDEAS
OTHER MEMBERS OF THE CULTURE SHARE THE BELIEF.
ASSOCIATED WITH VERY STRONG AFFECT.
NOT HELD FIRMLY.
ATLEAST SOME LEVEL OF DOUBT AS TO ITS TRUTHFULNESS.
NOT RECOGNIZED AS ABSURED.
ACCEPTABLE.
CAN OCCUR IN BOTH HEALTHY AND MENTALLY ILL PATIENTS.
KENDLER’S VECTORS FOR DELUSION:
five stages in the development of delusion(FISH & CONRAD)
FACTORS CONCERNED WITH GENERATION OF DELUSIONS
PATHPOPHYSIOLOGY OF DELUSIONS
PRIMARY DELUSIONS
SECONDARY DELUSIONS
SYSTEMATIZATION
DELUSIONS ON THE BASIS OF CONTENT OF DELUSIONS
THANK YOU
The term “psychosomatic disorder” is mainly used to mean “a physical disease that is thought to be caused, or made worse, by mental factors.” ... For example, chest pain may be caused by stress and no physical disease can be found.
Classification in Psychiatry
The concept, reliability, validity, advantages and disadvantages of different classification systems, controversies in psychiatry classification
DISORDER CONTENTOF THOUGHT -DELUSION
BY DR.WASIM
UNDER GUIDANCE OF
DR.SANJAY.JAIN
Definition of delusion:
Delusions are categorized into four different groups
THERE ARE 2 TYPES OF DISORDERS OF THOUGHT CONTENT
1.DELUSION
2.OVERVALUED IDEAS
DISTINGUISED
DELUSION
OTHER MEMBERS OF THE CULTURE DONOT SHARE THE BELIEF.
NEED NOT BE ASSOCIATED WITH AFFECT.
FIRMLY SUSTAINED BELIEF.
CONVINCED THAT DELUSION IS REAL.
RECOGNIZED AS ABSURED.
CANNOT BE ACCEPTED.
OCCUR IN MENTALLY ILL PATIENTS.
OVERVALUED IDEAS
OTHER MEMBERS OF THE CULTURE SHARE THE BELIEF.
ASSOCIATED WITH VERY STRONG AFFECT.
NOT HELD FIRMLY.
ATLEAST SOME LEVEL OF DOUBT AS TO ITS TRUTHFULNESS.
NOT RECOGNIZED AS ABSURED.
ACCEPTABLE.
CAN OCCUR IN BOTH HEALTHY AND MENTALLY ILL PATIENTS.
KENDLER’S VECTORS FOR DELUSION:
five stages in the development of delusion(FISH & CONRAD)
FACTORS CONCERNED WITH GENERATION OF DELUSIONS
PATHPOPHYSIOLOGY OF DELUSIONS
PRIMARY DELUSIONS
SECONDARY DELUSIONS
SYSTEMATIZATION
DELUSIONS ON THE BASIS OF CONTENT OF DELUSIONS
THANK YOU
The term “psychosomatic disorder” is mainly used to mean “a physical disease that is thought to be caused, or made worse, by mental factors.” ... For example, chest pain may be caused by stress and no physical disease can be found.
Acute stress disorder (ASD) is a mental disorder that can occur in the first month following a trauma. The symptoms that define ASD overlap with those for PTSD. One difference, though, is that a PTSD diagnosis cannot be given until symptoms have lasted for one month. Also, compared to PTSD, ASD is more likely to involve feelings such as not knowing where you are, or feeling as if you are outside of your body.
How common is ASD?
Studies of ASD vary in terms of the tools used and the rates of ASD found. Overall, within one month of a trauma, survivors show rates of ASD ranging from 6% to 33%. Rates differ for different types of trauma. For example, survivors of accidents or disasters such as typhoons show lower rates of ASD. Survivors of violence such as robbery, assaults, and mass shootings show rates at the higher end of that range.
reaction to stressful experiences. the normal reactions and psychological disorders related to it. short discussion of PTSD, acute stress reaction and Adjustment disorder along with treatment options.
very summarized management of each condition. good for medical students
Emotion, Classification of emotion, Normal emotional reactions, Abnormal emotional reactions, Abnormal reaction of emotion, Morbid expression of emotion, Communication of mood, Categories of emotion, Pathological changes in mood, Feeling of loss, Anhedonia, Feeling of impending disaster, Ecstasy, Feelings attached with the perception of objects, Feelings directed towards people, Free floating emotion, Experience and expression of emotion, Vital feelings, Religious feelings, Manic Depressive mood, Suicidal thoughts, Depersonalization, Internal restlessness, Cyclothymia and related conditions, Depression and loss, Grief, Helplessness and hopelessness, Mania, Manic thoughts
Diagnostic Criteria:
exposure to actual or threatened death, serious, or sexual violence in one( or more) of the following ways:
1) Directly experiencing the traumatic events.
2) Witnessing in person
3) Learning that the traumatic event occur to close family member or friend.
4) Experiencing repeated or extreme exposure to aversive details of the traumatic events.
Cognitive Behavioral Therapy (CBT) of AnxietyDavid Walczyk
An overview of Cognitive Behavior Therapy (CBT) for anxiety and, in particular, generalized anxiety disorder (GAD). The clinical case material portion of presentation has been removed.
Course Description (From www.PESI.com):
Attend this day of training and leave with a brand new toolkit of skills, interventions, and principles for rapid success with traumatized clients. Join Jamie Marich and learn the standard of care for treatment in the field of traumatic stress – and its key ingredients. Implement evidence-based treatment protocols and interventions for establishing safety, desensitizing and reprocessing trauma memories, metabolizing and resolving grief/loss and finally, assisting clients in reconnecting to lives full of hope, connection, and achievement.
Jamie is a certified EMDR Therapist and approved consultant through the EMDR International Association (EMDR). She is additionally a member of the American Academy of Experts in Traumatic Stress, the International Association of Trauma Professionals (IATP), and has earned Certification in Disaster Thanatology.
Jamie began her career in social services as a humanitarian aid worker in post-war Bosnia-Herzegovina opening her eyes to the widespread, horrific impact of traumatic stress and grief.
Objectives:
Describe the etiology and impact of traumatic stress on the client utilizing multiple assessment strategies.
Assess a client’s reaction to a traumatic event and make an appropriate diagnosis.
Explain how grief, bereavement, and mourning are accounted for in the new DSM-5®.
Implement interventions to assist a client in dealing with the biopsychosocial manifestations of trauma, PTSD, and traumatic grief/complicated mourning.
Utilize appropriate evidence-based interventions to assist a client in dealing with the biopsychosocial-spiritual manifestations of trauma.
Explain the effects of trauma on the structure and function of the brain.
Schizophrenia Spectrum & Other Psychotic Disorders for NCMHCE StudyJohn R. Williams
Quick review of the essential points— DSM5 diagnosis criteria, assessments, treatments—of these disorders to better prepare for the National Clinical Mental Health Counseling Exam. This was informed by several exam prep programs, and can be used like flashcards or as a presentation.
Acute stress disorder (ASD) is a mental disorder that can occur in the first month following a trauma. The symptoms that define ASD overlap with those for PTSD. One difference, though, is that a PTSD diagnosis cannot be given until symptoms have lasted for one month. Also, compared to PTSD, ASD is more likely to involve feelings such as not knowing where you are, or feeling as if you are outside of your body.
How common is ASD?
Studies of ASD vary in terms of the tools used and the rates of ASD found. Overall, within one month of a trauma, survivors show rates of ASD ranging from 6% to 33%. Rates differ for different types of trauma. For example, survivors of accidents or disasters such as typhoons show lower rates of ASD. Survivors of violence such as robbery, assaults, and mass shootings show rates at the higher end of that range.
reaction to stressful experiences. the normal reactions and psychological disorders related to it. short discussion of PTSD, acute stress reaction and Adjustment disorder along with treatment options.
very summarized management of each condition. good for medical students
Emotion, Classification of emotion, Normal emotional reactions, Abnormal emotional reactions, Abnormal reaction of emotion, Morbid expression of emotion, Communication of mood, Categories of emotion, Pathological changes in mood, Feeling of loss, Anhedonia, Feeling of impending disaster, Ecstasy, Feelings attached with the perception of objects, Feelings directed towards people, Free floating emotion, Experience and expression of emotion, Vital feelings, Religious feelings, Manic Depressive mood, Suicidal thoughts, Depersonalization, Internal restlessness, Cyclothymia and related conditions, Depression and loss, Grief, Helplessness and hopelessness, Mania, Manic thoughts
Diagnostic Criteria:
exposure to actual or threatened death, serious, or sexual violence in one( or more) of the following ways:
1) Directly experiencing the traumatic events.
2) Witnessing in person
3) Learning that the traumatic event occur to close family member or friend.
4) Experiencing repeated or extreme exposure to aversive details of the traumatic events.
Cognitive Behavioral Therapy (CBT) of AnxietyDavid Walczyk
An overview of Cognitive Behavior Therapy (CBT) for anxiety and, in particular, generalized anxiety disorder (GAD). The clinical case material portion of presentation has been removed.
Course Description (From www.PESI.com):
Attend this day of training and leave with a brand new toolkit of skills, interventions, and principles for rapid success with traumatized clients. Join Jamie Marich and learn the standard of care for treatment in the field of traumatic stress – and its key ingredients. Implement evidence-based treatment protocols and interventions for establishing safety, desensitizing and reprocessing trauma memories, metabolizing and resolving grief/loss and finally, assisting clients in reconnecting to lives full of hope, connection, and achievement.
Jamie is a certified EMDR Therapist and approved consultant through the EMDR International Association (EMDR). She is additionally a member of the American Academy of Experts in Traumatic Stress, the International Association of Trauma Professionals (IATP), and has earned Certification in Disaster Thanatology.
Jamie began her career in social services as a humanitarian aid worker in post-war Bosnia-Herzegovina opening her eyes to the widespread, horrific impact of traumatic stress and grief.
Objectives:
Describe the etiology and impact of traumatic stress on the client utilizing multiple assessment strategies.
Assess a client’s reaction to a traumatic event and make an appropriate diagnosis.
Explain how grief, bereavement, and mourning are accounted for in the new DSM-5®.
Implement interventions to assist a client in dealing with the biopsychosocial manifestations of trauma, PTSD, and traumatic grief/complicated mourning.
Utilize appropriate evidence-based interventions to assist a client in dealing with the biopsychosocial-spiritual manifestations of trauma.
Explain the effects of trauma on the structure and function of the brain.
Schizophrenia Spectrum & Other Psychotic Disorders for NCMHCE StudyJohn R. Williams
Quick review of the essential points— DSM5 diagnosis criteria, assessments, treatments—of these disorders to better prepare for the National Clinical Mental Health Counseling Exam. This was informed by several exam prep programs, and can be used like flashcards or as a presentation.
Generalized Anxiety Disorder (GAD), Anxiety, Anxiety Disorders, Risk Factors , Signs and Symptoms of GAD, DSM V Diagnostic Criteria for Generalized Anxiety Disorder, ICD 10 CriteriaF41.1 Generalized anxiety disorder, Prevalence and Age of Onset, Treatment, Self-help Strategies For GAD
Adjustment disorders are commonly seen in primary care settings in which the 1-year prevalence varies from 11% to 18% of those with any clinical psychiatric disorder. [Casey PR et al., 1984]
A recent study [Maercker A et al., 2012] in the general population found the prevalence of adjustment disorder to be 0.9%,
What is Generalized anxiety disorder (GAD), Definition of Generalized anxiety disorder (GAD), Classification of Generalized anxiety disorder (GAD), Clinical manifestation of Generalized anxiety disorder (GAD), Risk factors and investigations of Generalized anxiety disorder (GAD), Medications and therapies for Generalized anxiety disorder (GAD),
Post-traumatic stress disorder (PTSD) develops after exposure to a terrifying event in which serious physical harm occurred or was threatened. PTSD can occur in people of any age and women are affected more than men. Some events that can trigger this disorder comprise: accidents, natural or human-caused disasters, violent personal assaults or military combat.
Troops who serve in wars and conflicts, rescue workers involved in the aftermath of disasters; survivors of accidents, rape, physical and sexual abuse, bombing or other crimes are exposed to highly stressful events and have increased risk for developing PTSD.
Autoimmune rheumatic diseases are due to a compromised immune response against the self. Physicians have commonly observed that stress adversely affects patient’s disease and many studies have demonstrated that a high percentage of patients have reported unusual emotional stress before disease onset. Stress is now days an important risk factor for the pathogenesis of autoimmune disease.
Research among veterans showed that those diagnosed with PTSD had higher risk for diagnosis with an autoimmune disorder like rheumatoid arthritis, systemic lupus erythematosus autoimmune thyroiditis, multiple sclerosis, alone or in combination, compared to veterans with no psychiatric disorder.
A large longitudinal study of civilian women, demonstrated that exposure to trauma and PTSD were associated with increased risk of SLE occurrence. A group of patients with fibromyalgia and PTSD reported significantly greater levels of avoidance, hyperarousal, anxiety, and depression than did the patients without PTSD symptoms.
Conclusion. Rheumatic diseases are common chronic disorders. Several risk factors contribute to their pathophysiology like genetic factors, sex hormones, infections and stress. Research has showed that psychological stress and stress-related hormones are involved in immune modulation, which may result in autoimmune disease. Further studies are needed to clarify the pathophysiological implications of stress and trauma on the onset and activity of rheumatic autoimmune diseases and to determine whether treatment of PTSD and lifestyle changes can decrease the risk for developing autoimmune disorders in patients with this severe psychological disorder.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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Best Ayurvedic medicine for Gas and IndigestionSwastikAyurveda
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
2. Introduction
This category differs from others in that it includes disorders identifiable not
only on grounds of symptomatology and course but also on the basis of one or
other of two causative influences -
• an exceptionally stressful life event producing an acute stress reaction, or
• a significant life change leading to continued unpleasant circumstances that
result in an adjustment disorder.
3. Components of response to stress
• 1-an emotional response with somatic accompaniments e.g anxiety
• 2-a coping strategy- seeking help, problem solving, ventilation, avoidance,
substance use, aggression etc
• 3-a defense mechanism- repression, projection, sublimation etc.
4. Classification of Reactions to stressful
experience
ICD-10
Acute stress reaction
PTSD
Adjustment disorder
•Brief depressive disorder
•Mixed anxiety and depressive disorder
•Predominant disturbance of other emotions
•Mixed disturbance of emotions and conduct
•Other specified symptoms
DSM-4
Acute stress disorder
PTSD
Adjustment disorder
•With depressed mood
•With anxiety
•With disturbance of conduct
•With mixed disturbance of emotions and
conduct
•Unspecified
6. Acute stress reaction
• A transient disorder of significant severity which develops in an individual
without any other apparent mental disorder in response to exceptional
physical and/or mental stress and which usually subsides within hours or
days.
7. Acute Stress Reaction
• Individual vulnerability and coping capacity play a role in the occurrence and severity of acute
stress reactions
• The symptoms show great variation but typically they include an initial state of "daze", with
some narrowing of attention, inability to comprehend stimuli, and disorientation.
• This state may be followed either by further withdrawal from the surrounding situation (to the
extent of a dissociative stupor or by agitation and over-activity (flight reaction or fugue).
Autonomic signs of panic anxiety (tachycardia, sweating, flushing) are commonly present.
• The symptoms usually appear within minutes of the impact of the stressful stimulus or event,
and disappear within 2-3 days (often within hours).
• Partial or complete amnesia for the episode may be present.
8. Diagnosis
• In ICD-10-
• Moderate 2/7 and severe 4/7 of the following symptoms:
• Withdrawal from expected social interactions
• Narrowing of attention
• Apparent disorientation
• Anger and verbal aggression
• Despair and hopelessness
• Inappropriate or purposeless activity
• Uncontrollable and excessive grief
9. Management
• Planning for disaster-
• Immediate and appropriate response to psychological effects of major disaster
according to decided priority needs of adults, children and team members.
• Psychological assistance for victims of disaster by Alexander (2005):
• Comfort & consolation, Protection from threat/distress, immediate physical care,
Reunion with loved ones, Sharing experiences, Linking survivors with support,
Identifying those who need help further.
10. Management
• Debriefing : After disaster counseling has taken the form known as debriefing or
Critical incident stress debriefing (CISD) individually/group.
• Facts- victim relates what happened
• Thoughts- describe their thoughts after event
• Feelings- emotions associated with incident
• Assessment- take stock up of responses
• Education- Counselor offers information about stress response and management.
11. Management
• Follow up after 1 month, identify subjects likely to develop PTSD.
• Offer psychotherapy to those without social support (friends, family) or
confidentiality issues (rape)
• Incase of depression, insomnia or anxiety medication should be prescribed.
12. Post-Traumatic Stress disorder
• This arises as a delayed and/or protracted response to a stressful event or
situation (either short- or long-lasting) of an exceptionally threatening or
catastrophic nature, which is likely to cause pervasive distress in almost
anyone (e.g. natural or man-made disaster, combat, serious accident,
witnessing the violent death of others, or being the victim of torture,
terrorism, rape, or other crime).
13. Clinical picture
Hyperarousal Intrusions Avoidance
Persistent anxiety
Irritability
Insomnia
Poor concentration
Intense intrusive imagery
‘flashbacks’
Recurrent distressing dreams
Difficulty recalling stressful events at will
Avoidance of reminder of events
Detachment
Numbness
Diminished interest in activities
14. PTSD- Diagnosis
• Symptoms begin soon after stressful event, after days or months but rarely
after 6 months.
• PTSD can’t be diagnosed until 1 month of symptomatology has passed.
Until then it is classified as acute stress reaction.
• Many cases are persistent; about half recover within 1 year but 1/3 don’t
recover even after many years.
15. Predisposing factors
• Individual factors that increase vulnerability to development include:
• Personal history of mood/anxiety disorders
• Previous history of trauma
• Female gender
• Neuroticism
• Lower intelligence
• Poor social support
16. Treatment
• Counseling
• Emotional Support, Encourage recall to integrate the events into the
patient’s experience and facilitate working through associated emotions.
There might be feelings of guilt, purposelessness and other concerns in
cases of rape or personal assault which would need addressing.
17. Treatment
• Cognitive-behavioral treatment
• When symptoms are severe or long-standing CBT is most appropriate.
• The components of treatment:
• Information about the normal response to severe stress and importance of confronting situations and memories related
to traumatic events.
• Self-monitoring of symptoms
• Exposure to situations that are being avoided
• Recall of images of the traumatic events
• Cognitive restructuring through the discussion of evidence for and against the appraisals and assumptions
• Anger management for people who still feel angry about the traumatic events and their causes.
18. Medication
• Anxiolytics should be avoided if diagnosis of PTSD has been established as
they may lead to dependence.
• A number of antidepressants have shown efficacy in clinical trials, SSRIs,
SNRIs,TCAs, and MOAIs. There are also preliminary data supporting
Mirtazipine and augmentation with atypical antipsychotics.
19. Adjustment disorders
• States of subjective distress and emotional disturbance, usually interfering with
social functioning and performance, and arising in the period of adaptation to a
significant life change or to the consequences of a stressful life event (including the
presence or possibility of serious physical illness).
• The stressor may have affected the integrity of an individual's social network
(through bereavement or separation experiences) or the wider system of social
supports and values (migration or refugee status).The stressor may involve only
the individual or also his or her group or community.
20. Diagnosis
• The manifestations vary but none of the symptoms is of sufficient severity or
prominence in its own right to justify a more specific diagnosis.
• These include depressed mood, anxiety, worry (or a mixture of these), a feeling of
inability to cope, plan ahead, or continue in the present (social/occupation)
situation, and some degree of disability in the performance of daily routine.
• The individual may feel liable to dramatic behaviour or outbursts of violence, but
these rarely occur. However, conduct disorders (e.g. aggressive or dissocial
behaviour) may be an associated feature, particularly in adolescents.
• In children, regressive phenomena such as return to bed-wetting, babyish speech,
or thumb-sucking are frequently part of the symptom pattern.
21. Diagnosis
• The onset is usually within 1 month of the occurrence of the stressful event
or life change, and the duration of symptoms does not usually exceed 6
months.
• If the symptoms persist beyond this period, the diagnosis should be
changed according to the clinical picture
22. Diagnosis
• Brief depressive reaction
• A transient, mild depressive state of duration not exceeding 1 month.
• Prolonged depressive reaction
• A mild depressive state occurring in response to a prolonged exposure to a stressful
situation but of duration not exceeding 2 years.
• Mixed anxiety and depressive reaction
• Both anxiety and depressive symptoms are prominent, but at levels no greater than
specified in mixed anxiety and depressive disorder or other mixed anxiety disorder
23. • With predominant disturbance of other emotions
• The symptoms are usually of several types of emotion, such as anxiety, depression,
worry, tensions, and anger. Symptoms of anxiety and depression may fulfil the
criteria for mixed anxiety and depressive disorder or other mixed anxiety disorder
but they are not so predominant that other more specific depressive or anxiety
disorders can be diagnosed.
• This category should also be used for reactions in children in which regressive
behaviour such as bed-wetting or thumb-sucking are also present.
• With predominant disturbance of conduct
• The main disturbance is one involving conduct, e.g. an adolescent grief reaction
resulting in aggressive or dissocial behaviour.
24. Treatment
• Designed to help patients resolve the stressful problems and aid natural
process of adjustment.
• Encourage problem solving, discourage maladaptive coping strategies,
facilitate communication.Occasionally medications (anxiolytic or hypnotic)
might be needed.