This is seminar presented as part of academics in my department. Please comment on the content, so that i can improve myself. If the content is good, kindly like it.
Psychoeducation is an important element of psychiatric treatment. It has a significant role in
promoting mental health, preventing mental illness, increasing mental health awareness, creating opportunities
and improving the quality of life of the patient, caregivers and the community. To achieve these goals,
psychoeducation programmes seek to provide families with the information they need about mental illness
and the coping skills that will help them to deal with their loved one's psychiatric disorder. In a nutshell
Psychoeducation’s goal is to offer education and therapeutic strategies to improve the quality of life for the
family while decreasing the possibility of relapse for the patient (Solomon, 1996).
Brief therapy, sometimes also referred to as short term therapy (usually 10 to 20 sessions) , is a generic label for any form of therapy in which time is an explicit element in treatment planning.
This presentation is about geriatric Psychiatry awareness. it contains basic information about what is geriatric psychiatry, which are the main psychiatry disorder found in elderly and how to manage them?. it contains some detailed information about late life depression, delirium and dementia in geriatric population.
A general overview on Social Work in Psychiatric Settings.
Global and National Statistics on Mental Health.
Role and Challenges of Psychiatric Social Worker.
World View of Disorders and Culture Bound SyndromesImran Waheed
A lecture by Dr Imran Waheed, Consultant Psychiatrist, delivered in Birmingham, UK on February 7th 2012. The audience was medical students in Birmingham.
Psychoeducation is an important element of psychiatric treatment. It has a significant role in
promoting mental health, preventing mental illness, increasing mental health awareness, creating opportunities
and improving the quality of life of the patient, caregivers and the community. To achieve these goals,
psychoeducation programmes seek to provide families with the information they need about mental illness
and the coping skills that will help them to deal with their loved one's psychiatric disorder. In a nutshell
Psychoeducation’s goal is to offer education and therapeutic strategies to improve the quality of life for the
family while decreasing the possibility of relapse for the patient (Solomon, 1996).
Brief therapy, sometimes also referred to as short term therapy (usually 10 to 20 sessions) , is a generic label for any form of therapy in which time is an explicit element in treatment planning.
This presentation is about geriatric Psychiatry awareness. it contains basic information about what is geriatric psychiatry, which are the main psychiatry disorder found in elderly and how to manage them?. it contains some detailed information about late life depression, delirium and dementia in geriatric population.
A general overview on Social Work in Psychiatric Settings.
Global and National Statistics on Mental Health.
Role and Challenges of Psychiatric Social Worker.
World View of Disorders and Culture Bound SyndromesImran Waheed
A lecture by Dr Imran Waheed, Consultant Psychiatrist, delivered in Birmingham, UK on February 7th 2012. The audience was medical students in Birmingham.
Projektpläne, Dokumente, Berichte, Adressen sowie alle weiteren relevanten Projektinformationen werden zentral verwaltet und sind immer auf dem aktuellsten Stand. Interne wie externe Mitarbeiter können ohne Einschränkungen zusammen arbeiten. Integrierte Workflows garantieren, dass die notwendigen Projektprozesse zeitnah und wie gewünscht abgearbeitet werden.
NBCC, NAADAC, CAADAC, and California Board of Behavioral Sciences approved Mental Health continuing education and addictions counselor training series. Narrated versions and CEUs available at http://www.allceus.com
SAINT FRANCIS DE SALES COLLEGE, AALO
DEPARTMENT OF SOCIOLOGY,
NATIONAL WEBINAR
ON
“MENTAL HEALTH AND WELL- BEING”
Sociological Perspectives on
Mental Health and Illness
1.1.6 AWHN Conference 6 2010 Federation:
What Works? Services for Culturally and Linguistically Diverse Women with Co-occurring Mental Health and Drug and Alcohol Issues
2.1.7 AWHN Conference 6 2010 Federation:
What Works? Services for Culturally and Linguistically Diverse Women with Co-occurring Mental Health and Drug and Alcohol Issues
Internet Addiction Disorder & Blue Whale Challengedonthuraj
Presentation discuss on Internet addiction and Some information about Blue Whale challenge... (Regarding blue whale the information is from w=various media)
This is a ppt on Ragging. I have covered on basic definition, psychological aspects & legal aspects related to ragging in India. summing with some suggestions.
Complementary and Alternative therapies in Psychiatrydonthuraj
This is a seminar which i had presented as a part of academic activity in my department. Please comment on the seminar, so that i can make any future changes... Thank you.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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!
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
2. First Note…
• “ Eve ry c ulture e njo y s
s o m e fo rm o f hum o ur.
But, hum o ur ha s
d iffic ulty c ro s s ing
c ultura l bo und a rie s
be c a us e wha t is
hum o ro us in o ne
c o untry is o fte n no t
hum o ro us in a no the r”
- Ro g e r A te ll.
x
3. Definitions
• Social psychiatry- It is a branch of
Psychiatry that focuses on the
interpersonal and cultural context of
mental disorder and mental wellbeing.
• Stigma- Undesirable ‘deeply discrediting’
attributes that ‘ disqualify one from full
social acceptance’ and motivate efforts by
the stigmatised individual to hide the mark
when possible (Goffman 1963).
4. Definitions
• Culture:- It is defined as a set of
meanings, norms, beliefs, values, and
behaviour patterns shared by a group of
people.
• Transcultural Psychiatry:- It is a branch
of psychiatry concerned with the cultural
context of mental disorders and the
challenges of addressing ethnic diversity
in psychiatric services.
5. Definitions
• Synonyms - Cross-Cultural psychiatry, Ethnopsychiatry,
Comparative & Cultural psychiatry.
• Emic – Etic:- Terms used by anthropologists to refer to
different kinds of data concerning human behaviour.
– Emic / Inside view: - Behaviour described as seen
from the perspective of cultural insiders, in constructs
drawn from their self-understanding.
– Etic / Outside view: - Behaviour described from a
vantage external to the culture, in constructs that
apply equally well to other cultures.
6. Definitions
• Culture Bound Syndromes:- forms of
psychopathology produced by certain
systems of implicit values, social
structures and obviously shared beliefs
indigenous to certain areas (Yap 1985).
• e.g., dhat syndrome, koro, latah,
pibloktoq, witiko psychosis, voodoo etc,
7. Why Transcultural psychiatry
important???
• Boundaries between normality and pathology vary
across cultures.
• Thresholds of tolerance for specific symptoms or
behaviours differ across cultures.
• A given behaviour is abnormal or not and whether
it requires clinical attention depends on cultural
norms.
• Awareness of the significance of culture may
correct mistaken interpretations of
psychopathology.
• Culture contributes to vulnerability and
suffering.
8. Why Transcultural psychiatry
important???
• Cultural meanings, habits, and traditions
contribute to either stigma or support.
• It provides coping strategies and suggest help
seeking options.
• Influences acceptance or rejection of a diagnosis
and adherence to treatments.
• Cultural differences between the clinician and
patient have implications for the accuracy and
acceptance of diagnosis as well as for treatment
decisions and clinical outcomes.
9. History
• 19th century- alienists believed that
insanity is rare among ‘primitive’ people
and more prevalent as civilization
evolves.
• Alienists also believed that insanity
could be reaching alarming levels in
large European cities.
10. History
He thought that high
frequency of insanity could
be due to– disordered life,
– abuse of alcoholic
beverages,
– consanguine marriages,
– social disturbances,
– revolutions,
– abrupt changes of habits,
– customs and values.
Esquirol
11. History
• Believed that railways and
modern ships help man to deal
with difficulties of life →thus
protect from the risk of
becoming insane.
• Hard life, excessive labour,
discipline, and rigid and
authoritarian education →
shield from mental illness.
• Attributed the increase in
insanity to self-indulgence,
sexual excesses and the lack
of sacrifice.
Maudslay
12. History
• In 1843, published
first study on mental
illnesses among
‘exotic people’ based
on visits to eastern
Mediterranean area.
Moreau de Tours
13. History
• Winslow was the
superintendent of a
psychiatric
sanatorium in Bengal.
• In 1853, he
summarized the
ethno psychiatric
observations.
Winslow
14. History
• Colonialism was
accompanied by the growing
interest in special mental
illnesses among the native
people.
• Alienists noticed contrasts
b/w patients seen there
and those previously seen in
Europe.
• Lead to identification of
Culture bound syndromes.
15. Nosology- ICD 10
• Culture bound syndromes included under
“Other Specified Neurotic Disorders”
(F48.8) in “Neurotic, Stress related and
Somatoform Disorders” (F40 – F48).
• This label lacks descriptive and
explanatory power.
• It does not make differences related to
the characterization and diagnosis in
different cultures or ethnic groups.
16. Nosology- DSM IV TR
• Culture Bound Syndromes are mentioned in
a glossary in Appendix I.
• It provides a cultural formulation to
supplement the multi axial diagnostic
assessment.
• Cultural formulation provides an
opportunity to describe the individual’s
cultural and social reference group and
ways in which the cultural context is
relevant to clinical care.
17. Nosology- DSM 5
• Assessment by using the Cultural Formulation
Interview (CFI)- gives impact of culture.
• Includes– Cultural identity of the individual,
– Cultural conceptualization of distress,
– Psychosocial stressors and cultural features of
vulnerability and resilience,
– Cultural relationship between the individual and
the clinician and
– Overall cultural assessment.
18. Social factors and mental
illness
•
•
•
•
•
•
•
•
Social class
Sex
Domicile
Marriage
Family
Religion
Age
Migration
19. Social class
• Various studies find a definite inverse relation
between social class and psychiatric patient.
• Numerous explanations have been
postulated like
–
–
–
–
–
Greater genetic predisposition.
Social stress hypothesis.
Social selection hypothesis.
Differential tolerance hypothesis.
Small city hypothesis.
20. Social class
• Social class hypothesis- there is a greater
stress as a result of living in poverty.
• Social selection hypothesis- has “drift” &
“residue” hypothesis
– Drift hypothesis- mentally ill person tend to drift
downwards in society where social demands ae
less.
– Residue hypothesis- mentally healthy individuals
in lower class tend to move upward in class,
leaving behind residue of mentally ill persons.
21. Social class
• Differential tolerance hypothesis- various
communities have different levels of
tolerance for schizophrenia. Many pts
therefore move into areas that are more
tolerant towards behaviour.
• Small city hypothesis- In small cities there
is less social isolation & everybody knows
everybody.
22. Social class
• In India, Nandi et al found results
contrasting to west.
• They found people in higher class had the
highest risk of developing mental illness.
• Thus our social class is not strictly
comparable with the west.
• In absence of suitable system to classify
class, relation between Social class and
mental illness cannot be established.
23. Sex
• No consistent sex difference in
schizophrenia.
• Affective disorders, anxiety disorders and
primary degenerative dementia is mc in
females.
• Personality disorders and substance abuse
disorders mc in males.
• Younger boys have higher morbidity than
girls until they reach puberty, after
adolescence girls show higher rates of
morbidity.
24. Sex
• Research shows that adult women are more
predisposed to anxiety and depression
whether at home or at work.
• As house wife, women are isolated from
outside and exposed to unstructured
household work.
• As working women, they are faced with
disadvantage of salaries, promotions and
family aspirations v/s professional interests.
25. Sex
• In India, again morbidity is higher in
women.
• Reasons could be due to
– Lack of education,
– Superstitious beliefs,
– Social stigma,
– Matrimonial placement,
– Inequality with males,
– Orthodox families.
26. Domicile
• Urban areas have higher morbidity.
• Schizophrenia, anxiety and personality
disorders are mc in urban areas.
• Manic depressive mc in rural areas.
• In India, Nandi et al found that mental
illness is unrelated to urban or rural areas.
• They postulated that community having
high level of aspiration show higher stress
dependent mental disorders.
27. Marriage
• Married persons have better mental health
than unmarried people.
• But some contrasting studies in India,
where higher morbidity in married when
compared to single.
• Reasons could be early pregnancy,
responsibility of rearing children and
multiple chorus.
28. Family
• Families are the primary transmitters of
the cultural patterns from one generation
to the other.
• Greater vulnerability is observed in
nuclear family than joint family.
• Elder sibling is more privileged in regard to
inheritance, but at the same time has to
go through stress due to responsibilities of
the family.
29. Religion
• Different religions again cause barriers,
with non integration of people with
different faiths.
• In India, kapur et al did a study in kota
which found
– Brahmins with lower case rates than bants
and mogers.
• However there were other factors like
socioeconomic and educational status.
30. Age
• In west, age does not show consistent
relationship morbidity.
• In India, there is increase in morbidity after 30
and decrease after 50yrs.
• Various reasons implicated are–
–
–
–
Shorter life span,
Physical problems are more common,
Joint family and
Old age symptoms may be considered as normal
for the age.
31. Migration
• Mental health of immigrants has been a
concern to governments.
• Previously when no legal restriction was
there on migration in US, ratio of mental
illness was higher in immigrants than the
natives.
• Kaila et al concluded that overseas
migration is associated with greater risk of
mental illness than internal migration.
32. Migration
• Srole et al concluded that low status and
poverty are responsible for poor mental
health of immigrants.
• Murphy postulated reasons for relation
between migration and mental illness
– Persons with incipient mental illness, unable to
cope in their homeland migrate.
– Hardships of migration precipitate mental illness.
– Contributes with other factors to the increase.
34. Patho-genic effects
Cultural beliefs, values, traditions and
norms are seen to have direct effect.
– e.g., dhat syndrome, koro, frigophobia.
Culture
STRESS
PSYCHO
PATHOLOGY
35. Patho-selective effects
Through enculturation & socialization some
individual members of a given society select
culturally influenced reaction patterns, which
may be pathological.
– amok, family suicide.
********
Culture
STRESS
* *
********
* ***** *
Selected people in society
PSYCHO
PATHOLOGY
36. Patho-plastic effect
Manifestations of symptoms are highly
influenced by the culture settings of the
society in question.
– pibloktoq, brain fag
DELUSION
ADUITORY HALLUCINATION
OBSESSION
PHOBIAS
CULTURE
President of US
is more popular
Delusion of grandiosity
I am President of US
37. Patho-elaborating effects
Situations where the cultural context
exaggerates behaviours which otherwise
are normal.
– e.g., latah.
CULTURE
Behavior Reinforcement
Response to Startle
Cultural acceptance
Behavior
38. Patho-facilitative effects
Culture influences the frequency at which
a particular problem occurs.
– e.g., drunkenness, anorexia.
#$%^&*@+$#@%^*+$
^&*U#@*+%
Cultural facilitation for ‘+’
#$%^&*@+$#@%^*+$
^&*U#@*+%
+++++++++
+++++++++
Media facilitation
Global prevalence
Prevalence in facilitated society
39. Patho-reactive effects
How society and individuals react to
psychopathology, and thereby affect the
expression, course and outcome of
psychopathology.
Culture
Psychopathology
Course & Outcome
41. Alcoholism
• Drinking practices and the definition of what
constitutes normal drinking vary.
• Substantial differences in these definitions
and practices exist within country based on
ethnic & culture.
• Clinicians & Public health officials attempting
to develop effective prevention and
treatment approaches must consider the
population’s attitudes and expectations.
42. Alcoholism- India
• Differ considerably b/n southern &
northern areas, of different castes.
• Not considered as central to normal
social life.
• In certain tribal groups considered as a
gift to mankind.
• Religion also plays an important role, like
Muslims, Buddhists and Jains are
strictly prohibited.
43. Alcoholism- India
• Among Hindus, Brahmins and other Upper
caste are forbidden from drinking.
• Caste groups who are meat eaters are
permitted to drink.
• Drinking among females is infrequent in
India, except in particular festival seasons.
• But trend is changing with urbanization &
globalization.
44. Schizophrenia
• Epidemiological studies show more
prevalence in societies that had greater
exposure to western influences.
• This suggests that “as civilisation makes
in roads, schizophrenia follows in its
footsteps”.
• Lowest rates:- Taiwanese (0.9/1000).
• Highest rates:- developed country
Sweden (9.5/1000).
45. IPSS
• In this 9 field centers in 9 countries
were selected.
• Mc- paranoid > schizoaffective subtype.
• WHO researchers concluded from
study that there were “clear
differences in the course and outcome
of schizophrenia, with pts in developing
countries having better outcomes than
those in the developed countries”.
46. Schizophrenia
• Social and emotional withdrawal, auditory
hallucinations, general delusions and
flatness of affect- in all samples.
• Delusions of destructiveness and religious
nature- frequent among Christians and
Muslims.
• Delusions of jealousy- mc Asians.
• Social hallucinations- mc in africans and
north east.
47. Schizophrenia
• Depersonalisation- mc in urban patients.
• Delusions of Grandeur- mc in rural
patients.
• FTD and flatness of affect- higher in
illiterates.
• Paranoid delusions- mc in literate.
• Hebephrenic / Catatonic types- mc in
non western countries.
48. Schizophrenia
• Paranoid type- mc in Western countries.
• In India, Catatonic rigidity, Negativism
and stereotypy are more common.
• In Africa, patients are quieter,
displaying deterioration such as blunting
of affect/ bizarreness of behaviour.
• In Japan, more ideas of reference,
disturbance of thinking, apathy, social
isolation and loss of interest.
49. Schizophrenia
• In America- greater disruption of reality
testing, hallucinations and bizarre ideas.
• In Italy- more hostile, acting out, elation
and bizarre mannerisms. No feelings of
sin/ guilt.
• In Irish- more preoccupation with guilt
concerning sexuality.
• Variations in symptomatology are
attributed to various factors.
50. Mood Disorders
• US Epidemiological Catchment Area
(ECA) study- BPAD equally prevalent
among different ethno racial groups in
US when other demographic
differences were controlled.
• WHO Collaborative study- found
Sadness, Joylessness, Anxiety, Tension
and Lack of energy were the most
common symptoms.
51. Mood Disorders
• In Eastern culture- higher frequency of
Somatic symptoms.
• In India, the symptoms which are
prominent are Chest, Musculo Skeletal,
GIT and Sexual symptoms.
• In Asian countries, guilt feelings are
less when compared to in many Western
countries.
52. Mood Disorders
• In Africa, frequent clinical
presentations of mania than depression.
• In Afro-Caribbean, more of mood
incongruent symptoms → over diagnosis
of schizophrenia.
• Psychomotor agitation and decreased
need for sleep could be considered free
from any cultural influence.
53. Mood Disorders
• Grandiosity and excessive involvement in
activities- masked/superimposed on
certain cultural behaviours.
• Chinese Classification of Mental
Disorders opted for maintaining the
diagnostic category “unipolar mania”,
considering it valid in Chinese patients.
• Similar picture was found in patients
belonging to the Yoruba tribe in Nigeria.
54. Somatoform disorders
• Previously, somatization was believed to
be more common among patients nonWestern cultures.
• WHO collaborative study- similar
pattern of association between Western
and non-Western countries
• This indicates that cultural factors
influence subsequent illness behaviour.
55. Culture Bound Syndromes
• Def- These are mental conditions or
psychiatric syndromes whose
occurrence or manifestations are
closely related to cultural factors and
which thus warrant understanding and
management from a cultural
perspective.
• Recent suggestions to rename it as
“Culture Related Specific Syndromes”.
56. Culture Bound Syndromes
• Earliest described in journal was “amok”
by W. Gilmore Ellis in 1893.
• Later latah (1897), pibloktoq (1913),
witiko psychosis (1933), koro (1934), imu
syndrome (1938), dhat syndrome (1940)
etc.
• In 1969, Yap coined the term CBS.
57. Culture Bound Syndromes
• Both ICD 10 and DSM 5 do not include a
diagnostic section, but CCMD 2 R includes
Koro, Qigong induced mental disorder and
Superstition & Witchcraft induced mental
disorder.
• Different categorizes for classification
proposed are– cardinal symptoms (Yap),
– taxons (Charles C Hughes)
– relationship to culture (Tseng & McDermott).
59. Dhat syndrome
• ‘Dhat’ gets its origin from the Sanskrit
word ‘Dhatus’.
• In Susruta Samhita, it means “elixir that
constitutes the body”.
• In Charaka samhita, disorder of Dhatus
have been described as “Shukrameha” in
which there is a passage of semen in the
urine.
• First described in western literature by
NN Wig.
60. Dhat syndrome
• It is more prevalent in the India.
• It showed global presence
– China (Shen K'uei),
– Sri Lanka (Prameha) and
– other parts of South East Asia (Jiryan)
• Malhotra and Wig called ‘Dhat’ ‘a sexual
neurosis of the Orient’.
• In China, Shen-K'uei has been associated with
epidemics of Koro.
62. Symptoms
• Vague somatic symptoms due to semen
loss.
• Semen loss via nocturnal emissions,
urine and masturbation.
• Weakness (70.8%), fatigue (68.7%),
palpitations (68.7%), sleeplessness
(62.4%), anxiety, loss of appetite and
guilt.
63. Clinical profile
•
•
•
•
•
Age range - 20-38 years.
Age of onset- 16-24 years.
Marital status- unmarried (54.2%).
Education- 5th class or above (79.1%).
Patients divided into three categories– Dhat alone.
– Dhat with comorbid depression & anxiety.
– Dhat with sexual dysfunction.
65. Treatment
• Wig suggested
–
–
–
–
–
Emphathetic listening,
Non-confrontational approach,
Reassurance,
Correction of erroneous beliefs,
Use of placebo, anti-anxiety and
antidepressant drugs, wherever required.
• Good response- anti-anxiety and
antidepressant drugs as compared to
psychotherapy.
66. Possession Syndrome
• Diagnosable under Dissociative
disorders.
• Person is possessed usually by
‘spirit/soul’ of deceased relative or a
local deity.
• Speaks in changed tone, sometimes in
opposite sex tone.
• Usually seen in rural areas or in
migrants from rural areas.
67. Possession Syndrome
• In religious shrines during special annual
festivals where people get possessed
simultaneously.
• Majority are females who otherwise
don’t have any outlet to express their
emotions.
• Treatment- careful exploration of
underlying stress which precipitated
the possession attack.
68. Koro
• Koro- Malay word meaning “the head of
a turtle”.
• Reported primarily among the Chinese
of southern coastal china.
• In India it is seen in Northeast states
like Assam.
• There is fear of retraction of genital
organs.
69. Koro
psychosexual problems
•lack of masculine relations,
•lack of heterosexual relations,
•misconceptions about sexual practices
•existence of castration anxiety
Sudden & intense anxiety that penis or vulva or nipples will retract into body
This belief will lead to panic reaction
70. koro
• Sociocultural and community factors >
Individual psychopathology.
• It occurs as an epidemic in a particular
group.
• Strong belief that ghosts are involved
and driving away of ghosts would lead to
removal of the disease.
71. Secondary Koro…!!!
• Emergence of cases in association with
drugs.
• Common drug associated is Cannabis.
• Precipitated by withdrawal from drugs
like Heroin, Buprenorphine.
• Amphetamine, Imipramine, Ludiomil and
l-dopa consumption have preceded
symptoms.
72. Bhanmati Sorcery
• Seen in South India.
• It is believed to be due to psychiatric
illness i.e. conversion disorders,
somatization disorders, anxiety
disorder, dysthymia, schizophrenia etc.
• Nosological status unclear.
73. Suudu
• Syndrome of painful urination and pelvic
“heat” familiar in south India.
• Occurs both in males and females.
• Attributed to an increase in the “inner
heat” of the body often due to
dehydration.
• Treated by local practices like applying
sesame oil, having oil massage and intake
of fenugreek.
74. Gilhari Syndrome
• Characterised by patient complaining of
small swelling on the body changing its
position from time to time as if a gilhari
(squirrel) is travelling in the body.
• Not much literature available.
• Nosological status is not clear.
75. Ascetic Syndrome
• First described by Neki (1972).
• Appears in adolescents and young
adults.
• Characterised by social withdrawal,
severe sexual abstinence, practice of
religious austerities, lack of concern
with physical appearance and
considerable loss of weight.
76. Mass Hysteria
• Short lasting epidemics where hundreds
to thousands of people believe and
behave in a manner in which ordinarily
they won’t.
• Choudhary et al (1993) reported an
epidemic of atypical hysteria in a tribal
village of the State of Tripura India.
• Twelve persons were affected in a chain
reaction within a span of ten days.
77. Mass Hysteria
• Cardinal feature was an episodic trance
state of 5 to 15 min.
• It was associated with restlessness,
attempts at self-injury, running away,
inappropriate behaviour, inability to
identify family members, refusal of food
and intermittent mimicking of animal
sounds.
• Self-limiting and showed an individual
course of one to three days duration.
78. Culture bound suicide
• Sati: self-immolation by a widow on her
husband’s pyre.
• Named based on Hindu mythology.
• Seen mostly in Upper Castes notably
Brahmins and Kshatriyas.
• Banned in India since 19th century by
Raja Ram Mohan Roy.
79. Culture bound suicide
• Jouhar: Suicide committed by a woman
even before the death of her Husband
when faced by prospect of dishonour
from another man.
• Santhara/Sallekhana: Voluntarily giving
up life by fasting unto death over a
period of time for religious reasons to
attain God/ Moksha.
80. Honour Killings
• It is murder of a member of a family or
social group by other members, due to
the belief that the victim has brought
dishonour upon the family or community.
• Seen in Muslims, Sikhs, and Hindus.
• Rights are collective, not individual.
• Family, clan, and tribal rights supplant
individual human rights.
81. Why Culture Bound
Syndromes difficult to
classify?
• Classification of CBS into diagnostic
categories is based on a perception of
their predominant symptoms.
• But identifying predominance of
symptoms itself is problematic.
• For e.g., koro, Initially as a somatoform
disorder on the basis of the perception .
Recently as an anxiety disorder.
82. Food for thought…
• How do we characterize the culture bound
syndrome within its cultural context?
• What are the defining features of the
phenomenon?
• Who are the people who experience
culture-bound syndromes and what is their
social structural location?
• What situational factors provoke these
syndromes?
• So on…???
83. References
•
•
•
•
•
•
•
•
•
•
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