Upload
pk-doctors
View
6.009
Download
3
Embed Size (px)
Citation preview
Prof. Dr. Haroon Rashid ChaudhryDPP (UK), FACHARZT (PSYCH. & NEUROLOGY) FACP (USA) MRCPsych (London)
FRCP (Ireland)
Head of the Department of Psychiatry Fatima Jinnah Medical College Zonal Representative
World Psychiatric Association (WPA)(Western & Central Asia)
Honorary Executive Director Fountain House, Lahore
INTRODUCTION TO PSYCHIATRY
WHAT IS HEALTH?
World Health Organization's Definition
“A state of complete physical, mental, social and spiritual well being and not merely the absence of disease or infirmity”
WHAT IS MENTAL HEALTH?
DIVERSE OPINIONS EXIST
The most acceptable concept now –a – days
A person who is:
Able to to cope/function normally
Meets the responsibilities
Expresses balanced attitude towards
day to day challenges/ problems
MENTAL HEALTH IN THE WORLD
MORE THAN TWO FIFTHS OF THE TOTAL DISABILITIES
ARE DUE TO MENTAL ILLNESSES
(WORLD HEALTH REPORT, 2001)
MENTAL HEALTH IN THE WORLD
EXISTING DATA SUGGESTS:
Schizophrenia (above the age of 18): 45million
Depression: 340millionBoth disorders cause 60% Suicide across the globe.
(Desjarlais R et al 1995 WORLD HEALTH REPORT, 2001)
MENTAL HEALTH IN THE WORLD
Mental Retardation 4.6% (total psychiatric diagnoses)
Alcohol Dependence 140 million
(Nations for Mental Health, WHO, 2001)
MENTAL HEALTH IN THE WORLD
Alzheimer’s disease: 11 million
Epilepsy: 45 million
(Murray L and Lopez A 1996)
DISEASES IN 2020
Ischaemic Heart Disease Depression Road Traffic Accident Cerebrovascular Diseases Chest Diseases
(Murray L. And Lopez A., 1996)
MYTHS Violent Aggressive Irrational Untreatable Unreliable Dependent Chronic
PREJUDICE
Every Patient Deserves a Clinician
And a Healer who is not Prejudiced
AETIOLOGY
Genetics
Biological Factors
Psychological Factors
Social Factors
Bio Psycho Social Model
Psychosocial Factors
GeneticsBiological Factors
GENETICS
Twins Studies
Family Studies
Adoptions Studies
Mode of Inheritance
Molecular Genetics
BIOCHEMICAL
Postmortem Studies
Brain Biochemistry & Imaging
Peripheral Measures
PSYCHOLOGICAL FACTORS
• Parental Deprivation
• Relationship with Parents
• Life Events
• Effect of Physical illness
• High Express Emotion
ANGER
QUARRELS
SPELLS OF CRYING
EMOTIONAL REACTIONSEVERY DAY OCCURANCE IN SOCIETY
SOCIAL FACTORS
• Place of Residence
• Occupation and Social Class
• Culture
• Migration
• Social isolation
National Seminar on Post Earthquake Mental Health Activities
CLASSIFICATIONS
International Classification of Diseases (ICD-10)
The Diagnostic and Statistical Manual (DSM-IV)
ORGANIC MENTAL DISORDERS
Delirium
Dementia
Amnestic Disorders
Personality and Behavioural disorders due to brain disease damage and dysfunction
PSYCHIATRIC DISORDERS
• Psychotic Disorders
• Non Psychotic Disorders
• Personality Disorders
PSYCHIOTIC DISORDERS
• Schizophrenia
• Drug Induced Psychosis
• Schizoaffective
• Postnatal Psychosis
MOOD DISORDERS
• Bipolar Affective Disorder
• Major Depression
• Post Natal Depression
PERSONALITY DISORDERSCLUSTER A
• Paranoid Schizoid, Schizotypal
CLUSTER B
• Antisocial, Border line, histrionic, narcissistic
CLUSTER C
• Avoidant, Dependant, Obsessive Compulsive
ANXIETY DISORDERS
Generalized Anxiety Disorder
Panic Disorder
Phobic Disorders
Obsessive Compulsive Disorder
Post Traumatic Stress Disorder (PTSD)
Hypochondriacal Disorder
Substance Abuse Disorders Intoxication Abuse Dependence Withdrawal Psychotic Disorders Amnestics Disorders Mood Disorders Anxiety Disorders Sexual Dysfunctions Sleep Disorders
CLASSES OF SUBSTANCE ABUSE DRUGS
Alcohol Caffeine Opioids Inhalents Nicotine Cannabis Sedatives / Hypnotics Multiple Drugs Use
PSYCHIATRIC DISORDERS, WITH SOMATIC SYMPTOMS
Stress & Adjustment Disorders Mood Disorders Anxiety Disorders Somatoform Disorders
Dissociative / Conversion DisordersHypochondriacal syndromePsychogenic autononinc dysfunctionPain syndrome
AROUSAL RESPONSE
MALE Erectile impotence
Premature Ejaculation Retarded Ejaculation
FEMALE Lubrication Failure
Anorgasmia
SEXUAL DYSFUCNTIONS
PSYCHOSEXUAL DISORDERS
Gender identity Gender Role
Drive and Responsiveness
Sexual Preferences
Relationshipbehaviour
CHILDHOOD PSYCHIATRIC DISORDERS
• Problems of Preschool Children
• Specific Developmental Disorders
• Pervasive Developmental Disorders
CONTD…..
• Principal Psychiatric Disorders• Hyperkinetic Disorders
• Conduct Disorders
• Juvenile Delinquency
• Anxiety Disorders
• Somatization Disorders
• Depressive Disorders
• School Refusal
• Functional Enuresis • Stammering • Schizophrenia• Gender Identity Disorders• Child Abuse
– Physical – Sexual – Emotional
CONTD…..
SPECIFIC DEVELOPMENTAL DISORDERS
• Specific Reading Disorders
• Mathematical Learning Disorders
• Communication Disorders
CONTD…..
Types Of Mental Retardation
• Mild (IQ 50 - 70)
• Moderate (IQ 35 – 49)
• Severe (IQ 20 - 34)
• Profound (IQ below 20)
PHYSICAL DISORDERS AMONG THE MENTAL RETARDED
• Sensory Disorders
• Motor Disorders
• Epilepsy
• Incontinence
• Schizophrenia
• Mood Disorders
• Emotional Disorders
• Eating Disorders
• Personality Disorders
• Cognitive Psychiatric Disorders
• Behaviour Disorders
PSYCHIATRIC DISORDERS AMONG THE MENTAL RETARDED
EFFECTS OF MENTAL RETARDATION ON THE FAMILY
• Initially Shock
• Depression
• Guilt
• Shame
• Anger
• Inability to cope with practical and financial problems