Ur Next Posting-psychiatry ?

[SUMAN-SAJAN]

Definition
Psychiatry is branch of medicine that deals with mental illness.

CAPACITES REQUIRED TO BE A GOOD PSYCHIATRIST
1.Collect data and organise them
2.Understanding of each problem
3.Rational management strategy


Mental Health
# adjustment to environment
# adaptation
# productivity

Pillars of Personality
Cognitive (thought)
conative (behaviour)
Affective (feeling)


Criteria required to determine the normal and abnormal behaviour
1. Statstiscal criteria
2. Social criteria

Mental illness
Collection of abnormal behaviour. Broadly divided into Psychosis and neurosis.
Psychosis
Include mania and schizophrenia

Neurosis
Include depression , anxiety , drug/alcohol taking behaviour and conversion disorder .

Difference between psychosis and neurosis
1.Insight is present in neurosis but absent in psychoses
2.Reality testing intact in neurosis but impaired in psychoses
3.Psychoses is more severe than neurosis
4.Psychotic cant perform day to day activity but neurotic can
5.subjective distress more in neurosis, distress to others more in neurosis

What is Insight ?
Degree of awareness.
patient's knowledge about the morbidity.


MOOD
Mood may be abnormal in three ways
1.Nature may be altered ;anxiety, depression, elation, anger
2.May fluctuate ;blunting, flattening , apathy
3.May be inconsistent

PERCEPTION
A process of deriving experiences from the sensory inputs provided by the sense organs.


HALLUCINATION
A perception without external stimulus , that is as real as normal percept , should occur when patient is conscious and not under voluntary control.

Commenest hallucination in psychiatry
Auditory

Classification of hallucination
1.According to complexity
Elementary
Complex

2.According to sensory modality
auditory
visual
gustatory
olfactory

3.According to special features
Auditory:
2nd person- feature of depression
3rd person- feature of schizophrenia

Visual
usually a feature of organic brain diseases


Differential diagnosis of hallucination
affective disorder
schizophrenia
organic disorder
dissociative states


DISORDERS OF THOUGHT
1.Abnormal thought
delusion
obsession

2.Disorder of stream
pressure: ex-mania
poverty ot thought ex: depression
thought block: ex schizophrenia

3.Disorder of form
perseveration - persistent and inappropriate repitition of same thought
flight of ideas - ex. mania
loosening of ideas - ex. schizophrenia

SCHIZOPHRENIA
1st rank symptoms of Schneider
1.Hallucination
thought echo
third person auditory hallucination
some body commenting on his work

2.Thought alienation
thought insertion
thought withdrawl
thought broadcast

3.Passivity phenomenon
made feelings
made act
made impulses
somatic passivity

4.Delusional perception


ANXIETY
Unpleasureable emotional state associated with psycho-physiological changes in response to a psychic conflict.

Types of anxiety
1.Generalised
anxiety is continuous

2. Phobic
anxiety is intermittent and arising in only particular circumstances

3.Panic
anxiety is intermittent but unrelated to particular circumstances

IN ANXIETY THERE IS ABSENCE OF ORGANIC BRAIN DISEASE.

TO BE CONTINUED ..................................

leTS PrAY foR RapId RecOvErY Of ThE paTieNtS In tHe PsyCHiATry WaRd

-SUMAN

[RAAZ]

Will be really helpful for anyone going on to psychiatry. These basic things are very much necessary to be known before you enter psychiatry or you won't understand a thing there.

[SPRimal]

really a gooooooooooooooooooooood work man,,,,,,,,,,

toooooooooooooooooooooooooooooo thanks to uuuuuuuu,

kp it up!!!!!!!!!!!!!

[SUMAN-SAJAN]

Ur Next Posting-psychiatry ?

Drugs frequently used :
Anxiolytics

SABBS
S-Sedative antihistamines ex: hydroxyzine
A-azapirones ex: buspirone
B-benzodiazepines ex: diazepam , oxazepam
B-beta blocker ex: propanolol
S-SSRIs ex: sertraline , citalopram


Mood stablisers OR anti-maniac

lithium
carbamazepine
sodium valproate
gabapentene
lamotrigine



Antidepressants
monoamine reuptake inhibitor

TCA
SSRI

monoamine oxidase inhibitor

phenelzine
tranykypromine
moclobemide

5-HT2 receptor antagonist

mirtazepine
nefazodone
trazodene


Antipsychotic

Typical

Phenothiazines
chlorpromazine
prochlorperazine
promazine
thioridazine


Thioxanthine
flupenthixol
clopenthixol

Butyrophenone
haloperidol
droperidol

Substituted benzamides
sulpiride
amisulpride


Atypical
risperidone
clozapine
olanzapine
zotepine
quetiapine
ziprasidone


ATYPICAL ANTIPSYCHOTIC HAS NO OR VERY LITTLE EXTRA-PYRAMIDAL SIDE EFFECTS.

EXTRA PYRAMIDAL SIDE EFFECTS
1. Acute dystonia
-torticollis
-tongue protusion
-grimacing
-opisthotonus

2. Akathisia
-motor restlessness

3. Parkinsonian symptoms
-akinesia
-expressionless face
-rigidity
-tremor
-stooped posture
-festinant gait

4. Tardive dyskinesia
-chewing and sucking movement
-grimacing
-choreo athetoid movement
-akathisia


leTS PrAY foR RapId RecOvErY Of ThE paTieNtS In tHe PsyCHiATry WaRd

Suman

[Khushboo]

Thanx a lot Suman as my next posting is Psychiatry and I m sure this would be a great help for my posting.