RxPG - Mental Disorders - An Introduction

What is Mental Illness ?

It is the Disorder of Mind:

Triad of Mind Cognition (or) Behaviour,Emotion, Conation or thought

The Character of Medical Illness :

1. Person’s behaviour is causing distress & suffering to the Individual or Others.
2. Abnormal changes in one’s thinking, feeling, memory, perceptions and judgment à Change in talk & behaviour.
3. Abnormal behaviour cum disturbance in person’s day to day activity, job and Interpersonal relationship.

“A person who is sad, bad or odd can be considered as mad, if these qualities cause problems to him & to others.”

Signs & symptoms of Mental Illness

Sudden onset
Onset
Gradual progressive

Mild
Cl. future
Very severe

I. General Behaviour
1. Sleep disturbance – Insomnia

2. Loss of appetite refusal of food
a. intrest depression
b. appetite
c. time Mania
d. Refuse to eat à paranoid

3. Personal appearance
- Neglected, poor self care - schizophrenia
- Neatly & colourful - mania
- Appear seductive – Hysteria

4. Sex :
- feel & lost their libido

5. Personel Relationship
- Hostile, Angry
- Withdrawn & aloof
- Excited & unnecessary interferes

6. Interest in work hobbies & surrounding
- May decline

7. Behaviour
- Peculiarly, Irritate others, dangerous to himself, overactive, restless,

8. Disturbance in thinking
- evident from his talk.
- Excessive talk, Irrelevant talk, meaningless, Incoherent talk, thought block, thought Insertion, thought withdrawal, thought broadcasting.
- Disorder of content of thought (Delusions)
Delusion à false fixed Belief
Character
1. Person convinced about a particular belief.
2. Cannot be corrected by reason or logic.
3. Not shared by members & same community

Primary à arises from own
Delusion
Secondary à part of Psychiatric symptoms

Types

- Paranoid Delusion
- Delusion of grandiose
- Delusion of Jealousy or infidelity
- Delusion of Control (Passivity phenomenon)
- Hypochondriacal Delusion
- Nihilistic Delusion

II. Ideas of Reference
- People around talk about him and make fun of him.

III. Disturbance of Perception

1. Illusion
à Misinterpretation (False perception of a real sensory stimulus.
2. Hallucination
- False perception which occurs without an external stimulus
- Auditory, Visual, Olfactory, Gustatory and Tactile
- Normal à Hyponogagic & hypnopompic

IV Disturbance of memory
- Due to Lack of Interest, Agitation or Poor Registration.
Amnesia : lack of memory for certain period of person walking life. HI, post ECI, Epilepsy.

Dysamnesia or Paramnesia
- damage to hippocampus & mammillary bodies
- Confabulation à Alcoholic, Encephalitis.
- filling up – memory gap.

Organic memory impairment
-Dementia

V Consciousness
- Awarness of surroundings

confusion

Disorientation

VI. Disturbance of Affect or Mood
- Mood – Internal Emotional state of an Individual
- Affect – External expression of Emotional Context
- Elation, Depression, Anxiety, Inappropriate affect, Apathy, Incongruous affect.

VII. Distrubances Motor Activities.
Catalepsy à Immobile position that is constantly maintained.
Waxy Flexibility à person can be moulded into a position which is then maintained.
Negativism à Motiveless resistance
Stupor à Lack of reaction & unawareness of surroundings.
Echoprasia à Pathological imitate of movements of one person by another.
Posturing à Voluntary assumption of bizarre & maintaining it for long periods of time.

Abnormality

- Away from Normal
- Statistically infrequent
- It is not according to the Society’s Standard or expectation.
- Maladaptive
- produce personal distress
- legally à not to judge – right or wrong.

Biological Factors
Psychological Factors
Social Factors

1. Biological Factors

- Genetic (Hereditary)
– Twin studios
- Biochemical
– Neuro-transmitters – Dopamive, Serotomia, Acelzlchibica, Noepinepha, Epi*** -etc
- Brain Damage
- Infection, Injury, Intoxication, Tumours

2. Psychological Factors à Personality & Temperament

- Early upbringing
- Conflicts

3. Social Factors

- Loss
- Psychosocial Stress
- Adversity
- Poverty
- Migration
- Unemployment
- Urbanisation

General Classification of Mental Disorders

Normal Classification

According to ICD or DSM

1. Organic Mental Disorder
- Delirium
- Dementia

2. Functional (non-organic) Mental Disorders
a. Psychotic Disorders
- Schizophrenia
- Mood Disorder
- Delusional Disorder

b. Neurotic Disorders
- Anxiety Disorder
- Phobic Disorder
- Obsessive Compulsive Disorder
- Hysteria
- Hypochondriasis

3. Personality Disorders
4. Psychosexual Disorders
5. Stress related Disorders
- Acute Stress Reaction
- Post Traumatic Stress Disorder
- Adjustment Disorder

6. Mental Disorders due to Psychoactive Substance Abuse
- Alcohol Dependence
- Other drugs Dependence

7. Psychosomatic Disorders
8. Child Psychiatric Disorders
- Autism
- Developmental disorders
- Mental Retardation
- Attention Defecit Disorders
- Emotional Disorders
- Habit Disorders

9. Other Disorders
- Eating Disorder
- Sleep Disorder
- Disorders of Memory
- Epilepsy & Psychiatric
- Psychiatric Disturbances in Women
- Psychiatric Disturbances in Adolescence
- Psychiatric Disturbances in Old Age