M. I. Pyrogov Vinnitsa National Medical University Chair of Psychiatry and Addictology icon

M. I. Pyrogov Vinnitsa National Medical University Chair of Psychiatry and Addictology




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M.I. Pyrogov Vinnitsa National Medical University

Chair of Psychiatry and Addictology


GENERAL CHARACTERISTIC OF ORGANIC AND SYMPTOMATIC MENTAL DISORDERS.

MENTAL DISORDERS DURING INFECTIOUS DISEASES

AND BRAIN INJURES.

ECOLOGICAL PSYCHIATRY.


Abstracts of lecture


Lecturer: Associated Professor, PhD Teklyuk S.V.


Vinnytsya 2009 y.

Plan of the lecture

  1. GENERAL CHARACTERISTIC OF ORGANIC AND SYMPTOMATIC MENTAL DISORDERS.

    1. Associations Between Physical and Psychiatric Disorder.

    2. Psychiatric Consequences of Physical Illness.

    3. Determinants of Psychiatric Consequences by Physical Illness.

    4. Psychiatric Assessment of a Physically Ill Patient.

  1. MENTAL DISORDERS DURING INFECTIOUS DISEASES AND BRAIN INJURES.

  1. Mental disorders during infectious diseases

      1. General characteristic of mental disorders during infectious diseases.

      2. Acute exogenous reactions due to infectious diseases.

      3. Сlinical courses of mental disturbances in infectious diseases.

      4. Spe­cific features of mental disturbances in certain infectious diseases:

    • mental disorders in streptococcal infection;

    • mental disorders in scarlet fever;

    • mental disorders in flu;

    • mental disorders in AIDS;

    • mental disorders in syphilis.

  1. Mental disorders due to brain injures.

  1. Classification of the traumatic brain injuries.

  2. General characteristic of mental disorders due to brain injures.

  3. Characteristic of mental disorders according to stages clinical course of TBI:

    • the acute or primary stage;

    • the sub-acute or secondary stage;

    • reconvalescence stage;

    • the stage of remote after-effects (or residual stage).

  1. The treatment.

  2. The prophylaxis.

  1. ^ ECOLOGICAL PSYCHIATRY.

  1. Classification of environmental factors able to cause specific and nonspecific mental disorders.

  2. Classification of mental disorders caused by intoxication.

  3. Mental syndromes in acute intoxications.

  1. Mental disorders in drug-induced intoxications.

  2. Mental disorders in food poisonings.

  3. Mental disorders in occupational and domestic poisonings.

  4. Treatment

  5. Prophylaxis.

  1. Postradiation mental disorders.


List of recommended literature

Basic literature.

  1. Concise Oxford Textbook of Psychiatry. M. Gelder, D. Gath, R.Mayou. – Oxford; New York; Tokyo; Oxford University Press, 2007. – 953 p.

  2. Modern Synopsis of Psychiatry. A.M. Freedman, H.I. Kaplan, B.J. Sadock. – USA, 1982. – 433 p.

  3. Psychiatric Dictionary / 5th ed. R.J. Campbell. – Oxford; New York; Oxford University Press, – 1981. – 693 p.

  4. Psychopatology and addictive Disorders / Ed. By Meyer. - New York; London, 1986. – 283 p.

  5. Psychiatry: course of lecture /Ed.by V.S. Bitensky. – Odessa, 2005. – 336 p.

  6. Zimbardo Ph.G. Psychology and Life. - USA, 19991. – 189 p.


Additional literature.


  1. Brundtland G.H. Mental health in the 21st century // Bulletin of the World Helth Organization. – 2000. - №87. – Р. 411.

  2. Desjarlais R., Eisenberg L., Good B. et al. World Mental Health: Problems and Priorities in Low-Income Countries. – New York: Oxford University Press, 1995. – 144 p.

  3. Marsella A., Kleinman A., Good B. Cross-cultural studies of depressive disorders. An overview. Culture and depression. – Berkley: University of California Press, 1985. – 213 p.

  4. Mulrow C.D., Williams J.W. Jr., Trivedi M., et al. Treatment of depression: newer pharmacotherapies. Rockville, MD: Agency for Health Care Policy and Research, 1999. – 253 р.

  5. Murray C.J.L., Lopez A.D. The global burden of disease: a comprehensive assessment of mortality and disability from disease, injuries and risk factors in 1990 and projected to 2020. Cambridge, MA: Harvard University Press, 1996. – 68 p.

  6. Kielholz P. Masked Depression. — Berne, 1973. – 97 p.

  7. Lopez-Ibor J. J. The Present Status of Psychotropic Drugs / Ed. by A. Cerletti, F. J. Bove. - New York, 1999. - 519 p

  8. Preskorn, S.H. Outpatient management of depression: A guide for the Primary-care practitioner/ S.H. Preskorn. - Wichita; Kansas: Professional Communications,Inc., 1994. - 147 p.

  9. Ustun T.B., Sartorius N. Mental Illness in General Health Care. An International Study. – Chichester: John Willey @ Sons Ltd, 1995. – 336 p.


^ I. GENERAL CHARACTERISTIC OF ORGANIC AND SYMPTOMATIC MENTAL DISORDERS.

Physical symptoms and psychiatric disorder commonly occur together both in patients who consult general practitioners, and in patients referred to all specialists in all branches of medicine and surgery. This association arises partly because psychiatric disor­ders can present with physical symptoms (for example an anxiety disorder with palpitations), partly because physical illness can pro­voke a psychological reaction (for example heart disease provok­ing anxiety), and partly through chance association.

In the care of every patient, attention must be given to the ef­fects of physical illness on psychological and social functioning. It is particularly important to identify the sizeable minority of pa­tients who develop psychiatric disorders during physical illness. There are three reasons why these psychiatric disorders should not be missed:

  • a severe psychiatric disorder is likely to need immediate treat­ment, particularly if there is a risk of suicide or violence;

  • a moderately severe psychiatric disorder, if left untreated, can delay recovery from physical illness;

— a mild psychiatric disorder causes suffering which could be alleviated.

Mild and moderately severe mental disorders can usually be treated by the doctor who is treating the physical illness. For se­vere disorders and those that are less severe but persistent, treat­ment by a psychiatrist is likely to be required. Also an advice of a psychiatrist can be valuable in the differential diagnosis of medically unexplained somatic symptoms that may have psychologi­cal causes.
^

Associations Between Physical and Psychiatric Disorder:


  • Psychological factors as causes of physical illness

  • Psychiatric disorders presenting with physical symptoms

  • Psychiatric and physical disorder occurring together by chance

  • Psychiatric consequences of physical illness:

Organic disorders

Functional disorders (depression, anxiety)

  • Other associations:

Deliberate self-harm

Alcohol and other substance abuse

Eating disorders

1. Psychological factors as causes of physical illness. Psycho­logical factors may cause psychosomatic disorders — physical ill­nesses which develop as the result of acute or chronic stress. The psychosomatic approach in medicine proceeds from the belief that mind and body are tightly connected, and every significant change in the state of mind (like intensive affect) causes bodily changes through the influence of the autonomous nervous system. Nor­mal functioning implies that the organism is able to make ade­quate adjustment to the short- and long-term demands of its en­vironment and is therefore able to carry on without prolonged somatic or mental distress. When, however, environmental pres­sures or internal resources are such that adaptation cannot be maintained without disorganisation of behaviour, the organism will react to the pressures or stresses by developing a neurotic, psychotic or psychosomatic reaction. Which manner of response will be favoured depends on a great many factors, constitutional as well as environmental.

A psychosomatic breakdown implies that appropriate action (corresponding to the emotion) is either impossible, or the discharge of excitation is inadequate, and the excess floods the central nerv­ous system or the vegetative system. Because adequate discharge is impossible, the organ system remains chronically innervated, "excited." If this condition persists long enough, or if there is some constitutional weakness in the organ system, a somatic breakdown occurs and new adjustments must ensue.

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