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Ministry of Health of Ukraine

Bukovynian State Medical University


“Approved”

on the methodical meeting

of the Department of neurology, psychiatry

and medical psychology nm. S.M.Savenko

“____” ___________ 2009 (Report № __).

Chief of the Department

_______________________

Professor V.M. Pashkovsky


Methodical INSTRUCTION

for 4-th year students of medical faculty №2

(the speciality “medical affair”)

for independent work during preparing to practical class


Theme 3: General principles of treatment, rehabilitation and examination of mental diseases and disorders.


MODULE 1. GENERAL QUESTIONS OF PSYCHIATRY AND NARCOLOGY. GENERAL PSYCHOPATHOLOGY


Topical module 1. General questions of psychiatry and narcology


Сhernivtsi, 2009

^

1. Actuality Aim

The treatment of mental disorders may include the use of psychotherapy, psychiatric medication, case management, or other practices

2. Hours: 2



3. Teaching goal

The students must know:

  • Psychotherapy. The maintenance of concept.

  • Value of a psychotherapy at various diseases.

  • Kinds of a psychotherapy.

  • Psychiatric medication in treatment of mental desorders.

  • Electroconvulsive therapy.

  • Creative therapies.

  • Services for mentally ill.


and be able to:

  • objectively and scientifically determine the place and role of consciousness;

  • interpret conditions to create healthy psychological climate in the medical environment;

  • analyze psychological peculiarities of patients with various pathologies;

  • to determine the way of communication with patients with accentuated personality;

  • know methods of research of personality;

  • evaluate the results of experimental-psychological research of patient’s personality and attitude toward a disease.

Assimilate practical skills

  • analyze psychological peculiarities of patients with various accentuation;

  • communication with patients;

  • methods of research of attitude toward a disease;

  • experimental-psychological research of patient’s personality.


^ 4. List of disciplines necessary

for learning theme 1


Title of the discipline

Content of the discipline necessary for learning medical psychology

Anatomy

Brain construction

General psychology

Psychic functions of a normal person. Consciousness and self-consciousness. Psychology of personality.

Neuropsychology

Functions of different brain structures.

Normal physiology

Brain functions. Physiology of high nervous activity.



^ 5. Content of the theme


The treatment of mental disorders may include the use of psychotherapy, psychiatric medication, case management, or other practices.

A major option for many mental disorders is psychotherapy. Psychotherapy is an interpersonal intervention, usually provided by a mental health professional, that employs any of a range of specific psychological techniques. There are several main types. Cognitive behavioral therapy (CBT) is used for a wide variety of disorders, based on modifying the patterns of thought and behavior associated with a particular disorder. There are various kinds of CBT therapy, and offshoots such as Dialectical Behavior Therapy. Psychoanalysis, addressing underlying psychic conflicts and defenses, has been a dominant school of psychotherapy and is still in use. Systemic Therapy or Family therapy is sometimes used, addressing a network of relationships as well as an individual themselves. Some psychotherapies are based on a humanistic approach. Some therapies are for a specific disorder only, for example interpersonal and social rhythm therapy.

Mental health professionals often pick and choose techniques, employing an eclectic or integrative approach tailored to a particular disorder and individual. Much may depend on the therapeutic relationship, and there may be issues of trust, confidentiality and engagement.

Psychiatric medication is also widely used to treat mental disorders. These are licenced psychoactive drugs usually prescribed by a psychiatrist or family doctor. There are several main groups. Antidepressants are used for the treatment of clinical depression as well as often for anxiety and other disorders. Anxiolytics are used, generally shorter-term, for anxiety disorders and related problems such as insomnia. Mood stabilizers are used primarily in bipolar disorder, mainly targeting mania rather than depression. Antipsychotics are used for psychotic disorders, notably in schizophrenia. Stimulants are commonly used, notably for ADHD.

Despite the different conventional names of the drug groups, there can be considerable overlap in the kinds of disorders for which they are actually indicated. There may also be off-label use. There can be problems with adverse effects and adherence.

Electroconvulsive therapy ECT is sometimes used, for example in prolonged mood disorder unresponsive to other interventions. Psychosurgery, including Deep brain stimulation, is another available treatment for some disorders.

Creative therapies are sometimes used, including music therapy, art therapy or drama therapy.

Lifestyle adjustments and supportive measures are often used, including peer support, self-help and supported housing or employment. Some advocate dietary supplements. Many things have been found to help at least some people. A placebo effect may play a role.

Often an individual may engage in different treatment modalities and use various mental health services. These may be under case management (sometimes referred to as "service coordination"), use inpatient or day treatment, utilize a psychosocial rehabilitation program, and/or take part in an Assertive Community Treatment program.

Mental health services may be based in hospitals, clinics or the community.

Some approaches are based on a recovery model of mental disorder, and may focus on challenging stigma and social exclusion and creating empowerment and hope.


^ 5.2. Theoretical questions:

  1. Psychotherapy. The maintenance of concept.

  2. Value of a psychotherapy at various diseases.

  3. Kinds of a psychotherapy.

  4. Psychiatric medication in treatment of mental desorders.

  5. Electroconvulsive therapy.

  6. Creative therapies.

  7. Services for mentally ill.



^ 5.3. Practical training during the tutorial

1. Clinical observation of the behavior of the patient.

2. Clinical interview and plan of psychological research.


5.4. Materials for self-control

A. Questions for self-control:

  1. Psychotherapy. The maintenance of concept.

  2. Value of a psychotherapy at various diseases.

  3. Kinds of a psychotherapy.

  4. Psychiatric medication in treatment of mental desorders.

  5. Electroconvulsive therapy.

  6. Creative therapies.

  7. Services for mentally ill.



Literature

  1. Clinical Psychiatry from Synopsis of Psychiatry by H.I.Kaplan, B.J.Sadock. – New York: Williams @ Wilkins. – 1997.

  2. Psychiatry. Course of lectures. – Odessa: The Odessa State Medical University. – 2005. – 336 p.

  3. Lectures.

  4. Internet resource.

  5. Менделевич В.Д. Психиатрическая пропедевтика. – М.: Медицина, 1997.

  6. Морозов Т.В., Шумский Н.Г. Введение в клиническую психиатрию. – Н.Новгород: Изд-во НГМА, 1998.

  7. Попов Ю.В., Вид В.Д. Современная клиническая психиатрия. – М., 1997.

  8. Сонник Г.Т. Психіатрія: Підручник / Г.Т.Сонник, О.К.Напрєєнко, А.М.Скрипніков. – К.: Здоров’я, 2006.     



Prepared by assistant S.D.Savka


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