Psychiatry 3-4 Flashcards
Define neurasthenia
An ill-defined medical condition charcterised by fatigue, headache and irritability associated chiefly with emotional disturbance.
Explain Mr Smith’s neurasthenia story from Sydney 1891
Mr Smith enters 5 months of treatment. Doctors were under the impression that the body has a limited amount of energy it could use. Mr Smith was known to masturbate a lot, therefore the doctor said this was the cause for all his exhaustion. The doctor prescribed a better diet for Mr Smith and his treatment was a success.
Reasons given for neurasthenia?
- Nervous diathesis; limited supply of energy
- Neurasthenia occurs when the demands of the environment exceed the available energy of the individual; mis-match
- Irritations travel through the body because of reflex irriation
- Centres of reflex action: the brain, the digestive system and the reproductive system
Who got neurasthenia?
The best and brightest, highly cultured individuals and the most refined.
What was the treatment for neurasthenia for males and females?
Females: rest cure, massage, injections
Men: play sports, go outdoors, hiking, camping, strenuous work
What was one of the original drinks to treat neurasthenia? What do we use today?
Coco-cola started out as a treatment for neurasthenia because it contained coco beans it actually gave you energy.
Today we have products like red bull, berocca, coffee.
In which country is neurasthenia a legit diagnosis?
China
What did Sigmund Freud discover at Charcot’s clinic about hysteria?
Hysteria behaves as if the nervous system does not exist (e.g. paralysis)
What is hysteria?
Pain and suffering.
It often results from repressed conflicts within the person, and occurs most frequently in young woman.
Symptoms of hysteria
Catalepsy: fainting, trance states, rigidity of limbs, unresponsive.
Hysterical fits: convulsive attacks, screaming, extreme bodily movements.
Hysterical paralysis: paralysis, blindness, deafness, inability to speak (mutism).
What is the course of the disease hysteria?
First, loss of appetite, weight loss, pains, headaches
Then, catalepsy and convulsions.
Later, paralysis.
Hysteria treatments
Denial, scolding, punishment and threat; suggestion; hydrotheraphy, electrotheraphy, surgery, hypnosis
What did Jean-Martin Charcot (1825-1893) think about hysteria?
He believed that hysteria is a functional disease of the nervous system. It is hereditary, constitutional, degenerative. There is no cure, and ovaries are particularly important.
How did hysteria disappear?
Physicians discourage symptoms of hysteria; hysteria is defined as caused by suggestion, and therefore not real; a new explanation: mental cause; there has been a change in diagnostic practice
What is hysteria today?
Morgellon’s disease - artificial fibres coming out of very itchy wounds.
What are 2 ways diseases are discovered/made?
- Grass-roots model
2. Top-down
Define mental hygiene
The branch of psychiatry that deals with the science and practice of maintaining and restoring mental health, and of preventing mental disorder through education, early treatment, and public health measures
What does public health focus on?
Interest in prevention (curing disease, treating disease in early stages, promoting health); structural solutions (population-wide, structural initiatives)
Why has there been a decline of contagious disease?
Standard of living: access to food, standard of housing, access to care; fresh drinking water; sewers
What would reduce the prevalence of mental illness?
Reduce poverty, abolish war and abolish abuse (physical, sexual) of children
What was mental hygiene like in 1910-1920?
There were lesser forms of mental illness; reintegration in community after discharge; reforming medical education.
They believed they could trace ‘feeblemindedness’ across family trees, and that it is inherited.
What was mental hygiene like in 1920-1930?
No longer concerned with insane people, but instead starts to focus on kids. Opened up child guidance clinics (initially apart of the courts in order to try and prevent a life of crime) however the success rate was low. So they attempted to treat middle-class troublesome children, which appeared to help, so they got a lot more funding for promoting mental health in all school children.
They attempted to prepare all kids to be mentally healthy, in order to be able to cope with the pressures of normal society.
What was mental hygiene like in 1930-1940?
The great depression:
Community mental health hygiene projects (choir, theatre groups, trying to keep people busy)
Society as the patient: social and cultural reconstruction; don’t bother fixing individuals, you need to fix society, that is the stem of all the problems currently.
What was mental hygiene like after 1945?
After the successful treatment of neurosis, psychiatrists thought they could do anything. Social psychiatry established to determine the prevalence of mental illness in society.
Most mental illness outside hospitals, most individuals with mental illness never see mental health care professionals, mental illness related to poverty.
