Psychiatry 3-4

Question 1

Define neurasthenia

Answer 1

An ill-defined medical condition charcterised by fatigue, headache and irritability associated chiefly with emotional disturbance.

Question 2

Explain Mr Smith’s neurasthenia story from Sydney 1891

Answer 2

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.

Question 3

Reasons given for neurasthenia?

Answer 3

1. Nervous diathesis; limited supply of energy
2. Neurasthenia occurs when the demands of the environment exceed the available energy of the individual; mis-match
3. Irritations travel through the body because of reflex irriation
4. Centres of reflex action: the brain, the digestive system and the reproductive system

Question 4

Who got neurasthenia?

Answer 4

The best and brightest, highly cultured individuals and the most refined.

Question 5

What was the treatment for neurasthenia for males and females?

Answer 5

Females: rest cure, massage, injections

Men: play sports, go outdoors, hiking, camping, strenuous work

Question 6

What was one of the original drinks to treat neurasthenia? What do we use today?

Answer 6

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.

Question 7

In which country is neurasthenia a legit diagnosis?

Answer 7

China

Question 8

What did Sigmund Freud discover at Charcot’s clinic about hysteria?

Answer 8

Hysteria behaves as if the nervous system does not exist (e.g. paralysis)

Question 9

What is hysteria?

Answer 9

Pain and suffering.

It often results from repressed conflicts within the person, and occurs most frequently in young woman.

Question 10

Symptoms of hysteria

Answer 10

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).

Question 11

What is the course of the disease hysteria?

Answer 11

First, loss of appetite, weight loss, pains, headaches

Then, catalepsy and convulsions.

Later, paralysis.

Question 12

Hysteria treatments

Answer 12

Denial, scolding, punishment and threat; suggestion; hydrotheraphy, electrotheraphy, surgery, hypnosis

Question 13

What did Jean-Martin Charcot (1825-1893) think about hysteria?

Answer 13

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.

Question 14

How did hysteria disappear?

Answer 14

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

Question 15

What is hysteria today?

Answer 15

Morgellon’s disease - artificial fibres coming out of very itchy wounds.

Question 16

What are 2 ways diseases are discovered/made?

Answer 16

1. Grass-roots model

2. Top-down

Question 17

Define mental hygiene

Answer 17

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

Question 18

What does public health focus on?

Answer 18

Interest in prevention (curing disease, treating disease in early stages, promoting health); structural solutions (population-wide, structural initiatives)

Question 19

Why has there been a decline of contagious disease?

Answer 19

Standard of living: access to food, standard of housing, access to care; fresh drinking water; sewers

Question 20

What would reduce the prevalence of mental illness?

Answer 20

Reduce poverty, abolish war and abolish abuse (physical, sexual) of children

Question 21

What was mental hygiene like in 1910-1920?

Answer 21

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.

Question 22

What was mental hygiene like in 1920-1930?

Answer 22

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.

Question 23

What was mental hygiene like in 1930-1940?

Answer 23

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.

Question 24

What was mental hygiene like after 1945?

Answer 24

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.