Psychiatry

Question 1

What is it?

Answer 1

medical specialty- prescribe drugs instead of psych treatments.
-medicine for illness with psych causes, signs, symps & treatments.

Question 2

History

Answer 2

• start Asylums (bedlam)- admitted if danger to self/others

- recent expansions- life style management- e.g. enhance work, sleep, sex life, “smart drugs” (caffeine)

Question 3

Probs with Psychiatry

Answer 3

1- invention of new diagnoses to sell drugs
2- widening diagnostic criteria include more ppl to sell drugs
3- widening of drug indications (from rarely used for severe, to freq & varied use)
4- drugs used in new groups (adolescences/children)
5- drug related psychiatric probs (side effects, withdrawal, multi-drug combos).

Question 4

Psychiatric disorders

Answer 4

Psychosis

• severe & rarer (hospitalized) tend lack insight & often suicidal.
• Qualitative- e.g. Hallucinations & Delusions.

Neuroses

• seen as an outpatient.
• Quantitative- usually extreme emotional experiences.
  e. g. Anxiety, Fatigue, OCD.

Question 5

Treatments

Answer 5

(all drugs are unique classes not distinct- drugs overlap)
6 main types (H,T,S,N,A,L)

1- Hypnotics, Sedatives (induce sleep)
2- Tranquilizers, Anxiolytics.
3- Stimulants.
4- Neuroleptics, Antipsychotics.
5- Anti-ds (Tricyclics, SSRIs).
6- Lithium- (mood stabilizers)

non-drug- ECT (electroconvulsive therapy).

Question 6

Psychotic feats- Hallucinations

Answer 6

Hallucinations-

• sensory percep when no real object.
• occur in any percep/sensory modality.
• vision/hearing/touch/taste/smell/proprioception.
• to sufferer hallu looks 100% real, expect others to see them.

In Sz, Mania, Psychotic Depress, Brain Dieases (dmg, delirium, dementia), drug withdrawal.
-in normal ppl occur- Hynagogic hallus before sleep and Hyponomic (waking). (10% normal ppl reported it questionaire).

1- Touch- fluid in body, touched/injected, formication (ants)= common coke withdrawal.
2- Smell/Taste- poison, delusion of persecution.
–Depress- foul smell, rotting, nihilistic delusions of nothingness.
3- Visual- ass with brain diseases or dysfunction (drugs, delirium).
4- Auditory- hearing voices.
–esp Mania & Depression usually mood congruent.

Question 7

Psychotic feats- Delusions

Answer 7

Delusion- false belief of idea (NOT percep).

1-False, dominating, unshakable- evidence no effect on person suffering.
2- Out of keeping with personality & culture.
3- No insight- they believe it is real.

Primary delusions- out of nowhere (greenlight= I’m god)- precursor to Sz- not triggered by hallucinations.

Secondary delusions- to explain a hallucination (formication).

Types
Mania- grandiose.
Depress- guilt, poverty, sin.
Sz- paranoid, self-referential, persecutory, conspiracy.

Question 8

Thought Disorders

Answer 8

-how do we know about thoughts?

Indirectly
1- Observation- esp speech.
2- Reports from patients 
--(a) during thought disorder.
--(b)- after recovery (if they remember).

Thought disorder similar to what happens in dreams, can’t make sense of world- lack insight to condition.

Sz type- called Hebephrenia (disorganised)

• -Thought Blocking/withdrawal (stop/start new topic).
• -Thought Insertion (alien thoughts put in head).
• -Concrete Thinking (not abstract)- everything literal.
• -Knight’s Move Thinking- can’t see connections (world salad).

Psychotic Depress- thought retardation (slowing)

Mania- accelerated thinking- “Flight of Ideas”- rapid, loud, continuous- full of puns/jokes/word associations- however stays connected.