1.52k likes | 4.85k Views
Definition. Psychiatry is that branch of medicine dealing with mental disorder and its treatmentPsych : soul or mindIatros : healer. Common confusions within psychiatry . Psychology : a science that investigates behaviour, experience, and normal functioning of the mindPsychotherapy : the treatmen
E N D
1. An Introduction to Psychiatry H.Amini M.D.
Department of Psychiatry
TUMS
2. Definition Psychiatry is that branch of medicine dealing with mental disorder and its treatment
Psych : soul or mind
Iatros : healer
3. Common confusions within psychiatry Psychology : a science that investigates behaviour, experience, and normal functioning of the mind
Psychotherapy : the treatment of psychological issues by non-physical means
Psychoanalysis : a particular sort of psychotherapy, or means of exploring the unconscious mind
4. Why Study Psychiatry ? Psychiatric disorders are prevalent and often go untreated : * lifetime prevalence in USA : 28% * lifetime prevalence in Iran : 10.5-21% * only 40% receive treatment during lifetimes * in general practice : 1/6-1/4 of the patients seen have a psychiatric problem
5. Why Study Psychiatry ?… …. * depression is diagnosed in only 50% of those with depression who present to GPs * adequate treatment ensues in only about 17% of depressed patients in primary care settings * half the patients who commit suicide sought treatment in a primary care setting within 1 month of dying * two-thirds of patients with undiagnosed depression have six visits or more a year with GPs for somatic complaints
6. Why Study Psychiatry ?… Global burden of mental disorders
Subject of medicine is human being, a “biopsychosocial”
Consideration of the psychological aspects of the doctor-patient relationship
7. Models of Mental Disorders Dogmatism
Eclectism
Pleuralism
Integrationism
8. Biopsychosocial Approach Mental health care is a multiagency task which may involve multidiciplinary teams of workers developing in conjunction with the patient/client and their carers, a program of treatment and support to meet their needs
9. Barriers to Dx & Treatment in Primary Care Settings(patient factors) May present with a somatic complaint
Concurrent medical illness often obscures psychiatric symptoms
Denial
Stigma & shame
The belief that psychiatric illness is untreatable
The belief that drugs are mind-altering and/or addictive
10. Barriers to Dx & Treatment in Primary Care Settings(physician factors) A lack of time
Fear of being embarrassed
Uncertainty
Fear that the patient will have an illness that is unresponsive to treatment
Prior negative experience
Lack of knowledge
11. Psychiatric Interview(aims) Obtain information
Understand the person with the illness
Form a therapeutic relationship
Assess the emotions and attitudes of the patient
Provide the patient with information about the illness, treatment recommendations, and prognosis
12. Psychiatric Interview(general advice) Putting the patient at ease : * place : not to be overheard * arrangements for seating * greet the patient by name * introduce yourself with your own name and your role * explain
13. Psychiatric Interview…(general advice) Starting the interview : * begin with a general question * to avoid closed questions and leading questions
Proceeding with the interview : * to keep the patient to relevant topics, while letting him talk freely
14. Psychiatric Interview…(general advice) Non-verbal communication : * the interviewer’s non-verbal cues are important in guiding the interview
Finishing the interview
15. The Psychiatric History Identifying data: name, age, sex, marital status, education, occupation, address, …
Present Illness: * patient’s description of the problem * details of the nature of the problem * present severity of the symptoms other relevant problems * onset and course
16. The Psychiatric History… Family history: * parents: age, occupation, personality,relationship with the patient * sibling: * social position; atmosphere of the home * Hx of mental disorder or drug abuse
17. The Psychiatric History… Personal history: * mother’s pregnancy and birth * early development * childhood separation, emotional problems * schooling and higher education * occupations * sexual relationships
18. The Psychiatric History… Personal history…. * menstrual history * marriage * children * forensic history
Past illness: * past medical history * past psychiatric history
19. The Psychiatric History… Premorbid personality: * relationships * leisure activities * prevailing mood * attitudes, standards * habits
Drugs, alcohol, tobacco