1 / 28

Etiology of mental disorder

Etiology of mental disorder. How different between psychiatric disorder and other medical disorders? The Stress-diathesis model The Bio-Psycho-Social modelThe 4Ps modelThe integrative model for case formulation . How different between psychiatric disorder and other medical disorders?. Thai fema

phallon
Download Presentation

Etiology of mental disorder

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

    1. Etiology of mental disorder Paul Thisayakorn, MD.

    2. Etiology of mental disorder How different between psychiatric disorder and other medical disorders? The Stress-diathesis model The Bio-Psycho-Social model The 4Ps model The integrative model for case formulation

    3. How different between psychiatric disorder and other medical disorders? Thai female, 22 y/o Complaint of Lt.side weakness ,numbness and progressive headache for 1 mo. Looked cachexia, febrile, cervical LN positive, oral thrush positive ,motor gr.III, decrease pinprick sensation,rt. Blood profile and CT show the abnormality Thai female , 22 y/o Her mother complaint of behavioral change (talk with herself, withdrawn, preoccupy about religion) for 1 mo. Poor hygiene, poor eye contact ,guarded, and said that she can contact to the ghost and god. She also thought that her friends poisoned her. PE: normal Blood profile and CT: normal

    4. General approach Problem list (sign& symptom) Psychiatric problems or not? What is the psychiatric syndrome? What is the DSM-IV diagnostic system? What are the causes of the syndrome? How to manage this syndrome?

    5. Problem list (sign& symptom) Consciousness Perception Mood & affect , anxiety Memory & cognition Thought (form & content) intelligence Motor behavior

    6. Problem list (sign& symptom) Disorder or not? ? Use your feeling ? Use your rationale ? Use criteria

    8. What is the psychiatric syndrome? Organic mental disorder Substance use disorder Psychotic disorder Mood disorder Anxiety disorder Somatoform disorder Dissociative disorder Personality disorder Adjustment disorder

    9. What is the DSM-IV diagnostic system? Syndromal approach Diagnostic criteria Axis I Axis V

    10. Etiology of mental disorder :The history Superstitious, supernatural Black bile ? melancholia Unknown neurological symptom ? hysterical conversion Freud ? intrapsychic problem The emerging of neurotrophic drug and other modern knowledge But we still can not completely explain the etiology of the mental disorder!!!

    11. The Stress-diathesis model A person may have a specific vulnerability (diathesis) When acted on by a stressful influence? develop a psychiatric symptom The difference between individual, character of stress ? loss of balance

    12. The Bio-Psycho-Social model The diathesis or the stress can be biological, psychosocial, environmental or both Combination of these 3 factors ? disorder The difference between the severity of Bio-Psycho-Social factors in each person

    13. The Bio-Psycho-Social model Genetic factor ; heterogeneous genetic basis for some mental problems ex. Alzheimers dementia, Substance use disorder, Schizophrenia, Mood disorders, even homosexuality!!!

    14. The Bio-Psycho-Social model Neuropathology - neuroanatomy and neuroimaging : frontal lobe, temporal lobe, limbic system (ex.amygdala,hippocampus), fronto-subcortical circuit etc. - developmental-degenerative process : childhood mental disorder, Schizophrenia as the dementia precox, psychotic symptoms in dementia pt.

    15. Neuropathology

    16. The Bio-Psycho-Social model Neuropathology -neurophysiology ; electrophysiology (psychiatric symptoms in epilepsy, limbic kindling in Bipolar disorder), abnormal sleep-wake cycle in mood disorder -neurochemistry (neurotransmitter : DA, NE, 5HT, Ach, GABA) ; Dopamine hypothesis in Schizophrenia, Catecholamine abnormality in MDD, decrease of Ach in AD, etc., the efficacy of psychotropic drugs, the effect of substance use

    17. The Bio-Psycho-Social model Neuropathology -neuroendocrinology ; cortisol level in chronic stress person, Hypo-hyperthyroid cause the mental change, Sex hormone related to premenstrual-postpartum symptoms -neuroimmunology ; stress and immune response (eg. academic stress during final exam among medical students ? low NK cell activity), psychiatric manifestation in SLE, MS

    18. The Bio-Psycho-Social model Psychological cause -psychoanalytic theory : topographic theory (unconscious-preconcious-concious), structural theory (Id-Ego-Superego), Eriksons 8 stages of life cycles -cognitive-behavioral theory : stimuli ? sensation ? perception ? thinking ? emotion ? behavior ex. Cognitive triad in depression

    19. The Bio-Psycho-Social model Psychological cause -Existential-humanistic theory ; ex. loss of meaning of life ? suicide , end of life situation ? depression, Satirs model -Personality theory ; ex. :Schizotypal PD (A) vs. schizophrenia :Antisocial PD (B) vs. alcohol use :Borderline PD (B) vs. mood disorder :Histrionic PD (B) vs. somatization disorder :Avoidant PD (C) vs. anxiety disorder

    20. Behavior Feeling Thought & perception Expectation Yearning self

    21. The Bio-Psycho-Social model Social cause -Socioeconomic and cultural factors ; a disproportionate number of schizophrenia pts. are in the low socioeconomic groups (contrastively to Bipolar disorder). ; Social stressors in urban settings affect the development of schizophrenia in persons at risk. ; The stress of immigration ? delusional disorder ; single status as a risk of suicide

    22. The Bio-Psycho-Social model Family dynamic ; high expressed emotion in family ? high relapse rate, the impact of family problem to the child (eg. Divorce , loss of parent) , the formation of gender identity and role etc. Learning theory (classical conditioning, operant conditioning, social learning theory) ex. Phobia & PTSD, learned helplessness vs. depression, aggressive social behavior vs. aggression in children

    23. The 4Ps model There are many factors along ones lifetime that may contribute to the mental disorder. Predisposing factors Precipitating factors Perpetuating factors Protective factors

    24. The 4Ps model

    25. The case formulation 4Ps X Bio-Psycho-Social ? case formulation

    26. The case formulation ????????????? ???? 19 ?? ?????????????????? 2 ?????????????????????????????????????????? 1 day PTA ???????????????????????? ???????????? ??????????????? ??????????????????????? ?????????????????????????? ?????????????????? ????????????????????????????????????????????????????????????????? ????????????????????????????????????????? 3 ????? ?????????????? ????????????? ?????????????????????????????????????????????????????????? ????drop????? ??????????????????????????????????????????????? ????????????? ???????????????? ??? ???????????????? ??????????????????????????? ??????????????????? ????????????????? ??????????????????????????????? ????????????????????? ?????????????? ???????????????? ????????????? ???????? ?????????? ?????????????????? ?????? ?????????? ??????????????????????????????????? ?????????????????????????????? ?????????????????????????????? ?????????????? ??????????????????????

    27. The case formulation

    28. Conclusion There are many factors that cause the mental disorder One specific factor can not completely explain these illnesses. Stress-diathesis model + Bio-Psycho-Social model + 4Ps model help us understand the etiologies of the psychiatric disorders.

More Related