PsYcHiAtRy

Psychiatry: The branch of medicine that deals with the diagnosis, treatment, and prevention of mental and emotional disorders. Psychiatric disorder: Psychiatric disorder is a disturbance of  Cognition  Conation  Affect

Concepts of normal mental health According to WHO health is a state of complete physical, mental and social well-being and not merely absence of disease or infirmity Medical model (normality as health): Absence of psychiatric disease Statistical model(normality as an average): falls within two standard deviations of normal distribution Utopian model(normality of as Utopia):optimal functioning Subjective model: absence of distress Social model:to behave in a socially permissive behaviour Process model(normality as a process): a dynamic and changing process Continuum model: describes normality and mental disorder as falling at the two ends of continuum

Common traits and qualities in normal individual Reality orientation Self-awareness and self knowledge Self-esteem and self acceptance Ability to exercise voluntary control over behaviour Ability to form affectionate relationships Pursuance of productive, goal directive activities

Classification in psychiatry Psychiatry has been rapid changes in classification to keep up with a conglomeration of growing research data dealing with epidemiology, symptomatology, prognostic factors, treatment methods and new theories for causation of psychiatric disorders. The Hippocratic Oath, (400 BC)It formed the basis for codes governing both early Islamic and Christian medicine and remains the inspiration for their modern counterparts. six types of mental disorders:  Phrenitis(acute mental disturbances with delirium),  Mania(acute mental disturbances without delirium),  Melancholia(all kinds of chronic mental disturbances),  Epilepsy(fits with loss of consciousness),  Hysteria(pain,dyspnoea and convulsion),  Scythian disorders (comparable to transvestism) The Chakra Samhita, written by an Indian physician in the first century AD, covers confidentiality, considerateness to patients, and keeping abreast of medical knowledge.

In 19 th century,Phillippe Pinel adopted a descriptive system of classification in which delirium, mania with delirium,melancholia,dementia and idiocy. His disciple Esquirol followed Pinel’s system adding one more category – Monomania-and gave accurate clinical descriptions for each category. The present day classification used in most of the countries is rooted in a system compiled by Emil Kraeplin( ) The two prevalent systems of classification are ICD produced by WHO and the diagnostic and statistical manual (DSM) of mental disorders published by the American Psychiatric association. Latest version of these classification DSM IV, ICD 10, resembles each other in most of the details but differ in others, all categories used in DSM-IV are seen in ICD-10 but all categories of ICD-10 are not seen in the other. DCM-IV is used in USA while other use ICD-10 classifications. Even some countries in Europe and other several countries have their own system of classification.

Main categories of disorders in ICD-10 Code category F0:-organic including symptomatic mental disorders F1:-Mental and behavior disorders due to psychoactive substances use F2:-schizophrenia,schizotypal and delusional disorders. F3:-mood(affective)disorders. F4:-Neurotic,stress-related and somatoform disorders. F5:-Behavioural syndromes associated with physiological disturbances and physical factors. F6:-Disorders of adult personality and behavior. F7:-mental retardation F8:-disorders of psychological development F9:-behavioural and emotional disorders with onset usually occurring in childhood or adolescence

Some versions of ICD-10 Clinical Descriptions and Diagnostic Guidelines (CDDG) Diagnostic Criteria for Research (DCR) Multi-axial Classification Version Primary Care Version

Major categories of conditions according to DSM-IV 1. Disorders usually first diagnosed in infancy, childhood and adolescence. 2. Delirium,Dementia and amnestic and other cognitive disorders. 3. Mental disorders due to a general medical condition not elsewhere classified. 4. Substances-related disorders. 5. Schizophrenia and other psychotic disorders. 6. Mood disorders. 7. Anxiety disorders 8. Somatoform disorders. 9. Factitious disorders 10. Dissociative disorders. 11. Sexual and gender identity disorders. 12. Eating disorders 13. Sleep disorders. 14. Impulse control disorders not elsewhere classified.

DSM-IV: Multiaxial Classification Axis I:Psychiatric Syndromal Diagnosis Axis II:Personality Disorders and Mental Retardation Axis III:General Medical Conditions Axis IV:Psychosocial and Environmental Problems Axis V:Level of Functioning ( Global Assessment of Functioning)