1. Module One Introduction Lesson 1: What is mental disorder Lesson 2: Psychiatric evaluation

2. Lesson 1 WHAT IS MENTAL DISORDER

3. Step 1: Brainstorming What do humans need in order to have good mentl health?

4. Step 2: Theory presentation The term mental disorder comprise a variety of problems that are connected to the mental situation and the behavior of the person Various mental disorders are manifested through a variety of symptoms, such as delusions, sentimental instability, conduct disorders, memory decline, etc.

5. Step 2 (continued) The mental disorder might be the result of a physical illness or to be manifested through physical symptomatology A large group of mental disorders is psychosis in which the patients loose in a degree the conscience of reality and manifest symptoms like delusions or aberrative ideas (hallucinations). Such disorders are Schizophrenia and Bipolar Disorder.

6. Step 2 (continued) Another group includes the disorders related to anxiety (neurosis). This includes the Anxiety Disorders, Phobias, Obsessive – Compulsive Disorders etc The conduct disorders comprise the different situations where the personality has implanted elements that make difficult the adaptation and the social behavior of the person

7. Step 2 (continued) Some mental disorders might be connected with the damage of encephalic structure. These are called Organic Mental Disorders and an example is Dementia. Alcohol and toxic agents abuse might also cause mental disorders.

8. Step 3 (continued) The mental disorders can be separated to many diagnostic categories. At diagnosis are used two official Classification Systems that are internationally recognized. One is “The Diagnostic and Statistical Manual of Mental Disorders, 4 th Edition, known as DSM-IV, which comes from the USA. The other is ICD – 10 “International Classification of Diseases”, 20 th edition of WHO (World Health Organisation), Chapter 4: Mood (affective) disorders

9. Step 2 (continued) The use of classification Systems is additional to the accurate diagnosis of mental disorders, to educational purposes and to facilitate the communication of the professionals in mental health and in research. Especially with DSM- IV apart from the categories of the diseases, it is possible to evaluate important psychological and social factors that influence a patient, as well as its efficiency in total.

10. Step 3 The mental disorders can be manifested at in any age (children, adults, elderly). A research in USA proved that about one third of adults manifested a mental disorder within 12 months. About half the population presents a mental disorder during its life.

11. Step 3 (continued) Some types of mental disorders are more common than others. Women in general manifest more often mental disorders. Social factors that predispose the manifestation of mental disorders include situations such as poverty, isolation, immigration, unemployment, widowhood, divorce etc.

12. Step 4: Summary Which are the needs of the person that should be satisfied in order to enjoy good mental health. Why the persons with mental disorders might have additional needs. Which are the mental disorders.

13. Step 4 (continued) Which factors contribute to their cause ? Which are the ways of treatment? What is their rate of incidence and in which categories of persons are more often.

14. Step 5: Conclusion In order to diagnose the needs of persons with psychiatric disorders, you should know the following : Why the persons with mental disorders need the understanding of their biological, psychological and social problems. How can these problems be manifested. What can professionals offer.

15. Step 6:Questions and comments (10΄)

16. Step 7: Lesson’s evaluation (10΄)

17. Lesson 2 PSYCHIATRIC EVALUATION

18. Step 1: Introduction  When the patient is examined from a psychiatrist or another professional in mental health, he always does a psychiatric evaluation.  This is usually done in the context of an interview with the patient and eventually with a relative or a person that knows him very well.

19. Step 1 (continued)  Additional information are also collected from an older medical report of the patient (if it exists) or from members of the personnel that know him  Furthermore there are some tests to be done, where it is judged necessary, but the main source of information is the psychiatric interview.

20. Step 1 (continued)  Even though the psychiatric interview has to be done in a calm space without interventions or disturbances, there are unfortunately occasions that it is done in noisy and crowded places, as for example the Out-patients clinics of a hospital.

21. Step 1 (continued)  The interview constitutes a way of collecting information through the appropriate questions and observation. It is however a good way to create a good relation with the patient, which is therapeutic by itself.  The patient might also consider useful to ask some questions and have information for his problem.

22. Step 2: Slide projection Slide 1.2.1: what a psychiatric evaluation includes Psychiatric interview  Personal data  Reference source  Main disturbances and problems  Case – history of these problems  Development history  Family history  Medical report  Report of substances used  Examination of mental functions

23. Step 2 (continued) Psychological tests Physical examination and lab tests  Haematological tests  X-rays  Brain Electro Scan  Brain Section Scans

24. Step 3:Slide projection Slide 1.2.2: examination of mental functions Appearance and behavior  Clothing and appearance  Posture and walking  Physical characteristics  Face expression  Eye contact  Gesture activity  Mannerisms

25. Step 3 (continued)  Talking : it can be examined by observing the way that the patient talks  Rhythm  Tone, Volume, Clearness  Disturbances

26. Step 3 (continued)  emotional situation: Comprises the examination of the mood that is related to how the patient himself feels and the feeling that is the manifestation to the outside of this mood. The examination of the mood is done thanks to a series of questions (for example “how is your mood like lately?”), while the evaluation of the feeling is done by observation.  Mood  Emotion (variety, intensity, mutability, unsuitability)

27. Step 3 (continued)  Thought: the evaluation of thinking is based on what the patient says either by himself either responding to questions.  Coherence (flow of ideas, quality of association of ideas)  Content  Distortions (aberrative ideas)  Obsessional activities (compulsions, phobias, hypochondriasis)  Morbid activities (depressive aberrative ideas)  Suicide or homicide tendency

28. Step 3 (continued)  Perception: It is related to the stimulus income from the environment with the sensations of the person. The perception whether it is examined simply by observation whether with appropriate questions (ex. “has ever happened to hear people talking around you while other people could not hear it?”  Hallucinations  Delusions  Depersonalization

29. Step 3 (continued)  Emotional situation and mental functions: There are mainly used special questions for the examination of these functions.  Conscience and orientation  Concentration  Memory  Knowledge  Abstraction  Judgment  Sensitivity

30. Step 4:slide projection Slide 1.2.3:psychological tests  IQ test (WAIS-R IQ tests)  Personality tests  Projectibe test (Rorschach, ΤΑΤ)  Personality Inventory (MMPI, EPQ)  Neuropsychological tests (Bender –Gestalt)  Diagnostic tests (PSE, SADS, SCID)  Psychiatric Rating Scales (BPRS, Hamilton Rating Scale for Depression, Beck Depression Inventory and Mini Mental State Examination)

31. Step 5: Questions and comments (10΄)

32. Step 6: lesson’s evaluation (10΄)