Psychiatry L1

Psychiatry

• Definition: A clinical discipline focusing on the diagnosis and treatment of mental illnesses.

  • Diagnosis: Involves investigation of the etiology, pathogenesis, course, and outcomes of mental illness.

  • Treatment: Encompasses methods of therapy, organization of care, rehabilitation of patients, and prevention strategies.

Leading Causes of Disability

• The 10 leading causes of disability worldwide:

  1. Monopolar depression: 42,972 DALYs (10.3%)

  2. Tuberculosis: 19,673 DALYs (14.9%)

  3. Traffic accidents: 19,625 DALYs (19.6%)

  4. Alcohol consumption: 14,848 DALYs (23.2%)

  5. Self-harm: 14,645 DALYs (26.7%)

  6. Manic-depressive (bipolar) disease: 13,189 DALYs (29.8%)

  7. War: 13,134 DALYs (32.9%)

  8. Violence: 12,955 DALYs (36.0%)

  9. Schizophrenia: 12,542 DALYs (39.0%)

  10. Iron deficiency anemia: 12,511 DALYs (42.0%)

Fields Related to Psychiatry

• Key interdisciplinary areas:

  • Judicial psychiatry

  • Narcology (study of addiction disorders)

  • Transcultural psychiatry

  • Social psychiatry

  • Sexology

  • Suicidology

  • Psychopathology

  • Psychopharmacology

  • Psychotherapy

Cycle of Psychiatry Lectures

• Lecture structure and practical exercises covering:

  • Basics of mental pathology and psychiatric examination.

  • Disorders of sensation, perception, thinking, memory, and consciousness.

  • Emotional and voluntary sphere disorders.

  • Abnormalities of mental development and psychogenic diseases.

  • Therapy methods and age-related features of mental disorders.

  • Legal aspects of psychiatric care, focusing on prevention and rehabilitation.

Final Lesson and Assessment

• Credit requirements for students:

  • Must pass test control with satisfactory grades and attend lectures/practical classes.

  • Signing credit is done after the final lecture, barring any missed lectures or debts.

Basic Concepts in Mental Pathology

• Norm-Pathology Continuum: Understanding the variations in mental health, affected by physiological and pathological mechanisms.

  • Pathology can exhibit as developmental abnormalities or personality changes.

• Pre-pathological Conditions: Risk factors that may lead to mental illness but do not currently result in disadaptation.

• Health-Disease Spectrum: Focus on continuous qualitative characteristics reflecting mental and social functioning.

Mental Health Characteristics

• Defined as:

  • Subjectively felt, objectively verifiable, stable yet improvable.

  • Enables harmonious interactions within one’s environment and resilience to stress.

Mental Illness

• Described as qualitative changes in mental processes affecting psychosocial functioning.

• Symptoms reflect the root cause less and evolve independently from external influences.

Classification of Mental Disorders

• Classes of Mental Disorders:

  • Developmental abnormalities (psychopathy, oligophrenia)

  • Exogenous and psychogenic disorders (e.g., addictions, PTSD)

  • Endogenous diseases (affective psychoses, schizophrenia).

Historical Evolution of Psychiatry

• Hippocrates: Introduced the humoral theory—brain's function depends on the balance of bodily fluids.

• Plato: Proposed the psychodynamic theory focusing on the soul’s rationality and the need for control over passions.

• Philippe Pinel: Reformed treatment approaches by adopting a more humane perspective towards mental illness.

• Emil Kraepelin: Developed nosological classification of mental diseases based on clinical patterns.

• Treatments evolved over centuries from dietary measures to psychopharmacotherapy in the 20th century.

Ethical Principles in Psychiatry

• First, do no harm (Primum non nocere).

• Benevolence: Striving for maximum patient benefit while minimizing harm.

• Respect for autonomy: Emphasizing patient partnership instead of paternalistic approaches.

• Confidentiality: Protecting patient information without consent.

• Fairness: Equitable distribution of medical care and treatment.