Basic Notes in Psychiatry by Dr Michael I. Levi MB, BS(Lond.), MRCPsych Part I (auth.)

By Dr Michael I. Levi MB, BS(Lond.), MRCPsych Part I (auth.)

The beginner in psychiatry calls for a skeletal framework which he can dress steadily with extra element and complex knowing. with no constitution the naive within the topic needs to fail to orientate via to a clearer conceptualization of key and correct matters in psychiatry at the present time. to permit for the purchase of easy techniques, assessment and revision, any provisional framework may still of necessity be concise and unpretentious. during this publication Dr. Michael Levi has succeeded in making a strong place to begin for the retention of latest wisdom, that may then be outfitted on via varied studying and medical event. A. Margo, FRCPsych advisor Psychiatrist IV advent the aim of scripting this booklet is to supply a concise precis of normal grownup psychiatry within the type of notes. i've got dependent those notes on what's normally seemed to be the main simply readable and flippantly 1 written textbook for the MRCPsych exam. The booklet is meant to have large readership - really between junior sanatorium psychiatrists, common practitioners and clinical scholars. additionally, the booklet can also be helpful to psychiatric nurses, psychiatric social employees and scientific psychologists. Reference 1. Gelder, M., Gath, D. and Mayou, R (1988). Oxford Textbook of Psychiatry (Oxford: Oxford scientific guides) v Acknowledgements I desire to thank Dr A. Margo for writing the Foreword to this book.

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Twin studies - concordance of the disorder in MZ twins is 50-80%; cf. concordance in DZ twins of 25%. II. Organic factors - some evidence for organic brain disease is provided by the frequency of obsessional symptoms in patients after the epidemic of encephalitis lethargica. III. Premorbid personality - 70% of patients with obsessive compulsive neuroses have premorbid anankastic personality traits - cleanliness, orderliness, rigid, checking. IV. Psychoanalytic theory (Freud) 1. Obsessional symptoms result from repressed impulses of an aggressive or sexual nature.

HYSTERIA Definition Hysterical dissociation - an apparent dissociation between different mental activities. I. II. Hysterical conversion- the term stems from Freud's theory that mental energy can be converted into certain physical symptoms. Epidemiology Onset usually before the age of 35. I. II. Probably more common among women. III. More common in lower social classes. Clinical features Hysterical dissociation - the major dissociative reactions are: 1. Psychogenic amnesia. 2. Psychogenic fugue (wandering).

Differential diagnosis Exclude: personality disorders; anxiety neuroses; depressive disorders; schizophrenia; organic disorders - dementia. Management Physical - some advocate a trial of tricyclic antidepressants in all I. patients. II. Social - search for meaning of symptoms in social/family setting, where appropriate. Exercise caution where symptoms serve powerful defensive purposes. III. Psychological - supportive measures are the mainstay of treatment. Patients should be educated over the role of psychological factors in the symptoms.

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