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Ministry of Health of Ukraine Kharkov State Medical University Gavenko Ministry of Health of Ukraine Kharkov State Medical University Gavenko V.L., Samardakova G.A., Sinayko V.M., Korostiy V.I., Kozhina A.M., Mozgovaya T.P., Dyomina O.O. Dedicated to the 200th anniversary of Kharkіv State Medical University PSYCHIATRY edited by Prof. Gavenko V.L. Manual for English medium students of higher medical schools and interns 1 CONTENTS Introduction Subject and tasks of psychiatry. Causes and classification of mental diseases. Organization of aid to mental patients, peculiarities in functioning of psychiatric establishments Main sections of modern psychiatry Classification of mental diseases Organization of psychiatric aid DISTURBANCES OF SENSATIONS AND PERCEPTIONS Classification of disturbances of sensations and perceptions Particular kinds of hallucinations Syndromes of disturbances of sensations and perception DISTURBANCES OF THINKING AND INTELLECT Classification of disturbances of thinking Speech disturbances Speech disturbances mostly caused by organic lesions of the brain Disturbances of intellect Syndromes with a prevailing disturbance of thinking Peculiarities of disturbances of thinking in children DISTURBANCES OF MEMORY Classification of disturbances of memory DISTURBANCES OF EMOTIONS Classification of disorders in emotions and feelings Syndromes of disturbances of emotions Methods of investigation of emotions DISTURBANCES IN EFFECTOR-VOLITIONAL SPHERE Classification of effector-volitional disturbances 2 DISTURBANCES OF CONSCIOUSNESS Classification of disturbances of consciousness Age-related peculiarities in disturbances of consciousness PSYCHOPATHOLOGICAL SYNDROMES ORGANIC AND SYMPTOMATIC MENTAL DISORDERS Mental disorders in general and cerebral infections Mental disorders in AIDS Mental disorders in brain injuries Mental disorders in burn disease ECOLOGICAL PSYCHIATRY. MENTAL DISORDERS IN FOOD, OCCUPATIONAL AND DOMESTIC POISONINGS Mental disorders in food poisonings Mental disorders in occupational and domestic poisonings Postradiation mental disorders MENTAL DISORDERS IN BRAIN TUMOURS MENTAL DISORDERS IN SOMATIC AND ENDOCRINE DISEASES Peculiarities of mental disorders in various somatic diseases Mental disorders in diseases of respiratory organs Mental disorders in patients with a gastrointestinal pathology Mental disorders in renal diseases Mental disorders in hepatic diseases Mental disorders in women with an obstetric-gynaecological pathology Mental disorders in vascular diseases MENTAL DISORDERS OF PRESENILE AND SENILE AGE Nonpsychotic mental disorders of involutional genesis 3 Functional psychoses of presenile age Senile and presenile dementiae EPILEPSY MENTAL DISORDERS IN ABUSE OF PSYCHOACTIVE SUBSTANCES Alcoholic mental disorders Chronic alcoholism Alcoholic psychoses Peculiarities of alcoholism in women Peculiarities of alcoholism at juvenile and young age Treatment of alcoholism Narcomaniae Opiumism Cannabism Narcomaniae caused by soporifics Narcomaniae caused by barbiturates Narcomaniae caused by abuse of psychostimulants Narcomaniae caused by hallucinogens Toxicomaniae Toxicomaniae caused by abuse of tranqillizers Toxicomaniae caused by abuse of psychostimulants Toxicomaniae caused by soporifics Toxicomaniae caused by abuse of cholinolytic preparations Toxicomaniae caused by inhalants Nicotinism (tobacco dependence) Peculiarities of narcomaniae and toxicomaniae in juveniles Peculiarities of narcomaniae and toxicomaniae in women Etiology of narcomaniae and toxicomaniae 4 General principles in treating narcomaniae and toxicomaniae SCHIZOPHRENIA, SCHIZOTYPICAL AND DELUSIONAL DISORDERS Schizophrenia Schizotypical disorder Chronic delirious disorders Acute and transitory psychotic disorders Induced delusional disorder Schizoaffective disorders AFFECTIVE DISORDERS Manic-depressive psychosis PSYCHOGENIC DISEASES Neuroses (neurotic disorders) Posttraumatic stress disorder (PTSD) Somatoform disorders Psychosomatic diseases Psychogenic (situational) psychoses Anorexia nervosa and bulimia nervosa PERSONALITY DISORDERS Character accentuations Psychopathies Psychosexual disorders HYPERKINETIC DISORDERS SOCIAL BEHAVIOUR DISORDERS OLIGOPHRENIAE INFANTILE AUTISM TREATMENT OF MENTAL DISEASES 5 PSYCHOHYGIENE, PSYCHOPROPHYLAXIS AND REHABILITATION OF MENTAL PATIENTS MEDICAL EXAMINATION OF MENTAL PATIENTS Medical labour examination and social-occupational rehabilitation of mental patients Forensic psychiatric medical examination Medical military examination 6 INTRODUCTION A doctor of any speciality must know main mental disorders occurring in various diseases, as many patients with these disturbances at first consult general practitioners rather than psychiatrists. The ability to reveal the character of these disorders, devise correct tactics in each case makes it possible to increase efficacy of therapy for these patients. The manual is to facilitate students’ preparation for classes in psychiatry and pursues the aim of optimization in the process of studies. It is written with regard for practical problems which the futurex doctors will have to solve. The present manual is composed in compliance with the syllabus in psychiatry and narcology worked out by the basic department of the Ministry of Health of Ukraine – the Department of Psychiatry and Narcology of Kharkov State Medical University. In an intelligible form, the book informs about the main disturbances of the psychic activity, describes signs and syndromes of mental diseases. Unlike previous ones, this manual elucidates criteria of the current international classification of mental diseases, describes psychopathological syndromes in accordance with these criteria. The manual “Prepedeutics of Psychiatry” enables future doctors to learn fundamentals in the diagnosis of mental disorders and master psychiatric terms. In compliance with the requirements of the regulations for the procedure of preparation and publication of the educational and educational-methodical literature for higher medical and pharmaceutical educational establishments with the 3rd–4th levels of accreditation, the objective of the lesson, its contents and test questions are determined for each studied subject. In order to improve successfulness of the students’ mastering the knowledge, the manual contains problems for independent preparation which are composed according to the format of test tasks of “Krok-2” licensing examination. 7 SUBJECT AND TASKS OF PSYCHIATRY. CAUSES AND CLASSIFICATION OF MENTAL DISEASES. ORGANIZATION OF AID TO MENTAL PATIENTS, PECULIARITIES IN FUNCTIONING OF PSYCHIATRIC ESTABLISHMENTS Psychiatry is the medical science dealing with the study of diagnosis, etiology, pathogenesis and rate of mental diseases, as well as organization of the psychiatric aid. Psychiatry (Greek psyche – soul, iatreia – treatment) = treatment of the soul. Tasks of psychiatry: study of the rate, conditions of origination, nosological structure and clinical peculiarities of mental diseases; study of the etiology and pathogenesis of mental diseases; treatment and prevention of mental diseases; social-labour rehabilitation of patients; labour, forensic and military psychiatric examination; carrying out of sanitary-educational and psychohygienic measures among the population. Psychiatry is an integral part of medicine organically connected with all its sections. Every doctor in his practical activity will often come across various psychiatric problems. It is caused by the fact that in cases of all diseases patients develop some or other mental disorders: from nonpsychotic (most frequently) to psychotic, and sometimes defect-organic ones. Every doctor is obliged to adequately determine the register of these disturbances and devise his tactics in each particular case. It is expedient to divide all mental disorders into 3 groups depending upon the level and depth of the disturbances. These are 3 different registers of mental disorders: psychotic, nonpsychotic, and defect-organic. The psychotic state is characterized by presence of at least one of the following signs: clouding of consciousness, delusions, hallucinations. In this situation the patient cannot critically assess his diseased state and does not understand the morbid character of the disturbances. Nonpsychotic (borderline) mental disorders are mostly characterized by disorders of emotions and in the effector-volitional sphere. The patients critically assess their diseased state, understanding that they are ill. 8 Defect-organic disorders are manifested through disrupted intellectual functions (of memory and thinking). Every doctor must be able to give emergency aid in various acute psychotic states, as well as carry on necessary measures aimed at prevention of mental disorders in patients with various forms of pathology. Main sections of modern psychiatry Pediatric, juvenile and geriatric psychiatry study peculiarities in clinical manifestations of mental disorders depending upon the age. Narcology includes diagnosis, treatment and prevention of alcoholism, narcomaniae and toxicomaniae. Forensic psychiatry works out fundamentals for legal-psychiatric experts’ examination and prevention of socially dangerous actions. Lately, such a section as penitentiary psychiatry was separated; it studies peculiarities of mental disorders in people serving their sentences in places of imprisonment. Social psychiatry studies the role of social factors in the etiology, course, treatment and prevention of mental disorders. Psychotherapy studies different methods of psychotherapeutic influence on patients. Psychoneurology studies
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