Ministry of Health of Ukraine Ministry of Education and Science of Ukraine Kharkiv National Medical University V. N. Karazin Kharkiv National University PSYCHIATRY AND NARCOLOGY Tutorial for forieng medium students of higher medical schools and interns PSYCHIATRY AND NARCOLOGY: підручник для студентів медичних університетів та лікарів інтернів Recommended by KhNMU Academic Councile Protocol № 6 of 26.06.2020. Authors: Kozhyna H., Mishchenko Т., Maruta N., Gaichuk L., Haydabrus A., Korostiy V., Korovina L., Koshchii V., Leshchyna I., Minko O., Radchenko T., Semikina O., Sinaiko V., Shtryhol D., Skrynnyk O., Strelnikova I., Tieroshyna I., Vovk V., Zelenska K. Authors: Hanna M. Kozhyna Professor MD, PhD, DMSc Head of Department of Psychiatry, Narcology, Medical Psychology and Social Work Kharkiv National Medical University Tamara S. Mishchenko Professor MD, PhD, DMSc Head of Department of Clinical Neurology, Psychiatry and Narcology V. N. Karazin Kharkiv National University Nataliya O. Maruta Professor MD, PhD, DMSc Deputy Director on Scientific Work , Chief of Borberline Psychiatry Department of the Institute of Neurology, Psychiatry and Narcology of the NAMS of Ukraine Larysa M. Gaichuk MD, PhD, Associate Professor of the Department of Psychiatry, Narcology, Medical Psychology and Social Work Kharkiv National Medical University Andriy V. Haydabrus MD, PhD, Associate Professor of the Department of Clinical Neurology, Psychiatry and Narcology V. N. Karazin Kharkiv National University Volodymyr I. Korostiy Professor MD, PhD, DMSc, Professor of Department of Psychiatry, Narcology, Medical Psychology and Social Work Kharkiv National Medical University Liliia D. Korovina MD, PhD, Associate Professor of the Department of Psychiatry, Narcology, Medical Psychology and Social Work Kharkiv National Medical University Vladislava O.Koshchii MD, Assistant of Department of Psychiatry, Narcology, Medical Psychology and Social Work Kharkiv National Medical University Iryna V. Leshchyna MD, PhD, Associate Professor of the Department of Psychiatry, Narcology, Medical Psychology and Social Work Kharkiv National Medical University Olexander I. Minko Professor MD, PhD, DMSc, Professor of Department of Clinical Neurology, Psychiatry and Narcology V. N. Karazin Kharkiv National University Tetiana M. Radchenko MD, PhD, Assistant of Department of Psychiatry, Narcology, Medical Psychology and Social Work Kharkiv National Medical University Olena E. Semikina MD, PhD, Associate Professor of Department of Clinical Neurology, Psychiatry and Narcology V. N. Karazin Kharkiv National University Vadym M. Sinaiko Professor MD, PhD, DMSc, Professor of Department of Psychiatry, Narcology, Medical Psychology and Social Work Kharkiv National Medical University Diana V. Shtryhol MD, PhD, Associate Professor, Department of Clinical Neurology, Psychiatry and Narcology, V. N. Karazin Kharkiv National University Olga V. Skrynnyk MD, PhD, Assistant of Department of Clinical Neurology, Psychiatry and Narcology V. N. Karazin Kharkiv National University, School of Medicine (Kharkov) Iryna M. Strelnikova MD, PhD, Associate Professor of the Department of Psychiatry, Narcology, Medical Psychology and Social Work Kharkiv National Medical University Iryna F. Tieroshyna MD, PhD, Associate Professor of the Department of Psychiatry, Narcology, Medical Psychology and Social Work Kharkiv National Medical University Victoria І. Vovk MD, PhD, Associate Professor of the Department of Clinical Neurology, Psychiatry and Narcology V. N. Karazin Kharkiv National University Kateryna O. Zelenska MD, PhD, Associate Professor of the Department of Psychiatry, Narcology, Medical Psychology and Social Work Kharkiv National Medical University Kharkiv 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, Narcology, Medical Psychology and Social Work of Kharkov National 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 “Psychiatry and Narcology” 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. THE SUBJECT AND TASKS OF PSYCHIATRY AND NARKOLOGY. ORGANIZATION OF PSYCHIATRIC AID. METHODS OF EXAMINATION OF MENTAL DISEASE. CLASSIFICATION OF MENTAL DISEASE. REGISTER MENTAL DISEASE 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: 1. Study of the rate, conditions of origination, nosological structure and clinical peculiarities of mental diseases. 2. Study of the etiology and pathogenesis of mental diseases. 3. Treatment and prevention of mental diseases. 4. Social-labour rehabilitation of patients. 5. Labour, forensic and military psychiatric examination. 6. Carrying out of sanitary-educational and psychohygienic measures among the population. MAIN SECTIONS OF MODERN PSYCHIATRY: 1. General (study and treatment of mental illness) 2. Pediatric, juvenile 3. Geriatric 4. Narcology 5. Forensic psychiatry 6. Social psychiatry 7. Psychotherapy 8. Psychopharmacotherapy 9. Sexual pathology 10. Suicidology 11. Penitentiary psychiatry (It examines the characteristics of mental disorders in people who are in prison, risk factors for committing illegal actions). 12. Transcultural psychiatry (especially comparative studies of psychiatric disorders in people of different nations, cultures and social systems) HISTORY OF DEVELOPMENT A brief overview of the history of psychiatry Mental illness exists as long as humanity exists. In the pre-scientific period of the history of medicine prevalent primitive theological understanding of the anomalous behavior of the patients, which is reflected in myths and legends. The origins of the birth of psychiatry associated with the great physician and philosopher of ancient Greece - Hippocrates, which is rightly considered the founder of scientific medicine. Claudius Galen studied the brain, the seat of his mind thought, thoughts localized in the heart, the desire - in the liver. Mental illness Galen differentiated between on acute and chronic, related to the first feverish delirium, to the second - melancholy. The Middle Ages slowed down the development of science. During this period was dominated by the influence of the church on the diabolical obsession of apostasy, of holiness and possessed with a devil, so any violation of the psyche is not assessed as a disease but as a result of voluntary intercourse with the devil. In the early Middle Ages began to emerge and progressive views on the nature of mental illness. So, the famous Arab scholar Avicenna considered disease infringement of mental activity, and called for their treatment. These views Avicenna implemented in the construction of hospitals for the mentally ill. At the end of XVII - beginning of XVIII century in connection with the expansion of cities and crowded public authorities ordered the relatives of patients to protect the peace living nearby. In Europe, there are shelters for the mentally ill. The patients were kept in small rooms with stone floors and no furniture, chained to the walls. In the XVIII century there have been major changes in the organization of mental health care. This reflected the social changes that have occurred in France during the period of the bourgeois revolution. French psychiatrist Philippe Pinel (1745-1826), the chief doctor psychiatric hospital Bicetre achieved at the National Convention of the right to withdrawal of chains with the mentally ill and went down in history as the "father of modern psychiatry." F. Pinel - founder of psychiatry in France, its main merit is that he was "elevated to the rank of a crazy person of unsound mind". The closest disciple Pinel, Zh.Eskerol, laid the foundation for the scientific and clinical psychiatry, legalized the mandatory medical examination