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THE BASIC CONCEPT OF PSYCHIATRY

1. 2. 3. 4. 5. 6.

General systems theory Model of disease Doctor - Patient Models Concept of Normality Psychiatry and Psychology Definition of Mental Disorder

* Kaplan HI, Sadock BJ. Synopsis of Psychiatry Behavioral Sciences / Clinical Psychiatry, 10th.ed., 2007 * American Psychiatry Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed (DSM-IV). 1994

GENERAL SYSTEMS THEORY


The Biological Systems

The Psychological Systems

The Social Systems

The Biological Systems :


anatomical

structural
molecular

biological functioning

The Psychological Systems


psychodynamic the experience of events /

factors
motivation

illness
reaction to events / illness

personality

The Social Systems : cultural environmental familiar the expression experience of events / illness

MODEL OF DISEASE
The General Systems Theory

The Biopsychosocial Model of Disease


( George Engel ) Stressed an integrated system approach to human behaviour and disease

Each system affects and is affected by all the others

Promote a comprehensive understanding of disease and treatment

The doctor - patient relationship is a critical component

A dramatic example of Engels concept


The relation between sudden death (170) and psychosocial factors The potential triggering events : death of close friend grief loss of self esteem personal danger of threat the letdown after the threat has passed triumph reunion

All physicians must have knowledge of :


patients medical status

how patients individual psychology and sociocultural millieu affect the medical condition the emotional responses to the condition and the involvement with the doctor

DOCTOR-PATIENT MODELS
1. The active - passive model : a patient s complete passivity a physicians taking control when patients are unconscious, immobilized, delirious.

2. The teacher - student model : The role of the physician is paternalistic and controlling. The role of the patient is essentially one of dependence and acceptance

during a patients recovery from surgery

3. The mutual participation model : equality between doctor and patient

both participation require and depend on each others input.


Chronic illness : renal failure and diabetes conditions such as pneumonia

4. The friendship model :


dysfunctional unethical

CONCEPT OF NORMALITY
The normal person has a sense of his or her own worth and maintain a confident and purposeful self-image Behavior is assumed to be within normal limits : no manifest psychopathology

The doctor attemps to free patients from grossly observable signs and symptoms of disease

Health is a reasonable, rather than optimal, state functioning

Longitudinal studies

Operational definition of normality ( not absolute, rather is descriptive ) The teenager The adults

The Teenagers
1. Almost complete absence of gross psychopathology, severe physical defects, and severe physical illness. 2. Mastery of previous developmental tasks without serious setbacks. 3. Ability to experience emotional states flexibly and to resolve conflicts actively with reasonable success.

The Teenagers
4. Relatively good relationship with parents, sibling, and peers. 5. Feeling part of a larger cultural environment and being aware of its norms and values. The Adults Good adaptation to marriage, parenthood, work and leisure activities.

Mental Health
Mental health is a state of emotional willbeing in which person are able to function comfortably within their society and in which their personal achievements and characteristics are satisfactory to them. A mentally health individual : being in a state of equilibrium, somehow possessing a harmonious psychological wholeness

In a state a mental health : a person feels physically well, his thoughts are organized, his feeling are well modulated and his behaviours are coordinated and appropriate. He feels part of a group and is able to fulfill his role within it.

PSYCHIATRY
Branch of medicine concerned with the prevention, cause, treatment, and rehabilitation of mental disorders. Psychiatrist : medical doctor whose specialty is psychiatry

PSYCHOLOGY
Study and profession concerned with mental process and behaviour.

DEFINITION OF MENTAL DISORDER


A clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress (e.g., a painful symptom) or disability (i.e., impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability or an important loss of freedom.