医学英语 Psychiatry 精神病学教材课件.ppt

《医学英语 Psychiatry 精神病学教材课件.ppt》由会员分享，可在线阅读，更多相关《医学英语 Psychiatry 精神病学教材课件.ppt（63页珍藏版）》请在三一办公上搜索。

1、Handi Zhang,PSYCHIATRY,2,Mental Health Center, Shantou University,Zhang_Zhang_,Outline,Roots for psychiatryIntroduction to psychiatryBasic definitionsCommon psychiatric symptoms and signsThe categories类别 of psychiatric disordersMajor psychiatric disorders,3,Objectives,Roots VocabularyHaving a genera

2、l idea about psychiatry,4,5,psych,iatry,ment,mne,anxi,neuro,phren,schiz,memory,nerve,mind,treat,mind,Uneasy anxious,spilt,mind,Roots for psychiatry,6,Psychiatric disorder/mental disorder,With the acting of the external and internal factors on the brainthe function of brain become disturbedongoing 不间

3、断的patterns of cognition, emotion, and behavior go deviant不正常的, distressful and/or dysfunctionalfor a period of time.,7,8,psychiatrist,psychologist,Common clinical signs and symptoms,Normal mental activity Cognition (Sensation and perception, thought/thinking, attention, memory, intelligence, insight

4、, orientation方向)Emotion (mood, affect) Volition意志力 and behaviorConsciousness,9,Illusion错觉It is a false perception 曲解due to misinterpretation of the stimuli arising from an object.,10,Hallucination幻觉It is a false perception of something that is not really there. Hallucination may be visual, auditory,

5、 tactile, gustatory, or olfactory. Create by the mind .It is a sign of schizophrenia 精神分裂,11,Auditory hallucinationNon verbal auditory hallucination幻听Verbal auditory hallucinationCommenting 评论Ordering命令,12,Delusion妄想An abnormality in content of thought. It is an irrationally held a strong belief wit

6、h conviction that cannot be altered by rational合理的 argument. It is the signs of schizophrenia and bipolar disorder.,13,Delusions妄想 of persecution/persecutory迫害 delusionsDelusions of reference/ideas of reference牵连观念Delusions of being controlled/delusions of passivityGrandiose delusion夸大妄想 /delusions

7、of grandeur庄严 Delusions of guilt,14,Obsession强迫症，痴迷unwanted、 uncontrolledIt is a recurrent周期性的 thought that is unpleasant and provokes煽动 驱使 anxiety but cannot be got rid of. Obsessive thoughtObsessive ruminations沉思Obsessive doubtsObsessive impulseObsessive reminiscence回忆 怀旧,15,Compulsion 强迫症， 强制The

8、patients know that their behaviors are not normal but cannot inhibit it .It is repetitive behaviors or mental acts preformed over and over in response to an obsessive thought and usually leading to anxiety.Compulsive checkingCompulsive washingCompulsive counting Compulsive rituals 固定程序Obsessive-comp

9、ulsive disorder强迫性精神障碍,16,Amnesia健忘症It is a loss of memory.Anterograde顺行性could not remember events even after a few seconds or minutes.Retrograde 逆行性could not recall pre-existing memories.,17,Dementia痴呆It is a chronic or persistent disorder of the mental processes characterized by loss of intellectu

10、al abilities, memory disorders and changes in personality, deterioration恶化 of personal care, impaired reasoning ability, and disorientation.Mental retardation智力迟钝It is an abnormal lack of intelligence as determined by IQ testing.,18,Senile dementia (Alzheimers disease)老年痴呆 is an example of chronic b

11、rain syndrome, in which the brain atrophies萎缩, resulting in the loss of memory and intellectual functions, altered personality and other symptoms.,19,http:/,Mania躁狂症It is a state of mind characterized by excessive cheerfulness and hyperactivity, disorganization of behavior, and elevation of mood. Co

12、re核心 symptom: the elevation of mood (feel good even high)Easily changed, irritability过敏性的 易怒的Inflated膨胀的 self-esteemIncrease psychomotor activity (rapid thinking and speech, distractibility注意力分散)Decreased social inhibition with apparent disregard for potentially harmful consequences (sexual over-act

13、ivity, reckless鲁莽的 spending, dangerous driving, inappropriate business),20,DepressionIt is a mental state characterized by excessive sadness. Core symptom: depressed moodLoss of interestAnhedonia Negative, pessimistic thoughts about the self (low self-esteem), the world and the futureGuilt and worth

14、lessness or death or suicide,21,Apathy 冷漠It is loss of interest or emotional involvement.,22,Anxiety It is an abnormal and overwhelming sense of apprehension and fear. Involving subjective fear, bodily discomfort and physical symptomsPathological anxietyPresent in discrete attacks with no external s

15、timulus (panic disorder)Present in discrete attacks with feared stimuli (phobias)Present in generalized, persistent state (generalized anxiety disorder),23,PhobiaIt is an exaggerated夸张的, usually unreasonable, fear of someone or something. AgoraphobiaSocial phobiaSimple phobia/specific phobia,24,Summ

16、any,25,Illusion Hallucination Delusion Obsession Compulsion Amnesia Dementia Mental retardation,Mania Depression Apathy Anxiety Phobia,Case study 1,An 84-year-old woman is admitted to an acute medical ward. She lives alone. According to her neighbour she remained active until a few days ago. He reca

17、lls she was in hospital with a chest infection last year, but has never noticed her having any problems with her memory or any abnormal thoughts. She was admitted with confusion, after being found on the floor by paramedics. The patient tells you she was beaten up by the secret service who took her

18、to a police station. She believes the secret police followed her home due to connections that her dead husband had with a foreign police force.,26,She is irritable and has at times asked to go home as she believes she is still in the police station and has spent enough time there. She describes seei

19、ng many police officers sitting around drinking tea. Her speech is difficult to follow.,27,Case study 2,A 25-year-old woman lives with her mother. She was referred by her GP after she told him at a routine appointment that she often has an overwhelming impulse to jump in front of a train when she is

20、 standing at a station. This has alarmed her as she does not want to die. She has never harmed herself and has never wanted to. She has recently lost her job due to consistent poor time-keeping. Although she wakes several hours before she needs to leave the house, she cannot bear to leave until she

21、has washed herself at least five times.,28,If she touches the floor with her bare feet after her shower she has to start again. If she does not do this the thoughts of being contaminated with dirt become unbearable. She commnets that she knows her thoughts are “not logical” and feels frustrated that

22、 she cannot stop her excessive washing.,29,Diagnosis,ICD-10 (International Classification of Diseases)DSM-5 (Diagnostic and Statistical Manual of Mental Disorders)CCMD-3 (Chinese Classification and Diagnostic Criteria of Mental Disorders),30,The categories of mental disorders in DSM-,31,Schizophreni

23、a,Schizophrenia is a severe mental disorder characterized by withdrawal from reality, delusions, hallucinations, and changes in both behavior and mood. Schizophrenia is mainly divided into simple type, hebephrenic type, catatonic type, paranoid type and undifferentiated type. Life-time prevalence 1%

24、Onset age 18-25 years for men and 21-30 years for women,32,Subtypes of schizophrenia,Schizophrenia has also been subdivided on the basis of psychopathology, course, and response to treatmentHebephrenic schizophrenia/disorganized schizophreniaParanoid schizophreniaCatatonic schizophreniaSimple schizo

25、phreniaUndifferentiated schizophrenia,33,Paranoid schizophrenia,This type is the most common form of the illness.Is characterized by prominent突出的 paranoid delusion, thought processes and mood are relatively sparedThe patient may appear normal until his abnormal beliefs are uncovered揭露.,34,Catatonic

26、schizophrenia,This type is much less frequently now than in previous yearsMotor disturbance is the dominant featureStupor昏迷 (psychomotor inhibition), waxy flexibility蜡样屈曲, mutism缄默症, negativism否定论 and stereotyped陈旧的 act or speechAgitated hyperactivity (catatonic excitment),35,Hebephrenic schizophren

27、ia,About 11% of patients can be diagnosed this typeIs characterized by the absence of systematized delusions and the presence of incoherence and inappropriate affectSilly and childish behavior,36,Simple schizophrenia,About 2% of patients can be diagnosed this type.Is characterized by the insidious隐忧

28、的 development of odd behavior, social withdrawal, and declining performance at workClear symptoms are absentDifficult to identify reliablyPoor outcome,37,Undifferentiated schizophrenia,This type is the next most frequent formDelusions and hallucinations of any type are prominent and are accompanied

29、by incoherence and grossly of disorganized behavior.,38,Mood/affective disorders,Mood is a sustained持续的 emotional tone情绪基调 perceived along a normal continuum of sad to happy. Mood disorders are characterized by abnormal feelings of depression or euphoria精神欢快 with associated psychotic features in som

30、e severe cases.,39,The classification,40,Manic episode/mania,Depression (unipolar),Dysthymia,Bipolar disorders,Cyclothymia,Clinical presentations,Manic episode躁狂发作Major depressive episode抑郁发作,41,Manic episode,Three “high” symptomsEuphoric mood/elationAccelerated thought process and speech (flight of

31、 ideas) Increase in activity,42,Major depressive episode,Three “low” symptomsDepressed mood情感低落 (core symptom)Diminished ability to think or concentratePsychomotor retardation精神运动性障碍,43,Neurosis,Psychosis Neurosis is a mental illness in which insight is retained but there is a maladaptive不适应的 way of

32、 behaving or thinking that causes suffering. 1, absence of organic causes2, relatively good social function3, considerable insight,44,Neuroses,AnxietyPhobiaObsessive-compulsive disorderSomatoform disorders躯体病样精神障碍Neurasthenia神经衰弱症,45,Anxiety,Not attributable引起 to real dangerPersist state generalized

33、 anxiety disorderUnexpected attack panic disorder,46,GAD,CLINICAL FEATURESPsychological symptoms Physical symptoms Sleep disturbance,47,Psychological symptoms,Free-floating anxietyAnticipatory anxietyWorrying thoughtRestlessnessIrritablePoor concentration,48,Physical symptoms,Cardiovascular Palpitat

34、ion, discomfort in chest, pain over the heartRespiratory Constriction in the chest, difficulty inhaling, overbreathingGastrointestinal Dry mouth, difficulty in swallowing, epigastric discomfortNeuromuscular Headache, tremor, tinnitus, dizziness, aching muscles,49,Sleep disturbance,Difficulty falling

35、 asleepWaking up in the middle of sleepingEarly morning awakening,50,Panic disorder,Panic disorder is characterized by recurrent episodic severe panic (anxiety) attacks, which occur unpredictably and are not restricted to any particular situation or set of circumstances.,51,Panic attacks are discret

36、e periods of intense fear, impending doom or discomfort, accompanied by characteristic symptoms: palpitations, tachycardia, sweating, trembling, breathlessness, feeling of choking, chest pain/discomfort, nausea/abdominal discomfort, dizziness, paraethesias, chills and hot flushes, derealization, dep

37、ersonalization and fear of losing control, “going crazy” or dying.Not in real danger5-20 min, 1hWithout impairment of consciousnessAbsence of organic causes,52,Obsessive-compulsive disorder,Obsessions ThoughtsruminationsdoubtsImpulseCompulsions CheckingWashingCounting Rituals,53,Phobia,Provoked by p

38、articular objects or circumstancesAcute attackAvoidanceClassification AgoraphobiaSocial phobiaSimple phobia,54,Agoraphobia,Common themesCrowdingConfinement Open spacesSocial situationPublic transportationCrowded shopsEmpty streetsCinemas, theatres,55,Social phobia,Common themeBeing observed and open

39、 to criticismCommittees, seminarsSocial gatheringsWriting or performing in front of othersEating or drinking in publicEye to eye,56,Simple phobia,Common theme (Inappropriate anxiety)Animals, insectsBloodSharp objectsNatural phenomenon,57,Hysteria/dissociative (conversion) disorder,Hysteria is a psyc

40、honeurosis marked by emotional excitability and disturbances of the psychic, sensory, vasomotor, and visceral functions without an organic basis.,58,Stress-related disorders,Stress-related disorders are temporary mental disorders caused by stressing events (traumatic events) that threaten, harm or c

41、hallenge an individual. Stress-related disorders include acute stress disorder or acute stress reaction, and post-traumatic stress disorder.,59,Organic Psychoses (organic mental disorders),Organic psychoses (singular: psychosis) refer to the mental illnesses caused by an injury to the brain or by so

42、me interference with normal brain function. One form of organic psychosis is acute organic brain syndrome(OBS). Senile dementia is an example of chronic brain syndrome, in which the brain atrophies, resulting in the loss of memory and intellectual functions, altered personality and other symptoms.,6

43、0,Psychoactive Drug-related Mental Disorders,Psychoactive drugs or substances refer to chemical substances that work on central nervous system and affect brain functions, resulting in changes in perception, mood, consciousness and behavior. These substances include alcohol, opium, marihuana, ATS (Am

44、phetamine-Type Stimulants) such as ice (methamphetamine) and MDMA.,61,Case study 3,You as a psychiatrist are asked to visit a 22-year-old man, Tom, at home. His concerned mother reports that he dropped out of college two years ago and has become increasingly withdrawn since. He spends most of his da

45、y in his bedroom with the curtains drawn, muttering to himself about cars which stop outside the house. He is reluctant to talk to you, but eventually confides that he believes red cars follow him whenever he goes out, monitoring his movements because they want to kill him. He recently saw a red car

46、 parked at a bus stop and believed this was a message from MI5 telling him to “watch out”. He has smoked cannabis regularly since the age of 14, but less so in the last year.,62,The longest he has abstained from cannabis use was three months, but his made little difference to his symptoms. His mother tells you worry about her son is driving the family apart.,63,