نفسية عملي
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2
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Neurosis VS psychosis
: الفرق في المحاضرة السابقة مع اضافة مايلي
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Treatment for neurosis :-
1-psychotherapy .
2-anxiolytic or anti-depressants.
3-ECT.
Neurosis :female more than male are affected.
While in Psychosis :-
1-anti-psychotic
2-ECT
3-psychotherapy.
Male more are affected.
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Mental state examination :
1.appearance of the person(neglect himself?dirty? or how he looks?).
2.behaviour such as having Tics(involuntary suppressible movement of body parts, or facial
grimacing).
3.facial expression(sad,happy,blunt affect).
4.eye contactpt with depression will avoid eye to eye contact while manic pt will NOT.
5.others:-tatto,cannula for drug use,etc.
Notes on depression :-
It includes physical & psychological disturbance.
person talk with the pt ).
nd
**The delusion usually is persecutory in depression (2
**the pt has insight always"he confises that he has some functional disturbance
"psychologic illness& that he need treatment.
**depressed pt usually have good & normal appearance "he doesn't neglect himself".
Speech abnormalities in psychiatry:-
a-stream
Slow speech indicates depression
Pt can't concentrate,sleep
disturbance,low tone
voice,slow speech,loss of
appetite &dyspnea.
Unhappy ,sad all the time with feeling of guilty
"this feeling makes the pt very near to suicidal
thoughts or ideas"
كتابة الطالب
Rapid (flight )mania.
Thought block
Jumping from one topic to another.
b-content
delusion,circumstantiality"
delusion :-unshakable belief (ideas)in fully conscious person which are un reasonable.
يعني افكار غير
. منطقية واليمكن تغييرها
Circumstantiality:- يلف ويدور حول الموضوع الرئيسي بشكل غير مباشر من دون ان يصل الى الهدف من
.راوحلا
Hallucination :- misperception with no external stimulus in fully conscious person.
Note :- in schizophrenia there will be 3
rd
person commenting or arguing about the pt.
--cognitive function exam:-this includes the following:-
a-memory:-
-recent:-you will tell him something then ask him after few minutes about it.
-remote:-who was the president of Iraq in ---?what war we had witnessed last few yrs?
b-orientation:-place ,person,time.
c-general infos.
d-intelligence:-what level of education you have reached?graduated from where?or u can
give him an dilemma to resolve it ( (معضلةاو مسألة
e-concentration:-
نتكلم له قصة قصيرة
ثم نسأله عن تفاصيلها بعد ذلك
) او نلقنه ارقام ثم نسأله عنها مثلما قلناها له (ترتيبا
--Thinking :-
a-concrete :- in schizophrenia.
b-abstract thinking.
--Autism:-
Diagnosed usually before 3yrs with :-
1-pt has no concentration or attention his surrounding"apathy"
2-no spoken words .
3-no social communication with others.
Or sometimes he grows normal then subside.(after two yrs).
Treatment :-
1-speech therapy.
2-hyperbaric oxygen therapy:-leads to vasodilatation or vessels thus increasing the
neurotransmission of impulses with increase neurotransmitters in brain.
**these pts usually have permissive developmental disorder(Asperger disease).