General Psychiatry History of psychiatry

Reil johann Coined- Psychiatry Founded the first psychiatric journal

Freud, Sigmund Founder of psychoanalysis Coined - Free association, Oedipus, penis envy, Id, ego and superegoCocaine in Psychiatry Psychodynamic theory Wrote book - Interpretation of dreams

Alfred Adler Coined - Inferiority complex

Pavlov, Ivan Coined- Classical conditioning

Piaget, Jean Stages of cognitive development

Jung, Carl Coined- Introvert/ Extrovert, Electra complex

Kubler Ross 5 stages of grief in dealing with death

Erik Erikson Divided personality development in to 8stages - PSYCHOSOCIAL

Bleuler, Eugen Coined- Schizophrenia Described cardinal symptoms (4A’s) of SZ

Dendy Walter Coined- Psychotherapy

Sigmund Freud Erik Erikson

Emil Kraepelin Dementia praecox

THEORY

Skinner Coined - Operant Conditioning

PsychosexualDevelopment

Topographical theory of mind

(DABDA)

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Approach to patient

I. Identifying dataII. Source and reliabilityIII. Chief complaintIV. Present illnessV. Past psychiatric historyVI. Substance use/abuseVII. Past medical historyVIII. Family history

IX. Developmental and social historyX. Review of systemsXI. Mental status examinationXII. Physical examinationXIII. FormulationXIV. DSM-5 diagnosesXV. Treatment plan

Parts of the Initial Psychiatric Interview

History Examination Investigations Diagnosis

Most important in Psychiatry

Least important in Psychiatry

Reliability of information

• Relation to Patient• Intimacy with the patient • Interest of the patient’ • Does the Informant live with the patient? • Duration of stay with the patient • Intellectual and observational ability

Previous Year Questions AIIMS NOV17Q. Basis of reliability of information of patient provided by informants depends on all except?

A. Biological relation B. Educational statusC. Observation skillD. Duration of stay with the patient

a. Perinatal history b. Childhood history c. Education history d. Play history e. Emotional problem during adolescence f. Puberty g. Obstetrical history h. Occupational history i. Sexual and marital history j. Premorbid personality

COMPONENTS of Personal history

Previous Year Questions AIIMS MAY16Q. Personal history includes all except?

A. Food preferencesB. Academic history C. Occupational history D. Marital history

:

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Transference is redirection of a client's feelings from a significant person to a therapistThere are three stages in dealing and using transference in social casework. these stages are:

Understanding of the transference is essential for the worker as it helps to understand the behaviour of the client and to recognize its significance in his development process. Explains the present unconscious needs of the client.

Utilization of the transference depends on the understanding of the social case worker of the phenomena. It explains many cures or treatments of emotional disturbance by life situations and by fortune relationships with other problems

Interpretation of the transference, that is, confronting the individual with the awareness that his behaviour is the repetition of a specific unconscious infantile is definitely part of psychoanalytical therapy and requires preparation of the individual by the careful analysis of his unconscious defense.

Counter-transference is defined as redirection of a therapist's feelings toward a clientIt’s a therapist's emotional entanglement with a clientIt is a two way process. Social case worker has also unconscious tendency to transfer out the client. As in the case of transference, these counter transference feelings, both positive an negative,are unconscious but operate with force. Therefore, it is the job of case worker to recognize his feelings and must control them.

Transference

Counter-transference

Previous Year Questions NEET PG 21Q. While therapy session a therapist developed unconscious and conscious feelings towards the patient . what is it called?

1. Understanding the Transference 2. Utilizing the transference. 3. Interpreting the transference.

↳ burner transference

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Mental status examination

Components of MSE

Psychiatric equivalent of the physical examination in the rest of medicine

Appearance and Behavior

Motor Activity

Speech

Mood and affect

Thought

Perception

Cognition

Abstract ReasoningInsight

Judgment

Look for

Orientation Attention and concentration Memory

Test For

Does the patient appear to be his or her stated age, younger or older? Is this related to the patient's style of dress, physical features, or style of interaction?

Appearance and Behavior

Motor Activity Normal, Slowed (bradykinesia), or Agitated (hyperkinesia).

Gait, freedom of movement, any unusual or sustained postures, pacing, and handwriting

To note:

SpeechElements considered include fluency, amount, rate, tone, and volume.

Mood and affect

Patient's internal and sustained emotional state.

"sad," "angry," "guilty," or "anxious"

Expression of mood or what the patient's mood appears to be to the clinician.

Mood

What you feel

Affect

What you see

Congruent to mood Incongruent to mood

Matching

Bipolar

Not matching

Schizophrenia

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HEALTHY THINKING

CONSTANCY- Persistence of a completed thought whether simple or complex.Organisation- Contents are related but do not blend with each other but organisedContinuity- Thoughts or ideas are arranged in order

Disorders of thought

Stream

Flow of ideas1. Disorders of tempo- i. Flight of ideas ii. Inhibition of thinking

2. Disorders of Continuing- i. Perseveration ii. Thought blocking

Content

1. Overvalued idea2. Magical thinking3. Superstition4. Delusion - Fixed, firm belief in something that is not a fact

Possesion

1. Thought block2. Obsession— Repeated intrusive thoughts eg:- OCD3. Thought alienation- Controlled by someone eg:- Schizophrenia i. Thought insertion ii. Thought withdrawal iii. Thought broadcasting

Form

The way thoughts are put in.Characteristic of Schizophrenia i. Loosening of association ii. Verbigeration- no connection b/w words iii. Neologism - coining new word iv. Tangentiality- loss of connection v. Circumstantiality- unnecessary details vi. Derailment- jumping to new topic

Previous Year Questions INICET NOV 20211. A 40 yr old male patient comes to psychiatry OPD with complaints of having repetitive thoughts that his hands are dirty, though they are not. He knows that these are his thoughts only. This gives him discomfort and hence he has to wash them again and again. This is a disorder of thought of?

Thought

Thought broadcasting

The patient believes that his thoughts are broadcast so that he himself or others can hear them.

Possesion

Thought insertion

The patient believes that thoughts that are not his own have been inserted into his mind.

Thought withdrawal

The patient believes that thoughts have been taken away from his mind.

→ By Schneider

( false fixed belief)

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