COMMON PSYCHIATRIC ILLNESSES
(1) ANXIETY DISORDERS
•The
characteristic feature of anxiety disorder is excessive fear or worry.


(2) CLINICAL DEPRESSION
•Depression
is one of the most common psychiatric illnesses.
•The lifetime prevalence rate of depression is 7%.
• The symptoms are
present for at least 2 week period.
•Depression
may include the following symptoms:
•Low
mood, reduced energy & activity,
•Poor
concentration,
Psychomotor retardation/agitation
•Disturbed
sleep
•Diminished
appetite
•Ideas
of guilt/worthlessness,
Reduced self esteem/ self confidence
•Loss
of interest in pleasurable activities
•Self
Harm/ Suicidal thoughts
(3) BIPOLAR AFFECTIVE DISORDER (BPAD)
Bipolar Affective Disorder is
characterized by changes in mood, energy, and activity levels. These moods range from periods of extremely “elated, irritable, or energized behaviour (known as manic episodes) to very “down", sad, indifferent, or hopeless periods (known as depressive episodes). The lifetime prevalence of bipolar disorder is 0.6%. The symptoms last at least 1 week and present most of the day.
(4) SCHIZOPHRENIA
•Schizophrenia is a debilitating psychiatric illness characterized by
distortions in perception, affect, thinking and behaviour. The person looses touch with reality.
•Lifetime prevalence of schizophrenia
is 0.3-0.7%.
•The common symptoms are present for a significant portion
during a one
month period:
•Hallucinations: a sensory perception (vision, audition, touch, smell
and taste) that occurs in the absence of external stimuli.
•Delusions:
fixed, false/irrational beliefs which have no basis in reality
•Disorganized Behaviour: odd behaviour which looks grossly abnormal
•Disorganized Speech: irrelevant talk which has no meaning.
•Affective Disturbances: apathy, anhedonia (lack of interest in
daily/pleasurable activities), showing no emotions or limited emotions
(5) OBSESSIVE COMPULSIVE DISORDER (OCD)
•OCD
comprises of obsessions, compulsions or both.
•They must be
present for at least 2 week period.
•The prevalence
rate in general population is 2%.
•Obsessions are
ideas, images, impulses that enter the patient’s mind again and again in a
stereotyped form which cause distress and patient is unable to resist them.
•Thoughts are
recognized as one’s own even though they are involuntary and often repugnant.
•Some common
types of obsessions are contamination fears, intrusive violent thoughts and
images, fear of harming yourself or others etc.
•Compulsions are
stereotyped behaviours that are
repeated again and again.
•Compulsive
acts try
to neutralize the anxiety that arises from obsessive thoughts.
•Some common
types of compulsions are cleaning/washing, arranging and rearranging objects,
checking electrical appliances or locks etc, hoarding large number of items etc.
•Depression
and
anxiety are common along with OCD symptoms.
(6) SOMATOFORM DISORDERS
•Somatoform
disorders are characterized by the presence of the following:
•Repeated
presentation of physical symptoms, together with persistent requests for
medical investigations, in spite of
repeated negative findings and reassurances by doctors that the symptoms have
no physical basis.
•If any
physical disorders are present, they do not explain the nature and extent of
the symptoms or the distress and preoccupation of the patient.
•The
diagnosis requires the presence of the following:-
(1)At least 2 years of multiple and variable physical
symptoms for which no adequate physical explanation has been found
(2)Persistent
refusal to accept the advice or reassurance of several doctors that there is
physical basis for the symptoms.
Some
degree of impairment of social and family functioning attributable to the
nature of the symptoms and resulting behaviour.
(7) INSOMNIA
•Characterized
by
difficulty with sleep initiation and/or maintenance, and final
awakenings that occur earlier than the
established wake-up time.
•Patient complaints duration of sleep being short or that sleep feels broken, less refreshing or insufficiently deep or that the pattern of sleep has changed for worse.
•Complains of sleep
occur in many psychiatric disorders, including
depression, generalized anxiety, panic and
phobia etc.
•Early
insomnia or difficulty in getting sleep, occurs in normal
people who are aroused through anxiety or excitement. Their
thoughts tend to dwell on the affect laden experiences of the immediate past
and also to rehearse ways of dealing with problems. This makes them experience
fatigue.
(8) POST-TRAUMATIC STRESS DISORDER
This arises as a response to a stressful event or situation (either
short or long lasting) of an exceptionally threatening or catastrophic nature
which is likely to cause pervasive distress in anyone (ex: natural/man-made
disaster, combat, serious accident, witnessing the violent death of others,
being the victim of torture, terrorism, rape or other crimes.
Reliving of trauma in intrusive memories (“flashbacks”) or dreams, detachment
from other people, anhedonia, avoidance of activities and
situations, reminiscent of trauma, acute bursts of fear, panic, aggression, hypervigilance, enhanced startle
reaction, insomnia, anxiety and depression.
(9) SEXUAL DISORDERS
The The essential features of sexual dysfunctions are an inability to respond to sexual stimulation, or experience of pain during the sexual act. Dysfunctions can be defined by disturbance in the subjective sense of pleasure or desire usually associated with sex, or by the objective performance. Sexual dysfunctions can be lifelong or acquired, generalized or situational and result from psychological factors, physiological factors, combined factors and numerous stressors including prohibitive cultural mores, health and partner issues and relationship conflicts.
Sexual dysfunctions includes:
- Lack or loss of sexual desire
- Sexual Aversion and lack of sexual enjoyment
- Failure of genital response
- Orgasmic Dysfunction
- Premature ejaculation
- Non-organic Vaginismus
- Non-Organic Dyspareunia
- Excessive sexual drive
- Other sexual dysfunction, not caused by organic disorders/disease
(10) SUBSTANCE ADDICTION
The essential feature of a substance use disorder is a cluster of cognitive, behavioural physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems. These substances could include Alcohol, Tobacco, Ganja, Charas, Cocaine etc. Consumption of substances can be described in terms of following states:
ACUTE
INTOXICATION: Temporary condition following the consumption of substances which result in disturbances in level of consciousness, cognition, perception, affect or behaviour or other psychophysiological functions/ responses.
HARMFUL USE: Harmful patterns of use which causes damage to physical and mental health, criticized by others and associated with adverse social consequences.
SUBSTANCE DEPENDENCE: It is characterized by a strong desire or sense of
compulsion to take the substance, a physiological withdrawal state, evidence of tolerance-need for
increased doses of psychoactive substances to achieve the desired effect, neglect of other alternative
pleasures/interests, persistent substance use
in-spite of harmful consequences such as harm to liver, impairment of cognitive
functioning etc.
WITHDRAWAL STATE: A group of symptoms that the
individual experiences when the patient has ceased or reduced substance use
that has been heavy and prolonged. Some of these symptoms could be sweating,
increased hand tremor, insomnia, vomiting, hallucinations/illusions, psychomotor
agitation, anxiety, or seizures.
(9) SEXUAL DISORDERS
Lack/loss of sexual desire
Sexual Aversion and lack of sexual enjoyment
Failure of genital response
Orgasmic Dysfunction
Premature ejaculation
Non-organic vaginismus
Non-organic dyspareunia
Excessive sexual drive
Other sexual dysfunction, not caused by organic disorders or disease.