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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.
           
  •      In manic phase, the patient may exhibit the following symptoms:
    •     Elevated mood,
    •      Increased energy,
    •      Increased activity,
    •      Increased talkativeness,
    •      Over familiarity,
    •      Increased sexual energy,
    •      Decreased need for sleep,
    •      Increased irritability 
    •      Grandiose ideas.
(4) SCHIZOPHRENIA

Schizophrenia is a debilitating psychiatric illness characterized by distortions in perception, affect, thinking and behaviourThe 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.