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Unit 5 Neurotic D
Unit 5 Neurotic D
Unit 5 Neurotic D
Neurotic/anxiety disorder
Neurotic disorders
Introduction:
Neurotic disorder (neurosis) is a less severe form of
psychiatric disorder where patient s shows either
excessive or prolonged emotional reaction to any given
stress. These disorders are not caused by organic disease
of the brain and however severe; do not involve
hallucination and delusions.
Definition
The term neurosis is define as the presence of a
symptom or group of symptom which cause
subjective distress to the patient, the symptoms is
recognized as undesirable (i.e insight is present). The
personality and behavior are relatively persevered
and not usually grossly disturbed. The contact with
reality is preserved. There is an absence of organic
causative factors.
Causes of neurosis
2. Respiratory
Confusion
Difficulty inhaling
Over breathing
Chocking
Gastrointestinal
Dry mouth
Difficult in swallowing
Epigastric discomfort
Frequent loose motion
Abdominal pain
genito- urinary
Freqyency of micturation
Sexual dysfunction
Menstrual dysfunction
Ammenorrhea
5 neuromuscular
Tremor
Pricking sensation
Tinnitus
Tension headache
blurring of vision
Dilated pupils
Phobic disorders
A phobia is an unreasonable fear of an object, or
situation or activity. Fear is rational reaction to an object,
identified external danger and may involve flight or
attack in self-defense.
Types of phobia
1. Simple phobia
2. Social phobia
3. Agora phobia
1. Simple phobia (specific phobia)
Simple phobia is a strong persisting fear of an object or
specific situation. It is more common than social phobia.
E.g of simple phobia include animal type, natural
Rita Yadav Page 13
Mental health nursing 2nd year
Etiology
Traumatic social experience e.g embarrassment or by
social skills deficits that produce recurring negative
experience.
Genetic factors
Environmental factors
Abnormalities are some neurotransmitters system
(e.g nor epinephrin, gamma aminobutaric acid
(GABA), dopamine.
Treatment
1. pharmacotherapy
Benzodiazepines (e.g , alprazolam, clonazepam,
loraepam , diazepam)
Antidepressants (e.g imipramine, seraline)
2. behaviour therapy
Fooding
Systematic desensitization
Relaxation technique
Exposure and response prevention
3. cognitive therapy is used to break anxiety pattern.
4. psychotherapy-supportive psychotherapy
Nursing interventions
Reassure the patient that he is safe.
Explore patient‘s perception of the threat to physical
integrity.
Patient may choose either to avoid phobic stimulus or
attempt to eliminate the fear associated with it.
If the patient elects to work on eliminating the fear ,
techniques of desensitization or implosion therapy
may be employed.
Encourage patient to explore underlying feeling that
may be contributing to irrational fears.
Attend group activities with the patient that may be
frightening for him.
Administer antianxiety medications as ordered by the
physican, monitor for effectiveness and adverse
effects.
Positive reinforcement for voluntary interactions with
others.
1. Washers
2. Checkers
3. Pure obsession
4. Primary obsessive
1. washers
This is commonest type. Here the obsession of
contamination with dirt, germs and body excretion. The
compulsion is washing of hands or the whole body
repeatedly many times a day. it usually spreads on to
washing of clothes, washing of bathroom, bedroom,
doorknobs and personal articles.
2.checkers
In this type, the person multiple doubts. E.g the door
has been locked, kitchen gas has been left open,
counting of money was not exact etc. the
compulsion of course is checking repeatedly to
remove the doubt. Any attempt to stop the checking
leads to more anxiety.
3.Pure obsessions
etiology