Introduction

By: Dr. Mohamad Ezzat Arafa

Professor of Psychiatry,Faculty of
Medicine, Cairo University.
 Psychiatry
• Psychiatry is the branch of Medicine that deals with
the diagnosis and treatment of Psychiatric Disorders.

• Psychiatric disorders are disorders in mental or

psychological functions manifested as disorders of
perception, thinking, emotions, decision taking and
motor behavior.

• Psychiatry is different from Psychology.

 Psychiatry
• Psychology is the scientific study of individual
human behavior (perception, thinking, emotion
and motor behavior).

• It is not concerned with the diagnosis and

treatment of disorders of these functions.

• Psychology is not a branch of medicine.

• Human behavior in groups is the domain of
Sociology.
 Psychiatry
• There is a degree of overlap between
Neurology and Psychiatry.

• Psychiatric disorders are due to disorders of

the brain (the organ responsible for mental
functions)

• Still, it is different from Neurology (central

and peripheral) that result in sensory and
motor physical manifestations.
 Psychiatry
• In the last two decades, psychiatry has gained
increasing importance to general medical
practice.

• Epidemiological evidence has shown that

psychiatric disorders are widely spread, may
be more prevalent than most other medical
disorders.
 Psychiatry
• Many of physical complaints presenting to
other medical specialties are primarily
symptoms of pure psychiatric disorders.

• The psychiatric aspect of patients with medical

and surgical disorders plays an important role
in the prognosis and management of those
patients.
 Psychiatry
• In October 2001, the WHO Yearly Report
cited four psychiatric disorders among the top
ten diseases that caused worldwide disability
in all age groups.

• They are Unipolar Depression (ranked 1st),

Alcohol Use Disorders (ranked 5th),
Schizophrenia (ranked 7th), and Bipolar
Mood disorder (ranked 9th).
 Psychiatry
• Revolutionary advances in research on the
brain was reflected on a much better
understanding of the underlying
pathophysiological and neurochemical
abnormalities associated with psychiatric
disorders.

• Many therapeutic interventions were

introduced, and changed the prognosis of
many psychiatric disorders.
 The Mind-Brain Relationship
• Today with the great advances in
neuroscience, the mind and brain are
understood as one and the same.

• Mind, although abstract in nature, is thought to

be the product of biological processes in the
brain.

• These processes may be visualized in the brain

by special neuroimaging techniques.
 The Mind-Brain Relationship
• Mental functions such as memory, learning,
habituation, and conditioning are now defined
in neuro-molecular and neurophysiological
terms.

• For example, consolidation of memory is now

believed to be the product of long term
potentiation inside the neuron.

• This alters synaptic activity resulting in actual

change in synaptic structure.
 The Mind-Brain Relationship
• This ability of brain synapse to alter its configuration
in response to experience is called brain plasticity
which has far reaching effects on our understanding
of mind-brain relationships.

• This means that psychological influences lead to

functional and structural changes in the brain, e.g..
what we do in psychotherapy with our patients is
translated into enduring brain structural changes with
repeated sessions.

• It also means that experience shapes the structure of

the brain.
 Evaluation of Normality and
Abnormality
• Understanding normality is both important and
difficult.

• In medicine, clinicians are educated to

intervene in order to return individuals to a
normal non-pathological healthy state.

• They are aided by measurable attributes such

as blood counts or other laboratory tests.
 Evaluation of Normality and Abnormality
• In psychiatry, a person is considered abnormal
(disordered) if he displays two major
characteristics:

(1) clear psychiatric symptoms and signs

leading to significant distress to the patient or
suffering to others; and :

(2) manifest decline in social and vocational

adjustment.
 Evaluation of Normality and Abnormality
• Psychiatric symptoms and signs are not as easily
measurable as laboratory test.

• Departure from normality may be considered as an

exaggeration of a normal mood or behavior such as
anxiety or depression.

• Accordingly people who manifest anxiety or

depression in an exaggerated form are considered
abnormal.

• In other instances, the person is considered abnormal

if he displays symptoms that should not occur in
normal life, such as hallucinations and delusions.
 Evaluation of Normality and Abnormality
• Psychiatric disorders have an impact on social
and vocational functioning of patients.

• This gives psychiatry a great economic and

societal value.

• Psychiatric patients always perform at a lower

level than expected making them a great
economic burden and a source of lots of
familial and social problems.