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Psychiatric Suggestions
Psychiatric Suggestions
Author
Shahariar Nadim
&
Sumaiya Akter
Psychiatric Disorder-Diagnosis
and treatment
Term 02 Suggestions
"Just because no one else can heal or do your inner work for you. that doesn’t mean you can, should, or
need to do it alone." -Shahariar Nadim
1. Write the names of five antipsychotic drugs.
3. What do you mean by phobia? What are the types of phobias? How do
you manage?
Phobia: Persistent, irrational fear of a specific object, activity, or situation that
results in a compelling desire to avoid the phobic stimulus.
There are three types of phobias –
Specific or simple phobia (e. g spider phobia, height phobia, phobia of
flying, phobia of dental chair, phobia of illness, phobia of animals, storms,
height, water, injections, blood, elevators, driving etc.).
Social phobia (e.g. phobia in restaurants, canteen, dinner parties,
seminars, board meetings
Agoraphobia (e.g. being on a bridge, traveling in bus or train or
automobiles or planes)
4. Write down five symptoms of a Manic episode. What are the common
side effects of antipsychotics?
Here are some strategies that are often used to manage GAD:
Psychotherapy:
Panic attack: A panic attack is a sudden episode of intense fear that triggers
severe physical reactions when there is no real danger or apparent cause.
Panic attacks typically include some of these signs or symptoms:
• Sense of impending doom or danger
• Fear of loss of control or death
• Rapid, pounding heart rate
• Sweating
• Trembling or shaking
• Shortness of breath or tightness in your throat
• Hot flashes
• Nausea
• Abdominal cramping
• Chest pain
• Headache
• Dizziness, lightheadedness or faintness
• Numbness or tingling sensation
• Feeling of unreality or detachment
Or/ This is an emergency medical situation for the patient where there is an
episodic period of intense fear or discomfort, in which 4 out of 13 following
symptoms have to be present. The symptoms develop abruptly and reach a peak
within 10 minutes.
i Palpitation, pounding heart, or increased heart rate
14. What are the causes of Psychiatric disorders? Why psychiatry learning
is important for an Occupational therapist?
There is rarely one single cause of a mental disorder. Most mental disorders are
caused by a combination of factors, which include:
• Biological factors
• Stressful life events
• Individual psychological factors e.g. poor self-esteem, negative
thinking
• Adverse life experiences during childhood e.g. abuse, neglect,
death of parents, or other traumatic experiences.
• Socio-economic factors.
Mental disorders are NOT the result of possession by evil spirits, curses,
astrological influences, or black magic.
Psychiatry learning and its importance for Occupational Therapists:
For Occupational Therapists (OTs), understanding psychiatry is crucial for
several reasons:
Accurate assessment
Effective treatment planning
Holistic approach
Promoting mental health wellness
Client-Centered Care
Mental Health Promotion and Prevention
Kurt Schneider (1887 – 1967): He was a German Psychiatrist who first classified
the symptoms of schizophrenia in 1938.
The presence of at least one first-rank symptom in the absence of organic illness
is usually diagnostic of schizophrenia
1. Auditory hallucination: 3rd person type, running commentary type
2. Primary delusion: Delusional perception
3. Thought insertion
4. Thought withdrawal
5. Thought broadcasting
6. Delusion of control- action, and feelings are experienced as controlled by
an external force or agency
7. Hearing of one‘s own thoughts (thought echo)
8. Somatic hallucination
Management:
Assessment and Diagnosis:
History taking, examination (general examination, systemic examination &
mental state examination), relevant investigations.
Treatment:
Pharmacological treatment:
Anti-psychotics medications
• Typical or 1st generation anti-psychotics eg. Haloperidol,
Chlorpromazine,
Trifluoperazine etc.
• Atypical or 2nd generation anti-psychotics eg . Olanzapine, Risperidone,
Aripiprazole, Quetiapine, Clozapine etc.
Other Treatment: ECT (Electroconvulsive therapy)
Non-pharmacological treatment:
Psychosocial management – Psychoeducation, family psychotherapy,
cognitive behavior therapy, social skill training, group therapy, vocational
therapy, and rehabilitation.
Hospitalization:
16. Write down the clinical features of OCD. How will you manage it?
Obsession
In obsession, the patient has recurrent and persistent thoughts, impulses, or
images- that are intrusive and inappropriate. The person attempts to suppress
such things but fails.
Compulsion
There are repetitive behaviors (like washing, ordering, checking), or mental acts
(like praying, counting, and repeating words silently). The person feels driven to
perform in response to an obsession and resists the obsession.
These are usually associated with certain degrees of anxiety and depression.
Treatment
Obsessive-compulsive disorder is typically treated by
Psychotherapy
Cognitive behavioral therapy (CBT)
Exposure and response prevention therapy (ERP)
medication, or
both at the same time
Lifestyle change
Management:
OTs can help with activities of daily living, cognitive retraining, and
sensory stimulation.
OTs can adapt daily activities, promote independence, and facilitate
participation in meaningful occupations.
Functional assessment
Adaptive equipment
Environmental modifications
Community reintegration: Support participation in meaningful activities
and social interaction.
21. What are the difference between epileptic fit and Conversion disorder?
Difference between epileptic fit and fit from conversion disorder
Epilepsy/True Seizure Conversion
disorder/Pseudoseizure
Consciousness Real loss No real loss
Fits alone / during sleep Yes No
Every fit same as the other Same in each situation Different in each situation
Movement of the limbs Yes, in typical fashion Yes, but variable
Tongue bite Present Absent
Incontinence of urine and Present Absent
faeces
History of fall and injury Present & Genuine This may be present due
to constant friction over
the ground
Types of ASD:
1. Au�s�c Disorder
2. Asperger Syndrome
3. Pervasive Developmental Disorder
Management:
Assessment and Diagnosis:
History taking, Mental State Examination, Investigations Diagnosis
Treatment:
Pharmacological treatment:
A. Acute phase
1. Anti-psychotic drugs: Typical or atypical anti-psychotic drugs to reduce
the hyperactivity, violent behavior, and delusion of patients.
2. Mood stabilizers: Lithium carbonate, Sodium valproate,
Carbamazepine, Lamotrigine, etc.
3. Benzodiazepine: Lorazepam, Clonazepam, Diazepam etc for sedation
initially.
B. Maintenance phase
Mood stabilizers only.
Non-pharmacological treatment:
Psychosocial management – Family psychotherapy, interpersonal
psychotherapy and
rehabilitation.
Hospitalization:
Indications for hospitalization are as follows –
1. For safety ( because of violent behavior, suicidal and
homicidal ideation) 2) Non-compliance to treatment
Follow Up