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THE BASIC CONCEPTOF PSYCHIATRY
Dr. Lynna Lidyana SpKJ
1. General systems theory2. Model of disease3. Doctor - Patient Models4. Concept of Normality5. Psychiatry and Psychology6. Definition of Mental Disorder
* Kaplan HI, Sadock BJ. Synopsis of Psychiatry Behavioral Sciences / Clinical Psychiatry, 8th.ed., 1998* American Psychiatry Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed (DSM-
IV). 1994
The Biological Systems
The Psychological
Systems
The Social
Systems
GENERAL SYSTEMS THEORY
The Biological Systems :
• anatomical
• structural biological functioning
• molecular
The Psychological Systems
• psychodynamic the experience of events /
factors illness
• motivation reaction to events / illness
• personality
The Social Systems :
• cultural the expression
• environmental experience of events /
• familiar illness
MODEL OF DISEASE
The General Systems Theory
The Biopsychosocial Model of Disease
( George Engel )
Stressed an integrated system approach to human behaviour and disease
Each system affects and is affected by all the others
Promote a comprehensive understanding of disease and treatment
The doctor - patient relationship is a critical component
A dramatic example of Engel’s concept
The relation between sudden death (170) and psychosocial factors
The potential triggering events :• death of close friend• grief• loss of self esteem• personal danger of threat• the letdown after the threat has passed• triumph• reunion
All physicians must have knowledge of :
• patient’s medical status
• how patients individual psychology and sociocultural millieu affect the medical condition
• the emotional responses to the condition and the involvement with the doctor
DOCTOR-PATIENT MODELS
1. The active - passive model :a patient ‘s complete passivitya physician’s taking control
when patients are unconscious,immobilized, delirious.
2. The teacher - student model :
• The role of the physician is paternalistic and controlling.
• The role of the patient is essentially one of dependence and acceptance
during a patient’s recovery from surgery
3. The mutual participation model :
• equality between doctor and patient
• both participation require and depend on each other’s input.
• Chronic illness : renal failure and diabetes
• conditions such as pneumonia
4. The friendship model :
• dysfunctional
• unethical
CONCEPT OF NORMALITY
• The normal person has a sense of his or her own worth and maintain a confident and purposeful self-image
• Behavior is assumed to be within normal limits : no manifest psychopathology
The doctor attemps to free patients from grossly observable signs and symptoms of disease
Health is a reasonable, rather than optimal, state functioning
Longitudinal studies
Operational definition of normality( not absolute, rather is descriptive )
The teenagerThe adults
The Teenagers
1. Almost complete absence of gross psychopathology, severe physical defects, and severe physical illness.
2. Mastery of previous developmental tasks without serious setbacks.
3. Ability to experience emotional states flexibly and to resolve conflicts actively with reasonable success.
The Teenagers4. Relatively good relationship with parents,
sibling, and peers.5. Feeling part of a larger cultural
environment and being aware of its norms and values.
The Adults Good adaptation to marriage, parenthood,
work and leisure activities.
Mental Health• Mental health is a state of emotional will-
being in which person are able to function comfortably within their society and in which their personal achievements and characteristics are satisfactory to them.
• A mentally health individual : being in a state of equilibrium, somehow
possessing a harmonious psychological “wholeness”
• In a state a mental health :
a person feels physically well, his thoughts are organized, his feeling are well modulated and his behaviours are coordinated and appropriate. He feels part of a group and is able to fulfill his role within it.
PSYCHIATRY
• Branch of medicine concerned with the prevention, cause, treatment, and rehabilitation of mental disorders.
• Psychiatrist : medical doctor whose specialty is psychiatry
PSYCHOLOGY• Study and profession concerned with mental
process and behaviour.
DEFINITION OF MENTAL DISORDER
A clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress (e.g., a painful symptom) or disability (i.e., impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability or an important loss of freedom.