Kuliah 1 - The Basic Concept

7/31/2019 Kuliah 1 - The Basic Concept

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THE BASIC CONCEPT

OF PSYCHIATRY


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1. General systems theory

2. Model of disease

3. Doctor - Patient Models

4. Concept of Normality5. Psychiatry and Psychology

6. Definition of Mental Disorder

* Kaplan HI, Sadock BJ.

Synopsis of Psychiatry Behavioral Sciences /

Clinical Psychiatry, 10th.ed., 2007

* American Psychiatry Association.

Diagnostic and Statistical Manual of Mental Disorders, 4th ed(DSM-IV). 1994


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The Biological

Systems

The Psychological

Systems

The Social

Systems

GENERAL SYSTEMS THEORY


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The Biological Systems :

anatomical

structural biological functioning

molecular

The Psychological Systems

psychodynamic the experience of events /

factors illness

motivation reaction to events / illness

personality


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The Social Systems :

cultural the expression

environmental experience of events /

familiar illness


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MODEL OF DISEASE

The General Systems Theory

The Biopsychosocial Model of Disease

( George Engel )

Stressed an integrated system approach to

human behaviour and disease


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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


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A dramatic example of Engels 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


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All physicians must have knowledge of :

patients 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


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DOCTOR-PATIENT MODELS

1. The active - passive model :

a patient s complete passivity

a physicians taking control

when patients are unconscious,

immobilized, delirious.


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2. The teacher - student model :

The role of the physician is paternalistic

and controlling.

The role of the patient is essentially oneof dependence and acceptance

during a patients recovery from surgery


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3. The mutual participation model :

equality between doctor and patient

both participation require and depend on eachothers input.

Chronic illness : renal failure and diabetes

conditions such as pneumonia


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4. The friendship model :

dysfunctional

unethical


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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


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The doctor attemps to free patients from grossly

observable signs and symptoms of disease

Health is a reasonable, rather than optimal, statefunctioning


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Longitudinal studies

Operational definition of normality( not absolute, rather is descriptive )

The teenager

The adults


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The Teenagers

1. Almost complete absence of grosspsychopathology, severe physical defects,and severe physical illness.

2. Mastery of previous developmental taskswithout serious setbacks.

3. Ability to experience emotional states

flexibly and to resolve conflicts activelywith reasonable success.


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The Teenagers

4. Relatively good relationship with parents,sibling, and peers.

5. Feeling part of a larger cultural

environment and being aware of its normsand values.

The Adults

Good adaptation to marriage, parenthood,work and leisure activities.


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Mental Health

Mental health is a state of emotional will-being in which person are able to functioncomfortably within their society and in

which their personal achievements andcharacteristics are satisfactory to them.

A mentally health individual :

being in a state of equilibrium, somehowpossessing a harmonious psychologicalwholeness


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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.


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PSYCHIATRY

Branch of medicine concerned with theprevention, cause, treatment, andrehabilitation of mental disorders.

Psychiatrist : medical doctor whose

specialty is psychiatry

PSYCHOLOGY

Study and profession concerned withmental process and behaviour.


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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 animportant loss of freedom.


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Kuliah 1 - The Basic Concept