Nursing Path
CARING is the essence of NURSING. -Jean Watson
Nursing Path
Knowing is not enough, we must APPLY. Willing is not enough, we must DO. -Bruce Lee
Nursing Path
Treat the patient as a whole, not just the hole in the patient.
Nursing Path
Success is not final. Failure is not fatal. It is the courage to continue that counts. -Winston Churchill
Nursing Path
A problem is a chance for you to do your best. -Duke Ellington
History of Mental Health Care (Important People)
1.
| Sigmund Freud 1856- 1939 |
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2.
| Alfred Adler |
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3.
| Anna Freud (1895 –1982) |
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4.
| Erik Erikson (1902 -1994) |
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5.
| Jean Piaget (1896 –1980) |
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6.
| Abraham Harold Maslow (1908 –1970) |
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7.
| Carl Rogers (1902 –1987) |
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8.
| B. F. Skinner (1904 –1990) |
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9.
| Eugen Bleuler (1857 -1939) |
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10.
| Emil Kraepelin (1856-1926) |
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11.
| Harry Stack Sullivan (1892- 1949) |
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12.
| Kurt Schneider (1887 –1967 |
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13.
| John Bowlby (1907 - 1990) |
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14.
| John F Cade (1912 –1980) |
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15.
| Joseph Wolpe (1915- 1997) |
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16.
| Aaron T. Beck |
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17.
| Julius Wagner-Jauregg (1857 -1940) |
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18.
| Ugo Cerletti (1877 - 1963) |
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19.
| Arvid Carlsson (1923-) |
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20.
| Egas Moniz (1874 –1955) |
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21.
| Maxwell Jones |
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22.
| Karl Jaspers |
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23.
| Karl Leonhard |
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24.
| Jacob Moreno - |
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25.
| Kubler Ross (1926-2004) |
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26.
| Leo Kanner (1894 –1981) |
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28.
| Ivan Pavlov (1849 –1936 ) |
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29.
| Clifford Beers (1876 – 1943) |
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30.
| Philippe Pinel (1745 –1826) |
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31.
| William Tuke (1732 – 1822) |
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32.
| John Conolly (1830), |
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33
| William Cullen |
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34.
| Hildegard Peplau (1909 -1999) |
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35.
| Linda Richards (1841 –1930) |
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36.
| Alois Alzheimer (1864–1915), |
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37.
| Franz Mesmer (1734–1815) |
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38.
| William Battie, (1758). |
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39.
| Kahlbaum (1874) |
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40.
| Hecker |
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41.
| Jean-Etienne Esquirol (1772–1840) |
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42.
| Georges Gilles de la Tourette |
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43.
| Kurt Schnider |
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44.
| Benjamin Rush, (1745- 1813) |
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45.
| David T Wong (1940- |
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46.
| Herbert Y Meltzer (1932- |
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47.
| Carl Wernike (1848-1950) |
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48.
| Korbian Broadman (1868-1918) |
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49.
| Sergi Korsakove (1853-1900) |
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50.
| Jean Martin Charcot (1825-1893) |
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51.
| Carl Gustav Jung (1875- |
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52.
| Hans Berger (1873 –1941) |
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- Psychiatry, Third Edition. Edited by Allan Tasman, Jerald Kay, Jeffrey A. Lieberman, Michael B. First and Mario Maj. John Wiley & Sons, Ltd, 2008.
- Sims, A. Symptoms in the Mind: An Introduction to Descriptive Psychopathology (3rd ed). Elsevier, 2002.
- Fish, F. Clinical Psychopathology, Signs and Symptoms in Psychiatry. Bristol: J. Wright & Sons. 1967.
Common Syndromes
- Metabolic syndrome (syndrome x, insulin resistance syndrome, Reaven’s syndrome): a
combination of medical disorders that increase the risk of developing
atherosclerotic disease and type II diabetes mellitus. WHO-1999
criteria for metabolic syndrome include:
- Presence of DM/impaired Glucose tolerance
- BP > 140/90 mmHg
- Dyslipidemia
- Central obesity
- Microalbiminuria
- Serotonin syndrome:
- a serious adverse effect of SSRIs and/or MAOIs characterized by a classic traid of mental status changes, neuromauscular abnormalities and autonomichyper activity. Patient may present with agitation, sweating, rigidity, hyperreflexia, myoclonus, tachycardia, and hypotension.
- Neuroleptic Malignant Syndrome:
- a serious complication of antipsychotics medications characterized by hyperthermia, rigidity, tachycardia, decreased level of consciousness, and elevated serum CPK-MB levels.
- Munchausen Syndrome by Proxy (MSP):
- a form of child abuse in which parents (usually mother) invent or directly induce their children’s illness or symptoms and seek medical assistance. Parents may report that their children had seizures or suffer from abdominal pain when their children are well.
- Rett’s syndrome:
- A disorder reported in girls characterized by a period of apparent normal early development and normal head circumference at birth, there is deceleration of head growth between the age of 5 months and 30 months and loss of purposive hand movements and acquired fine motor movements.
- Covarde syndrome:
- a conversion disorder seen in partners of expectant mothers during their pregnancy includes nausea, vomiting, abdominal pain and food cravings.
- Cotard’s syndrome: a combination of severely depressed mood with nihilistic delusions and/or hypochondriacal delusions usually seen elderly.
- De Clerambault syndrome: erotomania or delusion of love usually seen in females.
- Ganser syndrome’ (Ganserism): the production of approximate answers usually seen in criminals awaiting trial for serious offences
- Othello syndrome (Ey syndrome): a monosymptomatic delusional disorder where the core delusion has the content of delusional jealousy.
- Ekbon’s syndrome: a delusional belief that one’s skin is infested with multiple tiny mite like animals.
- Capgras syndrome: a type of delusional misidentification in which the patient believes that important people in one's life have been replaced by impostors.
- Syndrome of Fregoli: the pt. identifies a familiar person (usually his persecutor) in various strangers, who are therefore fundamentally the same individual.
- Diogenes syndrome: hoarding of objects usually of no practical use and neglect of one’s home or environment.
- Stockholm syndrome: is a psychological phenomenon in which hostages express empathy and have positive feelings towards their captors, sometimes to the point of defending them.
- Klein- Levin syndrome (KLS):
- This is a sleep-related syndrome characterized by hypersomnia, hyperphagia and hypersexuality.
- Shaken-Baby syndrome:
- A condition in which fatal injuries from child abuse characterized by retinal hemorrhage and intracranial injury. It occurs when parents or other care givers violently shake infants by their extremities or shoulders, usually out of frustration and rage over the child’s incessant crying.
- Tourette’s syndrome:
- A disorder characterized by multiple motor tics, multiple vocal tics , coprolalia and copropraxia.
- Restless-Leg syndrome (RLS) (Eckbom syndrome)
- RLS is a sleep-related disorder characterized by an experience of uncomfortable feeling on the leg muscles on awakening from sleep, which sometimes resemble painful creeping sensations deep inside the calf muscles.
- Pickwickian syndrome
- sleep apnea in elderly obese.
- Asperger’s syndrome:
- Stiff-person syndrome;
- Sturge-Weber syndrome
- Angelman (“happy puppet”) syndrome:
- Autoscopic syndrome;
- Down’s syndrome:
- Turner’s syndrome;
- Culture-bound syndrome:
- Aicardi syndrome:
- Psychiatry, Third Edition. Edited by Allan Tasman, Jerald Kay, Jeffrey A. Lieberman, Michael B. First and Mario Maj. John Wiley & Sons, Ltd, 2008.
- Sims, A. Symptoms in the Mind: An Introduction to Descriptive Psychopathology (3rd ed). Elsevier, 2002.
- Fish, F. Clinical Psychopathology, Signs and Symptoms in Psychiatry. Bristol: J. Wright & Sons. 1967.
Collective Symptoms
- Positive symptoms: refers to presence of delusions, disordered thoughts and speech, and tactile, auditory, visual, olfactory and gustatory hallucinations
- Negative symptoms : are deficits of normal emotional responses or of other thought processes, and respond poorly to medication which includes flat or blunted affect and emotion, poverty of speech (alogia), inability to experience pleasure (anhedonia), lack of desire to form relationships (asociality), and lack of motivation (avolition).
- Biological symptoms (somatic symptoms./melancholic symptoms.): refers to changes in sleep, appetite, libido, activity, diurnal changes in mood, anhedonia, early morning awakening, and psychomotor agitation or retardation.
- Psychotic symptoms: presence of hallucinations and delusions
- First Rank Symptoms of Schizophrenia (Kurt Schneider)
- Audible thoughts (thought echo)
- Voices heard arguing
- Voices heard commenting on one's actions
- Somatic/thought passivity experiences (delusions of control)
- Thought withdrawal
- Thought insertion - Thoughts are ascribed to other people who intrude their thoughts upon the patient
- Thought broadcasting (also called thought diffusion)
- Delusional perception
- Motor Symptoms of schizophrenia
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- Psychiatry, Third Edition. Edited by Allan Tasman, Jerald Kay, Jeffrey A. Lieberman, Michael B. First and Mario Maj. John Wiley & Sons, Ltd, 2008.
- Sims, A. Symptoms in the Mind: An Introduction to Descriptive Psychopathology (3rd ed). Elsevier, 2002.
- Fish, F. Clinical Psychopathology, Signs and Symptoms in Psychiatry. Bristol: J. Wright & Sons. 1967.
ABNORMALITIES OF MOTOR BEHAVIOUR
- Psychomotor Retardation: Slowed mental and motor activities.
- Stupor: A state in which a person does not react to the surroundings: (mute, immobile and unresponsive).
- Catatonic Stupor: Stupor with rigid posturing
- Psychomotor Agitation: Restlessness with psychological tension. (Patient is not fully aware of restlessness.)
- Catatonic Excitement: Marked agitation, impulsivity and aggression without external provocation.
- Chorea: sudden involuntary movement of several muscle groups with the resultant action appearing like part of voluntary movement.
- Aggression: Verbal or physical hostile behaviour, with rage and anger.
- Akathisia: Inability to keep sitting still, due to a compelling subjective feeling of restlessness.
- Dyskinesia: Restless movement of group of muscles (face, neck, hands).
- Dystonia: Painful severe muscle spasm.
- Torticollis: Contraction of neck muscles.
- Tics: Sudden repeated involuntary muscle twisting. e.g. repeated blinking, grimacing.
- Compulsions: Compelling repeated irrational actions associated with obsessions. e.g. repeated hand washing.
- Echopraxia: Imitative repetition of movement of somebody.
- Waxy Flexibility: Patient’s limbs may be moved like wax, holding position for long period of time before returning to previous position.
- Stereotypies: Purposeless repetitive involuntary movements. e.g. foot tapping, thigh rocking.
- Mannerism: Odd goal-directed movements. e.g. repeated hand movement resembling a military salute.
- Automatic obedience: the pt. carries out every instruction regardless of the consequences.
- Perseveration: is a senseless repetition of a goal-directed action, a particular response, such as a word, phrase, or gesture which has already served its purpose (beyond their relevance).
- Dyspraxia; inability to carryout complex motor tasks, although the component motor movements are preserved.
- Omega sign (Athanassio): the occurrence of a fold like the Greek letter omega in the forehead above the root of the nose produced by the excessive action of the corrugator muscle; seen in depression.
- Ambitendency: a motor symptom of schizophrenia in which there is an alternating mixture of automatic obedience and negativism.
- Mitgehen: The pt. moves his body in the direction of the slightest pressure on the part of the examiner. seen in catatonia
- Mitmachen (Co-operation): The body can be put to any position without any resistance on the part of the pt. seen in catatonia.
- Trichotillomania: a condition characterized by an overwhelming urge to pluck out specific hairs.
- Pyromania: impulsive repetitive, deliberate fir-setting without external rewards.
- Dipsomania: uncontrollable craving for alcohol or compulsive drinking of alcohol.
- Kleptomania: a disorder in which the individual impulsively steals things other than personal use or financial gain.
- Negativism: an apparently motiveless resistance to all commands and attempts to be moved or doing just the opposite.
- Psychiatry, Third Edition. Edited by Allan Tasman, Jerald Kay, Jeffrey A. Lieberman, Michael B. First and Mario Maj. John Wiley & Sons, Ltd, 2008.
- Sims, A. Symptoms in the Mind: An Introduction to Descriptive Psychopathology (3rd ed). Elsevier, 2002.
- Fish, F. Clinical Psychopathology, Signs and Symptoms in Psychiatry. Bristol: J. Wright & Sons. 1967.
ABNORMALITIES OF SPEECH
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- Verbigeration; repetition of words of phases while unable to articulate the next word in the sentence/senseless repetition of same words or phrases over and over again.
- Pressure of Speech: rapid, uninterrupted speech that is increased in amount.
- Mutism: inability to speak.
- Elective Mutism: refusal to speak in certain circumstances.
- Poverty of Speech: restricted amount of speech.
- Stuttering (Stammering): frequent repetition or prolongation of a sound or syllable, leading to markedly impaired speech fluency.
- Cluttering: dysrhythmic rapid and jerky speech.
- Clang Associations (Rhyming): association of word similar in sound but not in meaning (e.g. deep, keep, sleep)
- Punning: playing upon words, by using a word of more than one meaning (e.g. ant, aunt)
- Word Salad: incoherent mixture of words and phrases.
- Dysphasia: impairment in producing or understanding speech.
- Dysarthria: difficulty in articulation and speech production.
- Sensory Aphasia: nonsensical fluent speech due to lesion affecting Wernicke’s (receptive) area.
- Motor Aphasia: impairment in the ability to formulate fluent speech due to lesion affecting Broca’s (motor) area.
- Dysphonia: difficulty in voicing speech clearly, due to dysfunction of vocal cords or soft palate.
- Circumstanciality: over inclusion of details delaying reaching the desired goal.
- Coprolalia: forced vocalization of obscene words or phrases,
- Palilalia: is characterized by the repetition of a word or phrase; i.e., the subject continues to repeat a word or phrase after once having said. It is a perseveratory phenomenon.
- Alogia: lack of speech output.
- Mutism: complete absence of speech.
Echolalia: imitation of words or phrases made by others.
- Psychiatry, Third Edition. Edited by Allan Tasman, Jerald Kay, Jeffrey A. Lieberman, Michael B. First and Mario Maj. John Wiley & Sons, Ltd, 2008.
- Sims, A. Symptoms in the Mind: An Introduction to Descriptive Psychopathology (3rd ed). Elsevier, 2002.
- Fish, F. Clinical Psychopathology, Signs and Symptoms in Psychiatry. Bristol: J. Wright & Sons. 1967.
