Psychosis and neurosis

Basic level class for MSW

1. Psychosis and Neurosis Aarcha Gowri Varma II year PSW IMHANS Aarcha Gowri Varma , MPhil PSW, IMHANS

2. NEUROSIS Coined by William Cullen , Scottish doctor neurosis means "nerve disorder," According to Cullen - those nervous disorders and symptoms that do not have a clear organic cause  class of functional mental disorders. Aarcha Gowri Varma , MPhil PSW, IMHANS

3. Freud – anxiety neurosis- conflicts with inner self Characteristic symptom is anxiety In touch with reality Not used in todays psychiatry Only a part of his personality has disease. Aarcha Gowri Varma , MPhil PSW, IMHANS

4. Typed of neurotic Anxiety Somatoform Dissociation Depression Aarcha Gowri Varma , MPhil PSW, IMHANS

5. 1. The Anxiety Disorders Physical symptoms Palpitation (Increased heart +sweating) nausea Muscle tension Chest discomfort Breathing difficulty Gastric issues Emotional/behavior symptoms Restlessness and agitation Inability to sit still and remain calm Social withdrawal and isolation Intense fear,tension Inability to properly meet responsibilities at home, work, or school Irritability Congnititve symptoms Decreased attention , concentration, memory , thoughts about suspected dangers, such as fear of dyin Aarcha Gowri Varma , MPhil PSW, IMHANS

6. I.Anxiety disorders – Generalized Anxiety Disorder •Anxiety is unfocused or free floating ie individual is fearful and apprehensive but often does not know what he/she is afraid of. Panic Disorder recurrent attacks of severe anxiety (panic attacks) which are not restricted to any particular situation or set of circumstances. Lasts for few minutes and subsides Phobias •The term "phobia" means "fear.“ •It is a strong, persistent and unwarranted fear of some specific object or situation. – Obsessive-Compulsive Disorder •It is characterized by obsession (intrusive, repetitive thoughts or images that produce anxiety) or compulsions (the need to perform acts or dwell on thoughts to reduce anxiety) Post-traumatic Stress Disorder Develops in response to a traumatic event. Images/thoughts of the traumatic event keeps coming to the mind causing extreme distress and anxiety symtpoms Aarcha Gowri Varma , MPhil PSW, IMHANS

7. II. The Somatoform Disorders " Soma" means "body," Complains of physical symptoms that are similar authentic medical conditions – but have no physiological basis. –The symptoms are not voluntary or under conscious control. SOMATOFORM DISORDERS Somatization disorder Conversion disorder Hypochondriasis Aarcha Gowri Varma , MPhil PSW, IMHANS

8. Types of Somatoform Disorders 1.Somatization disorder multiple somatic complaints in the absence of a physical cause that occurs over a period several years Common complaints are pain symptoms: back pain, pain in arms and legs gastrointestinal symptoms: nausea, vomiting, Other symptoms: dizziness, breathing difficulties Aarcha Gowri Varma , MPhil PSW, IMHANS

9. 2 . Conversion Disorder : an expression of psychological conflict or need that involves an alteration or loss of physical functioning that suggests a bodily cause in the absence of a medical reason symptoms or deficits that affe ct voluntary motor or sensory functions , which suggest another medical condition which is a pseudoneurological symptom: caused by psychological factors because the illness is preceded by conflicts or other stressors . Signs,symptoms )Paralysis , blindness, and mutism   , Involuntary movements , Aarcha Gowri Varma , MPhil PSW, IMHANS

10. 3 .Hypochondriasis Preoccupation with fears of having, a serious disease based on the person's misinterpretation of bodily symptoms. eg ) normal head ache is interpreted as the person is having brain tumor. Doctor shopping Even is spite of medical results patient wont get satisfied . Aarcha Gowri Varma , MPhil PSW, IMHANS

11. III. Dissociative disorder A period when we feel disconnected from the environment and/or from ourselves usually after a traumatic experience . D issociation or separation of a part of person’s consciousness, memory or identity. Aarcha Gowri Varma , MPhil PSW, IMHANS

12. Types:- Dissociative Amnesia - Loss of memory of particular time period Dissociative Fugue Inability to recall personal identity and past with for a given time The person disappears, roams around replacing them with an imaginary identity and past begins a new life in some other place, but is not conscious of having done these things. Dissociative Identity Disorder (old name: "Multiple Personality) the person develops several alternate personalities, each of which seems like a normal person. The currently "active" personality may or may not have any awareness of what was happening when other personalities were active Aarcha Gowri Varma , MPhil PSW, IMHANS

13. Depression Persistent feeling lo low mood, sadness for more then two weeks. Symptoms Crying spells Inability to experience happiness or joy Lack of interest in previously enjoyed things Sleep and appetite disturbance Suicidal ideations, death wishes Along with disturbance in attention concentration and memory. Mild, moderate and severe Anxiety can lead to depression and vice versa. Aarcha Gowri Varma , MPhil PSW, IMHANS

14. Etiology and treatment of neurotic disorders –BIOPSYCHOSOCIAL MODEL ETIOLOGY Biological factors:-- Genetically predisposition Psychological Personality Attitude Coping mechanisms, Social Stressful life events TREATMENT Pharmacotherapy Benzodiazepines Anti depressants SSRI Psychotherapy -CBT, Psychoanalysis, relaxation techniques Etc Other psychosocial interventions Family intervention, case work group work etc Aarcha Gowri Varma , MPhil PSW, IMHANS

15. PSYCHOSIS C haracterized by a loss of contact with reality . Impairment in personality, functioning Poor insight –awareness of having a disorder Entire personality is affected Has two types of symptoms –negative and positive symptoms Aarcha Gowri Varma , MPhil PSW, IMHANS

16. POSITIVE SYMPTOMS NEGATIVE SYMPTOMS Feelings or behaviors that  are  usually not present in normal people. Found in addition in psychotic patients Lack of  A lack of feelings or behaviors that are usually present in normal people Usual behaviours which are found lacking in psychotic patients Delusion Hallucination Lack of emotion Lack of motivation Catatonia Aarcha Gowri Varma , MPhil PSW, IMHANS

17. Delusion -False, irrational, unshakable belief Despite contrary evidence, a person in a delusional state can’t let go of their convictions . Types – Persecutory- “someone is trying to harm me” / follow, spied,/ some one is doing black magic against me Grandiose - 0ver-inflated/over valued sense self worth, power, knowledge, or identity eg ) I am the God. I am a celebrity Reference – belief that others are taking ill about me. Infedility Aarcha Gowri Varma , MPhil PSW, IMHANS

18. Hallucination- Disorder of perception P erception in the absence of external stimulus Types Auditory- hear Visual -see Olfactory -smell Tactile -touch Aarcha Gowri Varma , MPhil PSW, IMHANS

19. Catatonia psycho-motor immobility or abnormality Excitement- non-goal-directed hyperactivity and impulsiveness or stupor - reduced responsiveness to the environment Aarcha Gowri Varma , MPhil PSW, IMHANS

20. Psychotic disorders Schizophrenia – Delusion and hallucination Catatonic schizophrenia – catatonia Bipolar Affective Disorder- depression + mania(excited state with increased talk, over familiarity, over spending ) may have psychotic symptoms Schizoaffective – psychotic symptoms + mood disorder Delusional disorder- only delusions of various kinds Aarcha Gowri Varma , MPhil PSW, IMHANS

21. THANK YOU….. Aarcha Gowri Varma , MPhil PSW, IMHANS