Encyclopedia on Psychiatry Department (Medical Branch)
How do we define psychiatry?
Definition of Psychiatry: Psychiatry is an important part of modern medical science. It mainly studies the etiology, symptom characteristics and clinical consultation, clinical diagnosis, treatment and rehabilitation, social management, judicial appraisal and assessment of mental disorders.
What does psychiatry mean?
Meaning of Psychiatry: Modern psychiatry includes the diagnosis and treatment of various mental disorders, neurosis, psychosomatic diseases or mental disorders accompanied by physical diseases, communication adaptation disorders, personality disorders, sexual psychological biases and many types of children’s intellectual or moral developmental disorders. Psychiatry theoretically involves medical genetics, psychological development and social sciences and is combined with psychological counseling in clinical practice.
Common Disease Name:Psychology
Psychiatry Degree: MD for full fledged practice
Common Symptoms in psychiatric problems
- Sensory disturbance
- Thinking disorder
- Affective disorder
- Will disorder
- Attention disorder
Table of Content
2) Common psychiatric symptoms
a) Cognitive impairment
b) Thinking logic barrier
c) Affective disorder
d) Disorder of will
e) Attention Disorder
f) Motor and behavioral disorders
g) Memory impairment
h) Intellectual impairment
j) Directional force
4) Psychotropic substances
5) Basic information
6) Research methods
7) Genetics research
8) Biochemical aspects
11) Genetic factors
12) Mental disorders treatment
Different degrees of mental developmental disorders characterize clinical manifestations.
1.Genetic defects: Genetic mutations, polygenic inheritance are the main factors. Cultural background, physical condition, and personality characteristics are genetically predisposable.
2.Environmental Induction: Individual life experience, social status, cultural background, etc. may be induced to varying degrees to affect the patient’s disease and life.
2. Common Mental Symptoms Studied in Psychiatry Department
a. Cognitive Impairment
Perception is feeling and perception. Various attributes of objective things in the human brain and by means of past experience form the complete impression.
1. Sensory Disorders
These are more common in organic diseases of the nervous system and snoring:
i. Sensitization: Allergies increase the sensitivity to general external stimuli, such as the harshness of sunlight, the harshness of sound and uncomfortable feeling of touching the skin. This is more common in neurosis, menopause syndrome and so on.
ii. Decreased sensation is reduced sensitivity to general external stimuli, and the sensory threshold is increased. Patients are slightly or completely unable to perceive strong stimuli (the latter is called anesthesia). Seen in depression, stupor and disturbance of consciousness. We can see deprivation of sensation in hysteria and is referable as switching symptoms such as blindness and deafness.
iii. Internal perceptual discomforts are all kinds of uncomfortable and / or unbearable strange sensations that happen to generate inside the body, such as pulling, squeezing, swimming and ants crawling. The nature is difficult to describe. There is no clear local positioning and the concept of suspected disease can be secondary. More common in neurosis, schizophrenia, depression and somatization disorders.
2. Perceptual Disorders
Changes in the strength and nature of perception:
Intensity: Patients show better feelings than usual during manic episodes. The opposite is true during depressive episodes with worse feelings than usual.
Nature: Often unpleasant or with distortion. As some patients with schizophrenia describe, the taste of flowers is particularly irritating and spicy, and the taste of food is particularly unpleasant.
I. Illusion is an object’s wrong perception of objective things: Illusions can occur in normal people, but afterwards the conditions improve or are explained. In normal people’s illusions they can quickly recognize errors and correct them. Illusions usually occur in the following four situations.
i. Illness occurs when there is sensory stimulus level reduction due to poor sensory conditions.
ii. Illusion occurs when there is reduction in intelligibility of perception due to fatigue and inattention.
iii. Illness occurs when the consciousness level of the object decreases.
iv. Illusion occurs when the emotion is in a certain strong state.
II. Hallucination is a kind of perceptual experience that occurs when an object person lacks the corresponding external stimuli acting on the sensory organs. Hallucinations have two characteristics:
i. realistic perception experience, not imagination.
ii. Most hallucinations come from the outside world. Normal people can also experience hallucinations which mainly occur before falling asleep and after waking up. Normal hallucinations are usually transient and simple, such as hearing a bell or a person’s name.
a. Auditory hallucination:
Auditory hallucination means that the patient can hear various sounds when there is no sounding object. This is one of the most common hallucinations. If what the patient hears is conversational speech, we know it as speech auditory hallucination. If the speech content is a review of the patient’s words and actions, we know it as a critical auditory hallucination. If the content of the speech is to order the patient to do something, it is called an imperative auditory hallucination. Speech auditory hallucinations, especially critical auditory hallucinations and command auditory hallucinations, are more common in schizophrenia.
Thinking ringing or thinking sound means that the patient hears his thoughts when he thinks about them. Functional auditory hallucination refers to the fact that when the patient hears the stimulus of the actual object, the auditory hallucination occurs. The auditory hallucination and the realistic stimulus coexist and disappear simultaneously. We can mainly find functional auditory hallucinations in schizophrenia.
b. Visual hallucinations:
Visual hallucinations refer to patients seeing objects when no object appears in front of their eyes. Visual hallucinations often appear alongside other hallucinations. Visual hallucinations are rich and diverse, and the image of an object can be clear and indistinct. There are objects with large hallucinations (giant hallucinations) and small hallucinations (both villain hallucinations). Patients’ attitudes towards visual hallucinations can be participants or bystanders. Visual hallucinations are more common in organic disorders such as delirium, poisoning, and epilepsy, but also in functional mental disorders such as schizophrenia.
c. Olfactory hallucinations:
Olfactory hallucinations refer to patients who smell special odors without objective material stimulation. Smell is usually an unpleasant taste for some patients. In schizophrenia, olfactory hallucinations are often in combination with other hallucinations and delusions. For a single phantom smell, temporal lobe epilepsy or temporal lobe organic damage needs to be considerable.
d. Taste hallucinations:
Taste hallucinations refer to patients who have a special taste without objective material stimulation. Most taste hallucinations are things that patients have come across before, such as unpleasant tastes. Common in patients with schizophrenia and epilepsy.
e. Tactile hallucination:
Tactile hallucination refers to the feeling that the skin and mucous membranes are touching when there is no objective material stimulation. The patient feels contact, acupuncture, insect crawling, and electrical inductance on or under the skin or mucous membranes. Tactile hallucinations are more common in schizophrenia, but also in peripheral neuritis and poisoning. Sexual organ contact sensation, called sexual hallucinations, can be found in schizophrenia and hysteria.
f. Ontological hallucination:
Ontological hallucination refers to the sensation of being touched and moving by the joints and muscles of a patient’s internal organs or body. Ontology hallucinations are also called somatosensory hallucinations. Patients experience visceral pinch, pull, swelling, insect crawling, knife cutting, and jittering experience, which are called visceral hallucinations. Ontology hallucinations are often combined with paranoid delusions and nothingness delusions, which are more common in schizophrenia and depression. The illusion that a patient feels a change in muscle or joint movement or position is called a motor illusion.
If the patient feels that the lips are moving, it is called speech motor hallucinations. If you feel that your limbs and torso are moving, it is called psychomotor hallucination. If the patient feels out of balance. It is called vestibular hallucination when you are on the inclined or rotating ground and hold the armrest tightly. Motor hallucinations are found in schizophrenia and organic diseases of the brain stem.
g. Reflective hallucinations:
Reflective hallucinations refer to the hallucinations that occur when one sensory organ of a patient is stimulated, and the other hallucinations are seen in schizophrenia and hysteria.
In short, hallucinations can occur in various mental disorders, occasionally in normal people. However, taste hallucinations, olfactory hallucinations, proprioception hallucinations, thinking sounds or thought-making sounds, functional hallucinations and reflex hallucinations are more common in schizophrenia.
According to the source of hallucination experience, it is divisible into true hallucination and pseudo hallucination.
True hallucinations: Hallucinations that patients experience are vivid, just like the external objective image, exist in the external objective space and patients obtain them through the sense organs. Patients often recount that this was what they saw and heard. As a result, patients are often convinced and respond to the hallucinations accordingly.
The hallucinations are not vivid and vivid, and their generation takes place in the subjective space of the patient, such as the brain and the body. Hallucinations are not obtained through sensory organs. If you hear voices in your belly, you can see a human figure in your head without your own eyes. Although the image of hallucinations is different from general perception, the patient often believes that he did hear or see it with a high degree of conviction.
According to the conditions produced by hallucinations, they can be divided into functional hallucinations, reflex hallucinations, hallucinations before going to bed and psychogenic hallucinations.
Psychogenic hallucinations are hallucinations that occur under the influence of strong psychological factors. The contents of hallucinations are closely relatable to psychological factors and we can find them in psychogenic psychosis and hysteria.
This kind of hallucinations occur before falling asleep. Patients can see the hallucinations by closing their eyes. Most of them are hallucinations, such as various animals, landscapes or individual parts of the human body. It is similar to the experience of sleeping.
Functional Illusion in Psychiatry
Reflex hallucinations: Reflex hallucinations refer to the hallucinations that a sensory organ of a patient produces when they are stimulated.
III. Perceptual Comprehensive Disorder in Psychiatry
This refers to patients who can perceive objective things, but they have wrong perceptions of certain individual attributes such as size, shape, color, distance and spatial location, which are more common in epilepsy:
a. Deformed Vision
Patients feel that the surrounding people or objects have changed in size, shape and volume. Seeing an object’s image larger than it actually is called a visually significant disease. For example, seeing his father becomes a giant with his head on the roof. For example, an adult male patient feels that the bed he sleeps is the size of a crib, and thinks that he cannot sit on his own body while sleeping.
ii. Disorder of spatial perception: The patient feels that the distance of things around has changed, for example, the car has entered the platform while waiting, and the patient still feels that the car is far away from him.
iii. Comprehensive disorder of time perception: Patients experience incorrect perception of the speed of time. If you feel that time is passing, you seem to be in a “space-time tunnel”, and things in the outside world change unusually fast. Or you may feel that there is solidification in time. The years are no longer passing, and things outside are stagnating.
iv. Non-photorealistic: Patients feel that the surrounding things and environment have changed and become unreal. The visual object is like a layer of curtains, like a stage set. The surrounding houses, trees, etc. are made of cardboard and lifeless. People around seem like lifeless puppets, etc. This patient has self-awareness. We can find them in depression, neurosis and schizophrenia.
b. Impaired Thinking Logic
Thinking is the indirect and generalized reflection of objective things by the human brain, an important feature of human spiritual activity, and an advanced stage of the cognitive process. Thinking is based on feelings and perceptions, and is expressed through words and words. Thinking includes analysis, comparison, synthesis, abstraction, generalization, judgment, reasoning and other processes. The thinking of a normal person has the following characteristics:
i. Purposefulness in psychiatry which means that thinking is carried out consciously around a certain purpose
ii. Coherence in psychiatry which means that concepts in the thinking process are connected and interconnected
iii. Logic in psychiatry means the thinking process. There is some truth and logic.
iv. Practicality, correct thinking can be tested by objective practice. The clinical manifestations of thinking disorders are various, including thinking form disorders, thinking content disorders and thinking attribute disorders.
I. Thinking form obstacles include associative obstacles and thinking logic obstacles. The common symptoms are as follows:
i. Thinking Ben Yi, also known as idea drifting, refers to the accelerated association of thinking and the increase in the number of associations. It is manifested that the patient’s thinking and conversation are very fast. One concept follows another, and a large number of concepts emerge, so that sometimes the patient has no time to express, or the listener cannot keep up with the patient’s speed. When speaking, the amount of speech increases significantly, the speed of speech becomes faster, and the flow of words continues. Often accompanied by the transfer of the environment, the sound is connected. Common in mania, but also in schizophrenia.
ii. Slow thinking, which means inhibition of association, refers to the slow association of thinking. It is characterized by a markedly slow amount of thinking activity, difficulty in association, difficulty in thinking, and slow response. The patient showed reduced speech volume, slow speaking speed, slow response and a feeling of clumsy brain. More common in depression, but also in schizophrenia.
iii. Poor thinking: This refers to empty thinking content and poor concepts and vocabulary. When patients answer questions, the main content is simple and empty. Patients often have a sense of emptiness in their brains. It is more common in schizophrenia, depression, cerebral organic mental disorders and mental retardation.
iv. Divergent thinking Refers to the purpose, coherence and logical obstacles of thinking. Each sentence of the patient can be established, and then there is no logical connection between the words and the words, so that others cannot understand what they are trying to explain. It is mainly seen in schizophrenia, but also in people with severe anxiety and reduced intelligence.
v. Breaking thinking: Severe thinking is called breakup of thinking. It is mainly manifested in that each sentence of the patient is not a sentence, but it is shown as a pile of words and mixed words. This is more common in schizophrenia. For example, mixed words appear in the context of impaired consciousness, which is called incoherent thinking.
vi. Pathological repetitiveness: Refers to the theme of the patient’s thinking process is sticky, staying on some minor issues. Can’t catch the main link. Patients add many unnecessary details when narrating one thing, and they cannot make things or questions concise. This is mainly seen in epilepsy, but also in cerebral organic and senile mental disorders.
vii. Interruption of thinking aka thinking block / blockage: The patient’s consciousness was clear without obvious external interference, and the thinking process suddenly interrupted in a short time, or the speech suddenly stopped. It appears as a sudden pause when the patient speaks, and then start another topic. If the patient feels that the thinking at that time is being taken away by some external force, it is said that the thinking is taken away. Both symptoms are important symptoms in the diagnosis of schizophrenia, and can also be seen in normal people with fatigue, distracted attention, and patients with neurosis.
Pathological symbolic thinking refers to the use of concrete concepts that are not commonly understood by patients to represent abstract concepts, which cannot be understood by others without the patient’s interpretation. Belongs to the logic of thinking. This is common in schizophrenia.
New words and expressions: This refers to patients who create some words, graphics, and symbols, and give special meaning. Sometimes patients piece together irrelevant words into new words that represent some new meaning. Mainly seen in schizophrenia.
Logical perverted thinking: The main feature is that the reasoning lacks logic, neither premise nor basis, or inversion of cause and effect. The reasoning is strange and strange and incomprehensible. For example, a patient said, “I’m going to die because the computer is infected with a virus.” Can be seen in schizophrenia and paranoia.
Continuous speech: This refers to the patient repeating the answer to the first question continuously while answering the question. It is mainly seen in organic disorders such as dementia, but also in other mental disorders.
Stereotyped language: This means that the patient mechanically repeats some meaningless words or sentences. This is mainly seen in schizophrenia.
Imitation language: This means that the patient imitates the words of the people around him, and what the people say, the patient repeats. This is mainly seen in schizophrenia.
viii. Obsessive-compulsive thinking or compulsive thinking: This refers to a concept or the same content of thinking that repeatedly appears in the patient’s brain, knowing that it is not necessary, but it cannot be rid of. Compulsive thinking can be expressed as certain thoughts, repeated recall (compulsive recall), repeated thinking of meaningless problems (compulsive poor thinking), some opposing thoughts in the brain (compulsive opposing thinking), total It is to doubt whether your actions are correct (compulsive doubt). Compulsive thinking is often accompanied by compulsive actions. Seen in obsessive-compulsive disorder, it is different from compulsive thinking. The former is clearly its own thoughts, appear repeatedly, and the content is repeated. The latter experiences that thinking is alien.
ix. Thinking Voices: When thinking, patients experience their thoughts and become voices, which can be heard by themselves and others. This is more common in schizophrenia.
Delusion in Psychiatry
Delusion is a pathological belief whose content is inconsistent with the facts and does not match the patient’s cultural level and social background. However, the patient is convinced that it is difficult to correct by using facts and reasoning. Paranoia is a content disorder.
Delusions are individual psychological phenomena, and collective beliefs. Although unreasonable, sometimes these cannot be attributed to delusions, such as religious superstition.
The difference between social life phenomena and delusions (prejudice, superstition, fantasy and overvalued ideas)
Prejudices: Prejudices are caused by people’s incorrect thinking methods or restrictions on their level of knowledge.
The concept of superstition was related to the social and cultural background of the time.
Imaginary content may be bizarre, but people can distinguish from reality and are not convinced.
The concept of overprice is a preconception with a strong emotional color, and it has a dominant position for a long time, but it can disappear when the emotional stability or the objective environment changes.
(3) Impairment of thinking attributes in Psychiatry: Normal people never doubt whether their thoughts belong to themselves or to others. Nor do they doubt whether their thoughts are not known by others. Common thinking attribute disorders are:
Thinking insertion refers to patients who think that certain ideas in their brains do not belong to themselves, but that someone from the outside world puts them into their brains through some technology or power. Often accompanied by victim delusions. If the patient experiences a compulsive emergence of a large number of unrealistic associations, it is called compulsive thinking. Both symptoms often appear suddenly and disappear quickly. It is of great significance for the diagnosis of schizophrenia.
Mind abstraction / stolen mind means that the patient thinks that his mind is gone and has been extracted and stolen by someone using some technique. Stolen patients often experience disruptions, in schizophrenia.
Dissemination of thoughts Patients feel that their thoughts are spread out in a special way, as if broadcasting has become known. Even if you don’t say your own thoughts, others will know that patients who are spreading their minds often show nervousness, are afraid to go out, and are accompanied by depression. This is found in schizophrenia.
4. Forced ideas
Forced ideas are repetitive, continuous thoughts, impulses or imaginations. Although they are clearly wrong, unnecessary and unreasonable, it is difficult for patients to overcome and get rid of them. The content of forced thinking is unpleasant and painful. Patients think that these ideas are meaningless, ridiculous and even unspeakable, so patients often feel pain. Resistance is a characteristic of obsessive ideas and a point of identification with delusion. Patients with obsessive-compulsive ideas often have anxiety and depression. The contents of compulsive thinking are fear of getting dirty or getting sick, impulsive or aggressive behavior, cleansing, suspecting that you are sick, imagination or thoughts of sexual behavior, blasphemy thoughts, etc.
The concept of coercion can be divided into the following types according to its expression.
Obsessive-compulsive thinking refers to the patient’s repeated and continuous emergence of some ideas.
Obsessive compulsive exhaustion means that the patient thinks over and over again, knowing that such thinking is unnecessary, but thinks over and over again.
Compulsive suspicion refers to the patient’s constant doubt or concern about what has been done, such as whether the door is closed.
Forced impulse / compulsive intention refers to the patient’s repetitive desire for some kind of impulse. Although he never takes concrete action, it makes the patient feel very nervous. Regardless of impulse desires, patients realize that this is unreasonable and restrained and never take action, which is the main point to distinguish from delusion.
Forced recall refers to the patient repeatedly recalling past events and experiences, knowing that it has no practical meaning, but cannot get rid of it, and constantly recall.
The concept of overprice is a misconception that predominates in consciousness, and its occurrence is generally based on facts. This kind of concept is one-sided and extreme, with strong emotional color, which obviously affects the patient’s behavior and other psychological activities. Its formation has a certain personality and realistic basis, and there are no logical reasoning errors. The difference between overvalued ideas and delusions is that their formation has a certain personality basis and realistic basis, the content is more in line with objective reality, and accompanied by a strong emotional experience. More common in personality disorders and psychogenic disorders.
Pathological jealousy syndrome, also known as Othello syndrome, is a psychiatric syndrome with a central symptom of jealousy and delusion of suspected spouse. The typical situation is seen in a person with a morbid personality. There are similar and lighter situations. The predisposing age is 30 to 40 years old, and the patient proves that his spouse has a new love with many plausible evidences, but often cannot tell the specific object. Repeated reconnaissance, interrogation, tracking, and torture for this purpose can last for several years. Attacks can occur and even spouses can be killed, just like Othello described by Shakespeare.
c. Affective Disorder
Emotions: The more basic inner experiences that are mainly associated with the physiological activities of the body and accompanied by obvious autonomic nervous responses are called emotions. Such as the pleasant feeling produced when watching a wonderful performance. Its duration is short and its stability is contextual.
Emotions 2: The high-level inner experiences associated with social and psychological activities are called emotions, such as friendship, aesthetics, love, and morality. It lasts for a long time and is both contextual and stable and long-term.
Mood: A lasting emotional state that affects an individual’s internal experience and behavior.
In psychiatric clinics, patients’ emotional disorders and affective disorders often appear at the same time, which is difficult to subdivide. Therefore, clinically, emotions and feelings are often used together.
In mental illness, affective disorder usually manifests in three forms, that is, changes in the nature of emotions, changes in emotional volatility and changes in emotional coordination.
I. Emotional disorders refer to pathological emotional states that occupy a significant predominant position in a patient’s mental activity, whose intensity and duration are not compatible with the actual environmental stimulus. Mental symptoms are considerable only when the emotional response cannot be explained in terms of its situation and mood background.
i. Emotional high: Emotional high means that the patient’s mood is abnormally high and his mood is particularly pleasant. It is often accompanied by obvious exaggerated colors, which are common in manic episodes, schizoaffective disorders and cerebral organic diseases. Patients with uneasy and contentious emotionally elevated states are called euphoria, and are more common in cerebral organic diseases or drunkenness.
ii. Depression means that the patient’s mood is abnormally low and his mood is depressed. Often inferiority, self-blame, self-sin, even self-harm or suicide. It is often accompanied by slow thinking, reduced movements and changes in some physiological functions, such as loss of appetite, sleep disorders, and amenorrhea. Depression is common in depressive episodes, and is also seen in depressive states during schizophrenia and physical illness.
iii. Anxiety: Morbid anxiety means that in the absence of corresponding objective factors, the patient has a state of extreme uneasy expectation, often accompanied by autonomic dysfunction and motor disturbance, and severe cases may have panic attacks. Anxiety is accompanied by severe motor disturbances, such as rubbing hands and feet, called agitation. Anxiety symptoms are most common in various anxiety disorders and are also found in other mental illnesses such as schizophrenia which can also occur on the basis of hallucinations and delusions.
iv. Fear refers to the anxious reaction that occurs when facing an adverse or dangerous situation. Fears are also accompanied by obvious symptoms of autonomic dysfunction. In severe cases, panic attacks may occur. Fear attacks often lead to resistance and escape. Terror is common in all kinds of phobias. It is also found in hallucinations, delusions, and delusions of other mental disorders.
II. Affective Volatility Disorders: Affective volatility disorders refer to emotional dysfunction, and patients show emotional instability, apathy, irritability, pathological passion and emotional numbness.
i. Irritability means that the patient’s irritable emotional / emotional response can be easily induced, and a slight stimulus can cause a strong emotional / emotional response or an outbreak of anger. Common in fatigue, personality disorders, neurosis, mania, paranoid psychosis, cerebral organic mental disorder and physical disorders associated with mental disorders.
ii. Emotional instability refers to the poor emotional stability of patients, such as joy, anger, sorrow and sadness, which can easily change. These can be often fluctuating from one extreme to the other, appear moody, and may not necessarily have clear external factors. Common in cerebral organic mental disorders, epileptic psychosis, alcoholism and personality disorders. Mild emotional instability related to the external environment can be a manifestation of personality. Patients are extremely sad and sentimental, sobbing and crying at every turn, known as emotional fragility. These are more common in hysteria, neurasthenia and depression.
iii. Emotional indifference: The patient is indifferent to objective things and his own situation, lacks the due inner experience and emotional response, and is in a state of no emotion. This is common in schizophrenia. If the patient’s emotional response to objective stimuli is significantly slower and the intensity is significantly reduced. It is called emotional retardation. This is common in schizophrenia, physical disorders, mental disorders, and dementia.
iv. Pathological passion refers to the sudden, intense and short-term emotional outbreak of a patient. Often accompanied by impulsive and destructive behavior, which cannot be fully recalled afterwards. This is found in cerebral organic mental disorders, physical disorders associated with mental disorders, epilepsy, alcoholism, reactive psychosis, mental retardation associated with mental retardation and schizophrenia.
v. Emotional numbness: The patient’s transient and deep state of emotional depression caused by very strong mental stimulation. For example, although the patient is in a state of extreme sadness or panic, but lacks the corresponding emotional experience and emotional response. It appears numb. Common in reactive mental disorders (acute stress disorder) and snoring.
III. Barriers to emotional coordination Refer to the patients’ internal experience is not compatible with environmental stimuli and facial expressions, or their internal experience seems contradictory.
i. Emotional inversion refers to the contradiction between the patient’s emotional response and the environment’s non-stimulus, or the facial expression is inconsistent with their inner experience. This is more common in schizophrenia.
ii. Emotional naive means that the patient’s emotional response degenerates to the level of childhood and is easily affected by intuition and instinctual activities, and lacks restraint. More common in hysteria and dementia.
iii. Patients with emotional contradictions refer to patients who experience two completely opposite emotions at the same time. However, the patient does not feel the contradiction and opposition between the two emotions, and does not feel distressed and upset. Contradictory emotional experiences are simultaneously revealed and put into action. Common in schizophrenia.
d. Disorder of Will
Will is the mental process by which people consciously determine a purpose and govern their actions to achieve a predetermined goal. Will and emotion are closely related and penetrate each other. In the process of will, the act governed and controlled by the will is called the act of will. Common will disorders are the following:
I. ‘Enhanced will’ refers to the patient’s pathologically confident and stubborn actions. Common in paranoid psychosis, schizophrenia, etc.
II. Weakened refers to the patient’s lack of initiative and progress, and lack of determination and strength to overcome difficulties. Common in depression, schizophrenia and drug addiction.
III. Lack of will means that the patient’s will requirements significantly diminish or disappear. It is manifested as lack of motivation and requirements for any activity, life is passive, and everyone needs supervision and management everywhere. And often accompanied by emotional apathy and poor thinking. This is more common in late schizophrenia and dementia.
IV. Contradictory intentions means that the patient has two completely opposite intentions and emotions on the same thing at the same time, but the patient does not feel wrong. Is an important symptom of schizophrenia.
Easily suggestive refers to the lack of subjective intentions of patients, their thoughts and behaviors are often affected by the words and deeds of others, dominated by the hints of others, do not analyze and think, and obey blindly. This is common in hysteria and hypnosis, but also in normal people.
e. Attention Disorder
Attention is the process by which mental activity is focused on something over a period of time. The directivity of attention shows that people’s psychological activities are selective and maintainable. The concentration of attention makes the object of attention distinct and clear. Attention is closely related to activities such as perception, memory, thinking and consciousness. Attention includes active attention / attention and passive attention / inattention. Active attention is the intentional attention to something, while passive attention is the inadvertent attention to surrounding things. Attention usually refers to active attention. Attention disorder usually manifests as follows:
i. Attention enhancement means that the patient is particularly easily attracted to something or pays particular attention to certain activities. This is common in schizophrenia, mania and suspected conditions.
ii. Attention loss, also known as attention dispersal, refers to the patient’s active attention loss, which is difficult to concentrate or can not last. Loss of attention is more common in neurosis, schizophrenia, ADHD, and fatigue.
iii. Transfer with the border means that the patient’s passive attention / involuntary attention is obviously enhanced. It appears that attention is easily attracted by outside things, and the object of attention often changes. Mainly seen in mania.
iv. Narrowing / Narrowing Attention: When the patient’s attention is focused on one thing, he can no longer pay attention to other things. That is, the range of active attention is reduced, the passive attention is weakened, and the patient’s performance is very slow. Common in patients with conscious or mental retardation, when normal people are tired.
v. Inattentive patients: Active and passive attention are weakened. External stimuli do not easily attract the patient’s attention. Common in patients with failure and heavy brain organic psychosis.
f. Movement and Behavior Disorders
Simple casual and involuntary movements are called movements. Motivated and purposeful complex random movements are an organic combination of a series of actions, called behaviors. Certain behaviors reflect certain thoughts, motivations and goals. Patients with mental illness may have motor and behavioral disorders or psychomotor disorders due to cognitive, emotional and will disturbances. Common motor behavior disorders are as follows:
I. Psychomotor excitement means that the patient’s movements and behaviors have increased significantly. Can be divided into coordinated and uncoordinated psychomotor excitement.
i. Coordinative psychomotor excitement refers to the increase in patients’ actions and behaviors consistent with the content of their thinking and emotional activities, and the increase in the amount of their thinking and emotional activities. The patient’s behavior is purposeful and understandable, and the movements of various parts of the body are coordinated with the entire mental activity, such as excitement when emotionally agitated, excitement of hypomania and restlessness during anxiety.
ii. Uncoordinated psychomotor excitement refers to an increase in a patient’s movements and behaviors that are inconsistent with their thinking and emotional activities, manifested as monotonous, unmotivated, purposeless, incomprehensible movements, or inconsistent with the patient’s entire mental activity. It is also inconsistent with its environment such as schizophrenic nervous excitement, youthful stupid behavior, acting strange, making faces, etc. Uncoordinated excitement, such as delirium, can also occur during disturbances of consciousness.
iii. Psychomotor inhibition refers to the inhibition of the patient’s entire mental activity, which is manifested by a significant reduction in the patient’s movements and behaviors. Common psychomotor inhibitions include wood stiffness, waxy flexion mutism and malaise.
a. Researcher Mu Zong refers to the complete suppression or reduction of action and speech activity, and often maintain a fixed posture. Severe stiffness is called stagnation. The patient is silent, motionless, foodless, has a fixed facial expression, retains urine and lacks response to stimuli. If left untreated, it can be maintained for a long time. Mild stupidity is called a stupid state. It is manifested as non-answering, immovable, dull expression, but can automatically eat and urinate when no one is. Severe stiffness is seen in schizophrenia and is called tension stiffness. Mild wood stiffness can be seen in major depression, reactive mental disorders and cerebral organic mental disorders.
b. Wax-like flexion occurs on the basis of wood stiffness. The patient’s limbs are at the mercy of the person. Even in an uncomfortable posture, they remain immobile for a long time like wax. If the patient’s head is lifted like a pillow, the patient does not move, and it can be maintained for a long time. This is called an “air pillow”. At this time, the patient is clearly aware and can recall when he is well. Found in the schizophrenic nervous type.
c. Silence: The patient is silent, does not answer questions, and sometimes can indicate by hand. Seen in hysteria and schizophrenia nervous type.
d. Illness: Patients not only do not perform the actions required of him, but also show resistance and opposite behaviors. If the patient’s behavioral response is completely contrary to the doctor’s requirements, it is called active violation. For example, when the patient is asked to open his mouth, he closes his mouth. If a patient refuses to respond to a doctor’s request without acting, it is called passive violation. More common in the nervous type of schizophrenia.
Other Special Symptoms
i. Stereotype refers to a patient repeating a monotonous action mechanically, often appearing with stereotyped speech. More common in the nervous type of schizophrenia.
ii. Continuous speech refers to the patient’s meaningless repetition of a purposed and completed speech or action. More common in organic mental disorders.
iii. Imitation action refers to the patient’s purposeless imitation of other people’s actions, often coexisting with imitation speech, seen in the schizophrenic nervous type.
iv. Posture refers to the patients making weird, stupid, childish pretentious movements, postures, gaits and expressions, such as making strange appearances and making funny faces. More common in adolescents with schizophrenia.
v. Forced action is that the patient knows that it is unnecessary, but it is difficult for him to refrain from repeating an action. If he does not repeat, the patient will have serious anxiety. Obsessive-compulsive action is often caused by obsessions. Obsessive-compulsive action is most common in obsessive-compulsive disorder, and is also found in mental disorders such as schizophrenia and depression.
vi. Impulsive behavior: This refers to the behavior that the patient suddenly produces, usually causing adverse consequences. It is common in personality disorders, schizophrenia, and normal people when they are particularly emotional.
IV. Instinctual behavior: Human instinctual behavior can be summarized into two categories: the instinct to preserve life and the physiological instinct to preserve ethnic continuity. Physiological instincts include safety, diet, sleep, and sexual needs. Abnormal instincts include suicide, eating disorders, sleep disorders and sexual dysfunction.
i. Suicide is a behavioral disorder that preserves the instinct of life. Common causes of suicide include: strong pressure from the outside world, momentary emotional impulses, in order to achieve a certain purpose, falsehoods come true, etc. Depression is the most common of various mental illnesses, followed by schizophrenia. Self-injury also belongs to instinctual behavior disorder, which refers to self-harm behavior without motive for death or causing consequences of death. It is more common in mental retardation, hysteria and schizophrenia.
ii. Eating Disorders Means disorders of the behavior of ingesting substances needed for life support.
Loss of appetite: refers to behaviors in which the number and frequency of eating patients are significantly reduced than usual. Common in depression, followed by anorexia nervosa and certain physical diseases.
Hyper appetite: refers to patients who often overeating. More common in mental retardation or schizophrenia, but also in mania, hysteria and so on.
Antifeeding: Refers to the behavior of a person with mental illness who refuses to eat because of suspicion of poisoning, hallucinations, delusions of being victimized, blurred consciousness and stiffness.
Aliphagia: refers to the behavior of eating things that ordinary people do not eat or do not eat often.
iii. Sleep Disorder Refers to the disorder of sleep and awakening periodically.
Insomnia: usually manifested as difficulty falling asleep, dreaming, awakening, and waking up early. Although some patients had fallen asleep, they did not feel asleep and developed severe anxiety, which is called subjective insomnia.
Drowsiness: often caused by weakness. Some patients show irresistible sleep, but they are short-lived and are more likely to wake up and become narcolepsy.
Sleepwalking: also known as sleepwalking, which refers to a patient who wakes up after sleeping for a while at night, has stupid behavior, unconsciousness, does not answer questions or answers vaguely. After a short period of activity, the patient would fall back to bed and cannot recall the next day. More common in children and hysteria.
iv. Sexual dysfunction
Organic sexual dysfunction: Sexual organs can cause spinal cord disease that often causes organic sexual dysfunction.
Functional dysfunction: caused by psychological factors, personality disorders, neurosis, mania, depression, various mental illnesses.
Common sexual desire disorders are hypersexuality, hyposexuality (impotence, premature ejaculation, etc.), wrong sexual desire (fetish, exposed yin, sadism and abuse).
g. Memory Disorders
I. Memory is the process of the information stored in the brain or the process of reproduction, including the four processes of memorization, preservation, recall, and recognition.
i. The Process of Memory
a. Remembering: It is the beginning of the memory process, which refers to the process in which things leave marks in the brain through perception. Good or bad memory depends on the level of consciousness and concentration.
b. Preservation: refers to the process of storing things that have been remembered in the brain, so that information storage is not lost. In the case of preservation disorders, patients cannot establish new memories, cannot learn, and the range of forgetting is increasing.
c. Remembrance: refers to the process of recreating the traces stored in the brain when necessary. If the memorization and preservation processes are normal, there are few obstacles to recall.
d. Recognition: refers to the process of verifying whether the reproduced image is correct, that is, when the original stimulus is reproduced, it can recognize that it is something that has been perceived in the past. Things that are difficult to remember can be recognized. Partial or complete loss of ability to recall and recognize is called forgetting.
ii. Form of Memory
a. Immediate memory: refers to the memory of the experience that occurred within a few seconds to 1 to 2 minutes.
b. Short-term memory: memories of experiences that occur within a few minutes to 1 hour.
c. Recent memory: refers to the memory of the experience that occurred in the 24-48h.
d. Remote memory: refers to the memory of the experience of 24 to 48 hours ago.
iii. Memory Content
a. Memory of Perceived Image: What is the object that you see or touch.
b. Memory of word concepts: remember the meaning of the words and concepts learned.
c. Emotional memory: remember the emotional connection at the time of an event.
d. Certain memory: remember how a certain action or operation should be performed.
The neurophysiological basis of memory involves the sensory contact areas of the cortex, the temporal lobe, the thalamus, and the entire cerebral cortex. The study found that the limbic system is closely related to memory, and put forward a memory circuit of “hippocampus-fornix-papillary body-nipple optic tract bundle-preoptic nucleus-cingulate gyrus-hippocampus”. The study also found that recent memory and distant memory are responsible for two systems. The memory circuit is mainly related to our recent memory, while distant memory is related to the neurons that control memory activity in the cortex and subcortex. When various stimuli enter the brain, there are two kinds of reactions. One is to activate the stored memory and produce a response corresponding to the situation at the time. The other is to form a new trace connection and establish a new memory to store.
B. Memory Disorders
I. Forgetting Refers to the patient’s partial or complete inability to reproduce past experiences.
i. Psychogenic amnesia: Also known as boundary amnesia, refers to the memory loss associated with a particular period / stage that a patient has experienced in the past. Usually this stage / period occurs when it is associated with unpleasant or intense situations of fear, anger, shame, and is highly selective. More common in hysteria.
ii. Organic amnesia: refers to patients with memory loss caused by brain diseases. Forgetting near things is usually more important than forgetting about distant things. The cause of organic forgetting can be the difficulty of the memorization process caused by the disturbance of consciousness, the difficulty of the preservation process that cannot form a permanent trace, the damage of the memory circuit, or the damage of all three processes.
Retrograde amnesia: Refers to patients who cannot recall a period of time before a brain injury. It is more common in brain trauma, concussion and acute conscious disturbance. The duration of forgetting is proportional to the severity of brain trauma.
Anterograde amnesia: Refers to patients who cannot recall what happened within a period of time after the onset of illness. Forgetting is caused by the inability of the disease to form a lasting mark. Common in acute organic encephalopathy, such as high fever delirium, epileptic hazy, drunkenness, traumatic brain injury, encephalitis, subarachnoid hemorrhage and so on.
Forgetting recent events: Refers to patients who cannot remember and reappear what happened recently.
Forgetfulness in remote events: Refers to patients who cannot recall and reproduce what happened in the past.
Amnestic Syndrome: Also known as Korsakov Syndrome, refers to patients with three major characteristics of disorientation, fiction and recent forgetting. Lesions in the hypothalamus, especially near the papillary body, cause this syndrome. It is common in patients with chronic diffuse encephalopathy, such as senile dementia, paralytic dementia, chronic alcoholic mental disorders, brain trauma and brain tumors.
II. Memory Error
i. Misconception: Refers to the patient’s wrong memory of the place, time, and plot of the event that he has experienced in the past, but the patient still believes it. It is more common in brain organic diseases and depression.
ii. Fiction: Refers to the missing part of the patient’s own memory, filled with a fictional set of things, the content is often vivid, changeable and with an absurd color. But patients often forget this instantly.
iii. It seems that acquaintances or old things are as new: This refers to the familiarity that patients have experienced when they feel something they have never experienced before or enter an unfamiliar environment. It refers to the strangeness of meeting for the first time when you feel something or environment you are already familiar with. These are obstacles to recall and recognition, which are common in epilepsy and also in normal people.
iv. Delusional memories: refers to patients with delusional memories.
v. Memory enhancement: refers to patients with pathological memory enhancement. Patients can recall very far and trivial things in the past, often including many details. More common in mania, obsessive-compulsive disorder and paranoid psychosis.
According to Ribot’s law, the more recent things are remembered, the faster they are forgotten. The development of forgetting always progresses from recent memory to distant memory.
Memory loss refers to the general decline of the four basic processes of memory, which are more common clinically. The lighter is the weakening of memories, such as not remembering the person who just met and the meal just eaten. In severe cases, memory also decreases, such as being unable to recall personal experiences. Can be seen in more severe dementia patients. Patients with neurasthenia have less memory loss, but have difficulty remembering. Can also be seen in normal elderly.
h. Intellectual Impairment : Mental Retardation
Intelligence, also known as intelligence, refers to people’s ability to recognize objective things and use knowledge to solve practical problems. This ability is developed in practice and is a combination of innate quality and acquired practice (social practice and education).
Intelligence includes observation, memory, attention, thinking, and imagination. It involves a series of cognitive processes such as perception, memory, attention, and thinking, and is manifested through the aforementioned psychological processes. According to the different capabilities of these manifestations, intelligence can be divided into abstract intelligence, mechanical intelligence and social intelligence. Abstract intelligence refers to the ability to understand and use concepts and symbols. Mechanical intelligence refers to the ability to understand, create and use machinery. Social intelligence refers to the ability to adapt to take appropriate actions in people’s relationships and social practices.
Clinically, it is often based on an individual’s ability to solve practical problems, using vocabulary, numbers, symbols, graphics and non-verbal materials to form concepts to determine a person’s level of intelligence. Currently, intelligence tests are used to assess an individual’s intelligence level. The commonly used intelligence test in clinical practice is the Wechsler intelligence test, referred to as WAIS. The results of the intelligence test are expressed by numbers, which is called IQ. Most people have IQ values between 90 and 110. IQ higher than 130 is high intelligence, and IQ lower than 70 is low intelligence.
The foundation of normal intelligence is a sound brain and proper learning and practice. Therefore, mental retardation is caused by brain diseases and lack of learning and practice. Learning and practice include not only the environment and teachers, but also the period of learning and practice.
Mental retardation can be divided into two types: mental retardation and dementia.
i. Mental retardation refers to congenital or perinatal period or before growth and maturity (before the age of 18). The development of the brain due to various pathogenic factors, such as heredity, infection, head trauma, endocrine abnormalities or hypoxia, etcmakes the brain dysplasia or obstruction, intelligent development stays at a specific stage.
ii. Dementia is a syndrome that refers to the comprehensive decline of intelligence caused by various factors such as disease after the brain is fully developed. It is manifested as disability in orientation, memory, understanding, calculation, learning, and judgment. This is common in senile dementia, cerebral arteriosclerosis, Parkinson’s disease, paralytic dementia, encephalitis sequelae, etc. But there is no disturbance of consciousness.
According to the nature of the pathological changes in the brain and the size of the range involved, it can be divided into general dementia and partial dementia.
The brain lesions of generalized dementia are mainly manifested as diffuse organic damage, and all aspects of intelligent activity are damaged, which affects all patients’ mental activities, and personality changes often occur. There is disorientation and lack of awareness. This can be seen in Alzheimer’s disease and paralytic dementia.
Partial dementia brain lesions only invade parts of the brain, such as invading the surrounding tissues of the cerebral blood vessels. The patient only produces memory loss, impaired understanding, difficulty in comprehensive analysis, etc. However, his personality remains good, his orientation is complete, and he has a certain degree of autonomy. Intellectual power can be seen after traumatic brain injury and early in vascular dementia. However, when dementia is severe, it is difficult to distinguish clinically from generalized or partial dementia.
Clinically, after severe trauma, it can produce a dementia-like performance, and the brain tissue structure does not have any organic damage, which is called pseudo-dementia. The prognosis is good and can be seen in hysteria and reactive mental disorders.
a. Ganser syndrome in Psychiatry: also known as psychogenic pseudodementia, that is, giving approximate and wrong answers to simple questions, giving people the feeling of deliberate contrition or joking. For example, when a 20-year-old patient was asked how many fingers she had in one hand, she answered “4”, and a simple calculation such as 2 + 3 = 4 gave an approximate answer. The patient understood the meaning of the question, but the answer was incorrect. There can also be errors in behavior, such as turning the key upside down to open the door. But they can correctly solve some complex problems such as chess and card games, and general life problems.
b. Childlike dementia in Psychiatry: Childish behavior that mimics the speech and behavior characteristics of young children. That is to say, adult patients behave like childish looks of ordinary children, learning the tone of young children’s speech, claiming to be only 3 years old and being called an aunt or uncle when they are everyone.
c. Depressive pseudodementia in Psychiatry: refers to patients with severe depression who suffer from cognitive decline in the presence of psychomotor depression, manifested as early symptoms of dementia, such as decreased computing ability, memory, comprehension and judgment Initiative. However, patients with depression experience can be identified. After the depression disappeared, his intelligence recovered completely.
i. Unconsciousness in Psychiatry
In clinical medicine, consciousness refers to a patient’s ability to correctly recognize and respond to the surrounding environment and himself. Consciousness involves mental activities / mental functions such as level of arousal, attention, perception, thinking, emotion, memory, directional behavior, etc., and is the basis of people’s intelligent activities, random actions and will behaviors. The excitability of the cerebral cortex and reticular activation system plays an important role in maintaining consciousness.
Impaired consciousness refers to the decline of consciousness, the change of consciousness range, and the change of consciousness content. The disturbance of consciousness is caused by the suppression of brain function. Many mental activities are affected during the disturbance of consciousness. These are manifested as an increase in sensory threshold, reduced, incomplete or even inability to perceive intelligibility. Also in decreased active attention, difficulty in or concentration of attention. Further in decreased thinking ability, and difficulty in forming new ones Concepts, loose thinking associations, slow thinking, vague content, abstract thinking and purposeful thinking difficulties. Also in slow and erratic emotional reactions. Also in memory loss, often forgetting delayed behavior and movement, lack of purpose and coherence. This is also in disorientation, involvement, etc. The order is time, place and person. Disorientation is an important sign to judge whether a patient has an unconscious disorder clinically.
Common clinical disorders of consciousness are drowsiness, lethargy, coma, cloudy consciousness, delirium, hazy consciousness, dream-like consciousness and blurred consciousness, etc.
i. Drowsiness means that the patient’s level of consciousness decreases. If no stimulus is given, the patient falls asleep, but can simply respond after calling or awakening. After stopping the stimulation, the patient goes to sleep again. At this point, the patient’s swallowing, pupils, and corneal reflexes were present. Found in functional and cerebral organic diseases.
ii. Drowsiness means that the patient has a lower level of consciousness and loses awareness of the surrounding environment and self-consciousness, but the patient may have a simple and mild reaction under strong stimulation. At this time, the reflections of the cornea and eyelashes are weakened, the light reflection and swallowing reflection still exist, the deep reflection is hyperactive, and the pathological reflection is positive. Involuntary movements and tremors may occur.
iii. In psychiatry, coma refers to the complete loss of consciousness, no response to external stimuli, and random movement disappeared. At this time, swallowing, cornea, cough, sphincter, tendon reflexes, and even light reflections disappear, which can lead to pathological reflexes. More common in the critical period of severe brain and physical diseases.
iv. Obliqueness, in psychiatry, means that the patient’s consciousness is impaired. The patient seems to be awake and unconscious, lacking initiative, and strong stimulation can cause a response. But the patient’s response is slow, simple to answer questions, low and slow speech, and time, place and person orientation. Obstructions include swallowing, cornea and reflection of light. Primitive movements such as licking lips, tongue extension, strong grip, sucking and pathological reflexes may also occur. More common in mental disorders caused by physical diseases.
Delirium At the same time that the consciousness of consciousness is reduced, a large number of illusions and hallucinations appear. The hallucinations are more common, and the contents of hallucinations and visual illusions are more vivid and vivid, such as seeing insects and beasts. Some content is horrible. Patients often have nervous and fearful emotional reactions, and appear uncoordinated psychomotor excitement. Inconsistent thinking, difficulty in understanding, and sometimes fragmented delusions. All or part of the patient’s directional force was lost, and most patients showed self-directed force preservation while the surrounding environment directional force was lost. Delirium is often aggravated at night, and the day is light and the night is heavy. It lasts several hours to several days, and may be partially or completely forgotten after consciousness is restored. Mental disorders caused by physical diseases and mental disorders caused by poisoning are more common.
In psychiatry, dream-like state Refers to a dream-like experience accompanied by a reduction in consciousness. The patient was completely immersed in the hallucinations and lost contact with the outside world, but his appearance seemed sober. The hallucinations are not completely forgotten. This lasts for days or months.
The hazy state refers to the narrowing of the patient’s range of consciousness, accompanied by a decrease in consciousness. Within a narrow range of consciousness, patients may have relatively normal perception and coordinated and coherent complex behaviors, but things outside this range cannot be judged correctly. It is manifested as associative difficulties, dull or confused expressions, or anxiety or euphoria, disorientation, illusions, delusions, delusions and corresponding behaviors. It often occurs suddenly, abruptly, recurrent, and lasts for several minutes to hours, and is forgotten or partially forgotten afterwards. More common in epilepsy mental disorders, brain trauma, cerebral hypoxia and snoring.
j. Directional Force in Psychiatry
Orientation refers to a person’s ability to recognize time, place, person and one’s state. The former is called the directing force on the surrounding environment and the latter is called the self-directing force. Temporal orientation includes the recognition of the time at the time, location orientation or spatial orientation refers to the recognition of the place, person orientation refers to the identity of the people in the surrounding environment and their relationship with the patient.
Also, knowledge of gender, age and occupation. A disability or misunderstanding of the environment or one’s own condition is called disorientation. Orientation disorder is more common in symptomatic psychosis and cerebral organic psychosis with conscious disturbance. Disorientation is an important sign of disturbance of consciousness, but disorientation does not necessarily have to be conscious. For example, patients with alcohol-toxic encephalopathy can have disorientation without consciousness.
Double redirection refers to a double experience of the time, place and characters of the surrounding environment. One experience is correct, while the other experience is related to delusion, which is delusional judgment or interpretation. For example, a patient considers the hospital to be a hospital and a prison, or thinks that it is a hospital but it is actually a prison. Common in toxic mental disorders and epileptic mental disorders.
Self-consciousness disorder in Psychiatry
Self-consciousness or self-experience: refers to the individual’s perception of their own mental and physical conditions. Everyone is aware of their existence and is an independent individual. Your own mental activity is completely controlled by you and known to you. The past me and the present me are the same individuals who are interconnected. Common self-awareness disorders include disintegration of personality, dual personality, barriers to self-limitation and lack of self-awareness.
i. Disintegration of personality means that the patient feels that he or she has made a special change or even no longer exists. Patients feel that the world is becoming unreal or non-existent, and is called a disintegration of reality or a sense of non-reality. Some patients feel that they have lost their emotional resonance with others and cannot produce normal emotions or feelings. More common in depression, but also in schizophrenia and neurosis.
ii. Dual personality means that the patient experiences two completely different psychological activities at different times, has two completely different mental lives and is a disorder of self-singleness. Common in hysteria and schizophrenia.
iii. Self-boundary barriers refer to patients who cannot distinguish themselves from the world around them and therefore feel that mental activities are no longer owned by themselves. Even if their own thinking is not spoken, others will know that it is called insight or thought dissemination. Your own thoughts, emotions, wills, impulses and behaviors are not your own. But these are manipulated or imposed by others or some kind of instrument, which is called a sense of being controlled. It is a characteristic symptom of schizophrenia. Self-boundary disorders are occasionally seen in epilepsy and other mental disorders.
Lack of self-awareness in psychiatry: Self-awareness, also known as comprehension or introspection, refers to the ability of patients to judge and recognize their own diseases. A patient’s correct understanding of his mental symptoms is called self-awareness and it is considered that his mental symptoms are not pathological. There are 4 criteria for judging whether there is self-awareness:
a. The patient realizes that there are phenomena that others think are abnormal
b. Patient recognizes that these phenomena are abnormal
c. The patient recognizes that these abnormalities are caused by their own mental illness
d. The patient realizes that they treat these symptoms It’s required. Generally speaking, the clinical symptoms disappear, and knowing that one’s mental symptoms are pathological, that is, the recovery of self-knowledge. Most people with mental illness have incomplete self-knowledge, and most patients with neurosis have self-knowledge. Clinically, the presence or absence of self-awareness and the degree of self-awareness recovery are taken as important indicators for judging the severity and improvement of the disease. The integrity of self-knowledge is one of the important indicators for the recovery of mental illness. Lack of self-awareness is characteristic of mental illness.
3. Origin of Psychiatry Department
People’s understanding of mental phenomena often determines and influences people’s understanding of mental health.
Difficult attitudes, perspectives and methods. The development process of psychiatry not only reflects the process of understanding of mental disorders and their laws, but also reflects the progress of human beings in correcting and reversing discrimination and prejudice against mental disorders.
In the cultural and medical classics of various times in various ethnic groups, all the symptoms of mental disorders, their diagnosis and treatment method and people’s views on these phenomena are recorded. However, in the long period of scientific and cultural backwardness, mental disorders are regarded as grotesque and weird, and patients are regarded as devil-ridden and abused or mutilated.
The development of material civilization science and technology has promoted the change of people’s attitude towards mental disorders. After the French Revolution in the 18th century, Pinel proposed to lift the yoke of patients and treat mental patients with a humanitarian attitude, thereby writing an epoch-making page in the history of psychiatry concepts. And led psychiatry to the threshold of medical science.
4. Psychotropic Drugs and Psychology
Since the early 1950s, psychotropic drugs have been widely used in the field of psychiatry, and the development of psychopharmacology and other brain sciences has promoted the rapid progress of contemporary psychiatry. Many effective measures have been summarized for treating mental disorders. For example, various types of psychotropic treatments largely control or eliminate the symptoms of mental disorders, and thus contribute to the implementation of psychotherapy, work and recreational therapy and social therapy.
With the innovation of medical methods, the atmosphere of the mental hospital has been changed. The closed caretaker management has been changed to open management. This completely lifts the restraint on the patient’s body and is beneficial to the rehabilitation of the patient.
At the same time, diagnostic techniques for mental disorders have also advanced. The application of EEG, brain potential distribution map, brain evoked potential brain computerized tomography scanner, and brain magnetic resonance technology can help to objectively test certain diseases. Many psychological testing, personality testing and intelligent testing methods are more conducive to the development of psychological diagnostic techniques for mental disorders. The popularity of psychiatric epidemiology and social psychiatry has explored the causes of mental disorders from a macro perspective, and social treatment and rehabilitation measures have achieved unprecedented results.
5. Basic Information about Psychiatry Department
Psychiatry is inextricably linked with clinical departments. For example, many neurological diseases, metabolic, endocrine disorders and visceral diseases may be complicated by mental disorders at different stages and need to be treated. Those with general physical disorders are also prone to some heart problems.
Physical and emotional problems therefore interfere with the diagnosis and treatment of the original disease, need to be identified and treated.
6. Research Methods in Psychiatry
Many research methods in psychiatry, such as personality tests and emotional assessment scales, can be applied to the investigation and research of psychosomatic diseases, or to other clinical departments. In addition, the implementation of mental health counseling and psychological treatment on health and disease in general hospitals is urgently needed by the general public and should be promoted.
The research on the etiology of psychiatry has been extended to many basic fields such as psychology, genetics, physiological psychology, neuropsychoendocrinology, psychopharmacology, neurophysiology and biochemistry. In these different fields, research results on psychological disorders will promote the advancement of relevant basic medicine.
7. Genetic Research in Psychiatry Department
Genetic studies have revealed several causes of mental retardation, such as congenital stupidity caused by chromosomal aberrations. Other genetic metabolic diseases such as phenylpyruvateuria are autosomal recessive, and phenylpropanoic acid is hydroxylated in patients. Enzyme deficiency, phenylpropionic acid cannot be oxidized to tyrosine, which eventually leads to mental retardation. A large number of statistical genetic data show that the expected incidence of children with a family history of schizophrenia is much higher than that of the general population.
8. Biochemical Aspects in Psychiatry
Biochemical discussions have also suggested some etiological factors related to mental disorders. For example, the study found:
Emotional psychiatric disease: there are changes in central neurotransmitters at the time of onset, mainly in the synapses of neurons, changes in noradrenaline and serotonin. In the manic state, norepinephrine increased, while the serotonin content was lower than normal in the depressed state.
For another example, in some patients with schizophrenia, the presence of over-methylated biogenic amine metabolites at the time of onset was also confirmed. In other patients, monoamine oxidase activity in platelets was reduced. Psychopharmacology can also provide clues to the pathogenesis of certain mental disorders. For example, dependence on the stimulant amphetamine can cause amphetamine-like toxic psychosis similar to schizophrenia.
9. Amphetamine and Psychology
Research suggests that amphetamine as a dopamine agonist enhances dopaminergic activity between synapses in central neurons and causes schizophrenia-like psychiatric disorders. However, different classes of antipsychotic drugs reduce dopaminergic activity by blocking dopaminergic receptors, and reduce the symptoms of schizophrenia. This makes people consider that dopaminergic activity may play an important role in the pathogenesis of schizophrenia . Many tricyclic antidepressants play a therapeutic role by blocking the reuptake of central monoamine in the presynaptic membrane and indirectly increasing the amine content. Therefore, it is assumed that there is a monoamine metabolism disorder in the onset of endogenous depression.
Due to the continuous innovation of micromorphological research methods and methods, neuropathology has also made great progress in the research of mental disorders caused by cerebral organic diseases. For example, the discovery and research of brown spots in different parts of the brain can help to understand the neuropathological characteristics of senile dementia, and help to differentiate between senile dementia and general aging.
Psychology has always been considered one of the important basic disciplines of psychiatry. Psychology and physiological psychology both have an influence on the diagnosis and treatment of psychiatry and the theoretical discussion. Among them, physiological psychology explores many psychological abnormalities, such as the neurological basis of mood, motivation and memory disorders, and these discussions help to gradually provide a physical and chemical basis for mental abnormalities.
Psychiatry can be divided into many specialties such as clinical psychiatry, adult psychiatry, child psychiatry, geriatric psychiatry, judicial psychiatry, liaison-consultation psychiatry, psychiatry epidemiology, social psychiatry, community psychiatry, occupational psychiatry Learn and more.
The development of psychiatry is getting faster and faster, but the main problem hindering the development of the discipline is still the etiology and pathogenesis of mental disorders that have not yet been clarified. Therefore, the etiology discussion is one of the important issues in the development of psychiatry in the future.
In the discussion of the etiology, people have generally attached importance to the new medical model of biology-medicine-psychology-society. They also have paid full attention to the research direction of combining micro and macro in methodology. In microscopic research, attention is paid to the role played by genetics and immunology in a number of mental disorders. At the macro level, epidemiological investigations in populations are also paid attention to in order to discover the laws of disease and the ecological factors of the disease. There are many social causes of mental disorders.
11. Genetic Factors
At present, many experts believe that the occurrence and development of mental disorders and the prognosis of the old and the genetic factors of individuals, susceptibility, personality characteristics before illness, the state of the body at the time of onset, trauma, environmental triggering factors, and social and cultural backgrounds extensive contacts. Therefore, we should make full use of the development results of natural sciences and social sciences and strengthen comprehensive research in multiple disciplines in order to accumulate data and achieve results.
Discussion on the pathogenesis theory of psychological stimulus factors has now developed to the depth of information theory. It is generally believed that an individual’s awareness, evaluation of the information, and the emotions that result from it will have an impact on health. People have carried out research work on neurophysiology, psycho-biochemistry and psycho-endocrine to clarify the mechanism of psychological abnormalities caused by psychological stimulation factors.
For another example, some mental disorders, such as schizophrenia, have obvious genetic factors, but how the genetic factors work remains to be elucidated. When conducting epidemiological research on mental illness, we must analyze and study the relevant ecological and environmental factors that affect the occurrence, development and outcome of mental illness. We should also seek the causes and laws from a macro perspective.
12. Treatment of Mental Disorders
The treatment of mental disorders usually adopts comprehensive measures, such as various psychotropic medications, psychological treatments, industrial treatments and social rehabilitation treatments. From a medical point of view, a pragmatic and eclectic approach is adopted for different schools of thought. In the implementation of treatment, a treatment team consisting of a psychiatrist, nurse, social worker, occupational therapist and psychologist generally works together.
Community treatment of mental disorders has received widespread attention and attention. Community medicine can reduce the human and material resources to prevent and treat a large number of people with mental disorders, which indicates that the development of contemporary medicine has reached the stage of combining medical and public health. The practice of community mental health needs the sympathy and support of the public. It is also necessary to cooperate with social forces to establish medical facilities. The established medical goals are planned.
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