M.I. Pyrogov Vinnitsa National Medical University
Chair of Psychiatry and Addictology
SUBJECT AND TASKS OF PSYCHIATRY. DISORDERS OF PERCEPTION
AND SENSATION. ABNORMALITY OF EMOTIONS AND WILL.
Abstracts of lecture
Lecturer: Associated Professor, PhD Teklyuk S.V.
Vinnytsya 2013 y.
Plan of the lecture
I.
SUBJECT AND TASKS OF PSYCHIATRY.
1. Definition of psychiatry.
2. Tasks of psychiatry.
3. History of development: six main periods.
4. Main principles of organization of psychiatric aid;
5. The scheme of organization of psychiatric aid:
1) Out-patient (outside the hospital) aid and the structure of a
psychoneurological dispensary.
2) In-patient psychiatric aid and the structure of a mental hospital.
3) Arrangement and organization of work of the closed mental
department (structure and therapeutic regimens).
4) Indications and the order of admission to the mental in-patient
department.
5) Social-rehabilitative establishments.
6. Methods of investigation in psychiatry:
1) Clinical interview and collection of anamnesis data.
2) Physical examination.
3) Observation.
4) Psychological investigation.
5) Additional investigations
7. Classification of mental disorders:
1) Basic classification categories: notions of symptoms, syndromes and
disease in Psychiatry.
2) Systems of classification:
 nosological trend
 syndromological trend
 registers of mental disorders
 psychoanalytic trend
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 pragmatic (eclectic, atheoretic) trend
 the International Classification of Diseases (ICD)
 the Diagnostic And Statistical Manual (DSM).
II.
DISORDERS OF PERCEPTION AND SENSATION.
1. Abnormalities of sensory functions:
1) Quantitative.
2) Qualitative.
2. Pathology of perception:
1) Agnosias.
2) Illusions.
3) Hallucinations:
 true hallucinations;
 pseudohallucinations;
4) Psycho-sensory disorders.
III.
ABNORMALITY OF EMOTIONS AND WILL.
1. Classification of emotional disorders.
2. Mood Disorders:
1). Depressive syndromes:
- classical (typical) depression
- depressive stupor
- agitated depression
- apathetic depression
- masked ( somatized) depression
2) Manic syndrome.
3) Methods of Investigation
3. Disturbance of behaviour, violation and drivers:
1) Scheme of a volitional action.
2) Motor disturbances
3) Pathology of volitional processes:
- hyperbulia;
- hypobulia;
- parabulia.
4) Impulsive drives.
5) Methods of Investigation
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List of recommended literature
Basic literature.
1. Concise Oxford Textbook of Psychiatry. M. Gelder, D. Gath, R.Mayou. –
Oxford; New York; Tokyo; Oxford University Press, 2007. – 953 p.
2. Modern Synopsis of Psychiatry. A.M. Freedman, H.I. Kaplan, B.J. Sadock. –
USA, 1982. – 433 p.
3. Psychiatric Dictionary / 5th ed. R.J. Campbell. – Oxford; New York; Oxford
University Press, – 1981. – 693 p.
4. Psychopatology and addictive Disorders / Ed. By Meyer. - New York; London,
1986. – 283 p.
5. Psychiatry: course of lecture /Ed.by V.S. Bitensky. – Odessa, 2005. – 336 p.
6. Zimbardo Ph.G. Psychology and Life. - USA, 19991. – 189 p.
Additional literature.
1. Brundtland G.H. Mental health in the 21st century // Bulletin of the World
Helth Organization. – 2000. - №87. – Р. 411.
2. Desjarlais R., Eisenberg L., Good B. et al. World Mental Health: Problems
and Priorities in Low-Income Countries. – New York: Oxford University
Press, 1995. – 144 p.
3. Marsella A., Kleinman A., Good B. Cross-cultural studies of depressive
disorders. An overview. Culture and depression. – Berkley: University of
California Press, 1985. – 213 p.
4. Mulrow C.D., Williams J.W. Jr., Trivedi M., et al. Treatment of depression:
newer pharmacotherapies. Rockville, MD: Agency for Health Care Policy and
Research, 1999. – 253 р.
5. Murray C.J.L., Lopez A.D. The global burden of disease: a comprehensive
assessment of mortality and disability from disease, injuries and risk factors in
1990 and projected to 2020. Cambridge, MA: Harvard University Press, 1996.
– 68 p.
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6. Kielholz P. Masked Depression. — Berne, 1973. – 97 p.
7. Lopez-Ibor J. J. The Present Status of Psychotropic Drugs / Ed. by A. Cerletti,
F. J. Bove. - New York, 1999. - 519 p
8. Preskorn, S.H. Outpatient management of depression: A guide for the Primarycare
practitioner/
S.H.
Preskorn.
-
Wichita;
Kansas:
Professional
Communications,Inc., 1994. - 147 p.
9. Ustun T.B., Sartorius N. Mental Illness in General Health Care. An
International Study. – Chichester: John Willey @ Sons Ltd, 1995. – 336 p.
Block of information
Psychiatry is the medical science dealing with the study of diagnosis, etiology, pathogenesis,
treatment and prevention of mental diseases.
Tasks of psychiatry are:
A) study of the rate, conditions of origination, nosological structure and clinical
peculiarities of mental diseases;
B) study of the etiology and pathogenesis of mental diseases;
C) treatment and prevention of mental diseases;
D) social-labour rehabilitation of patients;
E) labour, forensic and military psychiatric examination;
F) carrying out of sanitary-educational and psychohygienic measuresamong the population.
Psychiatry is an integral part of medicine organically connected with all its sections. Every
doctor in his practical activity will often come across various psychiatric problems. It is caused by
the fact that in cases of all diseases patients develop some or other mental disorders: from
nonpsychotic (most frequently) to psychotic, and sometimes defect-organic ones. Every doctor is
obliged to adequately determine the register of these disturbances and devise his tactics in each
particular case.
It is expedient to divide all mental disorders into 3 groups depending upon the level and
depth of the disturbances. These are 3 different registers of mental disorders: psychotic,
nonpsychotic, and defect-organic.
The psychotic state is characterized by presence of at least one of the following signs:
clouding of consciousness, delusions, hallucinations. In this situation the patient cannot critically
assess his diseased state and does not understand the morbid character of the disturbances.
Nonpsychotic (borderline) mental disorders are mostly characterized by disorders of
emotions and in the effector-volitional sphere. The patients critically assess their diseased state,
understanding that they are ill.
Defect-organic disorders manifest themselves through disrupted intellectual functions (of
memory and thinking).
History of development On the base of the theory, developed by an outstanding Russian psychiatrist Yu. V. Kannabikh, six historical periods can be distinguished in the
development of psychiatry:
1) the pre-scientific period, characterised by primitive religious understanding of the
mentally ill people's abnormal behaviour;
2) the period of ancient antique medicine, a more progressive period, when the first
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attempts at organising mental health treatment were made;
3) the third period, corresponding to the Middle Ages, was in general a period or
regress, when psychiatry returned to its prescientific period (theological scholastics);
4) the fourth period, from the beginning of the XVIII to the beginning of XIX century
was the stage of formation of psychiatry as a part of the medical science;
5) the fifth period was the epoch of E. Krepellin's nosological psychiatry. The creation
of a nosological classification of mental disorders was the main outcome of this stage;
6) the sixth, modern stage of development of psychiatry, formed in the XX century,
especially its last decades, can be called the period of social psychiatry; it is characterised by
wide development of community, social forms of mental health services; somatological
aspects of mental disorders got more attention; the circle of issues that are studied by
specialists in the field of psychiatry has broadly expanded.
Table 1. Classification of Emotional Disorders According to Different
Properties of Emotions
Properties
According to sensitivity and
intensity
According to stability
Distortion of emotions
Mood disorders
Features (symptoms)
Irritability Sensitivity Emotional coldness (blunting,
flattening)
Lability (emotional incontinence) Explosion readiness
Rigidity
Ambivalence, Parathymia, Pathologic affect
Euphoria (mania) Hyperthymia Dysphoria
Anxiety Depression (melancholy) Apathy
Table 1. Pathology of Volitional Processes
Hyperbulia
Hypobulia
Parabulia
a) Increase of volitional activity a) Motor retardation (slowness a) Catatonic syndrome
(purposeful activity)
of movements)
b) Hebephrenic syndrome
b) Redundancy of volitional activity b) Absence of movements
(motor excitement)
(stupor)
c) Hyperactivity
Table 2. Structure of the Catatonic Syndrome
Catatonic excitement
Catatonic motor retardation
Speech and motor excitement
Catatonic stupor (receptor and effector)
Impulsiveness
Automatic submission
Affectation
Negativism (active and passive)
Verbigeration
Waxy flexibility of muscles
Mutism
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