Medical studies programme
MODULE
PSYCHIATRY AND CLINICAL
PSYCHOLOGY
IV course
VII -VIII semesters
Kaunas university of medicine
Medical faculty
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Contents
General information
Module content
Module aim and objectives
Educational problems
1. First problem. Psychotic disorders
2. Second problem. Affective disorders
3. Third problem. Organic and symptomatic mental disorders
Lectures
Medical psychology
1. Medical psychology, history, content, research methods. Main communication forms. Medical
communication, peculiarities and affecting factors. Image of “perfect” doctor.
2. Main stresses at medical work, their influence on doctor’s health and personality. “Professional
burnout” reasons, features and avoidance techniques.
3. Medical interview stages, structure, functions. Possible doctor- patient’s relations models.
4. Work with motiveless, anxious, manipulating, aggressive patients. Normal methods of conflict
resolution.
5. Terminal illness psychology. Death. Doctor, dying person and his relative’s psychology. Grief
manifestation ways, normal and pathological course.
6. Suicidal behaviour risk factors, their identification. Doctor’s tactics in treating and dealing with
unwilling to live.
7. Disease, definition, psychology of diagnosing. Patient and disease. Disease stages and outcome
variations. View of internal (autoplastic) disease, components, meaning.
8. Psychosomatoses, origin models. Alexithymia. Stresses that cause psychosomatoses,
peculiarities, ways of effecting organism.
9. Somatoform disorders: patient’s relationship with disease and medics, successful work with
these patient’s references.
10. Personality disorders, differential diagnostics and treatment peculiarities.
11. Conception of mental disorders psychodynamic etiology.
12. Psychotherapy and psychosocial rehabilitation: essence, main types and methods of treatment,
indications for application and principles of effect.
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Psychiatry
1. Emergent psychiatric conditions evaluation, legal rights of patients, safety of patient and
personnel.
2. Patient in acute psychotic state, most common reasons, differential diagnostics and emergency
aid.
3. Schizophrenia, main diagnostic criteria, differential diagnostics, treatment.
4. Neurotic disorders differential diagnostics and treatment peculiarities.
5. Affective disorders, main diagnostic criteria, forms, differential diagnostics and methods of
treatment.
6. Simptomic and organic mental disorders in patients with somatic and degenerative diseases,
differential diagnostics and treatment.
7. Dementia and delirium main peculiarities in diagnostics and treatment.
8. Interface between psychoactive substance use and mental disorders.
Practical
1. Sensation and perception disorders.
2. Memory, attention disorders, dementia, seizures and organic psychosyndromes.
3. Thought and emotions disorders.
4. Volition and attraction disorders.
5. Dissociative and obsessive- compulsive disorders.
6. Somatoform disorders.
Seminar
1. Patient with mental disorders examination.
2. Organization of psychiatric help, legal issues, expertise.
3. Main treatment and rehabilitation principles in psychiatry.
4. Attraction and sexual disorders, diagnostics, treatment.
5. Eating and sleep disorders.
Examination program
Additions
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General information
Module moderator
• doc. dr. Virginija Adomaitienė, KMU Psichiatrijos klinika
(virginija.adomaitiene@med.kmu.lt)
Module coordinators
•doc. Regina Satkevičiūtė, KMU Psichiatrijos klinika
(regina.satkeviciute@med.kmu.lt),
• doc. Benjaminas Burba, KMU Psichiatrijos klinika
(benjamina.burba@med.kmu.lt )
Department and number of working days for the studies:
Kaunas University of Medicine Psychiatry Clinic – 20 working days (4 credits)
Subjects:

Psychiatry

Medical psychology
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Content of the module
While analysing problems of the module students acquire new knowledge of basic medical
psychology, basic and clinical psychiatry, which will be used in:

Practice of basic and specialized physicians

Entering the third University level medical studies, in order to prepare psychiatry physicians.
Goal of the module
Goal of the module is to prepare the students that have minimal level of knowledge in basic
medical psychology and clinical psychiatry, through the problematic studies. Students are expected
to be able to describe, analyze, explain and synthesize the psychical health problems of the patient.
In order to achieve this purpose students must:

To know the principles of main psychical and behavioural disorders, to recognize their main
symptoms and syndromes, basic principles of treatment and indications for psychiatric
consultation, hospitalization.

Learn how to suspect and recognize the psychosis, toxicomania, dementia, alcoholism,
personality disorders and others more frequent psychical diseases.

Learn how to recognize depression, panic and anxiety, eating disorders, patient’s suicidal
thoughts and organic psychic disorders.

To understand psychological peculiarities like communicating with patient, his disease and
diagnostics itself. To know peculiarities of behaviour with aggressive, manipulating, distressful,
non-observant to recommendations, chronic disease having patients. To understand basic defence
mechanisms.

Recognize psychosomatics, hypochondria and somatoform disorders, their development
mechanisms, to know basic treatment principles of such disorders.
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Problem training
1. First problem. Psychosis disorders.
Description. Patient V.Z., 21 years of age, was hospitalised by scheduled order into KMUK
Psychiatry clinic. Reasons in dispatch note where: anxiety, sleep disorder, inadequate behaviour.
Escorted by mother when arrive.
Complaints: Doesn’t air any grievance actively, suggest to ask a mother. When asked repeatedly,
answers that lately doesn’t sleep well and perhaps feels a little tired.
Anamnesis data: Unwillingly gives any personal data, communicates formally. Main answers to
any kind of question: “I don’t know”, “Don’t remember”. (Most data where obtained from patients
mother).
He was born and raised in a city, the only child in a family. Denies psychic disease
aggravated inheritance. Father works abroad for some time (owns construction company), „heavy“
character, strict, very demanding for himself and people around, cold emotionally, never shown a
warm feelings for relatives. Stated that he will only take care of his son and lets him live together
when (if) he ends the University education. Doesn’t have addictions, almost doesn’t drink alcohol
but if so becomes rough, brutal, motiveless aggressive. Mother is energetic, active, as well has a
private business. Careful, takes care of the home, strongly bounded to the son.
Early development was without disorders, started walking in time. Grew up in grandparent’s care
(both parents worked a lot in their own businesses. Since five years of age attended kindergarten,
adopted well, had few friends. In childhood had measles, scarlatina (scarlet fever), tended to get
cold more often.
Since seven years of age began to attend primary school, in beginning adopted badly. Later
adopted, but stayed quiet, shy, didn’t show intentions for leadership. He was good at studies,
especially mathematics and physics. Did not like biology, physical education lessons, but even there
he used to get a good grades. Was interested in electronics, cars, maintained that he wants to
become an engineer. Was passive in after class activities, such as (birthdays, dance evenings, trips),
used to go only if invited. Had few good friends used to meet them more often. Due to calm temper,
wide reading and politeness was loved by class girls, but did not have any closer girlfriend.
In family was calm, tidy, helped mother in household, was bounded emotionally to her. Had
wholesome resort to father, avoided closer footing. Was pleased to hear father leaving abroad,
stated to mother “from now on I’ll take care of you”. According to mother he was polite, lovely,
obedient kid.
As mother says, patient began to change at age of 15 – became secretive, inhibitive, irritable,
cross, complained about quickly getting tired, didn’t wanted to go in school. Most of the time used
to spend in his room listening loud music, less and less helped in household. Found new friends that
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his mother didn’t like (where riotous, rude), neglected his studies, became lesser and lesser grades.
He explained to mother that the objectives he used to like are “very mechanical, uninteresting,
spiritless, unreflecting his inner spiritual needs”. His classmates are „barren, primitive materialists“,
teachers – “stupid idiots that doesn’t understand basic things in live”. Became slatternly, wore old,
tattered clothes, made eccentric haircut, dyed them in gaily colours and pierced his ears, face and
thong. Used come back at home a little jolly. Several time was beaten in the street (as he describes
by “skinheads”), did not experienced any significant injuries. When commented about anything
reacted in anger, shouting that she doesn’t understand anything. Begun take interest in eastern
philosophy and religion. Sleep disturbance appeared; some nights missed sleep while reading
Budistic literature. Insisted discussing philosophical topics with his mother. Talked a lot about
meaning of life, humans place on earth, relation with religion and etc. When mother refused
motivating that she’s tired he became angry, called her “same primitive materialist as his
classmates”. He finished 8th school year quite good, as mother thinks more because of good
previous standing among teachers, rather than will to learn.
Summer holiday spent in village with his grandparents, helped in household a little but most
of the time he spent reading and meditating.
Next school year (age of 16 year), totally neglected his studies, where absent from schools
often, ended relations with classmates. Got used to drink alcohol quite often (beer only). Few times
was spotted smoking “marihuana” with his new mates. Regarding bad reports from teachers he was
considered by a school committee, afterwards he became anxious, weepy, complained having
headaches. Next day stated that he understood the situation, made serious conclusion “From now on
he’ll live righteously for goodness of all”. He started to study a bit more, stopped seeing his new
friends, quit drinking alcohol. He initiated youths charity group, became its leader. Used to say, that
his purpose: „To travel to India in order to gain more knowledge and spirituality”, that could be
used in intense political, social activity. While preparing he began attended eastern fighting art’s
classes used to return completely exhausted. Constantly red eastern philosophy literature, took
interest in Japanese and Indian art and conventions.
Few moths later his sleep disturbances exacerbated: couldn’t sleep at all or used to wake up
shortly after falling a sleep. Become angry and irritable in mornings. Began intentionally miss
classes, motivating being too tired, his reports fall down again.
Once he came back home drunk with somebody else’s wallet. He explained his mother that he
took this wallet away from a homeless person that he was drinking beer with. While drinking he
suddenly felt strong “negative” energy spreading from his companion. Saw “blackly radiant” circle
of “negative” energy surrounding his companion. That is why he decided to take “evil productive”
money. One part of the taken money he spent on drinks, the rest he gave to the mother and told to
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throw them away, because “negative” energy is spreading from them. This energy causes strong
pain in back and the private parts of body, “takes physical strength and ability to think clearly”.
Couldn’t fall sleep that night, walked around with a knife in his hand. Questioned his mother “what
would happen if he would kill somebody”, simultaneously he laughed unnaturally, saying it’s the
way he’s kidding and “checking mothers reaction”. Declared that has no feelings to his mother,
would not care if anything would happen to her. His look was strange, anxious, sometimes run to
the doors to check are they locked properly. Insisted that mother wouldn’t turn the lights on, not to
stand at the window because it’s “dangerous”. Next morning he visited a family doctor, with his
insisting and escorting mother. Doctor sent him to a “PSPC” and from there he was sent to
“KMUK”.
State of mind (Status psychicus): In the beginning of conversation was suspicious,
ostentatiously opposing, humiliating face looking around. He does not have any heath complaints,
in a peeved voice declares “ask my mother, she knows better about my complaints”. Extravagant
appearance (sharp coloured clothes, fluffed up hair, dyed clear yellow, lots of earrings in left ear,
eyebrow, thong).
Deliberate, orient in himself, time, location. Unwillingly answers the questions, formally, in a
few words. Mime is poor, especially upper face, look is unalive, angry. Voice sounds loudly, poorly
modulated and without intonation. Movements are sparse, a little edgy. During conversation
relaxes, starts talking more willingly gives anamnesis data, with his own specific interpretations and
motivations. When asked to comment his appearance he states that the way people look does not
have any importance, the only thing that matters is inside of the human. The thought resonant,
viscous with obvious tendency to symbolism, paralogism (tends to discuss about: “meaning of
humans life, his part in life, in this materialistic society; connection of religion and health in the
groups of intellectual and primitive people, influence of eastern philosophy creating individual
relationship of perfect “Karma” etc.”. Often changes topic of the conversation loses the thought he
began. Answer ends with a new question. Mood is lowered, dominates internal tension, dysphoria.
Emotions are characterless, poor vicissitude. States that he has no feelings for his relatives, cold to
mothers tears and feelings about this current situation (“It her problems, it doesn’t bother me at
all”).
Attention concentration is satisfactory. No memory disorders noticed. Tell poorly systemized
ideas of rapport, pursuance and raving (the people round about are angrily, want to disturb the trip
to India, harm his career, make him psychic patient). He thinks the others behave such way because
of his inadequate appearance in comparison with standards of society. Not critical in aspect of his
illness, thinks he’s totally healthy, doesn’t see any mismatch between reality and present situation.
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Indifferent to treatment, formally accepts to be hospitalized (“if you decided that I have too, let it be
then…”)
Somatic neurological state: without significant changes.
Question 1. As possible to prove the diagnosis? How would you assess the progress of a disease?
Question 2. What would you propose research and treatment plan?
Question 3. How should I deal with the patient's social problems?
Heart of the problem: it appears gradually developed feelings, thinking, the will of disorders at a
young age.
Clinical signs: neurotic illness debut (asthenic symptoms, sleep disturbance), thought disorder
(autistic, symbolic thinking, twaddle. Interpretational effects of persecution delirium ideas).
Emotional disorders (emotional inadequacy, paleness), perceptual disturbances (unpleasant
sensation, hallucinations), inadequacy of conduct (possibly due to delusions and perception
disorder), strong-willed impairment (reduction potential of energy, lack of motivation and direction
in the disords.
Objective: To familiarize students with mental illness identification and diagnostic importance of
symptoms, their patterns and dynamics of psychosocial patient care organization.
Learning objectives and content:
Once they leave to deal with this problem, students must be able to:
Recognize the first signs of endogenous mental disorders, their course, to know the diagnosis of
active principles, and be able to establish research and treatment plan, access to the patient's
psychosocial problem-solving capabilities.
Subject: Psychiatry
Department: Psychiatric clinic
References:
1. Psichiatrija /Moksl. redaktorius prof. A.Dembinskas. - Vilnius, 2003, 140-162; 162-183; 183189; 261-291; 427-448
Supplementary reading:
1. Kaplan and Sadock‘s Comprehensive Textbook of Psychiatry, by Benjamin Sadock, 2005,
Chapter 12: Schizophrenia, 2282 - 2556
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2. Clinical Handbook of Schizophrenia, by PhD Kim T. Mueser PhD and Dilip V. Jeste MD, 2008
3. Schizophrenia (Oxford Psychiatry Library), by David J. Castle and Peter F. Buckley, 2008
4. Essential Psychiatry, by Nicholas D. Rose, 1994
2. Second problem. Affect disorders
Profile: 34 years of age manageress has been hospitalized to Psychiatric Clinic in KMU for
confirmation of diagnosis and further development of treatment tactics since the home treatment
was not effective enough.
Complains: complaining weakness, sleeping disorder, fast tiredness, communication disorder, pain
in the both hands, severances in epigastrium and abdomen.
Personal profile: person was born and raised in the city as a second child in the family. Father
employed, do not have any health disorders, strong-willed, according to her words” he is a stern but
just man”, looking after the family. With the mother patient don’t communicate anymore (parents
have been separated when she was 6 years of age and mother went abroad).Father got married
second time. Relation in the family and with the stepmother is good, stepmother is friendly and
thoughtfully .Refer that sister committed suicide when she was very young ( can not explain the
circumstances).Grandfather (from mother side)was abused in alcohol, was irritable and hot
tempered person. He died when patient was 6 years old. There are no other psychiatric disorders
among others relatives. Relationship with her brother is good, they care and help to each other.
Babyhood ( according to her father) without disorders, the patient began to walk and speak on time.,
had been going to crèche with her brother, was calm, friendly, not direct, but associated with
people.
Had childish illness, denied operations and traumas.
She started attending school at 7 years of age, relationships with school friends were good, the
patient was friendly, compliant, had several good friends. The patient studied good enough, the
humanities liked more then exact sciences, liked to draw, went to art society. At 14nt year was
involved in sport activities encouraged by father, but it was not noticeable achievements. There was
few shorts periods (a few days) when patient become sad, didn’t want associate with people, was
crying locked in her room, everything around doesn’t seem right. The patient disguised hers
feelings from others, because she was afraid to bee valued as a weak, useless person. At the time
she didn’t have a boyfriend, according to the patient was “not courage“. Friends sneered at her
sometimes.
The school have finished as mediocre student, were studding at University of Technology,
manageress speciality. Studies were going well, she liked to live like a student , had enough
friends, became courage enough , initiative, organised friends evening-party, friends liked her and
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she was valued by others. Have met her future husband on second years of studies, they were
together for two years and got married. Relationship with husband is good enough, sometimes she
experiencing anger towards the husband but just for short periods of time. Sexual live without
disorders, there are no children (both decided to put in family lifes. Begun to work in private sector
as manageress assistant after finishing studies, an employer has noticed hers activeness and she was
promoted to group leader. The work was hard, responsible, but the patient liked fight with,
organised the work of group and to be apprised at hers true work.
State of health became wrong after she get cold and had sick sort .The temperature was height ,
used antibiotics, felt weakness for some time then came back to work., have realised that group
didn’t executed an important work, was very disappointed because of this, became irritable, have
been arrogating with others, upbraid with others. The health became to get worsted again, a patient
begin to feel the paint of both hands joints, sleep disorders has begin, begin to fell weakness at
morning, begin to be get up in morning, was angry, irritable, didn’t want to go to work., begin to
argued with her husband, begin to cry for no reason, didn’t want to clean home, begin to eat without
relish, loosed weight.
As hands pain went from bad to worse ( it felt like burning, tingling, strangle type, most in
first part of the day, at work time, less pain was in evenings ), she applied to family doctor. In
suspicion of rheumatic illness, there were made many tests, but diagnosis wasn’t confirmed. Family
doctor diagnosed “neurosis” and imposed medication Rudoteli, Diasepami (at night time). In a
week’s time health and sleep got better a little bit, but pain in hands got more intensive, pain in
abdominal area also occurred. She started thinking that she was dangerously ill, that she is going to
loose her job, become a burden to others to others.
At work she noticed that employers became disappointed in her, changed their opinion about
her, started to make fun out of her, turned group members against. She understood that soon she’ll
be fired and that her associates made fun of her or even hated. She sent e-mails to associates trying
to “to improve the situation, to tell them that this was their fault” but all she got was condemnation.
She stayed at work late doing nothing, suffering from hands pain, with sad thoughts about how
everybody disliked her, that she is worthless, load to everybody. This unpleasant period lasted for a
month.
Several days before hospitalization she felt especially bad: understood that director “made
everything for her to be fired, finally succeeded to turn associates against her”. She decided to stop
going to work, told her husband that “it’s better not to live”. She was hospitalized to KMUK mental
institution clinic at father’s and husband’s initiative.
State of mind: orientated, conscious. Look corresponds age and education. Answers to questions by
the meaning with several words, doesn’t keep conversation herself. Talks in sad low voice; face
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looks hypomimic, Veraguth's fold is in upper eyelid. When talking sits crouch, shoulders down, low
motions. Complains about pain in hands witch are very unpleasant, burning, tingling, strangle type.
Low mood. Can’t describe her mood by herself, claims that it’s neither good nor bad. Slow
thinking. Attention concentration is low. Memory is good. Doesn’t see the meaning to live, but
doesn’t have plans for suicide. Tells only that she is worthless, good for nothing, capable of
nothing, load for everybody. No critics for her state, doesn’t think that she is mentally ill, bad mood
is from overworking, adverse social circumstances, and negative employers’ opinion towards her.
Somatic and neurological state: good
Question 1. How would you reason the diagnosis and how would you value level of depression?
Question 2. Is there a risk of suicidal behaviour?
Question 3. What determined wrong diagnosis of neurosis?
Question 4. What test and treatment plan would you suggest?
Question 5. How would you resolve patient’s social problems?
Essence of a problem: misinterpretation “neurosis” diagnosis and inadequate treatment.
Clinical features: clear somatization component
in depressive structure, slow thinking,
interpretational herself humble, depreciation, proportion raving ideas, low mood, sleep disorder,
low working potential, psychomotorical suppression.
Objective: learn how to recognise depression, its expression, possible suicidal behaviour, treatment
principles and solutions of social problems.
Learning objectives:
At the end of analysing this problem, students should know how to:
- recognise symptoms of depression evaluate peculiarity of mental state, possible actions of suicidal
behaviour and course of illness, project an appropriate plan of tests and adequate treatment tactics.
Subject: Psychiatry
Department: Psychiatric clinic
References:
1. Psichiatrija /Moksl. redaktorius prof. A. Dembinskas. - Vilnius, 2003, 291-314; 314-335; 335345.
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Supplementary reading:
1. Kaplan and Sadock‘s Comprehensive Textbook of Psychiatry, by Benjamin Sadock, 2005,
Chapter 14: Mood disorders, 2661-2952
2. Mood Disorders: A Handbook of Science and Practice, by Mick Power, 2006
3. The third problem. Organic and symptomatic mental disorders
Description. 65 years old retired male A. B. is hospitalized to KMUK Psychiatry clinic for
diagnostics and treatment. Out-patient treatment was not effective.
Complaints: the patient complains of whole body (especially hands) tremor, dizziness. He became
more sensitive, often becomes pathetic, and cries when viewing TV translations, movies. He has
sleep disorders (it is difficult for him to fall asleep; he often awakes during the night, in the daytime
he feels tired, sleepy). He noticed that his memory was declining; it is difficult for him to memorize
new things. He forgets where he put things; sometimes he doesn’t recognize his acquaintances.
Anamnesis: the patient born in the city, in the two-child family. The family was harmonious, to this
day the patient has close relationships with his older brother. He denies inheritance of mental
disorders. The parents died 75 and 85 years old: the father died from stroke, the mother – from heart
failure. The prenatal history is normal, he was a healthy child. He wanted to go to school, developed
good peer relationships. He was an ordinary pupil, had not repeated any classes. In adolescence
were several incidents with teachers: on time he must to talk with principal for smoking, also he had
missed several classes. 16 years old he has begun to work in the factory as an assistant worker.
Secondary school he graduated in the night-school. He decided to go to the college and to become
mechanical. Here he studied “not bad”, but had problems with mathematics, that’s why he must to
begin correspondence course. Due to mathematics he didn’t graduated from college. From the
factory he was recruited to the army. He liked the army, because he worked in postal office and
didn’t feel the regime of the army. After the army he married (25 years). He has two adult children.
He was married for 24 years and divorced, according him, because his wife filed divorce petition,
because “the patient ganged up with a bad company”, begun to drink a lot of alcohol, not to come
back home. All his life he worked as a builder and alcohol was a part of the work. Sometimes his
binge drinking lasted for 6-10 days. After binge drinking he felt badly, and diminished the use of
alcohol. He never thought that he was alcohol-dependent. Hypertension was diagnosed 15 years
ago. He had convulsions 10 years ago, doctors thought that these convulsions were of epileptic
origin. He hasn’t had any more convulsions but continuously uses anticonvulsant drugs. In youth he
had several head traumas, one trauma was with a brief loss of consciousness. In 2007 April he had
his last head trauma. Somebody hit him from behind. He lost consciousness, friends brought him
home. The next day he came to the doctors. Doctors, according to the patient, did not diagnosed
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any brain damage. The patient worries for his memory about 6 months. He attends neurologists. The
first signs of memory declining he noticed about 3 years ago. He has begun to forget where he had
put things, names, and telephone numbers. At first he didn’t took attention to his memory problems,
but progressively his memory disorders begun to disturb his daily life: he didn’t remembered what
he had said, done, eaten, etc. Neurologists diagnosed Alzheimer’s disease (I stage) and administered
donepizil, but memory didn’t improve. Recently he has sleep disorders, has bad mood, begun to
avoid communication. Doctors didn’t noticed any significant somatic pathology, except wholebody, especially hands’, tremor. Psychologist consulted the patient: he diagnosed short-term and
long-term memory disorders, and easy cognitive defect (MMSE – 22 grades).
Psychic state: the patient is alert and awake throughout the interview, approachable to a verbal
contact; responds to questions according to the meaning, but not all questions are responded
correctly. Appearance is tidy, corresponds with age and social status. The patient’s orientation to
self, place is intact. He is disoriented to time (by several days). Contact is formal, the patient only
answers to the questions, doesn’t initiate conversation. Thinking is slow. Emotions are labile, the
patient during the conversation becomes upset, cries. Memory is declined; the patient doesn’t
remember last days’ events. There are pseudoreminescences and confabulations. The patient denies
hallucinations and delusions. The patient denies suicidal ideation. Insight is poor.
Question Nr 1. Which diagnostic tests are necessary for diagnosis?
Question Nr 2. About which organic disorders do you think?
Question Nr 3. What treatment is available for this pathology?
Main point of the problem: memory disorders in elderly.
Clinical signs: progressive memory declining, poor sleep, emotional lability. Increased blood
pressure, dizziness.
Goal: to get acquainted with mental disorders due to cerebral damage.
Tasks and content:
Students should know:
- To recognize and diagnose organic memory, sleep, mood disorders, is able to verify diagnosis and
to make treatment plan, to get acquainted with possible solutions of patients’ psychosocial
problems.
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Subject: Psychiatry
Department: Psychiatric clinic
References:
1. Psichiatrija /Moksl. redaktorius prof. A. Dembinskas. - Vilnius, 2003, 195-200; 459-474; 489508.
Supplementary reading:
1. Kaplan and Sadock‘s Comprehensive Textbook of Psychiatry, by Benjamin Sadock, 2005,
Chapter 10: Delirium
dementia and amnestic and other Cognitive disorders, 1793-19201
Chapter 11: Substance related disorders, 1922-2282
Chapter 13: Other psychotic disorders, 2557-2660
2. Oxford textbook of Psychopathology (Oxford Series in Clinical Psychology), by Paul H. Blaney
and Theodore Millon, 2008
Lectures
Medicinal psychology
1. Medicinal psychology, history, content, research methods. The main forms of
communication. Medicinal communication, peculiarities, factors. The view of “ideal”
physician.
Department: Psychiatric clinic.
The definition, content of medicinal psychology. Differences between psychiatry,
psychotherapy, general and other sub-fields of psychology. All research methods.
Main forms of communication (intrapsychic, lector-auditorium). The main attention is
for two-person communication. Specifics of communication, communication
influencing factors (environment, physician’s sex, age, appearance, communication’s
style, authority, etc). Characteristics of physician that has good communication skills
with patients.
2. The main stressors in the work of physicians, their influence to physicians’ health,
personality. Causes, signs of “burnout” and ways to avoid it.
Department: Psychiatric clinic.
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Main stressors in the medicinal work (stress due to direct work, stress due to work’s
organization, stress due to carrier’s problems), their influence to work’s quality and to
physician’s health and personality. “Medicinal deformation” of physician, dynamics of
“burnout”. Phases and characteristics of “burnout”, ways to avoid it.
3. Medicinal conversation: stages, structure, functions. Models of physician – patient
communication.
Department: Psychiatric clinic.
Main functions of medicinal conversation, factors influencing conversation. Main
stages of medicinal conversation (orientation, classification, definition and
conclusion), all parts of these stages (psychosocial, somatic, physician- patient
relationships). Possible models of physician-patient relationships (passivity – control,
dependence – expertise, cooperation and autonomy), indications, pros and cons.
4. Work with unmotivated, anxious, manipulative, aggressive patients. Conflict resolution
strategies.
Department: Psychiatric clinic.
“Difficult” patients, their behaviour, goals, “recognition” criterions. Causes of that
character and behaviour. Psychology of conflict, normal solutions of conflicts.
5. Dying patient’s psychology. Death. Psychology of physician, dying patient and his relatives.
Forms of grief, normal and pathological grief.
Department: Psychiatric clinic.
Reactions, psychological defence, adaptation or adaptation to reality. Psychological
problems of dying patient’s family and his treating physician. Symptoms of normal
and pathological grief. Ways to help for grieving person. Types of dying persons. The
question of telling truth to the patient. Relationships with patient’s relatives.
6. Risk factors of suicidal behaviour, recognition of suicidal risk factors. The tactic of
communication with persons that don’t want to live.
Students are familiarized with current situation of suicide problem in Lithuania, terms
of suicide behaviour, threatening suicide and real suicide are noticed. Risk factors,
signs, ways of threatening suicide are discussed. Reaction of environment of doctor
and patient, behaviour, when threatening suicide is suspected, rules of cooperating
with such patient are subjected.
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7. Disease, definition, psychology of disease diagnosing. Patient and disease. Stages of disease
and variants of disease termination. View of internal (autoplastic) disease, constituents,
meaning of them.
Department: Clinic of Psychiatry
Factors of disease stating (perception, interpretations, context, emotional condition,
look, choice of attention etc.) are discussed; the main relationship types between
person and his disease are noted. Internal components of disease (sensitive,
intellectual, emotional, forceful) and common emotional reaction to disease are noted.
8. Psychomatoses, models of their developing. Alexithymia. Stresses which invoke
psychosomatoses, singularities of them, and ways of influence on entity.
Department: Clinic of Psychiatry
All psychomatoses are listed during the lecture and main models of their developing
are explained. More information is given on alexithymia: criteria for identifying,
reasons are presented. The lecture is completed with presentation of classification of
stresses which provoke psychosomatoses, description, and discussion about ways of
influence on entity.
9. Somatoformic disturbances: patient’s relationship with disease and medics, guides for
successful work with such patients.
Department: Clinic of Psychiatry
Group of somatoformic diseases is shortly characterized, main differences between
different forms are marked. Information about etiology, progress and psychology of
the disorder is given. Medical examinations, reasons of unsuccessful diagnostics and
treatment are described, attitude of doctor to such patients is discussed. Guides for
successful work are given: they start from doctor’s attitudes to rules for patient
treatment and working with such patient.
10. Personality disorders, singularities of differential diagnostics and treatment.
Department: Clinic of Psychiatry
“Nuclear”, primary and secondary personality disorders are discussed, definitions of
such disorders are listed, differential diagnostics matters are stressed. Personality
changes determined by organic, psychological, social, psychical disorders, their
clinical manifestations and possibilities of treatment.
18
11. Conception of psychodynamic etiology of mental disorders.
Department: Clinic of Psychiatry
Students get acquainted with conception of psychoanalytic theory and psychodynamic
conflicts. Differences and correlations of classical biological – medical and
psychodynamic models of mental disorders in contemporary clinical practice are
analyzed. The main contemporary psychoanalytic – psychodynamic conceptions:
drives’ theory, psychology of Ego, theory of objective connections, psychology of
entity. Psychodynamic conflicts and their connection to clinical psychopathology are
discussed according to different attitudes of various theories.
12. Psychotherapy and psychosocial rehabilitation: essentiality, main kinds and methods of
treatment, indications of applying and principles of action.
Department: Clinic of Psychiatry
Students get acquainted with psychotherapy, as separate subject of science and
practice, history of psychotherapy, criteria of school of psychotherapy, directions and
classification of psychotherapy. Choosing of purpose of psychotherapy and main
stages of interpretation are discussed. Main phenomena of psychotherapy: transference
and resistance are analyzed. Nuances of psychotherapist’s emotional reactions to
patient are discussed. Students get acquainted with concept, goals and main principles
of psychosocial rehabilitation. A content of psychosocial team is discussed. Forms of
psychosocial rehabilitation such as day hospital, partial hospitalization, patients’ clubs,
training of social skills, psycho education, safe way, centres of psychosocial
rehabilitation and community mental health, family care, summer camps for patients,
safe work institutions and other means of therapy are discussed more detail.
Psychiatry
1. Evaluation of emergency cases in psychiatry, patients’ juridical rights, safety of patient and
staff.
Department: Clinic of Psychiatry
Criteria for evaluation of heaviness and riskiness of mental state, standards for safe
environment, interviewing the patient and behaviour with him are given. Juridical
rights of patient and ways of dealing with emergency situations are listed. The
discussion about safety of medical staff is carried on.
19
2. Patient with acute psychotic state, common reasons of such psychoses, differential
diagnostics and urgent help.
Department: Clinic of Psychiatry
Evaluation of mental state of patient, who’s having acute psychosis, differential
diagnostics and treatment possibilities are discussed during the lecture. Psychoses
arising from drugs’ usage, disorders of mood and schizophrenia are highlighted.
3. Schizophrenia, main diagnostic criteria, differential diagnostics and treatment.
Department: Clinic of Psychiatry
Definition of schizophrenia, historical changes in conception of this disease, it’s place
in contemporary classifications of mental disorders and psychosocial – economic
aspects are given during the lecture. Students get acquainted with epidemiology,
etiology and diagnostics of schizophrenia. Information about clinical singularities of
different form of this disease is given. Students get acquainted with different variants
of disease progression and basics of early diagnostics. Some aspects of differential
diagnostics and treatment are given too.
4. Differential diagnostics and treatment singularities of neurotic disorders.
Department: Clinic of Psychiatry
Neurotic disorders: reaction to severe stress, adaptation disorders, phobic and other
anxiety disorders, obsessive-compulsive disorders are discussed during the lecture.
Etiology, clinical manifestation and ways of progression of such disorders are
explained. Principals of differential diagnostics and treatment are given.
5. Affective disorders, main diagnostic criteria, forms, differential diagnostics and methods of
treatment.
Department: Clinic of Psychiatry
Concept, psychosocial and economic aspects of affective disorders are given during
the lecture. Epidemiology and etiology are analyzed. Students get acquainted with
diagnostic criteria and basics of differential diagnostics of separate forms (depression,
mania, bipolar disorders etc.) Incidence of latent (somatised) depressions, diagnostics
and singularities of treatment in the work of general practitioner are analyzed. Students
get acquainted with principals of treatment of affective disorders.
20
6. Symptomical and organic mental disorders originating from somatic and degenerative
diseases, differential diagnostics and treatment.
Department: Clinic of Psychiatry
Mental disorders originating from somatic and degenerative diseases such as
Alzheimer’s disease, Pick’s disease, Huntington’s chorea are analyzed in this lecture.
Mechanisms of development of mental disorders, progression, clinical manifestations,
possible outcomes, principles of treatment are explained. Differential diagnostics
between mental disorders originating from somatic pathology and primary mental
disorders is highlighted.
7. Main singularities of diagnostics and treatment of dementias and deliriums.
Department: Clinic of Psychiatry
Etiology of organic dementias and deliriums, singularities of clinical progression, main
diagnostic criteria, deferential diagnostics between them both, differential diagnostics
between dementia and pseudo dementia, singularities of treatment tactics are discussed
during the lecture.
8. Connection between abusing psychoactive substances and mental disorders.
Department: Clinic of Psychiatry
Mental disorders (such as acute intoxication, dependence syndrome, acute and chronic
abstinence and psychoses) originating from abusing psychoactive substances are
discussed during the lecture. Singularities of differential diagnostics and treatment
tactics are analyzed.
21
Practical
1. Disorder of sensation and consciousness
Subdivision: Psychiatry Clinics
Hyperestesis, hypestesis, analgesis, hyperpathy, hypopathy, senestopathy, synesthesis.
Illusion (physiological, affectogenical, verbal, ). Hallucination (simple and complex,
affectogenical, experimental, hypnogogic, real and pseudohallucinations). Visual,
auditory, psychical, gustatory, olfactory, tactile, visceral, proprioreceptorious, residual
hallucinations and their versions. Pseudohallucinations ant their types. Syndrome of
hallucinosis. Syndromes of the psychosensorical disturbances.
References:
1) Psichiatrija/Scientific editor Prof. A. Dembisnkas. – Vilnius, 2003, 128 – 138.
Supplementary reading:
1) Kaplan and Sadock‘s Comprehensive Textbook of Psychiatry, by Benjamin Sadock, 2005.
2) B. Burba, R. Satkevičiūtė, V. Taranda, Psichiatrijos saviruošos klausimai (bendroji
psichopatologija), Kaunas, 2006, 4 – 5; 18; 25 – 26; 30 – 31; 39; 94.
2. Disturbances of memory, attention, psychosyndromes of seizures and organical
psychosyndromes.
Subdivision: Psychiatry Clinics
Mood‘s quantitative (retrograde, anterograde, fixed, retardous, affectogenic, hysterical,
progressing amnesias; anecphoria, hypomnesias, hypermnesias) and qualitative
disturbancies (pseudo reminiscence, confabulation, cryptomnesions). Korsakow‘s
syndrome. Mental retardation: etiology, diagnostics, dementia, it‘s types, etiology,
diagnostics. Types of seizures, etiology, differential diagnostics. Variants of organic
psychosyndrome (asthenical, explosical, euphorical – apathetical). Confabulosis.
References:
1) Psichiatrija/Scientific editor Prof. A. Dembisnkas. – Vilnius, 2003, 195 – 200; 223 – 237.
Supplementary reading:
1) Kaplan and Sadock‘s Comprehensive Textbook of Psychiatry, by Benjamin Sadock, 2005.
2) B. Burba, R. Satkevičiūtė, V. Taranda, Psichiatrijos saviruošos klausimai (bendroji
psichopatologija), Kaunas, 2006, 5 - 6; 14 - 15;18 - 19; 27; 31; 40; 42 .
22
3. Contemplation‘s and emotional disorders.
Subdivision: Psychiatry Clinics
Contemplation‘s disorders (accelerated, retarded, pathologically meticulous, vague
thinking,
perseveration,
stereotype,
forced
thinking,
disorganized
thinking,
discontinuous thinking, incoherent thinking, XXX, symbolical thinking, paralogical
thinking, autistic thinking). Echolalia. Thinking content‘s disorders: delirium, it‘s
types according to formation,
content, consecution, amount. Interpretational and
visual delirium, affectogenic delirium, psychogenic delirium. Forms of the emotional
manifestation (affect, ecstasy, desire, anxiety, fear, panic, euphoria, dysphorea, moria,
etc). Syndromes of mania, hypomania, depression. Types of the depression‘s
psychopathology.
References:
1) Psichiatrija/Scientific editor Prof. A. Dembisnkas. – Vilnius, 2003,138 – 152, 162 - 183.
Supplementary reading:
1) Kaplan and Sadock‘s Comprehensive Textbook of Psychiatry, by Benjamin Sadock, 2005.
2) B. Burba, R. Satkevičiūtė, V. Taranda, Psichiatrijos saviruošos klausimai (bendroji
psichopatologija), Kaunas, 2006,6 – 8, 9 – 11, 19 – 21, 27 – 28, 32 – 33; 36; 40 – 41; 44 - 46.
4. Disorders of the willpower and urges.
Subdivision: Psychiatry Clinics
Hypobulia, abulia, hyperbulia, catathonic, psychogenic and other states of stupor and
agitation, the types clinical manifestation. Nutritional, self – preservation, libido,
kleptomania, pyromania and other manifestations of willpover disorders.
References:
1) Psichiatrija/Scientific editor Prof. A. Dembisnkas. – Vilnius, 2003, 183 – 195.
Supplementary reading:
1) Kaplan and Sadock‘s Comprehensive Textbook of Psychiatry, by Benjamin Sadock, 2005.
2) B. Burba, R. Satkevičiūtė, V. Taranda, Psichiatrijos saviruošos klausimai (bendroji
psichopatologija), Kaunas, 2006, 9 – 10, 29 – 30, 42 – 43, 45 - 47.
23
5. Dissociational and obsessive – compulsive disorders.
Subdivision: Psychiatry Clinics
Phobical anxiety disorders, panic disorders, generalized anxiety disorder, obsessive –
compulsive disorder, dissociational disorders, neurasthenia. Acute response to the
stress, acute stress disorders, posttraumatic stress disorders, their diagnostics and
treatment.
References:
1) Psichiatrija/Scientific editor Prof. A. Dembisnkas. – Vilnius, 2003, 183 – 195.
Supplementary reading:
1) Kaplan and Sadock‘s Comprehensive Textbook of Psychiatry, by Benjamin Sadock, 2005.
2) B. Burba, R. Satkevičiūtė, V. Taranda, Psichiatrijos saviruošos klausimai (bendroji
psichopatologija), Kaunas, 2006, 9 – 10, 29 – 30, 42 – 43, 45 - 47.
6. Somatoformic disorders.
Subdivision: Psychiatry Clinics
Somatization , hypochondrical disorder, differential diagnosis, treatment. Somatization
autonomic dysfunction, diagnostics, treatment. Permanent somatoformous pain
disorder, etiology, clinical manifestation, differential diagnostics, treatment.
References:
1) Psichiatrija/Scientific editor Prof. A. Dembisnkas. – Vilnius, 2003, 387 – 393; 395 - 406.
Supplementary reading:
1) TLK – 10, WHO, 1992, 127 – 136.
2) Kaplan and Sadock‘s Comprehensive Textbook of Psychiatry, by Benjamin Sadock, 2005.
24
Seminars
1. Examination of patient with mental disorder.
Subdivision: Psychiatry Clinics
Seminar‘s form – a discussion. Various factors misleading, perverting and aggravating
the patient‘s examination will be researched, the ways of their withdrawal will be
considerate. The lecturer will present a patient related to the topic. The seminar will be
finished by giving to each student a Psychiatry Clinic’s patient, which must be leaded
by the student for 16 days. In the end the patient’s medical history has to be written.
References:
1) Psichiatrija/Scientific editor Prof. A. Dembisnkas. – Vilnius, 2003, 99 - 126.
Supplementary reading:
1) Kaplan and Sadock‘s Comprehensive Textbook of Psychiatry, by Benjamin Sadock, 2005.
2. Organizing of the psychiatrical help, juridical aspects, topics, expertises.
Subdivision: Psychiatry Clinics
Not only rights of the patient and doctors but also various aspects of the psychiatrical
help, forced treatment, custody problems, forensic, work, postmortem, military
expertises will be discussed.
References:
1) Psichiatrija/Scientific editor Prof. A. Dembisnkas. – Vilnius, 2003, 40 – 44, 659 - 704.
Supplementary reading:
2) Sveikatos priežiūros teisės aktų rinkinys, 2000, 295 – 316.
3. Main principles of treatment and rehabilitation in psychiatry.
Subdivision: Psychiatry Clinics
Purpose of the seminar is to introduce the main ant the most modern psychiatric
methods of treatment and rehabilitation to students. Students have to divide into
groups, discuss and prepare a report in these fields: 1) Neuroleptics, the main
characteristics, indications, side effects and the most commonly used neuroleptics.
2) Tranquillizers, general characteristic of this group of medicines, indications on their
prescription, side effects, the main representatives.
25
3) Antidepressants, indications on their prescription, general characteristic, side
effects, the main representatives of this group of medicines.
4) Electroconvulsive therapy, indications and contraindications of prescription.
5) Psychotherapy and rehabilitation health restorative treatment.
References:
1.Psichiatrija/ scientific editor prof. A. Dembinskas.- Vilnius, 2003, 509 – 588; 606 – 608; 612 –
631; 532 – 648
Supplementary reading:
1. Vaistų žinynas, Vilnius, 2009, 91 – 118; 119 – 132
4. Attraction’s and sexuals disorders, diagnostics and treatment.
Department: Psychiatry clinic
The goal of seminar is to find out the way of attraction’s reflex, to familiarize with
manifestations and disorders of normal eating, self-preservation, sexual attraction, also
impulsive attractions, their diagnostics and opportunities of treatment.
Students prepare for seminar in small groups, present, debate in these topics:
1) To analyze increase, decrease, distribution of perversion, etiology, diagnostical
indications, occurring variants, opportunities of treatment, prognosis of self –
preservation attraction.
2) To analyze increase, decrease, distribution of perversion, etiology, diagnostical
indications, occurring variants, opportunities of treatment, prognosis of eating
attraction.
3) To analyze increase, decrease, distribution of perversion, etiology, diagnostical
indications, occurring variants, opportunities of treatment, prognosis of sexual
attraction.
4) To analyze distribution, etiology, diagnostical indications, occurring variants,
opportunities of treatment, prognosis of impulsive attractions.
Referencess:
1.Psichiatrija/ scientific editor prof. A. Dembinskas.- Vilnius, 2003, 314 – 335; 415 – 426; 345 –
353; 194 – 195
26
Supplementary reading:
1. TLK – 10, WHO, 1992, 138 – 142; 150 – 152; 168 – 174; 166 – 168
2. Kaplan and Sadock’s Comprehensive Textbook of Psychiatry, by Benjamin Sadock, 2005.
5. Eating and sleeping disorders
Department: Psychiatry clinic
Historical side of eating disorders in psychiatry. Distribution of anorexia nervosa,
etiology, criterions of diagnostics, behaviour singularities of patients, differential
diagnostics with other psychical and somatic diseases, opportunities of pharmaceutical
and psychotherapeutic treatment, prognosis.
Sleep structure. Classification of sleep – wake regimen disorders. Dyssomnia (
changes of insomnia, somnolence, sleep – wake regimen) etiology, criterions of
diagnostics, singularities of differentiation. Analysis of insomnia, like a symptom, in
other psychical end somatic diseases. Parasomnia (sleepwalking, sleep terrors,
nightmarish dream) etiology, criterions of diagnostics, singularities of differentiation.
Diagnostics opportunities of sleep – wake disorders, application of pharmaceutical and
psychotherapeutic treatment.
References:
1. Psichiatrija/ scientific editor prof. A. Dembinskas.- Vilnius, 2003, 415 – 426; 353 – 373
Supplementary reading:
1. TLK – 10, WHO, 1992, 138 – 150
2. Kaplan and Sadock’s Comprehensive Textbook of Psychiatry, by Benjamin Sadock, 2005.
27
Exam programme
Clinical psychology
1. Main communication forms. Peculiarities of medical communication. Characteristics of “ideal”
physician.
2. Stages and functions of medical conversation. Models of physician-patient communication.
3. Stressors in medical occupation, their influence to work and health. Signs of “burnout”, ways to
avoid it.
4. Death. Psychology of physician, dying person and his relatives.
5. Manifestations of grief. Normal and pathological grief.
6. Unmotivated, anxious and manipulative patients. Work with them.
7. Conflict resolution strategies.
8. Psychology of disease detection. Stages of disease. Disease and the patient.
9. An inner view of illness: pats, their significance.
10. Psychotherapy: essence, basic school, treatment methods, indications, mechanisms of action.
Psychiatry
1. Organization of psychiatric aid in Lithuania.
2. Nursing of psychiatric patients. Acute psychiatric treatment.
3. Legal aspects of the psychiatric aid.
4. Diagnostics of acute psychiatric conditions.
5. Examination of the psychiatric patient.
6. Disturbances in perception.
7. Disturbances of memory and attention.
8. Thought disturbances. Disturbances of mood.
9. Disorders of the will.
10. Mental impairment syndrome.
11. Convulsive syndrome. Organic psychosyndrome.
12. Acute conditions in psychiatry. Systematics of psychoses.
13. Diagnostics of schizophrenia: main symptoms, variants of the course of schizophrenia.
14. Clinical forms of schizophrenia: simple, paranoid, catatonic, etc.
15. Differential diagnostics of psychoses.
16. Schizophrenia: principles of treatment, psychosocial rehabilitation.
17. Systematics of affective disorders.
18. The problem of depression. Role of family doctor.
28
19. Somatic (“masked”) depressions: diagnostics and treatment.
20. Affective disorders: principles of treatment.
21. Suicide: risk factors and urgent help.
22. Panic disorders: clinical presentation, principles of treatment.
23. Phobic (anxiety) disorders: main clinical forms, principles of treatment.
24. Acute reactions to stress: clinical presentation, diagnostics.
25. Adjustment disorders: clinical presentation, principles of treatment.
26. Dissociative (conversion) disorders: clinical forms, principles of treatment.
27. Obsessive – compulsive disorders: diagnostics, principles of treatment.
28. Diagnostic criteria of specific personality disorders.
29. Antisocial and emotional unstable personality disorders: symptoms, differential diagnostics.
30. Paranoid personality disorders: symptoms, differential diagnostics.
31. Schizoid personality disorder: symptoms, differential diagnostics.
32. Anancastic personality disorder: symptoms, differential diagnostics.
33. Avoidant personality disorder: symptoms, differential diagnostics.
34. Histrionic personality disorders: symptoms, differential diagnostics.
35. Main sexual dysfunctions and deviations: main clinical signs, differential diagnostics, treatment.
36. Sleep disorders: causes, types, diagnostic criteria, treatment, and prevention.
37. Eating disorders: causes, types, clinical presentation, treatment, prevention.
29
Priedas Nr. 1
MODULE
„PSYCHIATRY AND CLINICAL PSYCHOLOGY“
Clinical psychology
Psychiatry
12 lecture
8 lecture
Main part
Special part
Discretionary work
Practical work
Discretionary studded
simptomic and syndromes
Individual work with patient
assigned to write the case-history.
practice identification
Seminar
Tutorial
sessions
Themes:
1. Examination of patient with
mental disorder..
2. Psychiatric help organization,
1. Senses and perceptive disorders.
2. Memory, attention, dementia, convulsion and
organic psychosindrom disorders.
3. Cognitive and emotions disorders.
4. Volition and attraction disorders.
5. Dissociative and obsessive – compulsive disorders
Thirst problem. Psychosis disorders.
Second problem. Affective disorders.
Juridical – law aspect, expertises..
3. The main treatment and rehabilitation
principal in the psychiatry.
4. Attraction and sexual disorders
diagnostic, treatment.
5. Eating and sleeping disorders.
6. Somatoform disorders...............................................................................................................................
Third problem: Organic and simptomic
Mental disorders.
30
Affix No. 2
Practical work, lectures and seminars schedule of psychical disorders module for IV course
students
Days
1.
2.
3.
4.
5.
6.
7.
8.
9.
Work character
Introduction: The conversance with structure, requirements and program of psychiatric
(1 hour)
clinic.
Lecture: Clinical psychology, history, content, investigation methods. The main forms of
(2hours) communication. Medical communication, peculiarities and working factors.
„Perfect“ physician picture.
Seminar: Psychical patient examination.
(2 hours)
Work preparation for tutorial session „Psychotic disorders“.
(1 hour)
Lecture: Stages, structure and functions of medical conversation. Potential models of
(2 hours) physician-patient intercourse.
Lecture: Psychodynamic etiology conception of psychical disorders.
(2 hours)
Practical work: Practical identification of sense and perceptual disorders studded by
(1 hour)
oneself.
Self-depended work: conversance with patient to write medical history.
(1 hour)
Lecture: Assessment of urgent psychiatric conditions, patient juridical rights, patient and
(2 hours) personnel security.
Practical work: practical identification of memory, attention, dementia, convulsion and
(2 hours)
organic psychosyndrom disorders studded by oneself.
Self-depended work: work with patient to write medical history.
(2 hours)
Lecture: Urgent psychotic condition patient, commonly reasons of psychosis, differential
(2hours) diagnostic and urgent aid.
Practical work: practical identification of intellectual and emotion disorders studded by
(2 hour)
oneself.
Self-depended work: work with patient to write medical history.
(2 hours)
Lecture: Schizophrenia, the main diagnostic criteria, differential diagnostic, management.
(2 hours)
Practical work: practical identification of volition and attraction disorders studded by
(2 hour)
oneself.
Self-depended work: work with patient to write medical history.
(2 hours)
Tutorial session: The problem „Psychotic disorders“.
(2 hours)
Lecture: The main stresses meted in medical work, physician‘s health and personality
(2 hours) impact of stresses. The reasons, symptoms and escape methods of „Professional
exhaustion“.
Self-depended work: work with patient to write medical history.
(2 hours)
Lecture: Psychology of patients ailing terminal disease. Death. Psychology of physician,
(2 hours) dying and immediate family. Manifestation of grief, normal and pathological
course of it.
Self-depended work: work with patient to write medical history.
(4 hours)
Lecture: Neurotic disorders differential diagnostic and peculiarities of management.
(2 hours)
Seminar: Psychiatric aid organisation, juridical- legal questions, expertises.
(3 hours)
Self-depended work: work with patient to write medical history.
(1 hour)
Lecture: Affective disorders, the main diagnostic criteria, forms, differential diagnostic
(2 hours) and management methods.
31
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
Practical work: Dissociative and obsessive-compulsive disorders searching in
(2 hours)
department.
Self-depended work: Work with patient to write medical history.
(2 hours)
Lecture: Suicidal behaviour risk factors, identification. Physician‘s tactics communicating
(2 hours) and managing with loathing to live.
Seminar: The main principles of managing and rehabilitation in psychiatry.
(3 hours)
Self-depended work: Work with patient to write medical history.
(1 hour)
Tutorial session: The problem „Affective disorders“.
(2 hours)
Lecture: Personal disorders, peculiarities of differential diagnostic and management.
(2 hours)
Self-depended work: Work with patient to write medical history.
(2 hours)
Lecture: Simptomic and organic psychical disorders in somatic and degenerative diseases,
(2 hours) differential diagnosis and management.
Seminar: Attraction and sexual disorders, diagnostic, management.
(3 hours)
Self-depended work: Work with patient to write medical history.
(1 hour)
Lecture: The main diagnostic and management peculiarities of dementia and delirium.
(2 hours)
Self-depended work: Work with patient to write medical history.
(4 hours)
Lecture: Correlation between psychoactive substance consumption and psychical disorders.
(2 hours)
Seminar: Eating and sleep disorders.
(3 hours)
Self-depended work: Work with patient to write medical history.
(1 hour)
Lecture: Somatoformic disorders: patients intercourse with disease and medics, guidelines
(2 hours) for successful work with these patients.
Practical work: Complement acquired knowledge about somatoform disorders in
(2 hours)
department.
Self-depended work: Work with patient to write medical history.
(2 hours)
Tutorial session: The problem „Organic and symptomatic psychical disorders“.
(2 hours)
Lecture: Working with motiveless, anxious, manipulative, aggressive patients. The normal (2 hours)
methods solving conflicts.
Self-depended work: Work with patient to write medical history.
(2 hours)
Lecture: Disease, definition, psychology of illness diagnostic. Patient and disease. Stages
(2 hours) and finish variants of disease. Inside (autoplastic) view of disease, constituents
and value.
Lecture: Psychosomatosis, rise models. Alexitymia. Stresses causing psychosomatosis,
(2 hours) peculiarities of stresses, organism impact methods.
Self-depended work: Work with patient to write medical history.
(2 hours)
Lecture: Psychotherapy and psychosocial rehabilitation: point, main brands and
(2 hours) management methods, application indications and working principles.
Self-depended work: Work with patient to write medical history.
(4 hours)
Delivery of medical history for evaluation.
Course credit.
Preparation for examination.
Programmed questioning.
Discussions.
32
Note: all saturdays occurred in psychical disorders module are ordered for self-depended work and literature studies.