Theme 4. General characteristic of organic and symptomatic mental disorders
Mental disorders as a result of brain injures and environmentally adverse effect.
I.
GENERAL
CHARACTERISTIC
OF
ORGANIC
AND
SYMPTOMATIC MENTAL DISORDERS.
1.
Associations Between Physical and Psychiatric Disorder.
2.
Psychiatric Consequences of Physical Illness.
3.
Determinants of Psychiatric Consequences by Physical Illness.
4.
Psychiatric Assessment of a Physically Ill Patient.
II.
MENTAL DISORDERS DURING INFECTIOUS DISEASES AND
BRAIN INJURES.
1.
Mental disorders during infectious diseases
1)
General characteristic of mental disorders during infectious
diseases.
2)
Acute exogenous reactions due to infectious diseases.
3)
Сlinical courses of mental disturbances in infectious diseases.
4)
Specific features of mental disturbances in certain infectious
diseases:
2.

mental disorders in streptococcal infection;

mental disorders in scarlet fever;

mental disorders in flu;

mental disorders in AIDS;

mental disorders in syphilis.
Mental disorders due to brain injures.
1)
Classification of the traumatic brain injuries.
2)
General characteristic of mental disorders due to brain injures.
3)
Characteristic of mental disorders according to stages clinical
course of TBI:

the acute or primary stage;

the sub-acute or secondary stage;

reconvalescence stage;

the stage of remote after-effects (or residual stage).
4)
The treatment.
5)
The prophylaxis.
III.
ECOLOGICAL PSYCHIATRY.
1.
Classification of environmental factors able to cause specific and
nonspecific mental disorders.
2.
Classification of mental disorders caused by intoxication.
3.
Mental syndromes in acute intoxications.
1)
Mental disorders in drug-induced intoxications.
2)
Mental disorders in food poisonings.
3)
Mental disorders in occupational and domestic poisonings.
4)
Treatment
5)
Prophylaxis.
4.
Postradiation mental disorders.
Tests
1. Which of the listed mental disturbances is characteristic for the acute (primary)
stage of traumatic brain injuries (TBI)?
a) organic brain syndrome
b) coma
c) traumatic delirium
d) depressive state
e) all listed
2. Which of the listed mental disturbances is characteristic for the period of
reconvalescence of traumatic brain injuries (TBI)?
a) organic brain syndrome
b) coma
c) delirium
d) depressive state
e) all listed
3. Which of the listed mental disturbances among the patients with TBI is
characterised by a profound loss of consciousness, absence of voluntary motor
activity, and failure to respond to stimuli?
a) coma
b) sopor
c) traumatic delirium
d) Korsakoff’s syndrome
e) all listed
4. Which of the listed mental disturbances is characteristic for chronic intoxications?
a) mania-like state
b) neurosis-like state
c) oneiroid syndrome
d) delirious syndrome
e) all listed
5. Which of the listed drug was overdosed among the patients that experienced
euphoria with a feeling of flight and development of bright coloured visual
hallucinations resembling a cartoon?
a) soporifics
b) antidepressants
c) Atropine
d) Benzhexol hydrochloride
e) Mepacrine hydrochloride
6. Which of the listed below mental disorders is characteristic for acute radiation
sickness?
a) neurasthenic
b) depressive syndromes
c) psychoorganic syndrome
d) delirium
e) psychopathy-like
7. Which of the listed mental disturbances is characteristic for the sub-acute
(secondary) stage of traumatic brain injuries (TBI)?
a) paranoid states
b) coma
c) delirium
d) depressive state
e) all listed
8. Which of the listed mental disturbances is characteristic for the stage of remote
aftereffects of traumatic brain injuries (TBI)?
a) organic brain syndrome
b) coma
c) delirium
d) depressive state
e) all listed
9. Which of the listed mental disturbances among the patients with TBI is
characterised by combination of anxiety, depression, and irritability, with
headache, dizziness, fatigue, poor concentration, and insomnia?
a) coma
b) post-concussion syndrome
c) traumatic delirium
d) Korsakoff’s syndrome
e) all listed
10. Which of the listed mental disturbances is not characteristic for acute
intoxications?
a) mania-like state
b) neurosis-like state
c) oneiroid syndrome
d) delirious syndrome
e) all listed
11. The patient was admitted to a resuscitation department with acute mental
disorders: he was excited, perceived bright visual hallucinations, was disorientated
in his surroundings, his behaviour depended upon the character of the hallucinations
without any critical attitude to them. The patient’s wife said that some hours before
they had had dinner with mushrooms and his husband had drunk about 200 ml of
vodka. After that her husband was painting the walls in the small room, than he
began to complain of a headache, nausea and he had vomiting. During examination
the patients' skin and mucosa were grey, he had some muscular twitching. His wife
didn’t have any problems. Which cause of the pathological state can you suppose?
a) mushroom poisoning
b) alcohol intoxication
c) aniline intoxication
d) epilepsy
e) schizophrenia
12. Which of the listed below mental disorders is characteristic for chronic radiation
sickness?
a) amentia
b) depressive syndromes
c) sopor
d) delirium
e) all listed
Clinical task 1.
The patient was admitted to a resuscitation department with acute mental disorders:
he was excited, perceived bright visual hallucinations, was disorientated in his
surroundings, his behaviour depended upon the character of the hallucinations
without any critical attitude to them. The patient’s wife said that some hours before
they had had dinner with mushrooms and his husband had drunk about 200 ml of
vodka. After that her husband was painting the walls in the small room, than he
began to complain of a headache, nausea and he had vomiting. During examination
the patients' skin and mucosa were grey, he had some muscular twitching. His wife
didn’t have any problems.
1. What symptoms does the patient have?
2. What psychopathological syndromes does the patient have?
3. What disease can you think of?
4. Prescribe treatment to the patient.
Clinical task 2.
Patient N., 36 y.o., is admitted to the mental hospital because of developed
affective disturbances: suddenly and for no serious reason he feels anger. His mood
during these periods is characterized by tension, depression combined with anger or
even rage, high irritability with a tendency to aggressive actions. Also he gets
exhausted quickly, feels tired even after 20 or 30 minutes of conversation with the
psychiatrist. Practically isn't able to read books, because can not concentrate, is easily
distracted to other subjects. His memory has become worse. The patient is critical to the
state of his health, understands that is ill and needs treatment. 15 years ago he was
treated because of depressive disorder and 3 years ago - after a head injury.
1. What symptoms does the patient have?
2. What psychopathological syndromes does the patient have?
3. What disease and its stage can you think of?
4. Prescribe treatment to the patient.
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.
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.