Psychiatry

 ### **Psychiatry – Study of Mental Health Disorders** **Psychiatry** is a **final-year MBBS** subject dealing with the **diagnosis, treatment, and prevention of mental disorders**. However, some basics are covered in **Physiology (Neurotransmitters, Brain Functions) and Pharmacology (Psychiatric Drugs) during the second year**. --- ## **1. Basics of Psychiatry** - **Mind-Body Connection**: Mental health affects physical health (**e.g., Depression → Weight loss, Sleep issues**) - **Neurotransmitters in Mental Disorders**: - **Dopamine** – ↑ in Schizophrenia, ↓ in Parkinson’s - **Serotonin** – ↓ in Depression, Anxiety - **GABA** – ↓ in Anxiety - **Norepinephrine** – ↓ in Depression, ↑ in Mania --- ## **2. Classification of Psychiatric Disorders (DSM-5 & ICD-10)** ### **A. Mood Disorders (Affecting Emotions)** #### **1. Major Depressive Disorder (MDD) – Persistent Low Mood** - **Symptoms (Mnemonic: SIG E CAPS)**: - **S**leep disturbance - **I**nterest loss (Anhedonia) - **G**uilt or worthlessness - **E**nergy loss (Fatigue) - **C**oncentration difficulty - **A**ppetite change - **P**sychomotor retardation - **S**uicidal thoughts - **Treatment**: - **First-line**: SSRIs (**Fluoxetine, Sertraline**) - **Severe Cases**: Electroconvulsive Therapy (ECT) #### **2. Bipolar Disorder (Episodes of Depression & Mania)** - **Manic Episode Symptoms (Mnemonic: DIG FAST)**: - **D**istractibility - **I**mpulsivity - **G**randiosity - **F**light of ideas - **A**ctivity increase - **S**leep deficit - **T**alkativeness - **Treatment**: Mood stabilizers (**Lithium, Valproate**), Antipsychotics --- ### **B. Anxiety Disorders** #### **1. Generalized Anxiety Disorder (GAD)** - **Chronic excessive worry** (>6 months) - **Symptoms**: Restlessness, Muscle tension, Sleep disturbance - **Treatment**: **SSRIs (Escitalopram), Buspirone, CBT** #### **2. Panic Disorder (Sudden Anxiety Attacks)** - **Symptoms**: Palpitations, Sweating, Fear of dying - **Treatment**: **Benzodiazepines (Acute), SSRIs (Long-term)** #### **3. Phobias (Irrational Fears of Specific Objects/Situations)** - **Examples**: - Agoraphobia – Fear of open spaces - Social Phobia – Fear of social interactions - **Treatment**: Exposure therapy, SSRIs --- ### **C. Psychotic Disorders (Loss of Reality Perception)** #### **1. Schizophrenia** - **Positive Symptoms (Excess behaviors)**: Hallucinations, Delusions, Disorganized speech - **Negative Symptoms (Deficit behaviors)**: Apathy, Social withdrawal, Flat affect - **Treatment**: - **Typical Antipsychotics**: Haloperidol (D2 Blocker, EPS side effects) - **Atypical Antipsychotics**: Clozapine, Risperidone --- ### **D. Substance Use Disorders (Addiction & Withdrawal)** - **Alcohol Use Disorder**: - **Withdrawal Symptoms**: Tremors, Seizures, Delirium tremens - **Treatment**: Benzodiazepines (Diazepam), Thiamine - **Opioid Addiction (Heroin, Morphine)**: - **Withdrawal Symptoms**: Sweating, Goosebumps, Diarrhea - **Treatment**: Methadone, Buprenorphine --- ### **E. Neurodevelopmental & Childhood Disorders** #### **1. Autism Spectrum Disorder (ASD)** - **Symptoms**: Communication difficulties, Repetitive behaviors, Social impairment - **Treatment**: Behavioral therapy, Antipsychotics (For aggression) #### **2. Attention Deficit Hyperactivity Disorder (ADHD)** - **Symptoms**: Inattention, Hyperactivity, Impulsivity - **Treatment**: Stimulants (**Methylphenidate, Amphetamines**) --- ### **F. Personality Disorders** - **Cluster A (Odd/Eccentric)**: Paranoid, Schizoid, Schizotypal - **Cluster B (Dramatic/Erratic)**: Borderline, Narcissistic, Antisocial - **Cluster C (Anxious/Fearful)**: Avoidant, Dependent, Obsessive-Compulsive --- ### **G. Somatic Symptom & Factitious Disorders** - **Somatic Symptom Disorder** – Excessive anxiety about physical symptoms - **Conversion Disorder** – Neurological symptoms (e.g., Paralysis, Blindness) with no medical cause - **Factitious Disorder** – Faking illness for attention (Munchausen Syndrome) --- ### **H. Suicide Risk Assessment** - **Risk Factors (Mnemonic: SAD PERSONS)**: - **S**ex (Male) - **A**ge (>60, Adolescents) - **D**epression - **P**revious attempts - **E**thanol abuse - **R**ational thinking loss - **S**ocial support lack - **O**rganized plan - **N**o spouse - **S**ickness - **Management**: Hospitalization, Antidepressants, Psychotherapy --- ## **3. Psychiatric Treatments** ### **A. Psychotherapy (Counseling)** - **Cognitive Behavioral Therapy (CBT)** → Anxiety, Depression - **Dialectical Behavioral Therapy (DBT)** → Borderline Personality Disorder - **Exposure Therapy** → Phobias, PTSD ### **B. Medications (Psychotropic Drugs)** - **Antidepressants (SSRIs, SNRIs, TCAs, MAOIs)** - **Antipsychotics (Typical & Atypical)** - **Mood Stabilizers (Lithium, Valproate)** - **Anxiolytics (Benzodiazepines, Buspirone)** ### **C. Electroconvulsive Therapy (ECT)** - Used for **Severe Depression, Schizophrenia, Catatonia** --- ## **4. Psychiatry Mnemonics & Study Tips** ✅ **SIG E CAPS** for Depression ✅ **DIG FAST** for Mania ✅ **SAD PERSONS** for Suicide Risk ✅ **Practice Psychiatry Case Presentations (Depression, Schizophrenia, Anxiety)** ---

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