Essay on Mental Disorders
With an integration of psychiatry in general medicine, it is becoming increasingly obvious the need for a broad discussion of the problems associated with mental disorders. This, above all, is a huge contingent of "difficult patients" with erased, atypical forms of mental disorders, somatic diseases with common symptoms.
In such cases, namely, mental diseases are often assumes “responsibility” for the increase of the frequency of demand for medical care, not enough sound re-examinations and risk of diagnostic errors.
Prompt and proper diagnosis of mental disorders in general medical practice is becoming crucial for the success of medical assistance provided only for one of ten patients so far. Clinical pathology analysis of this range is a part of complex psychosomatic problems, including a number of interdisciplinary aspects (issues of poly-professional interaction, creation of new forms of care, justification of treatment, improving the skills of internists and psychiatrists, etc.).
In the process of psychiatric diagnosis, the doctor relies on the identification of the symptoms (signs) of disease. Psychiatric diagnosis begins, namely, with the definition of certain signs of illness. In doing so, he identifies the relevance of the symptoms to a syndrome and the nosological form of the disease (Gamble and Brennan 126).
The symptoms, according to the concept of Jackson, are divided into positive and negative. The first symptoms include loss of certain functions of mental activity (the depletion of mental activity, reducing the energy capacity, dementia). The positive, or productive, symptoms are the result of the painful initiation of functional systems (illusions, hallucinations, delirium and obsessive ideas, manic and depressive state, etc.). Negative symptomatology (minus-signs) compared to the productive (plus-signs) are nosologically specific (Richards 86).
At the same time, it is inert, relatively invariant, and resistant to therapy. Negative and positive violations, despite the fact that differ from each other, are closely linked with some modification of ones, and other changes. A clear expression of negative symptoms involves rudimentary manifestations of positive one. Slow chronic illness is accompanied by the prevalence of negative symptoms, and the development of acute psychosis is accompanied by a pronounced productive disorders. Especially productive symptoms manifested clearly in the psychosis associated with disorders of consciousness (delirious, oneiroid, etc.), as well as other conditions involving a psychomotor excitation and acute symptoms of hallucination, raving (Russello 71).
The notion of “negative” and “positive” disorders is not always clearly defined, even among the cardinal in general psychopathology. In particular, the negative disorders are considered persistent, irreversible, and positive - temporary, dynamic, transitional expressions of mentality defect. However, clinical studies in recent years have shown that, when holding intense antipsychotic treatment, it is possible a reversibility and compensation of negative disorders. Therefore, it should be considered that the negative symptom is related not so much with the fallout of mental functions but with the temporary cessation of operation of individual systems(Gamble and Brennan 174).
What about the criminals? Are they mentally ill? U.S. Department of Justice interviewed 25,000 serving sentences. The results of this survey are disappointed.
It turned out that more than 50% of prisoners (705,600 people in state prisons, 479,900 people in local jails and 70,200 state prisoners) suffer from various psychical disorders. More than two-thirds of the mentally ill, before confinement, constantly suffering from any problems, they are two times more frequently than others convicted were living without shelter over their heads. A quarter of prisoners with mental disorders had been subjected to sexual or physical harassment in prison. Another quarter of the mentally ill are not sitting for the first time. Women have the largest number of mental health problems. About 73% of women, serving a term, suffer from it. Released offenders are prone to repeated violations of the laws. About 66% of them newly returned to prison (Russello 98).
It is undoubtedly, when setting the clinical diagnosis of mental illness, the physician should bear in mind what could change the identity of the patient, and in determining its causes, subjective history could not correspond to objective investigation. Factor, which was the cause of disease in later may have no influence on its course, and it will develop by its pathogenetic laws.
It must be said that a psychiatrist in their daily practical work constantly faced not only with various pathological phenomena of mental activity but also with abnormalities of somatic functions of the patient, as well as the complex interweaving of his interpersonal relationships.
Making a diagnosis is the final phase of a psychiatric diagnosis, which is based on comprehensive analysis of psychopathological symptoms, personal characteristics of the individual, the objective data and subjective history, the dynamics of the disease and the results of paraclinical studies. However, for accurate diagnosis of mental illness it is not enough only to a find pathological changes. To do so is necessary to study the etiology and pathogenesis of the disease.
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