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Psychiatry Instruction Outline

(For Nepalese students)

By Fengjie, Ma
Department of neurology and psychiatry of Weifang Medical College

Preface

Background
Psychiatry is a section of medicine. It is a clinical medicine that studies cause, mechanism,
clinical syndromes and signs, diagnosis, treatment and prognosis of mental illnesses and close
correlation with other subject. Mental illnesses are becoming one of the central diseases with
social development and are very common diseases. It badly impact health of human. This is a
comparative complex disease due to lacking of objective diagnostic instrument and treatment. So
it is important to master the essentials, know well about the etiology, and to understand the
principles of treatment, not only for this course itself, but also for all clinical courses. With the
amazing development of biochemistry, biophysics, molecular biology, genetic engineering and
other biosciences, the conception and extension of psychiatry is becoming more and more
complicated. As a result, the methods and lectured contents are required to be adapted at all the
challenges.

Aim
For psychiatry, the primary task is to master the basic theories, knowledge, and basic skills
for diseases and emergencies that commonly occur. All students should have the ability to collect
history, to perform systemic physical examination, and to understand the clinical significance of
laboratory results as well. Moreover, they should be able to make a primary diagnosis by integral
analysis of all clinical information. Referred to treatment, they are required to master the
principles for management of commonly occurring emergency and diseases.

Method
To attain that goal, various studying forms are indispensable. Theoretic lecture is important in
class, by which all students should learn the basic theoretic knowledge. As a complemental form,
practice for history collecting—scene simulation-- is helpful to strengthen theoretic knowledge
lectured in class. Of course, the clinical practice in hospital is a required step for every student. In
addition, ethical viewpoints, despite divergences among different cultures, are something input
through the whole education. Anyhow, treating patients with kindness and full respect is the same
in different cultural background. Other personalities such as patience, prudence and diligence are
important for a qualified doctor. Therefore, quality education should be embodied in class
lecturing and clinical practice.

Table 1 Curriculum plan for psychiatry

1
Topic General Theoretic Practice Study by
hour courses courses oneself
Introduction 1 1    
Semeiology 14 7 6 1
Organic disorder 9 4 4 1
Schizophrenia 9 4 4 1
Mood disorder 9 4 4 1
Neurosis 15 8 6 1
Stress related disorders 8 4 4
Somatotherapy 11 6 4 1
Psychotherapy 8 4 4  
  84 42 36 6

Curriculum
The curriculum includes theoretic courses in class and clinical practice in hospital, and the
former may have 2 forms--lecturing and discussion. All together, there are 42 theoretic courses
plus 36 clinical practical courses (table 1). The more detailed curriculum will be made accordant
to educational planning and calendar.

Evaluation for educational effectiveness


Educational effectiveness may be evaluated by topic discussion in class, homework,
sectional, midterm and final exams.

Chapter 1
Introduction
1. Purpose and desire: To understand the concepts of psychiatry.
2. Stress and difficulty: How to differentiate the mental disease and psychiatry.
3. Teaching style and length per chapter: Theoretics 1 lectures
4. Learning content
I、Concepts of psychiatry:
(1)mental diseases
(2)study of mental disease
(3)psychological medicine
(4)lunacy
(5)psychiatry
(6)mental disorders

II、Etiology of psychiatry:
(1)biology factors
(2)psychology factors
(3)society condition factors

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Chapter 2
Semeiology of mental disorders
1. Purpose and desire: Master the understanding of Semeiology of mental disorders.
2. Stress and difficulty: emeiology of mental disorders.
3. Teaching style and length per chapter: Theoretics 7 lectures
Practice courses 6 lectures
Study by oneself 1 lectures
4. Learning content

Section 1
Summary
1. Symptom of psychiatry
2. Study of mental disorder
3. Psychopathology

Section 2
Familiar symptoms of mental disorders

I、cognize and cognize disorders


(I)apperceive and apperceive disorders
1.disorders of sensation
(1)hyperesthesia
(2)hypoesthesia
(3)paraesthesia
(4)senestopathia
2. disorders of perception
(1)illusion
(2)hallucination
1)auditory hallucination
2)visual hallucination
3)olfactory hallucination
4)gustatory hallucination
5)tactile hallucination
6)visceral hallucination
(3)psychosensory disturbance
1)interspace psychosensory disturbance
2)time psychosensory disturbance
3)movement psychosensory disturbance
4)self-figure psychosensory disturbance
(II)thinking and thinking disorders
divide into:disorders of the thinking form

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disorders of the thinking content
1. disorders of the thinking form
(1)inhibition or retardation of thought
(2)flight of ideas
(3)circumstantiality
(4)looseness of thought
(5)splitting of thought
(6)poverty of thought
(7)thought block
(8)thought insertion
(9)thought hearing and thought echo
(10)diffusion of thought and thought broadcasting
(11)symbolic thought
(12)neologism
(13)paralogism thinking
(14)obsessive idea
2. disorders of the thinking content
Delusion is familiar symptom and primary divide into such some.
(1)delusion of persecution
(2)delusion of reference
(3)delusion of physical influence
(4)delusion of grandeur
(5)delusion of sin
(6)delusion of jealousy
(7)hypochondriacal delusion
(8)delusion of love
(9)thoughts are being read
3. over valued idea or hyperquantivalent idea
(III)attention and attention disorders
divide into: initiative attention disorders
passiveness attention disorders
familiar attention disorders:
1. hyperprosexia
2. aprosexia
3. hypoprosexia
4. transference of attention
5. deterioration of attention
(IV)memory and memory disorders:
1. hypomnesia
2. amnesia
3. hypermnesia
4. paramnesia
5. confabulation
6. psychogenic amnesia

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(V)intelligence and intelligence disorders:
1. mental retardation
2. dementia
3. fake dementia
(VI)orientation
(VII)insight

II、affection and affection disorders:


dispart into:
(I)change of affection character
1. elation
2. depression
3. anxiety
4. phobia
(II)change of affection stabilization
1. emotional fragility
2. apathy
3. pathological affect
(III)change of affection harmony
1. parathymia
2. affection infantility

III、will and action disorders


dispart into:will disorders
action disorders
(I)will disorders
1. hyperbulia
2. hypobulia
3. abulia
(II)action and behavior disorders
1. psychomotor excitement
2. psychomotor retardation
(1)stupor
(2)cerea flexibilitas
(3)mutism
3. negativism
4. stereotyped act
5. echopraxia
6. mannerism

IV、consciousness and consciousness disorders


1. drowsiness
2. clouding of consciousness
3. spoor

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4. coma
5. twilight state
6. delirium
7. oneiroid state

Consider the following:


What are the concepts and properties of common mental symptomatic?
In which mental diseases does common mental symptomatic often appear?

Chapter 5
Organic disorder
1. Purpose and desire: The purpose of this lecture is to understand the concept of brain
organic disorders, and master the syndromes of brain organic
disorders.
2. Stress and difficulty: The essential part of this lecture is the syndromes of brain organic
disorders.
3. Teaching style and length per chapter: Theoretics 4 lectures
Practice courses 4 lectures
Study by oneself 1 lectures
4. Learning content

Section 1
Summary
Ⅰ、Concepts
(Ⅰ)organic mental disorders
(Ⅱ)functionality mental disorders

Ⅱ、classification
(Ⅰ)brain organic mental disorders
(Ⅱ)mental disorders due to physical diseases
(Ⅲ)mental disorders due to psychoactive substances

Section 2
Common syndromes of brain organic disorders
Ⅰ、delirium
(Ⅰ)concept
(Ⅱ)pathogeny
(Ⅲ)damage
(Ⅳ)clinic represent
1. consciousness disorder
2. emotion disorder
3. behavior disorder

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4. perception disorder
(Ⅴ)the course of diseases and prognosis

Ⅱ、Amnestic syndrome or Korsakoff syndrome


(Ⅰ)concept
(Ⅱ)pathogeny
(Ⅲ)damage
(Ⅳ)clinic represent
1. near memory impair
2. paramnesia
3. confabulation
4. consciousness clear-headed
5. intelligence all right
(Ⅴ)the prognosis

Ⅲ、dementia syndrome
(Ⅰ)concept
(Ⅱ)pathogeny
(Ⅲ)damage
(Ⅳ)clinic represent
1. memory impair
2. intelligence impair
3. behavior disoeder
4. perception disorder
5. thinking disorder
6. consciousness normal
(Ⅴ)the prognosis

Consider the following:


1. What are the concepts and clinic representation of common symptomatic of organic
disorders?
2. What are the differences between different syndromes?

Chapter 8
Schizophrenia
1. Purpose and desire: understand the concepts and pathogeny of schizophrenia, and
memorize the clinic representation, diagnoses, how to distinguish schizophrenia from other
diseases, and therapies of schizophrenia.
2. Stress and difficulty: This lesson’s keystone are the clinic representations, how to
distinguish schizophrenia from other diseases, and therapies of schizophrenia.
3. Teaching style and length per chapter: Theoretics 4 lectures
Practice courses 4 lectures

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Study by oneself 1 lectures
4. Learning content
Ⅰ、Concepts
Ⅱ、Pathogeny
(Ⅰ)heredity factor
(Ⅱ)neurochemistry theory
(Ⅲ)society condition factor
Ⅲ、Clinic representation
(Ⅰ)Mental symptom
1. thinking disorder
2. sensibility
3. will and behavior disorder
4. other common symptom
5. insight damage
6. consciousness normal
7. intelligent normal
(Ⅱ)Clinic types
1. simple
2. hebephrenic
3. catatonic
4. paranoid
5. others
(Ⅲ)Diagnoses
(Ⅳ)Distinguish from other diseases
(Ⅴ)Therapies
1. medication
2. electroconvulsive therapy
3. psychotherapy

Consider the following:


What are the clinic representation, diagnoses, distinguish schizophrenia from other diseases,
and therapies of schizophrenia?

Chapter 9
Mood disorder
1. Purpose and desire: The purpose of this lecture is to understand the concept and pathogeny
of mood disorders, and master the clinic represent, diagnose, differentiation, and therapies of
mood disorders.
2. Stress and difficulty: The essential parts of this lecture are the clinic representation,
diagnoses, differentiation, and therapies of mood disorders.
3. Teaching style and length per chapter: Theoretics 4 lectures
Practice courses 4 lectures

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Study by oneself 1 lectures
4. Learning content
Ⅰ、Concepts
Ⅱ、Pathogeny
(Ⅰ)heredity factor
(Ⅱ)neurochemistry theory
(Ⅲ)society condition factor
Ⅲ、Clinic represent
(Ⅰ)mental symptom
1. mania outbreak
2. depression outbreak
(Ⅱ)clinic types
1. mania outbreak
2. depression outbreak
3. bipolar disorder
4. mix mood disorder
5. cyclothymic disorder
6. dysthymic disorder
Ⅳ、Diagnoses
Ⅴ、Differentiation
Ⅵ、Therapies
(Ⅰ)mania outbreak
1. medication
2. electroconvulsive therapy
3. other therapy
(Ⅱ)depression outbreak
1. medication
2. electroconvulsive therapy
3. psychotherapy

Consider the following:


What are the clinic represent, diagnose, differentiation, and therapy of mood disorder?

Chapter 10
Neurosis
1. Purpose and desire: The purpose of this lecture is to understand the concept and pathogeny
of neurosis, and master the clinic represent, diagnose, differentiation, and therapies of neurosis.
2. Stress and difficulty: The essential part of this lecture are the clinic representation,
diagnoses, differentiation and therapies of neurosis.
3. Teaching style and length per chapter: Theoretics 8 lectures
Practice courses 6 lectures
Study by oneself 1 lectures

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4. Learning content

Section 1
Summary
Ⅰ、Concepts
Ⅱ、Characteristics
Ⅲ、Composition

Section 2
Neurasthenia
Ⅰ、Definition
Ⅱ、Pathogeny
Ⅲ、Pathogenesis
Ⅳ、Clinic representation
Ⅴ、Diagnoses
Ⅵ、Differentiation
Ⅶ、Therapies
(Ⅰ)psychotherapy
(Ⅱ)medication
(Ⅲ)other therapy

Section 3
Hysteria
Ⅰ、Definition
Ⅱ、Pathogeny
(Ⅰ)psychology factor
(Ⅱ)heredity factor
(Ⅲ)character
(Ⅳ)physical force decline
Ⅲ、Pathogenesis
Ⅳ、Clinic representation
(Ⅰ)hysteria mental disorder
(Ⅱ)hysteria body disorder
(Ⅲ)hysteria special type
Ⅴ、Diagnoses
Ⅵ、Differentiation
Ⅶ、Therapies
(Ⅰ)psychotherapy
(Ⅱ)medication
(Ⅲ)other therapy

Section 4
Axiety
Ⅰ、Definition

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Ⅱ、Pathogeny
(Ⅰ)heredity factor
(Ⅱ)lactic acid theory
(Ⅲ)norepinephrine theory
(Ⅳ)serotonin theory
(Ⅴ)benzene acceptor theory
(Ⅵ)psychology factor
Ⅲ、Pathogenesis
Ⅳ、Clinic representation
Ⅴ、Diagnoses
Ⅵ、Differentiation
Ⅶ、Therapies

Section 5
Obsessive-compulsive neurosis

Ⅰ、Definition
Ⅱ、Pathogeny
(Ⅰ)neurochemistry theory
(Ⅱ)heredity factor
(Ⅲ)organic disease factor
(Ⅳ)psychology factor
Ⅲ、Pathogenesis
Ⅳ、Clinic representation
(Ⅰ)force conception
(Ⅱ)force action and behavior
Ⅴ、Ciagnoses
Ⅵ、Differentiation
Ⅶ、Therapies
(Ⅰ)psychotherapy
(Ⅱ)medication
(Ⅲ)physic therapy
(Ⅵ)surgery therapy

Section 6
Phobia
Ⅰ、Definition
Ⅱ、Pathogeny
Ⅲ、Pathogenesis
Ⅳ、Clinic representation
Ⅴ、Diagnoses
Ⅵ、Differentiation
Ⅶ、Therapies
(Ⅰ)psychotherapy

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(Ⅱ)medication

Section 7
Smatoform disorders
Ⅰ、Definition
Ⅱ、Pathogeny
(Ⅰ)heredity factor
(Ⅱ)character
(Ⅲ)neurochemistry theory
(Ⅳ)psychology factor
Ⅲ、Pathogenesis
Ⅳ、Clinic representation
(Ⅰ)somatization disorder
(Ⅱ)undifferentiated somatoform disorder
(Ⅲ)hypochondria
(Ⅳ)somatoform pain disorder
Ⅴ、Diagnoses
Ⅵ、Differentiation
Ⅶ、Therapies
(Ⅰ)psychotherapy
(Ⅱ)medication
(Ⅲ)other therapy

Consider the following:


1. What are the clinic representation, diagnoses, differentiation and therapies of neurasthenia
and Hysteria?
2. What are the characteristics of the different kinds of Neurosis?

Chapter 11
Stress related disorders
1. Purpose and desire: know the concepts of this kind of disease. Master the clinic
representation, diagnoses, differentiation, and therapies of the disease.
2. Stress and difficulty: This lesson’s keystones are the clinic representation, diagnoses,
differentiation, and therapies of the disease.
3. Teaching style and length per chapter: Theoretics 4 lectures
Practice courses 4 lectures
4. Learning content

Section 1
Summary
Ⅰ、Concepts
Section 2

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Stress related disorders
Ⅰ、Definition
Ⅱ、Classification
(Ⅰ)acute stress disorders
(Ⅱ)posttraumatic stress disorder
(Ⅲ)adjustment disorder

Chapter 15
Somatotherapy
1. Purpose and desire: Understand the treatment methods of mental disorders, and master the
use of medication for mental disorders.
2. Stress and difficulty: Use of Medication for Mental Disorders.
3. Teaching style and length per chapter: theropies 6 lectures
Practice courses 4 lectures
Study by oneself 1 lectures
4. Learning content

Section 1
Summary
Ⅰ、Treatment methods
(Ⅰ)somatotherapy
1.medication
2.Other therapy
(Ⅱ)psychotherapy
1.psychotherapy
2.Psychology counseling
Ⅱ、Treatment mode
(Ⅰ)hospitalization
(Ⅱ)outpatient therapy
Ⅲ、Psychotropic drugs classification
(Ⅰ)antipsychotic drugs
(Ⅱ)antidepressant drugs
(Ⅲ)mood stabilizers
(Ⅳ)antianxiety drugs

Section 2
Medications
Ⅰ、Antipsychotic drugs
(Ⅰ)definition
(Ⅱ)classification
(Ⅲ)pharmacology mechanism
(Ⅳ)adaptive evidence

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(Ⅴ)prohibit evidence
(Ⅵ)medicine-taking principles
(Ⅶ)side effects and manage methods

Ⅱ、Antidepressant drugs
(Ⅰ)definition
(Ⅱ)classification
(Ⅲ)pharmacology mechanism
(Ⅳ)adaptive evidences
(Ⅴ)prohibit evidences
(Ⅵ)medicine-taking principles
(Ⅶ)side effects and manage methods

Ⅲ、Mood stabilizers
(Ⅰ)definition
(Ⅱ)classification
(Ⅲ)pharmacology mechanism
(Ⅳ)adaptive evidences
(Ⅴ)prohibit evidences
(Ⅵ)medicine-taking principles
(Ⅶ)side effects and manage methods

Ⅳ、Antianxiety drugs
(Ⅰ)definition
(Ⅱ)classification
(Ⅲ)pharmacology mechanism
(Ⅳ)adaptive evidences
(Ⅴ)prohibit evidences
(Ⅵ)medicine-taking principles
(Ⅶ)side effects and manage methods

Section 3
Electroconvulsive therapy

Consider the following:


What are the psychotropic drugs’ functions?

Chapter 16
Psychotherapy
1. Purpose and desire: Understand the methods of Psychotherapies.
2. Stress and difficulty: None.

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3. Teaching style and length per chapter: Theoretics 4 lectures
Practice courses 4 lectures
4. Learning content
Ⅰ、Concepts
Ⅱ、Classification
(Ⅰ)psychotherapy
(Ⅱ)psychology counseling
Ⅲ、Psychotherapy principles
Ⅳ、Common psychotherapy methods
(Ⅰ)sustain psychotherapy
(Ⅱ)hypnosis and suggestion
(Ⅲ)relaxation therapy
(Ⅳ)systematic desensitization
(Ⅴ)flooding therapy
(Ⅵ)averseness therapy
(Ⅶ)cognize therapy
(Ⅷ)biofeedback therapy
(Ⅸ)Vorita therapy

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