THE BASIC CONCEPTOF PSYCHIATRY

Dr. Lynna Lidyana SpKJ

1. General systems theory2. Model of disease3. Doctor - Patient Models4. Concept of Normality5. Psychiatry and Psychology6. Definition of Mental Disorder

* Kaplan HI, Sadock BJ. Synopsis of Psychiatry Behavioral Sciences / Clinical Psychiatry, 8th.ed., 1998* American Psychiatry Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed (DSM-

IV). 1994

The Biological Systems

The Psychological

Systems

The Social

Systems

GENERAL SYSTEMS THEORY

The Biological Systems :

• anatomical

• structural biological functioning

• molecular

The Psychological Systems

• psychodynamic the experience of events /

factors illness

• motivation reaction to events / illness

• personality

The Social Systems :

• cultural the expression

• environmental experience of events /

• familiar illness

MODEL OF DISEASE

The General Systems Theory

The Biopsychosocial Model of Disease

( George Engel )

Stressed an integrated system approach to human behaviour and disease

Each system affects and is affected by all the others

Promote a comprehensive understanding of disease and treatment

The doctor - patient relationship is a critical component

A dramatic example of Engel’s concept

The relation between sudden death (170) and psychosocial factors

The potential triggering events :• death of close friend• grief• loss of self esteem• personal danger of threat• the letdown after the threat has passed• triumph• reunion

All physicians must have knowledge of :

• patient’s medical status

• how patients individual psychology and sociocultural millieu affect the medical condition

• the emotional responses to the condition and the involvement with the doctor

DOCTOR-PATIENT MODELS

1. The active - passive model :a patient ‘s complete passivitya physician’s taking control

when patients are unconscious,immobilized, delirious.

2. The teacher - student model :

• The role of the physician is paternalistic and controlling.

• The role of the patient is essentially one of dependence and acceptance

during a patient’s recovery from surgery

3. The mutual participation model :

• equality between doctor and patient

• both participation require and depend on each other’s input.

• Chronic illness : renal failure and diabetes

• conditions such as pneumonia

4. The friendship model :

• dysfunctional

• unethical

CONCEPT OF NORMALITY

• The normal person has a sense of his or her own worth and maintain a confident and purposeful self-image

• Behavior is assumed to be within normal limits : no manifest psychopathology

The doctor attemps to free patients from grossly observable signs and symptoms of disease

Health is a reasonable, rather than optimal, state functioning

Longitudinal studies

Operational definition of normality( not absolute, rather is descriptive )

The teenagerThe adults

The Teenagers

1. Almost complete absence of gross psychopathology, severe physical defects, and severe physical illness.

2. Mastery of previous developmental tasks without serious setbacks.

3. Ability to experience emotional states flexibly and to resolve conflicts actively with reasonable success.

The Teenagers4. Relatively good relationship with parents,

sibling, and peers.5. Feeling part of a larger cultural

environment and being aware of its norms and values.

The Adults Good adaptation to marriage, parenthood,

work and leisure activities.

Mental Health• Mental health is a state of emotional will-

being in which person are able to function comfortably within their society and in which their personal achievements and characteristics are satisfactory to them.

• A mentally health individual : being in a state of equilibrium, somehow

possessing a harmonious psychological “wholeness”

• In a state a mental health :

a person feels physically well, his thoughts are organized, his feeling are well modulated and his behaviours are coordinated and appropriate. He feels part of a group and is able to fulfill his role within it.

PSYCHIATRY

• Branch of medicine concerned with the prevention, cause, treatment, and rehabilitation of mental disorders.

• Psychiatrist : medical doctor whose specialty is psychiatry

PSYCHOLOGY• Study and profession concerned with mental

process and behaviour.

DEFINITION OF MENTAL DISORDER

A clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress (e.g., a painful symptom) or disability (i.e., impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability or an important loss of freedom.