mental disorder
Introduction
Introduction to mental disorders Mental disorders refer to disorders in which mental functioning of the brain occurs, leading to different levels of mental activity such as cognition, emotion, behavior, and will. Common mental illnesses include: affective disorder, brain organic mental disorder, schizophrenia, manic depressive disorder, menopausal mental disorder, paranoid mental disorder, and mental disorders associated with various organic lesions. Genetic factors are one of the most important pathogenic factors, but they are not the only factors, nor are they positive single-gene inheritance. It is generally believed that multi-gene interactions increase the "riskness" or possibility of mental disorders. In the case of schizophrenia, even if it is a single egg, the same rate is less than 50%. The lifetime prevalence of normal people is about 1%, and the lifetime prevalence of schizophrenia patients is only about 10%. Mental disorders caused by physical illness are mainly used to treat physical illnesses. If mental disorders do not affect the treatment of physical illnesses, they may not require special treatment or only symptomatic treatment. For other mental illnesses, drug therapy, shock therapy, etc. can be used depending on the situation. basic knowledge The proportion of sickness: 0.01% Susceptible people: no special people Mode of infection: non-infectious Complications: epilepsy dementia
Cause
Cause of mental disorder
Biological factors (35%)
1. Genetic factors are one of the most important pathogenic factors, but they are not the only factors, nor are they positive single-gene inheritance. It is generally believed that multi-gene interactions increase the "riskness" or possibility of mental disorders. In the case of schizophrenia, even if it is a single egg, the same rate is less than 50%. The lifetime prevalence of normal people is about 1%, and the lifetime prevalence of schizophrenia patients is only about 10%.
2. Central nervous system infection and trauma.
Psychological and social factors (25%)
1. Personality: Personality disorder itself is a mental disorder. People with impaired personality are more likely to suffer from mental disorders. And some personality disorders are closely related to specific mental disorders.
2. Stress: Stress is generally only a cause of mental disorder, and only in rare cases (such as acute stress disorder) may be the direct cause.
Psychological perspective:
Consciousness: psychoanalysis.
Cognitive theory: cognitive analysis.
Behavior Theory: Behavior Analysis.
Alzheimer's disease (20%)
Alzheimer's disease, also known as Alzheimer's disease, is a syndrome. After 65 years of age. Although the onset is slow, but the lesions are quietly and constantly, showing that the mental function is low, the patient is not as flexible as before, the memory is obviously reduced, and the medical so-called "forgetting period" (the first stage of senile dementia) Forgotten things, often with the help of notes, just finished doing things will be forgotten. Afterwards, attention can not be concentrated, the orientation is greatly affected, the vocabulary becomes very poor, and it is difficult to think of the appropriate language (not originally), and enter the so-called "chaotic period" in medicine (the second stage of senile dementia). Serious disorientation, unclear couples and parents, obvious anxiety, do not know what to do next. Delusions and hallucinations are becoming more and more obvious. Gastric brain angiography shows enlargement of the ventricles. At present, there are many reasons for causing Alzheimer's disease. One of the main ones is the atrophy of the cerebral cortex caused by arteriosclerosis.
Prevention
Mental disorder prevention
Primary prevention
Primary prevention aims to eliminate or reduce the cause or cause of the disease to prevent or reduce the occurrence of mental disorders. This is the most active and proactive preventive measure. However, because the cause of some mental disorders is unknown, primary prevention is mainly a mental disorder with a clear cause. It is possible to take decisive preventive measures against the cause. In addition to the elimination of the disease, we can use the existing knowledge to actively carry out primary prevention of mental disorders.
Secondary prevention
The goal of secondary prevention is early detection, early diagnosis, and early treatment. Strive for complete remission and good recovery to prevent recurrence. Secondary prevention measures should be given to mental disorders that are currently not eradicated by preventive measures. Early detection of patients and early diagnosis and treatment have a good effect on the course of disease and prognosis of various mental diseases. It is an extremely important part of the prevention and treatment of mental illness, especially patients who gradually become sick and have hidden symptoms and are not easily found. If early diagnosis and early treatment without delaying the condition, it is very important to prevent recurrence and reduce the chronic rate.
Tertiary prevention
The goal of tertiary prevention is to make rehabilitation arrangements for people with mental disabilities, to maximize the recovery of patients' social functions, to minimize the occurrence of mental disabilities, and to incorporate the prevention and rehabilitation of mental disabilities into the primary health care system. Go in.
Complication
Mental disorder complications Complications, epilepsy, dementia
Complications of mental disorders include secondary epilepsy, dementia, and hemiplegia.
Symptom
Symptoms of mental disorders Common symptoms Illusion thinking interrupted occupational neurosis Mania Cognitive dysfunction Paranoid paranoia Paranoid state Depression moody compensation Neurosis
Many people with mental disorders have delusions, hallucinations, delusions, affective disorders, laughter, self-talk, strange behavior, and decreased will. Most patients lack self-awareness, do not admit that they are sick, and do not actively seek medical help. .
Common clinical types are:
1, simple type: adolescent onset, slow onset, often difficult to find early, can appear similar to neurasthenia symptoms: fatigue, weakness, insomnia, decline in reading performance, solitude, lazy life, apathy. Sometimes people mistakenly think that patients are not cheerful or have personality problems.
2, youth type: more common in adolescence, onset more urgent, mainly manifested in bizarre thinking, difficult to understand, emotional mood, behavioral naive, stupid, impulsive, sexual desire, appetite and so on.
3, paranoid type: more common in young adults or middle-aged, slow onset, initially manifested as sensitive and suspicious, such as feeling around people talking about themselves, rejecting themselves, will gradually firmly believe in their own ideas to form delusions, their behavior and Emotional activities are also dominated by hallucinations and delusions.
4, nervous type: rarely seen at present, mostly in young and middle-aged disease, onset faster, more common in the stupor state, the patient's speech movement inhibition, no drink or not, muscle tension fixed in a certain position, no response to the environment There will even be a sudden wake up, no intention to injure people, and then suddenly lie down.
5. Mixed type (undifferentiated type): Other schizophrenia patients who are difficult to classify as the above type 4, this type is the most common, accounting for about 60%.
Examine
Examination of mental disorders
Medical history : personal history and past history, physical and mental health, what diseases, conditions, how to cure, whether there are sequelae, whether there is smoking, alcoholism, drug use, history of poisoning.
Physical examination : by examining the body and nervous system examinations.
Basic examination : ECG, EEG, blood, urine routine, liver function.
Special examination : If there is a problem with the EEG, it is unclear what nature can be used for further CT scan. If the CT diagnosis is unclear, you can do MRI. Suspected that there is inflammation in the brain, it can be used for lumbar puncture to test cerebrospinal fluid. Suspected that the brain is not enough blood can do cerebral blood flow map.
Diagnosis
Diagnosis of mental disorders
Disease diagnosis
It mainly relies on the medical report and clinical observation, examination and analysis of people close to the patient. There is no objective diagnostic tool for mental disorders. The existing laboratory methods are only for the exclusion of organic diseases or the identification of physical illnesses that may cause certain mental disorder symptoms, and ultimately determine the nature of mental disorders or rely on clinical mental status examination and analysis. Since the 1960s, many psychological measurement methods and scales have appeared, but practice has proved that these can only be used as an auxiliary means for clinical observation and diagnosis, and the diagnosis cannot be determined solely by the scale.
