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Mental Illness Mental disorders can be classified under two headings: Classification Description Organic These disorders are caused by, or associated with, disease of the brain tissue. An example of an organic disorder is a tumour Functional There is no clear physical cause for these disorders. They can result from an individual’s inability to adapt to his/her environment Organic mental illness Organic mental disorders are those caused by or associated with disease of the brain tissue. They may be acute, chronic or congenital. Classification Description Organic acute Acute organic brain disease is due to infection, trauma or tumour Organic chronic Chronic organic brain disease can be due to blood clots from the neck arteries. It occurs in the elderly and is usually irreversible. Chronic organic brain diseases include senile dementia and alzheimer’s disease Chronic congenital Children born with brain damage such as Downs Syndrome may have difficulty with gait and speech. This is often accompanied by mental impairment Functional mental illness Some people are more prone to functional mental illness than others. Psychiatrists have put forward some reasons for this. Various personality types are identified as being at risk. Examples are: Personality type Definition Obsessive The person is compulsive, a perfectionist, unable to relax Hysterical The person is excitable, emotional Inadequate The person has chronic dependence on others Paranoid The person is hypersensitive, suspicious The two main areas of functional disorder are psychoneurosis and psychosis. Psychoneurosis This refers to a group of disorders involving disturbed emotional responses, but lacking gross impairment of judgement. The person is aware (generally) that something is wrong and their reasoning is not impaired. Psychoneurosis is often due to circumstances such as bereavement, divorce, moving home, etc. It is a reactive disorder. It can present itself in several ways: Reaction Description Anxiety neurosis Intense prolonged anxiety, depression, nausea and insomnia Phobic reactions Unrealistic fears concerning particular situations or aspects, for example, fear of snakes, cancer phobia, etc ● Faulty home environment (for example, an alcoholic father) ● History of mental illness in a parent ● Only child These are generally reactive disorders. ● Only boy in a family of girls Psychosis The human personality is the basis for all functional mental disorders. It develops from the person’s genetic composition and the environment to which he/she is exposed, particularly in childhood. Persistent recurrence of irrational acts or Obsessive compulsive neurosis thoughts In psychotics, the disturbance of the mind is so great there may be a disintegration of the personality. They are unaware of anything being wrong and lose touch with reality. During acute attacks, odd behaviour occurs. This condition is generally not a reaction to circumstances and frequently no external cause can be identified. When there are defects in the personality development, disorders can occur. 46 Understanding underwriting 106027357.indd 46 06/10/14 9:47 am Psychosis can present itself in several ways. Psychotic group Description Manic depressive psychosis Main symptoms are elation (excitement), talkative, tireless etc. There may also be bouts of deep depression (bi-polar disorder) Melancholia Severe state of depression which occurs after the age of 45. Symptoms are weeping, pessimism, irritability etc Schizophrenia Symptoms are delusions, hallucinations etc. Schizophrenia means split personality. The person has a tendency to withdraw from reality. Thought problems and disorientation are also characteristic Alcoholic psychoses A group of disorders caused by alcoholic abuse. They can include symptoms like delirium, convulsions, terrifying hallucinations and memory loss Pathologic intoxication Affects people who only drink moderate amounts of alcohol. It causes a confused, disorientated state with subsequent amnesia or memory loss. Methods to investigate whether a patient is suffering from psychosis are as follows: Method Description Consultation A doctor talks to the patient to ascertain their current mental state. A psychiatrist may be consulted Electroencephalogram (EEG) This will show the electrical activity of the brain, and reveal any excessive or abnormal activity. This is only used occasionally People in some psychotic groups have a high suicide rate. Treatments for this include ● Hypnotics (sleeping tablets) ● Anti-depressants ● Anxiolytics These drugs can give relief and control of symptoms. However, some may be addictive and some of the stronger drugs for psychosis may produce side effects. Other treatments include: ● Electro-convulsive therapy (ECT). Electrodes are placed on the head and electric waves are passed through the brain to treat intractable depression ● Hospitalisation aviva.co.uk 47 106027357.indd 47 06/10/14 9:47 am