Introduction to Psychiatry

University:
Stanford University
Course:
MED 101 | Human Anatomy
Academic year:

2024
Views:

175

Pages:

1
Author:

larbi43100

INTRODUCTION TO PSYCHIATRY PART 1 – NEUROSIS VERSUS PSYCHOSIS Fundamental concepts Nothing being simple in psychiatry, it is absolutely necessary to limit oneself to a very superficial, and therefore questionable, approach to the different concepts. The vocabulary is also very fluid, which is why we will preferentially use terms which, although not at the cutting edge of psychiatry, have the advantage of being intelligible. As examples: paranoia is not synonymous with paranoid personality; the term neurosis has disappeared from the DSM (see the bibliography) since 1980; hysteria is mainly conversion, but the concept of anxiety hysteria also circulates. Even its status as a neurosis does not seem exclusive since some psychiatrists speak of hysterical psychosis. -Neurosis –The term neurosis was coined around 1770 by the Scottish physician William Cullen. A neurosis (or neurotic syndrome) is characterized by: the existence of disorders with psychological and/or somatic and/or behavioral expression; relatively superficial, plastic and sometimes reversible disorders; the absence of currently detectable anatomical or physiological lesions or disturbances; the fact that the subject recognizes his symptoms as pathological and possibly requests their disappearance; the persistence of the “reality system”; relative good social and professional adaptation (except in extreme cases); their sensitivity, although variable, to non-drug therapies (psychotherapy, hypnosis, etc.). Among the neuroses, we will briefly describe anxiety neurosis, phobic neurosis, obsessive neurosis and conversion hysteria. -Psychosis–The term psychosis was apparently coined by the Austrian physician Ernst von Feuchtersleben in 1845. Unlike the neurotic subject, the psychotic patient is not aware of his disorder, and he even denies its existence more or less categorically: he has therefore lost part of the sense of reality. Psychoses are therefore more serious illnesses than neuroses, and it is much more difficult to obtain active participation from the patient in their treatment. Unlike neuroses which are only functional disorders (no identifiable lesion), psychoses can certainly also be organic (brain lesion). Among the psychoses, we will briefly describe paranoid psychosis, manic-depressive psychosis, and schizophrenia (this in a separate chapter).