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History of psychiatry. Disorders of sensations and perception.

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History of psychiatry. Disorders of sensations and perception. Lyudmyla T. Snovyda. "A psychiatrist is a fellow who asks you a lot of expensive questions your wife asks for nothing" - Joey Adams. Psychiatry -. - PowerPoint PPT Presentation
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History of psychiatry. History of psychiatry. Disorders of Disorders of sensations and sensations and perception. perception. Lyudmyla T. Snovyda Lyudmyla T. Snovyda
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Page 1: History of psychiatry. Disorders of sensations and perception.

History of psychiatry. History of psychiatry. Disorders of sensations Disorders of sensations

and perception.and perception.

Lyudmyla T. SnovydaLyudmyla T. Snovyda

Page 2: History of psychiatry. Disorders of sensations and perception.

"A psychiatrist is a fellow who asks you a "A psychiatrist is a fellow who asks you a lot of expensive questions your wife asks lot of expensive questions your wife asks

for nothing" - Joey Adamsfor nothing" - Joey Adams

Page 3: History of psychiatry. Disorders of sensations and perception.

Psychiatry -Psychiatry - The term psychiatry, coined by Johann Christian Reil in The term psychiatry, coined by Johann Christian Reil in

1808, comes from the Greek “psyche” (soul or mind) and 1808, comes from the Greek “psyche” (soul or mind) and “iatros" (healer or doctor)“iatros" (healer or doctor)

Psychiatry is a medical specialty which exists to study, Psychiatry is a medical specialty which exists to study, prevent, and treat mental disorders in humans. Psychiatric prevent, and treat mental disorders in humans. Psychiatric assessment typically involves a mental status examination assessment typically involves a mental status examination and taking a case history, and psychological tests may be and taking a case history, and psychological tests may be administered. Physical examinations may be conducted administered. Physical examinations may be conducted and occasionally neuroimages or other neurophysiological and occasionally neuroimages or other neurophysiological measurements taken. Diagnostic procedures vary but measurements taken. Diagnostic procedures vary but official criteria are listed in manuals, the most common official criteria are listed in manuals, the most common being the ICD from the World Health Organization and the being the ICD from the World Health Organization and the

DSM from the American Psychiatric Association.DSM from the American Psychiatric Association.

Page 4: History of psychiatry. Disorders of sensations and perception.

Connection with other Connection with other specialities -specialities -

Those who practice psychiatry are different than most Those who practice psychiatry are different than most other mental health professionals and physicians in that other mental health professionals and physicians in that they must be familiar with both the social and biological they must be familiar with both the social and biological sciences. The discipline is interested in the operations of sciences. The discipline is interested in the operations of different organs and body systems as classified by the different organs and body systems as classified by the patient's subjective experiences and the objective patient's subjective experiences and the objective physiology of the patient. While the focus of psychiatry physiology of the patient. While the focus of psychiatry has changed little throughout time, the diagnostic and has changed little throughout time, the diagnostic and treatment processes have evolved dramatically and treatment processes have evolved dramatically and continue to do so. Since the late 20th century, the field continue to do so. Since the late 20th century, the field of psychiatry has continued to become more biological of psychiatry has continued to become more biological and less conceptually isolated from the field of and less conceptually isolated from the field of

medicine.medicine.

Page 5: History of psychiatry. Disorders of sensations and perception.

Connection with other Connection with other specialities -specialities -

While the medical specialty of psychiatry utilizes While the medical specialty of psychiatry utilizes research in the field of neuroscience, psychology, research in the field of neuroscience, psychology, medicine, biology, biochemistry, and pharmacology, medicine, biology, biochemistry, and pharmacology, it has generally been considered a middle ground it has generally been considered a middle ground between neurology and psychology. Unlike other between neurology and psychology. Unlike other physicians and neurologists, psychiatrists specialize physicians and neurologists, psychiatrists specialize in the doctor-patient relationship and are trained in in the doctor-patient relationship and are trained in the use of psychotherapy and other therepautic the use of psychotherapy and other therepautic communication techniques. Psychiatrists can communication techniques. Psychiatrists can therefore prescribe medication, order laboratory therefore prescribe medication, order laboratory tests, utilize neuroimaging in a clinical setting, and tests, utilize neuroimaging in a clinical setting, and conduct physical examinations.conduct physical examinations.

Page 6: History of psychiatry. Disorders of sensations and perception.

Ancient timesAncient times

Starting in the 5th century BC, mental disorders, Starting in the 5th century BC, mental disorders, especially those with psychotic traits, were considered especially those with psychotic traits, were considered supernatural in origin. This view existed throughout supernatural in origin. This view existed throughout ancient Greece and Rome. Early manuals written about ancient Greece and Rome. Early manuals written about mental disorders were created by the Greeks. In 4th mental disorders were created by the Greeks. In 4th century BC, Hippocrates theorized that physiological century BC, Hippocrates theorized that physiological abnormalities may be the root of mental disorders. abnormalities may be the root of mental disorders. Religious leaders and others returned to using early Religious leaders and others returned to using early versions of exorcisms to treat mental disorders which versions of exorcisms to treat mental disorders which often utilized cruel, harsh, and other barbarous often utilized cruel, harsh, and other barbarous methods.methods.

Page 7: History of psychiatry. Disorders of sensations and perception.

Ancient timesAncient times

Page 8: History of psychiatry. Disorders of sensations and perception.

Middle AgesMiddle Ages The first psychiatric hospitals were built in the medieval Islamic The first psychiatric hospitals were built in the medieval Islamic

world from the 8th century. The first was built in Baghdad in 705, world from the 8th century. The first was built in Baghdad in 705, followed by Fes in the early 8th century, and Cairo in 800. Unlike followed by Fes in the early 8th century, and Cairo in 800. Unlike medieval Christian physicians who relied on demonological medieval Christian physicians who relied on demonological explanations for mental illness, medieval Muslim physicians relied explanations for mental illness, medieval Muslim physicians relied mostly on clinical observations. They made significant advances to mostly on clinical observations. They made significant advances to psychiatry and were the first to provide psychotherapy and moral psychiatry and were the first to provide psychotherapy and moral treatment for mentally ill patients, in addition to other forms of treatment for mentally ill patients, in addition to other forms of treatment such as baths, drug medication, music therapy and treatment such as baths, drug medication, music therapy and occupational therapy. In the 10th century, the Persian physician occupational therapy. In the 10th century, the Persian physician Muhammad ibn Zakariya Razi (Rhazes) combined psychological Muhammad ibn Zakariya Razi (Rhazes) combined psychological methods and physiological explanations to provide treatment to methods and physiological explanations to provide treatment to mentally ill patients. His contemporary, the Arab physician Najab mentally ill patients. His contemporary, the Arab physician Najab ud-din Muhammad, first described a number of mental illnesses ud-din Muhammad, first described a number of mental illnesses such as agitated depression, neurosis, and sexual impotence such as agitated depression, neurosis, and sexual impotence (Nafkhae Malikholia), psychosis (Kutrib), and mania (Dual-Kulb).(Nafkhae Malikholia), psychosis (Kutrib), and mania (Dual-Kulb).

Page 9: History of psychiatry. Disorders of sensations and perception.

Middle AgesMiddle Ages In the 11th century, another Persian physician Avicenna In the 11th century, another Persian physician Avicenna

recognized 'physiological psychology' in the treatment of recognized 'physiological psychology' in the treatment of illnesses involving emotions, and developed a system for illnesses involving emotions, and developed a system for associating changes in the pulse rate with inner feelings, associating changes in the pulse rate with inner feelings, which is seen as a precursor to the word association test which is seen as a precursor to the word association test developed by Carl Jung in the 19th century.Avicenna was developed by Carl Jung in the 19th century.Avicenna was also an early pioneer of neuropsychiatry, and first also an early pioneer of neuropsychiatry, and first described a described a

number of neuropsychiatric conditions such as number of neuropsychiatric conditions such as hallucination, hallucination, insomnia, mania, nightmare, melancholia, insomnia, mania, nightmare, melancholia, dementia, epilepsy, paralysis, stroke, dementia, epilepsy, paralysis, stroke, vertigo and tremor.vertigo and tremor.

Page 10: History of psychiatry. Disorders of sensations and perception.

Middle AgesMiddle Ages

Psychiatric hospitals were built in medieval Europe from Psychiatric hospitals were built in medieval Europe from the 13th century to treat mental disorders but were the 13th century to treat mental disorders but were utilized only as custodial institutions and did not provide utilized only as custodial institutions and did not provide any type of treatment.Founded in the 13th century, any type of treatment.Founded in the 13th century, Bethlem Royal Hospital in London is one of the oldest Bethlem Royal Hospital in London is one of the oldest psychiatric hospitals. By 1547 the City of London psychiatric hospitals. By 1547 the City of London acquired the hospital and continued its function until acquired the hospital and continued its function until 1948.1948.

Page 11: History of psychiatry. Disorders of sensations and perception.

Early modern periodEarly modern period In 1656, Louis XIV of France created a public system of In 1656, Louis XIV of France created a public system of

hospitals for those suffering from mental disorders, but hospitals for those suffering from mental disorders, but as in England, no real treatment was being applied. as in England, no real treatment was being applied. Thirty years later the new ruling monarch in England, Thirty years later the new ruling monarch in England, George III, was known to be suffering from a mental George III, was known to be suffering from a mental disorder. Following the King's remission in 1789, mental disorder. Following the King's remission in 1789, mental illness was seen as something which could be treated illness was seen as something which could be treated and cured. and cured.

Page 12: History of psychiatry. Disorders of sensations and perception.

Early modern periodEarly modern period By 1792 French physician Philippe Pinel introduced By 1792 French physician Philippe Pinel introduced

humane treatment approaches to those suffering from humane treatment approaches to those suffering from mental disorders. William Tuke adopted the methods mental disorders. William Tuke adopted the methods outlined by Pinel and that same year Tuke opened the outlined by Pinel and that same year Tuke opened the York Retreat in England. That institution became known York Retreat in England. That institution became known as a model throughout the world for humane and moral as a model throughout the world for humane and moral treatment of patients suffering from mental disorders. It treatment of patients suffering from mental disorders. It inspired similar institutions in the United States, most inspired similar institutions in the United States, most notably the Brattleboro Retreat and the Hartford Retreat notably the Brattleboro Retreat and the Hartford Retreat (now the Institute of Living).(now the Institute of Living).

Page 13: History of psychiatry. Disorders of sensations and perception.

19th century19th century Universities often played a part in the administration of Universities often played a part in the administration of

the asylums. Due to the relationship between the the asylums. Due to the relationship between the universities and asylums, scores of competitive universities and asylums, scores of competitive psychiatrists were being molded in Germany. Germany psychiatrists were being molded in Germany. Germany became known as the world leader in psychiatry during became known as the world leader in psychiatry during the nineteenth century. The country possessed more than the nineteenth century. The country possessed more than 20 separate universities all competing with each other for 20 separate universities all competing with each other for scientific advancement. However, because of Germany's scientific advancement. However, because of Germany's individual states and the lack of national regulation of individual states and the lack of national regulation of asylums, the country had no organized centralization of asylums, the country had no organized centralization of asylums or psychiatry.Britain, like Germany, also lacked a asylums or psychiatry.Britain, like Germany, also lacked a centralized organization for the administration of asylums. centralized organization for the administration of asylums. This deficit hindered the diffusion of new ideas in This deficit hindered the diffusion of new ideas in medicine and psychiatry.medicine and psychiatry.

Page 14: History of psychiatry. Disorders of sensations and perception.

19th century19th century In the United States in 1834, Anna Marsh, a physician's In the United States in 1834, Anna Marsh, a physician's

widow, deeded the funds to build her country's first widow, deeded the funds to build her country's first financially-stable private asylum. The Brattleboro financially-stable private asylum. The Brattleboro Retreat marked the beginning of America's private Retreat marked the beginning of America's private psychiatric hospitals challenging state institutions for psychiatric hospitals challenging state institutions for patients, funding, and influence. Although based on patients, funding, and influence. Although based on England's York Retreat, it would be followed by England's York Retreat, it would be followed by speciality institutions of every treatment philosophy.speciality institutions of every treatment philosophy.

In 1838, France enacted a law to regulate both the In 1838, France enacted a law to regulate both the admissions into asylums and asylum services across the admissions into asylums and asylum services across the country. By 1840, asylums as therapeutic institutions country. By 1840, asylums as therapeutic institutions existed throughout Europe and the United States.existed throughout Europe and the United States.

Page 15: History of psychiatry. Disorders of sensations and perception.

19th century19th century However, the new and dominating ideas that mental However, the new and dominating ideas that mental

illness could be "conquered" during the mid-nineteenth illness could be "conquered" during the mid-nineteenth century all came crashing down. Psychiatrists and century all came crashing down. Psychiatrists and asylums were being pressured by an ever increasing asylums were being pressured by an ever increasing patient population. Overcrowding was rampant in patient population. Overcrowding was rampant in France where asylums would commonly take in double France where asylums would commonly take in double their maximum capacity. Increases in asylum their maximum capacity. Increases in asylum populations may have been a result of the transfer of populations may have been a result of the transfer of care from families and poorhouses, .care from families and poorhouses, .

Page 16: History of psychiatry. Disorders of sensations and perception.

19th century19th century but the specific reasons as to why the increase occurred but the specific reasons as to why the increase occurred

is still debated today. No matter the cause, the pressure is still debated today. No matter the cause, the pressure on asylums from the increase was taking its toll on the on asylums from the increase was taking its toll on the asylums and psychiatry as a specialty. Asylums were asylums and psychiatry as a specialty. Asylums were once again turning into custodial institutions and the once again turning into custodial institutions and the reputation of psychiatry in the medical world had hit an reputation of psychiatry in the medical world had hit an extreme low.extreme low.

Page 17: History of psychiatry. Disorders of sensations and perception.

20th century20th century The 20th century introduced a new psychiatry into the The 20th century introduced a new psychiatry into the

world. The different perspectives of looking at mental world. The different perspectives of looking at mental disorders began to be introduced. The career of Emil disorders began to be introduced. The career of Emil Kraepelin somewhat model this hiatus of psychiatry Kraepelin somewhat model this hiatus of psychiatry between the different disciplines. between the different disciplines.

Page 18: History of psychiatry. Disorders of sensations and perception.

20th century20th century Kraepelin initially was very attracted to psychology and Kraepelin initially was very attracted to psychology and

ignored the ideas of anatomical psychiatry. Following ignored the ideas of anatomical psychiatry. Following his acceptance for a professorship of psychiatry, and his acceptance for a professorship of psychiatry, and later his work in a university psychiatric clinic, later his work in a university psychiatric clinic, Kraepelin's interest in pure psychology began to fade Kraepelin's interest in pure psychology began to fade and he introduced a plan of a more comprehensive and he introduced a plan of a more comprehensive psychiatry.Kraepelin also began to study and promote psychiatry.Kraepelin also began to study and promote the ideas of disease classification for mental disorders, the ideas of disease classification for mental disorders, an idea introduced by Karl Ludwig Kahlbaum.an idea introduced by Karl Ludwig Kahlbaum.

Page 19: History of psychiatry. Disorders of sensations and perception.

20th century20th century The initial ideas behind biological psychiatry, stating The initial ideas behind biological psychiatry, stating

that these different disorders were all biological in that these different disorders were all biological in nature, evolved into a new idea of "nerves" and nature, evolved into a new idea of "nerves" and psychiatry became a sort of rough neurology or psychiatry became a sort of rough neurology or neuropsychiatry. Following Sigmund Freud's death, neuropsychiatry. Following Sigmund Freud's death, ideas stemming from psychoanalytic theory also began ideas stemming from psychoanalytic theory also began to take root. The psychoanalytic theory became popular to take root. The psychoanalytic theory became popular among psychiatrists because it allowed the patients to among psychiatrists because it allowed the patients to be treated in private practices instead of asylums. be treated in private practices instead of asylums. However the progress of psychiatry by the 1970s turned However the progress of psychiatry by the 1970s turned psychoanalytic theory into a marginal school of thought psychoanalytic theory into a marginal school of thought within the field.within the field.

Page 20: History of psychiatry. Disorders of sensations and perception.

20th century20th century ECT was "discovered" when Ugo Cerletti, psychiatrist, ECT was "discovered" when Ugo Cerletti, psychiatrist,

visited a Rome slaughterhouse to see what could be visited a Rome slaughterhouse to see what could be learned from the method that was employed to butcher learned from the method that was employed to butcher hogs. In Cerletti's own words, "As soon as the hogs were hogs. In Cerletti's own words, "As soon as the hogs were clamped by the [electric] tongs, they fell unconscious, clamped by the [electric] tongs, they fell unconscious, stiffened, then after a few seconds they were shaken by stiffened, then after a few seconds they were shaken by convulsions.... During this period of unconsciousness convulsions.... During this period of unconsciousness (epileptic coma), the butcher stabbed and bled the (epileptic coma), the butcher stabbed and bled the animals without difficulty....animals without difficulty....

Page 21: History of psychiatry. Disorders of sensations and perception.

20th century20th century "At this point I felt we could venture to experiment on man, and I "At this point I felt we could venture to experiment on man, and I

instructed my assistants to be on the alert for the selection of a instructed my assistants to be on the alert for the selection of a suitable subject."suitable subject."

Cerletti's first victim was provided by the local police - a man Cerletti's first victim was provided by the local police - a man described by Cerletti as "lucid and well-oriented." After surviving described by Cerletti as "lucid and well-oriented." After surviving the first blast without losing consciousness, the victim overheard the first blast without losing consciousness, the victim overheard Cerletti discussing a second application with a higher voltage. Cerletti discussing a second application with a higher voltage. He begged Cerletti, "Non una seconda! Mortifierel" ("Not another He begged Cerletti, "Non una seconda! Mortifierel" ("Not another one! It will kill me!")one! It will kill me!")

Ignoring the objections of his assistants, Cerletti increased the Ignoring the objections of his assistants, Cerletti increased the voltage and duration and fired again. With the "successful" voltage and duration and fired again. With the "successful" electrically induced convulsion of his victim, Ugo Cerletti brought electrically induced convulsion of his victim, Ugo Cerletti brought about the application of hog-slaughtering skills to humans, about the application of hog-slaughtering skills to humans,

creating one of the most brutal techniques of psychiatrycreating one of the most brutal techniques of psychiatry..

Page 22: History of psychiatry. Disorders of sensations and perception.

20th century20th century LobotomyLobotomy

Lobotomy is a surgical practice where parts of the Lobotomy is a surgical practice where parts of the frontal lobes are intentionally destroyed. Violent frontal lobes are intentionally destroyed. Violent criminals calm down, highly depressed people don't criminals calm down, highly depressed people don't seem so depressed any longer, and manics finally seem so depressed any longer, and manics finally mellow out. But they wander aimlessly, drool mellow out. But they wander aimlessly, drool uncontrollably, and have very little left of whatever uncontrollably, and have very little left of whatever "personality" they once had. If the goal is calm, quiet, "personality" they once had. If the goal is calm, quiet, and "nice" people, then it's a roaring success. and "nice" people, then it's a roaring success.

Page 23: History of psychiatry. Disorders of sensations and perception.

20th century20th century This period of time saw the reemergence of biological This period of time saw the reemergence of biological

psychiatry. Psychopharmacology became an integral part of psychiatry. Psychopharmacology became an integral part of psychiatry starting with Otto Loewi's discovery of the first psychiatry starting with Otto Loewi's discovery of the first neurotransmitter, acetylcholine. Neuroimaging was first utilized neurotransmitter, acetylcholine. Neuroimaging was first utilized as a tool for psychiatry in the 1980s. The discovery of as a tool for psychiatry in the 1980s. The discovery of chlorpromazine's effectiveness in treating schizophrenia in 1952 chlorpromazine's effectiveness in treating schizophrenia in 1952 revolutionized treatment of the disease, as did lithium revolutionized treatment of the disease, as did lithium carbonate's ability to stabilize mood highs and lows in bipolar carbonate's ability to stabilize mood highs and lows in bipolar disorder in 1948. While psychosocial issues were still seen as disorder in 1948. While psychosocial issues were still seen as valid, psychotherapy was seen to be their "cure." Genetics were valid, psychotherapy was seen to be their "cure." Genetics were once again thought to play a role in mental illness. Molecular once again thought to play a role in mental illness. Molecular biology opened the door for specific genes contributing mental biology opened the door for specific genes contributing mental disorders to be identified. By 1995 genes contributing to disorders to be identified. By 1995 genes contributing to schizophrenia had been identified on chromosome 6 and genes schizophrenia had been identified on chromosome 6 and genes contributing to bipolar disorder on chromosomes 18 and 21contributing to bipolar disorder on chromosomes 18 and 21

Page 24: History of psychiatry. Disorders of sensations and perception.

SensationSensation – – the most the most elementary stage, elementary stage, which reflects which reflects separate separate

quality of subject, which is acting in right moment to quality of subject, which is acting in right moment to sensory organs.sensory organs.

ClassificationClassification : : According to modality:According to modality: InteroceptiveInteroceptive – give signal about condition of our inner – give signal about condition of our inner

world: warm, cold, hunger, uncomfortability. These world: warm, cold, hunger, uncomfortability. These sensastions don’t have localisation, outside proection, sensastions don’t have localisation, outside proection, closely connected with emotional processes. closely connected with emotional processes.

ExteroceptiveExteroceptive – 5 sensation organs: smell, taste, sight, – 5 sensation organs: smell, taste, sight, hearing, tactile.hearing, tactile.

ProprioceptiveProprioceptive – information about body position, – information about body position, movement in space, everything which makes body scheme.movement in space, everything which makes body scheme.

Page 25: History of psychiatry. Disorders of sensations and perception.

SensationSensation – – AnesthesiaAnesthesia – absence of 1 or more type of – absence of 1 or more type of

sensation. sensation. AnalgesiaAnalgesia – loss of pain sensation ( at – loss of pain sensation ( at acute psychopathological diseases.) Patients, who acute psychopathological diseases.) Patients, who commit suicides: they cut their organs – at such commit suicides: they cut their organs – at such moment they don’t feel anything. After some time moment they don’t feel anything. After some time everything comes back with recreation of psyche. everything comes back with recreation of psyche. ( At deep depression, progressive paralysis, brain ( At deep depression, progressive paralysis, brain syphillis, convulsive disorders(hysteria), syphillis, convulsive disorders(hysteria), anaestesia anaestesia dolorosa depresia – absense of sensationdolorosa depresia – absense of sensation).).

HyperesthesiaHyperesthesia – subjective increasing of – subjective increasing of sensation. sensation. HyperalgesiaHyperalgesia – increasing of pain – increasing of pain sensastion (depression,espessially light).sensastion (depression,espessially light).

Page 26: History of psychiatry. Disorders of sensations and perception.

SensationSensation – – Optical hyperesthesiaOptical hyperesthesia – daily light blind a man. – daily light blind a man. Acustical h-siaAcustical h-sia – changes of – changes of perceptionperception threshold. Light sound threshold. Light sound

percept as strong one even to pain. This is sign of expercept as strong one even to pain. This is sign of exhhaustionaustion, , asthenic conditions.asthenic conditions.

Taste, smellTaste, smell – complains on increasing of these sensations. It – complains on increasing of these sensations. It could be at normal conditions. could be at normal conditions.

Skin sensationsSkin sensations – tactile and temperature. Touch to a body is – tactile and temperature. Touch to a body is unpleasantunpleasant..

ParesthesiaParesthesia – – distortion sensations.distortion sensations.

Page 27: History of psychiatry. Disorders of sensations and perception.

SenestopathySenestopathy – – psychosomatic sensation. It has such psychosomatic sensation. It has such signs:signs:

..Polymorphism of sensations (pain, Polymorphism of sensations (pain, heartburn, heartburn, electrisationelectrisation).).

..Sign which differentiates it from general somatic signs – Sign which differentiates it from general somatic signs – there are complains, but they don’t have any localization, there are complains, but they don’t have any localization, intensity, patients cannot explain them.intensity, patients cannot explain them.

It has matter during mask depression diagnostic: sen.-as cardio-It has matter during mask depression diagnostic: sen.-as cardio-vascular, central – neurotic, abdominal, skin- underskin, bone – vascular, central – neurotic, abdominal, skin- underskin, bone – muscle.muscle.

They could be: They could be: permanent, episodical, as attack (sen.- crisis). permanent, episodical, as attack (sen.- crisis). Accompanied with panic, vegetative disorders. They begin with Accompanied with panic, vegetative disorders. They begin with simple sen., after that they become very hard.simple sen., after that they become very hard.

Elementary senElementary sen.- those, which doesn’t have sensor modality .- those, which doesn’t have sensor modality (“my sole is trembling”).(“my sole is trembling”).Simple sen. – Simple sen. – concrete modalityconcrete modality – – pain, pain, parasthesias.parasthesias.

Page 28: History of psychiatry. Disorders of sensations and perception.

Senesthesia – Senesthesia – various disorders of various disorders of movement, which has subjective character, movement, which has subjective character, which are not confirm with objective which are not confirm with objective investigations (“my legs and arms are not investigations (“my legs and arms are not listening to me”).listening to me”).

Sinesthesia – Sinesthesia – appear as a result of action appear as a result of action of different sensation organs “colored of different sensation organs “colored music”. Smell calls some other sensation. music”. Smell calls some other sensation. Name of the person- some color etc.Name of the person- some color etc.

Page 29: History of psychiatry. Disorders of sensations and perception.

PERCEPTION - PERCEPTION - - - reflection of object in general.reflection of object in general. Classification: splitting, illusions, pseudohallucinations, Classification: splitting, illusions, pseudohallucinations,

hallucinations, eydetysm, disorder of sensor synthesis, hallucinations, eydetysm, disorder of sensor synthesis, hallucinoids.hallucinoids.

DoubleDouble - loss of capacity of whole object formulation. He - loss of capacity of whole object formulation. He percept normally object, but couldn’t join it together. Ex.- tree – percept normally object, but couldn’t join it together. Ex.- tree – it’s separately leaves, trunk etc. At infectious diseases.it’s separately leaves, trunk etc. At infectious diseases.

IllusionsIllusions – false perception of real existent object. – false perception of real existent object. Affective ill.- affect of fear, anxious, horror, connected with Affective ill.- affect of fear, anxious, horror, connected with

special emotional condition.special emotional condition. Verbal ill.- words, phrases are percept Verbal ill.- words, phrases are percept in place of real. in place of real. Pareydolia Pareydolia – optical illusions with fantastic content. Various – optical illusions with fantastic content. Various

objects which don’t have forms are seen in various pictures.objects which don’t have forms are seen in various pictures.

Page 30: History of psychiatry. Disorders of sensations and perception.

PERCEPTION - PERCEPTION - --

Page 31: History of psychiatry. Disorders of sensations and perception.

PERCEPTION - PERCEPTION - - - HallucinationHallucination – perception without object,which acts – perception without object,which acts

on sense organs.on sense organs. Visual.Visual. Simple – Simple – photopsiasphotopsias. Complex – have subject content – . Complex – have subject content –

zoological, demanomanic, antropomorphic(close people, zoological, demanomanic, antropomorphic(close people, dead people, body pieces, inner organs), panoramic- dead people, body pieces, inner organs), panoramic- ground, atomic explosure).etcground, atomic explosure).etc

Acustical.Acustical. Simple – sounds. Simple – sounds. Complex – comment, imperative, stereotypical – during Complex – comment, imperative, stereotypical – during

some time they hear same words or phrases.some time they hear same words or phrases.

Page 32: History of psychiatry. Disorders of sensations and perception.

PERCEPTION - PERCEPTION - - - Smell, tasteSmell, taste – when they don’t take food. – when they don’t take food. SkinSkin – tactile(touching,pressure, insects under skin, hair in the – tactile(touching,pressure, insects under skin, hair in the

mouth)etc.mouth)etc. Interoceptive, visceralInteroceptive, visceral – inside of the body animals, different – inside of the body animals, different

objects.objects. KinesteticalKinestetical – feel, like fingers are compressed in a fist, run – feel, like fingers are compressed in a fist, run

somewhere.somewhere. VestibularVestibular – feeling of falling, lifting. – feeling of falling, lifting. Symptom of twinSymptom of twin – feeling of body splitting. – feeling of body splitting. HypnogogicHypnogogic – in condition of falling asleep. – in condition of falling asleep. HypnopompicHypnopompic –in condition of getting up. –in condition of getting up. Affectogenic hAffectogenic h.- in condition of strss, affect..- in condition of strss, affect. InductiveInductive – they have collective character. There is inductor and the – they have collective character. There is inductor and the

person to whom induct. If we separate them we understand who is ill.person to whom induct. If we separate them we understand who is ill.

Page 33: History of psychiatry. Disorders of sensations and perception.

PERCEPTION - PERCEPTION - S-m Lippman, s-m Ashaphenburg, s-m Reyhardt.S-m Lippman, s-m Ashaphenburg, s-m Reyhardt.

Page 34: History of psychiatry. Disorders of sensations and perception.

PERCEPTION - PERCEPTION - PSEUDOHALLUCINATIONS.PSEUDOHALLUCINATIONS. At first was described by At first was described by

Candinskyy in 1890.Candinskyy in 1890. Pequliarities :Pequliarities :

..False objects, which are experience, such as False objects, which are experience, such as going in space ”see by mind, by inner eye, i can going in space ”see by mind, by inner eye, i can see by brain, hear by inner ear”.see by brain, hear by inner ear”.

..They have obusive character, appear suddenly, They have obusive character, appear suddenly, agains patients will. Feeling of self activity agains patients will. Feeling of self activity accompanied by someones action.accompanied by someones action.

..They don’t have objective reality, don’t mix with They don’t have objective reality, don’t mix with reality.reality.

..Difference between real and pseudohallucination.Difference between real and pseudohallucination.

Page 35: History of psychiatry. Disorders of sensations and perception.

PERCEPTION - PERCEPTION - As a rule, at pseudoh. We can see changes in behavior – As a rule, at pseudoh. We can see changes in behavior –

apsence of signs on outside world.apsence of signs on outside world. There are some objective signs: they watching or There are some objective signs: they watching or

listening to smth, close ears, nose, touch smth. They listening to smth, close ears, nose, touch smth. They hide somewhere, looking for smth, catching smth, run hide somewhere, looking for smth, catching smth, run somewhere- real.somewhere- real.

In pseudoh. – absence of attention on In pseudoh. – absence of attention on surrounding.surrounding.

Page 36: History of psychiatry. Disorders of sensations and perception.

PERCEPTION - PERCEPTION -

Page 37: History of psychiatry. Disorders of sensations and perception.

PERCEPTION - PERCEPTION - Hallucinoids Hallucinoids – – rudimentary display of rudimentary display of

visual h. Prestage of real h. Patients have visual h. Prestage of real h. Patients have some critics to them. It’s not h.-on, but it’s some critics to them. It’s not h.-on, but it’s not normal.not normal.

Eydetysm(Eydetysm(eidetic memoryeidetic memory)) – Man capacity to – Man capacity to hold for a long time some object, pictures. hold for a long time some object, pictures. As a rule visual, but could be auditorial and As a rule visual, but could be auditorial and tactile. Phenomenal visual memory.tactile. Phenomenal visual memory.

Page 38: History of psychiatry. Disorders of sensations and perception.

PERCEPTION - PERCEPTION - Depersonalization – is a nonspecific feeling that a

person has lost his or her identity, that the self is different or unreal. People may be concerned that body parts do not belong to them. People may have an acute sensation that their body has drastically changed.

Derealization – is the false perception by a person that the environment has changed. For example, everything seems bigger or smaller, or familiar surroundings have become somehow strange and familiar.

Page 39: History of psychiatry. Disorders of sensations and perception.

PERCEPTION - PERCEPTION - – DISORDER OF SENSORIAL SYNTHESISDISORDER OF SENSORIAL SYNTHESIS (psychosensorial (psychosensorial

disorders) – perception disorder of form, size, objects, disorders) – perception disorder of form, size, objects, oneself. oneself. On abolition from illusion there is no disorder of On abolition from illusion there is no disorder of identity of subject.identity of subject.

Metamorphosias Metamorphosias – perception disorder of form and size. – perception disorder of form and size. They are bigger – They are bigger – macropsiamacropsia or smaller – or smaller – micropsia.micropsia.

Dysmehalopsia – Dysmehalopsia – twisted.twisted. PaliopsiaPaliopsia – on abolition of 1 object – there a lot of them. – on abolition of 1 object – there a lot of them. Disorders of body scheme – Disorders of body scheme – autometamorphopsia. autometamorphopsia.

Macropsia – Macropsia – increasing (Huliver), increasing (Huliver), micropsiamicropsia –decreasing –decreasing (lilliputian).(lilliputian).

Disorders of time perception – increasing of time speedDisorders of time perception – increasing of time speed((at at manic patientsmanic patients)), decreasing of time speed(at depressive , decreasing of time speed(at depressive patients).patients).

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PERCEPTION - PERCEPTION -

Page 41: History of psychiatry. Disorders of sensations and perception.

–Thank you for your Thank you for your attention!attention!


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