Subject and task of psychiatry and narcology. History of development

and modern state of psychiatry and narcology. Psychonosology and diseases. Principles of therapy,

prophylaxis and rehabilitation of psychiatrical disorders. Pathology of

cognitive processes. Disorders of sensations, perceptions. Disorders of

memory.

"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

Basic Terms in PsychiatryBasic Terms in Psychiatry Psychiatry Psychiatry studies the causes of mental disorders, gives studies the causes of mental disorders, gives

their description, predicts their future course and their description, predicts their future course and outcome, looks for prevention of their appearance and outcome, looks for prevention of their appearance and presents the best ways of their treatmentpresents the best ways of their treatment

PsychopathologyPsychopathology describes symptoms of mental describes symptoms of mental disordersdisorders

Special psychiatrySpecial psychiatry is devoted to individual mental is devoted to individual mental diseasesdiseases

General psychiatryGeneral psychiatry studies psychopathological studies psychopathological phenomena, symptoms of abnormal states of mind:phenomena, symptoms of abnormal states of mind:

1. consciousness1. consciousness 5. mood (emotions)5. mood (emotions)2. perception2. perception 6. intelligence6. intelligence3. thinking3. thinking 7. 7. motormotor4. memory4. memory 8. personality8. personality

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

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

Psychiatry is a medical specialty which exists to Psychiatry is a medical specialty which exists to study, prevent, and treat mental disorders in study, prevent, and treat mental disorders in humans. Psychiatric assessment typically humans. Psychiatric assessment typically involves a mental status examination and taking involves a mental status examination and taking a case history, and psychological tests may be a case history, and psychological tests may be administered. Physical examinations may be administered. Physical examinations may be conducted and occasionally neuroimages or conducted and occasionally neuroimages or other neurophysiological measurements taken. other neurophysiological measurements taken.

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.

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.

Ancient timesAncient times

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).

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

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.

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.

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).

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.

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

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

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

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, .

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.

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.

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.

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.

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....

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..

20th century20th century 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.

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.

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).

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.

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.

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.

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.

PERCEPTION - 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.

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.

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

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.

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.

PERCEPTION - 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.

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.

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).

PERCEPTION - PERCEPTION -

Memory - Memory -

is considered by psychologists as is considered by psychologists as kind of activity, which provides kind of activity, which provides memorizing, keeping, retention, memorizing, keeping, retention, forgetting. It gives opportunity to forgetting. It gives opportunity to gather the information and on gather the information and on basis of basis of experience to use it later.experience to use it later.

Basic processes (functions) of Basic processes (functions) of memory: memory:

Memorizing of information (fixing);Memorizing of information (fixing); Saving or maintenance of Saving or maintenance of

information (information (RETENSIONRETENSION););

Recreation of information Recreation of information (reproduction);(reproduction);

ForgettingForgetting of information. of information.

Memory Memory is divided into three is divided into three kinds or stages: kinds or stages:

sensory memory, sensory memory, short-term memory, short-term memory,

and and long-term long-term

memorymemory

Disorders of memory:Disorders of memory:

Quantative disorders:Quantative disorders: Hypomnesia – decreasing of Hypomnesia – decreasing of

memorymemory Hypermnesia – increasing of Hypermnesia – increasing of

memorymemory Amnesia – loss of memoryAmnesia – loss of memory Paramnesia – memory distortionParamnesia – memory distortion

Types of Types of amnesiaamnesiass

FixativeFixative– loss of capacity to memorise – loss of capacity to memorise new or certain new or certain events. Previous events events. Previous events are kept in memory.are kept in memory.

Progressive amnesiaProgressive amnesia – – gradually gradually decreasing of memory. decreasing of memory.

Ribo LawRibo Law:: Memory is Memory is suffers from lately suffers from lately acquired to that, which was acquired acquired to that, which was acquired before. The most longer kinesthetic and before. The most longer kinesthetic and emotional memory are keptemotional memory are kept in storage. in storage.

Types of Types of amnesiaamnesiass RetrogradeRetrograde– loss of memory on events which took – loss of memory on events which took

place before psychosis or disorder of consciousness. place before psychosis or disorder of consciousness. Could last on few seconds, minutes, months, years.Could last on few seconds, minutes, months, years.

Anterograde -Anterograde - loss of memory on the events, which loss of memory on the events, which took place after psychosis or disorder of took place after psychosis or disorder of consciousness.consciousness.

Retroanterograde – Retroanterograde – before and after psychosis or before and after psychosis or disorder of consciousness.disorder of consciousness.

CongradeCongrade – loss of memory on period of absence of – loss of memory on period of absence of consciousness.consciousness.

TotalTotal Fragmentive – Fragmentive – during delirium.during delirium. RetardedRetarded– after some time of psychosis.– after some time of psychosis.

Types of Types of amnesiaamnesiass Specific alcoholic - palimpsestSpecific alcoholic - palimpsest – special sign for – special sign for

early alcoholism. Its a loss of memory on some details early alcoholism. Its a loss of memory on some details during alcohol drinking.during alcohol drinking.

Amnestic disorientationAmnestic disorientation – one of the main – one of the main components of Korsakoffs psychosis, as result of brain components of Korsakoffs psychosis, as result of brain trauma, atherosclerotic changes, at intoxication, trauma, atherosclerotic changes, at intoxication, poisoning by COpoisoning by CO..

Affectogenic– dAffectogenic– during pathological affect, connected uring pathological affect, connected with stress, psychotrauma.with stress, psychotrauma.

Amnesias may occur during disorders of Amnesias may occur during disorders of consciousness : consciousness : obnubilation, somnolence, sopor, obnubilation, somnolence, sopor, coma, during twilight conditions, pathologial affects, coma, during twilight conditions, pathologial affects, intoxications, vascular diseases, after traumas, intoxications, vascular diseases, after traumas, epilepsy, ECT.epilepsy, ECT.

Qualitive disordersQualitive disorders of of memory memory ((ParamnesiasParamnesias)) ::

PseudoreminiscencePseudoreminiscence – disorder of events – disorder of events localization in memory, “illusions of memory”. Gaps localization in memory, “illusions of memory”. Gaps in memory are completed with events which may be in memory are completed with events which may be present in life.present in life.

ConfabulationsConfabulations – pathological pictures, with which – pathological pictures, with which “amnestic windows” are completed with never “amnestic windows” are completed with never happen even in their life. happen even in their life.

CryptomnesiasCryptomnesias – they could not identify – they could not identify sourcesource of of informationinformation. They could define themselfs as authors . They could define themselfs as authors of books, music. of books, music.

AnecphoriaAnecphoria – – patient is able to patient is able to reproduct some reproduct some informationinformation only only with prompting with prompting..

EkmnesiaEkmnesia – events from the past are assimilated as – events from the past are assimilated as present.present.

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