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PSYCHIATRIC DISORDERS

Dementia

What is Dementia? Dementia is a condition which involves progressive and cognitive deficits. It usually affects memory first, with subsequent progression to cause dysphasia, agnosia, apraxia, diminished ability with executive function and eventually personality disintegration. Causes of Dementia It is caused by damage to or loss of nerve cells and their connections in the brain. …

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Autistic Spectrum Disorder

Introduction Autism or autistic spectrum disorder is a neurodevelopmental disorder characterized by qualitative impairments occuring in a child before the age of 36 months, in three key areas; social interaction (often the earliest features of Autistic Spectrum Disorder-ASD), communication, interests and activities. The clinical presentation is varied and may encompass children with severe manifestations of …

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Generalized anxiety disorders

Introduction Anxiety is a common symptom that occurs in all psychiatric disorders including depressive illness and most psychoses. Physical diseases like hyperthyroidism, cardiac disease or hypertension may also present with anxiety and therefore must be excluded. There are various forms of anxiety disorders (e.g. generalized anxiety disorders, panic disorders, phobias, obsessive compulsive disorder, acute stress …

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Alcoholic delirium tremens

Introduction Alcoholic delirium tremens is the most dramatic withdrawal syndrome. It usually starts 2-3 days after drinking stops. On average, the syndrome lasts 3 days but may continue for much longer. Without good supportive care and adequate treatment, Delirium Tremens (DT) is associated with significant mortality. Risk factors include long history of heavy alcohol use, …

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The Acutely Disturbed Patient

Introduction The acutely disturbed patient presents in an excited, agitated or aggressive state. There may be delusions and perceptual changes like hallucinations that overwhelm the patient. Disorientation and alteration in consciousness are often prominent when the cause is organic. The patients are usually brought in restrained by more than one person or by the police. …

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Attention Deficit Hyperactivity Disorder (ADHD)

What is Attention Deficit Hyperactivity Disorder (ADHD)? Attention Deficit Hyperactivity Disorder (ADHD) is the most common neurobehavioural disorder affecting children. It may present in infancy and can continue into adulthood. It affects 5-8% of children and nearly three times as many boys as girls. Nearly half the children presenting with ADHD may also have an …

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Altered Mental Status

Introduction Altered mental status is the acute alteration in brain function and may include alteration of arousal or awareness, thought content, memory or attention. Clinical presentation of altered mental status The presentation of this condition is dependent on the cause but may include: Agitated Restlessness Hemiparesis Visual deficit Dysphasia Differential diagnosis The mnemonic AEIOU TIPS …

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Neuroleptic Malignant Syndrome (NMS)

Introduction Neuroleptic malignant syndrome (NMS) is a life-threatening idiosyncratic reaction to antipsychotic drugs. It is characterized by fever, altered mental status, muscle rigidity, and autonomic dysfunction. It is mostly is caused by the use of high dose of antipsychotics: potent antipsychotics (e.g. haloperidol) and antipsychotics that are given via the intravenous or intramuscular routes. Diagnostic …

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Schizophrenia

Introduction Schizophrenia is a serious psychotic disorder characterized by multiple impairments in emotional, behavioural, cognitive, social, and occupational domains (among others). It affects about 1% of the population. Onset usually in late adolescence or early adulthood. It has a strong genetic component to its etiology; environmental factors, including pre-natal and obstetric factors, also implicated Clinical …

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Panic disorders

Introduction Panic disorder is a disorder characterized by episodic attacks of extreme fear, mostly unrelated to specific objects or situations. It is associated with multiple somatic and cognitive symptoms. Each attack lasts for about 5-30 minutes and often begins abruptly. It affects about 0.5-1.0% of the population Clinical features A feeling of choking Pounding heart …

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Insomnia

Introduction Insomnia is a condition characterized by difficulty in falling asleep or staying asleep. It may be primary and unrelated to any physical or mental disorder It may relate to a mental disorder, medical or physical conditions It may be an adverse effect of medication (or psychoactive substances) It is a common, often chronic problem; …

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Depression

Introduction Depression is a disorder of mood and affect in which the predominant emotion is sadness/ unhappiness. It can occur alone (unipolar depression) or as part of an alternation disorder in which elevation of mood also occurs (bipolar disorder). It varies in severity from mild to severe. Life events, especially those involving loss, are often …

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