The Health Significance Of Psychiatry As A Science And Classification Of Mental Diseases

The term psychiatry is derived from the Greek root, “psyche”= mental, and “iartos”= treatment. Psychiatry or psychological medicine can be defined as that branch of medicine concerned with the study, diagnosis, treatment and prevention of diseases of the mind. Psychiatric disorders may manifest at the emotional or behavioural level.

Psychiatry differs from psychology which is the study of normal behaviour and mental functions of man and animals.

History

Though, in prehistoric times, physical and psychological illnesses were treated with contempt, with the Renaissance movement, the attitude towards such victims came to be one of compassion. Mental hospitals have a long history of evolution. Originally, these were called lunatic asylums or mental asylums and they were places where the aggressive and violent psychiatric patients could be admitted and kept in isolation. Laws providing for the admission and detention of lunatics into such lunatic asylums were also formed and these were known as the Lunacy Acts. With the passage of time, these institutions came to be known as mental hospitals. The modern approach is to consider psychiatric patients also, along with the general stream of other patients and to provide treatment facilities for them in general hospitals under specially trained personnel. The mental hospitals are giving way to general hospitals and community psychiatry, especially with the advent of modern therapeutic interventions. The custodial care is being discouraged and the family and society are brought more and more to take care of the mentally ill patient is who are allowed to remain in the community itself as far as possible. This helps in minimizing psychiatric morbidity, enhancing early recovery and avoiding the social stigma. This practice of community psychiatry is a modern concept.

Mental diseases may be caused by psycho-social distress, sub-average intelligence, endocrine and metabolic disturbance, toxins and poisons, infections or degeneration of the brain matter, stroke, head injury, neoplasms etc. The mental diseases are classified on the basis of signs and symptoms (phenomenology). The various diseases are conveniently classified into psychosis, neurosis, personality disorders, sexual disorders, alcoholism and drug dependence, psychosomatic disorders, bahaviour disorders of childhood and mental retardation.

Psychosis: Psychosis is a major psychological disorder where the entire personality of the subject is disorganized. The subject never accepts that he is ill and does not seek treatment. He may retain false notions (delusions) and false sensory experiences (hallucinations). Schizophrenia, affective disorders, delirium and dementia are the common psychotic disorders. In the lay man’s term, these used to be known as madness or lunacy since the abnormalities are quite obvious even to the lay public.

Neurosis: In the case of neurosis, the individual subjectively suffers much because, of the bodily symptoms. A physical basis may not be evident to explain these symptoms. The manifestations may be chest pain, headache, paralysis, feeling of a lump, loss of speech, fear, diarrhea and the like. Only part of the personality of the subject is affected. Delusions and hallucinations are absent unlike as in psychosis. These individuals may seek the advice of different doctors in their helplessness. Anxiety neurosis, hysterical neurosis, depressive neurosis (reactive depression), obsessive compulsive neurosis and phobic neurosis are the common disorders in this group.

We will discuss the other clinical manifestations of mental diseases in subsequent hubs, just follow the slide below and click on the next hub.