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Introduction in Psychiatry

competences: to understand object


and limitations of psychiatry as medical
discipline, definition, history,
epidemiology

Psychiatry

Greek etymology

Psyche =soul

Iatrea =cure

Medical discipline
The study of psychiatric disorders
Medical assistance of the patients
Disorder versus disease
Distortions of personality
Changes of conscience
Changes of relationship with external medium

Psychiatry-a complex medical


discipline
Human personality functions:
Biological
Psychological
Axiological
Social
Cultural

Relationship with other medical


disciplines

Morfology
Fiziology
Biology
Genetic
Neurology
Endocrinologie
Internal medicine
Psihology
Sociology
Antropology

Burden of psychiatry
To prevent psychiatric disorders and to
promote mental health
Decrease of morbidity-diagnose and early
treatment of the patients
Recovery, reintegration and resocialization
of the patients
Education for young doctors
Scientifically research

Historical issues
before Hipocrate period
A period of ignorance and superstition (Regis)
- Supernatural forces determine psychiatric illness
- King Saul -developed manic and depressive episodes
along lifetime
-Licantropia of Nabucodonosorhe had delusional
thoughts that he will be transform into a wolf
-Paricid of Oreste, epilepsy of Hercule, violence
moments of Achile etc.
- Temple of Esculap persons who treated psychiatric
disorders using religious ceremonies, a form of
psihoterapy, kinetoterapy, meloterapy
-

Hipocratic period
Hippocrate considered that psychiatric disorders are
diseases of the brain and the patients must be treated by
the doctors and not by the priests
He described clinical aspects of phrenitis(acute fever
delirium), mania, hipocondriac delusional thoughts,
alcholic delirium,epileptic psychosis, hysteria
He treated psychiatric disorders using drugs like elebor
and mandragora
Herophyl i Erasistrat(300b.Ch)-they continued ideas of
Hipocrate about psychiatric disorders

Medium eve

Arabian concepts
Avicena published a book about melancholy
Ahmed Ibu Aljazzar published a book about love ill

European concepts in opposite with Arabian concepts about psychiatric disorders


Obscurantisme medical issues was influenced by religious concepts
Demonomanii-the devil come into the body of the patient and will determine
epilepsy
Persecutions and death condemnations for persons with psychiatric disorders

Bedlam in England (sec. XVI) was a settlement for patients with


psychiatric disorders, where they stayed without heat or bed;

Petite Maison in France-the patients were exposed in public and


they did not have any condition in this settlement

Modern period

Ph. Pinel (1772) new approaches of treatment for psychiatric


patients
Esquirol described clinical aspects of monomanie and dementia
Lasegue - described persecutory delusional thoughts
Falret described folie a deux
Baillarger described folie circulaire and folie a double forme
(manic and depressive episodes)
Magnan considered that clinical observation had a great role in
psychiatry
- discovered the concept of psychopathy
Griesinger psychiatric disorder represents a disease of the
functioning of the brain;
- he considered that there area certain connections
between psychiatry and neurology

Modern period (cont)

Russia (sec. XVIII, XIX) Balinski-conduced the first department of psychiatry at


Medico-Surgery Academy;
- Kandinski- realized the first classification in psychiatry and described
pseudohallucinations;
- Secenov-papers about reflex of the brain;
- Korsakov-described alcoholic psychosis.

Kraepelin-he realized boundaries and classifications of the entities of


psychiatry (introduced the concept of nosology in psychiatry)

Ribot - studied disorders of the memory

Charcot described hysteria

Freud

Bleuler

Meynert-described amentia,

Wernicke- described presbiofrenia, alcoholic halucinosis,

Kleist-described involution paranoia

Social psychiatry and development of psychiatric


assistance in Romania

feudal periode - medical assistance in psychiatry was realized in


some monasteries:
Cldruani, Schitul Balamuci, Mrcua in Muntenia
Schit Madona Ducu in Oltenia
Neam, Golia in Moldova
Matei Basarab 1652- in pravile described legal aspects about
assistance of psychiatric patients

Al. uu(1837-1919)- founder of Romanian school of psychiatry


Al. Obreja realized a modern assistance for psychiatric patients,
defined ciclofrenia (schizophrenia)
Iasi- in 1881, Golia became a base from psychiatric and
neurological medical education
Julien Lucacevski-preoccupied of epidemiology, therapy and
especially ergotherapy; 1883-1894- conduced Golia hospice
Al. Brescu-1895-course of pathology of mental disorders

Socola hospital
1905
Al. Brescu
C.I. Parhon
L. Ballif
P. Brnzei
T. Pirozynski
P. Boiteanu

Conceptions and new approaches


in psychiatry

Organogenetic hypothesis(Griesinger)-psychiatric disorders are explained by cerebral lesions

Psihogenetic hypothesis -psychiatric disorders are determined by some difficulties during lifetime

Organodinamism any psychiatric disorder involved an organic lesion undiscovered yet

Psihanalize human psychic was determined by an inconscience motivation; Freud- the essence
of inconscience is represented by the sexual instinct

Fenomenology (Jaspers) conserved the authenticity of psychopathological manifestations by


expressing all the feelings of the patients

Existentialism-the main important thing for understanding psychiatric disorders is the human
being and medical empathy

Psihosomatic stress can determine somatic illness

Pavlovism psychiatric disorders are determined by biochemical changes and cerebral lesions

Social Psihiatry

Transcultural Psihiatry a psychiatry in which we observed some characteristics of psychiatric


disorders from cultural aspects

Antipsihiatry (Cooper)- psychiatry is not a medical science

New approaches in psychiatry

clinico-nosologic direction (Kraepelin)- classification of psychiatric disorders


using clinico-nosological criterion, psychiatry become a medical science

clinico-statistic direction- created boundaries of syndromes, nosological


entities and created correlations between terminology from different
psychiatric schools

psihosocial direction the role of psychiatrists become more complex and


involve prophylaxis of psychiatric disorders and social recovering and
reintegration of the patients