learning points in psychi

Readers beware: this entry contains medical jargon in abundance. If you fail to comprehend any term, do not hesitate to ask, or you can google them up yourself.

After day 4 of life in the psychiatric ward and clinic, this is what I have learnt:

# The psychi ppl like to use short forms too:
o PR: pakar review (talk about campurization)
o TTH: talk to himself
o LTH: laugh to himself
o Setakat ni je yg I jumpe dulu (baru day 4)

# Most of the guys who become psychotic have a history of substance abuse. Glue sniffing is becoming a popular detrimental past time amongst the youngsters (cane anak muda bangsa kite nih? Cemane nak jadi pemimpin?)

# Despite knowing many cases of malay muslims guys who take alcohol, abuse drugs and are promiscuous, I can’t desensitize myself and am still judgmental against them

# Most of the women who suffer from depression are caused by problems with their husbands (yang kahwin lain)

# Schizophrenia in psychiatry is like diabetes mellitus in internal medicine. It’s a chronic incurable disease which can only be controlled with medication. And it is the umbrella body of many psychotic disorders. Most of the patients are diagnosed as schizophrenia.

# I think schizophrenia in adults are like autism in children in that both prefer to live in their inner worlds

# When the doctors (or med students) don’t know what to write as the chief complaint, they put it down as “abnormal behavior”.

# Diagnosis of psychotic patients in psychiatry depends more on how the psychiatrist was trained rather than the clinical presentation of the patient. One of my lecturers is anti-schizo, another diagnoses schizo freely while the third takes the middle road, haha.

#The difference between psychosis and neurosis is loss of insight. In the former, there is a loss.

# Insight include 3 things:
o Awareness of the being ill
o Attribution of the illness; recognize the abnormality of the phenomena is due to mental illness
o The need to seek treatment

# Absolute diagnosis of psychiatric patients is a challenge as there are no confirmatory/ diagnostic tests that can be carried out unlike in other disciplines.

# There are hardly any psychiatric symptoms that normal people do not experience (i. e low mood, feeling elated, spending spree, anorexia, weight gain or loss, anxious, phobias etc ) . What jifferentiates both groups is the degree of the symptoms that they have.

# Since treating patients with mental illness is mentally exhausting, psychiatrist can only see a maximum of 5 cases per day compared to (10-20 cases of in other specialist clinics).

# The psychiatric wardround is a sitting wardround. It’s good for those with flat feet and less stamina.

# The mini mental state examination (MMSE) is an unreliable test unless done at the first presentation or during an acute stage of illness. Otherwise, patients usually have memorized it and tak larat nak layan dah.

# Speech in MSE is assessed whether it is
o Coherent (understandable)
o Relevant (answers the examiners questions relevantly)
o Rational (the answeris correct)

# One’s socioeconomic status does render one susceptible to certain psychiatric disorders i.e
o High SES: anorexia nervosa and bipolar mood disorder
o Low SES: depression and schizophrenia (however banyak jugak educated people who become depressed)

# Stages of grief (by Kubler-Ross)can be remembered by the pneumonic SABDA:
o Shock/ denial: this can’t be happening to me
o Anger: why is this happening to me? Who is to blame?
o Bargaining: make this not happen and in return I will …
o Depression: I’m too sad to do anything
o Acceptance: I’m at peace with what has happened/ is going to happen?

# Delirium
o is a medical emergency (because psychotic patients act on their delusions and hallucinations)
o is under diagnosed as the cause can be any disease under the sun and also because it is usually undetected due to sun downing (worsening of symptoms toward the evening)
o affects extreme age groups (children and the elderly)