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Aetiology of Psychiatric Disorders

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e.g. - Genetic endowment - Environment in utero - Trauma at birth ... Genetic causes have been studies mainly in moderate to severe mood disorders and ... – PowerPoint PPT presentation

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Title: Aetiology of Psychiatric Disorders


1
Aetiology of Psychiatric Disorders
  • Dr. Fatima Al-Haidar
  • Associate Professor Consultant
  • Child Adolescent Psychiatry
  • College of Medicine, KSU.

2
Vague but important to
  • Diagnose and understand.
  • Allow early intervention.
  • Optimize treatment.

3
In Psychiatry, the study of causation is
complicated by two problems
  • Causes are often remote in time from the effects
    that they produce e.g. childhood experience ?
    adult neurotic disorders.
  • a) A single cause may lead to several effects
    e.g. deprivation of parental affection ?
    antisocial behavior, suicide, depression
  • b) A single effect may arise from several
    causes e.g.
  • M.R. Depression.

4
Classification of Causes
1- According to nature
a) Biological
b) Psychological
c) Social
5
2- According to
the effect a. Predisposing
factors b. Precipitating
factors c. Perpetuating
(maintaining) factors
6
  • A- Predisposing factors
  • - Operating from early life, that determine a
    persons vulnerability to causes acting close to
    the time of illness.
  • - Constitution is often used to
    describe the mental and physical make up of a
    person at any point in his life ? Personality is
    always an essential element that help to explain
    why the patient responds to certain stressful
    events and he reacts in a particular way.
  • e.g. - Genetic endowment
  • - Environment in utero
  • - Trauma at birth
  • - Social psychological factors in infancy
    early childhood.

7
  • B- Precipitating factors
  • Events that occur shortly before the onset of a
    disorder and appear to have induced it.
  • e.g. - Physical disease
  • - Drug
  • - Loss of job
  • - Changing residency

8
  • C- Perpetuating factors
  • These factors prolong the course of a disorder
    after it has been provoked.
  • e.g. - Intrensic to the disorder (avoidance in
    phobic disorders)
  • - Social circumstances (marital discords, over
    protecting parents).

9
Predisposing factors
Constitution
Illness
10
Approaches to Etiology
  • 1. Genetics
  • - Family risk studies
  • - Twin studies
  • - Adoption studies
  • - Genetic causes have been studies mainly in
    moderate to severe mood disorders and
    schizophrenia.

11
  • 2. Biochemical studies
  • - Can be directed either to the cause of the
    disease or to the mechanism by which it produces
    its effect.
  • - Most studies have focused on the monoamine
    neurotransmitters.
  • - 5 Hydroxy tryptamine.
  • - Noradrenaline
  • - Dopamine

12
  • 3. Endocrinology
  • Hormonal changes can have profound
    effects or mood and behavior.

13
  • 4. Neuropathology
  • Attempt to answer the question as to
    whether a structural change in the brain
    (localized or diffuse) accompanies a particular
    kind of mental disorder.
  • - There is an obvious application to the
    etiology of dementia and other psychiatric
    disorders associated with organic lesions.

14
  • 5. Psychological theories of
    etiology
  • a) Psychoanalysis
  • - Provides a comprehensive range of explanation
    for clinical
  • phenomena.
  • - The central feature is the concept of
    unconscious mind which
  • characterized by
  • a divorce from reality
  • b being dynamic
  • c being in conflict with the conscious mind.
  • - It is important in the etiology of neurotic
    disorders.
  • - Neurosis originate from failure to pass
    normally through 3 stages
  • of development oral ? anal ? genital.
  • - Anxiety is the central symptom of all
    neurosis.
  • - Defense mechanisms (such as rationalization
    and projection)
  • are used to reduce anxiety.

15
  • b) Learning theories
  • Experiences in childhood and later life give
    rise to neurosis.

16
  • c) Cognitive theories
  • Symptoms and behavior are produced and
    maintained by maladaptive ways of thinking.

17
6. Social Science
  • Many of the concepts used by sociologists are
    relevant to psychiatry.
  • e.g. (1) Life events ? Migration, unhappy
    marriage, problems of work.
  • (2) Family factors ? lack of social support,
    criticism, and over
  • protection within the family.

18
Example
  • - Nada is a 33 year old woman.
  • - Mother of 5 children.
  • - Presents with low mood and diminished
    interest in life activities.
  • - Divorced 8 months ago and return back to live
    with her family.
  • - Her father faces financial difficulties.
  • - Her grand father has history of major
    depression.
  • - Evil eye by a relative.
  • December 2006 / wendell
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