living with schizophrenia wmhd 2014
DESCRIPTION
WMHD 2014 Living With Schizophrenia.TRANSCRIPT
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LIVING WITH ‘ SCHIZOPHRENIA’
Dr Jaimon P MAssistant Professor
ESIC Medical CollegeParippally, Kerala
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HEALTH
World Health Organization-WHO State of complete physical, mental and
social well being Not merely the absence of disease Other dimensions;
Spiritual Intellectual Emotional
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MENTAL HEALTH
Successful performance of mental functions, in terms of thought, mood and behavior
Results in productive activities Fulfilling relationship with others Ability to adapt to changes To cope with adversity
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MENTAL HEALTH
Mental health is a state of emotional and social well-being.
Numerous factors affect one’s mental health Biological Factors Physical abilities and disabilities Social and environmental conditions and
stressors
5
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WMHD 2014
Introduce a quantified national reduction in premature mortality – a major health inequality is people with mental ill health dying 20 years younger than the general population
Everyone should have access to high quality, safe and speedy access to crisis care and be able to access psychological therapies
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SCHIZOPHRENIA
Distortions of thinking & perception and inappropriate/blunted affect.
Clear consciousness & intellectual capacity are usually maintained.
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SCHIZOPHRENIA
Emil Kraeplin (1856-1926) Eugene Bleuler (1857-1939) Kurt Schneider (1887-1967)
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EPIDEMIOLOGY
Life time prevalence- 1% All societies/all classes Male= female Onset earlier in males Peak age - 10-25 yrs Males - 25-35 yrs Females Bimodal peak females- > 40 yrs
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ETIOLOGY Biological Factors
Genetic Neurochemical Neuropathological Neurocircuitory Brain metabolism Evoked potential Psychoneuroimmunology Psychoneuroendocrinology Other theories
Psychosocial Factors
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FAMILY STUDIES
General population -1 % Non-twin sibling of F20 - 8% Child with one parent with F20 - 12% Dizygotic twin of F20 - 12% Child of two parents with F20 - 40% Monozygotic twin of F20 - 47%
Paternal age >60 yrs
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NEUROCHEMISTRY
Dopamine Serotonin Glutamate GABA Nor Epinephrine
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BIOLOGICAL FACTORS
Abnormal DST Decreased LH/FSH Blunted response to Prolactin/GH Autoimmune pathology IL-2 decrease Decreased peripheral lymphocytes Retroviral infection Eye movement dysfunction
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BIOLOGICAL FACTORS
Winter births Birth complications Influenza epidemic in 2nd trimester Maternal starvation Rh incompatibility
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PSYCHOSOCIAL THEORIES Sigmund Freud:
early fixation leading to intrapsychic conflicts and ego defect
Magret Mahler: distortion of reciprocal relationship
between mother& infant Learning theory:
Children learn irrational reaction& abnormal ways of thinking by imitating parents
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PSYCHOSOCIAL THEORIES
Adolf Meyer: reaction to adverse life events
Double blind theory: Gregory Bateson& Donald Jackson-
conflicting parental messages about their behaviour, attitudes, and feelings
Expressed Emotions
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SOCIAL FACTORS
40%- alcohol abuse 90%- Nicotine Cannabis 6 times risk Population density> I million Increased economical burden
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SIGNS & SYMPTOMS
Impaired sleep Impaired appetite Impaired personal care Unprovoked irritability Self talking/Muttering Self laughing Poor social interaction Difficulty in concentration
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SIGNS& SYMPTOMS
• Suspiciousness • Fearfulness• Irrelevant talk• Irregular job pattern• Hoarding behavior• Wandering tendency• Suicidal tendency• Abusiveness/destructiveness
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SIGNS& SYMPTOMS
Thought echo/insertion/ withdrawal/broadcasting Delusions of control/influence/passivity• Running commentary/ 3rd person AH/hallucinatory
voices from body Bizarre delusions Other Hallucinations Neologisms Catatonic behaviour Negative symptoms�
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SIGNS& SYMPTOMS
• Depressive/euphoric mood changes• Anhedonia• Autistic thinking• Affective flattening • Association loosening• Ambivalence • Avolition• Attentional disturbances
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MANAGEMENT
Hospitalization Confirm diagnosis Safety of the patient Initiation &Stabilization of medication Care of basic needs Psycho education Effective association with community
Improve Quality of Life Employment Social relationship
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MANAGEMENT
Acute stage Antipsychotics BZD
Maintenance stage Improve level of function Prevent psychotic relapse Manage Non compliance Manage side effects Health monitoring
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MANAGEMENT
Psychological interventions Psycho education Social skills training Cognitive Behavior Therapy Individual Psychotherapy Vocational Therapy Managing Expressed Emotions Family oriented therapy
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പു�നരധി�വാ�സം
വാ�ക്തി�ശു�ചി�ത്വം� പു�ലര്ത്തl, പു�ചികം, ജോ��ല�ക്കു�ജോപു�കംl ത്വം�ടങ്ങി�യദൈ�ന��ന പ്രപുവാ�ത്ത�കംള്ക്കു
പ്രപുയ�സംമന�ഭവാ�ക്കു�ന്നവാര�കം� ചി�ല ജോര�ഗി�കം•.
ആത്മവാ�ശു��സം വാ'ണ്ടെ)ട�ത്ത ണ്ടെമച്ചണ്ടെ+ട്ട �'വാ�ത്വംനയ�ക്കു�n പു�രനധി�വാ�സം പ്രപുവാര്ത്തനങ്ങി •
ജോര�ഗി�കംണ്ടെ-സംഹാ�യ�ക്കു�ന്ന�.
സം�മ/ഹാ�കംവാ� ണ്ടെത്വം�ഴി�ല്പുരവാ�മ�യ പുര�ശു'ലന നല കം�ന്നത്വം�അത്വം�ണ്ടെ3 ഭ�ഗിമ�ണ് .
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പു�നരധി�വാ�സം
പുണ്എങ്ങിണ്ടെനകം�ര�ക്ഷമമ�യ� ഉപുജോയ�ഗി�ക്കു�, ജോ��ല� എങ്ങിണ്ടെന പ്രപുയ�സം കം/ട�ണ്ടെത്വം ണ്ടെചിയ്യാം�
എന്നത്വം�ണ്ടെനക്കു�റി�ണ്ടെച്ച�ണ്ടെക്കു ജോര�ഗി�കംള്ക്കു ഉപുജോ�ശു നല്കം�ന്ന�.
ണ്ടെത്വം�ഴി�l പുര�ശു'ലനജോത്ത�ണ്ടെട�+ നല്ലചി�ന്തകം-< മനസ്സി�l ഊട്ട�യ�റി+�ക്കു�ന�ള്ള പ്രശുമങ്ങി-�ണ്�വാശു�.
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TIPS TO CARE TAKERS
സം കം�ജോസം�പ്ര@'ന�യ ജോര�ഗി�കം-<ണ്ടെട �'വാ�ത്വംന�ലവാ�രണ്ടെമച്ചണ്ടെ+ട�ത്ത�ന്നത്വം�l അവാണ്ടെരപുര�ചിര�ക്കു�ന്നവാര്ക്കു
വാ-ണ്ടെര പ്രപുധി�നമ�യ പുങ്കു�) . ആശു�പുപ്രത്വം� വാ�ട്ട വാ'ട്ട�ണ്ടെലത്ത�ന്ന ജോര�ഗി�കംണ്ടെ-
പുര�ചിര�ക്കു�ന്നവാര്ക്കു ഈഅസം�ഖണ്ടെത്തകം�റി�ച്ച വാ�ക്തിമ�യധി�രണ് ഉ)�യ�ര�ക്കുണ്.
ജോര�ഗി�കം• വാ')� പുഴിയഅവാസ്ഥയ�ജോലക്കു
മടങ്ങി�ജോ+�കം�ന�ള്ളസം�ധി�ത്വംകം• കം�റിയ ക്കു�ന�ള്ള
വാഴി�കംണ്ടെ-ക്കു�റി�ച്ച പുര�ചി�രകംr അറി�ഞ്ഞി�ര�ക്കുണ്.
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TIPS TO CARE TAKERS
ചി�കം�ത്സയ�l പുങ്കു�-�കം-�കം�ന്ന ജോര�ഗി'പുര�ചി�രകംര്ക്കു വാ-ണ്ടെരവാല�യ പുങ്കു�ണ്�ള്ളത്വം .
മര�ന്ന�കം• കം�ത്വം�സംമയത്ത നല കം�ന� മര�ന്ന�കം• കംഴി�ച്ച�ണ്ടെല്ലങ്കു�l ഉ)�കം�വാ�ന്ന പ്രപുശു നങ്ങിണ്ടെ-ക്കു�റി�ച്ച
ജോര�ഗി�കംണ്ടെ- പുറിഞ്ഞി�മനസ്സി�ല�ക്കു�ന� ജോര�ഗി'പുര�ചി�രകംr പ്രശുദ്ധി�ക്കുണ്.
ആശു�പുപ്രത്വം� വാ�ട്ട ജോര�ഗി�കംള്ക്കു� മത്വം�യ�യചി�കം�ത്സ ലഭ�ക്കു�ന്ന�ണ്ടെ)ന്ന ഉറി+<വാര�ത്ത�ന്നത്വം� വാ-ണ്ടെര
പ്രപുധി�നമ�ണ് .
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TIPS TO CARE TAKERS
മര�ന്ന�കം• ന�ര്ത്ത�ക്കു-യ�ന്ന ജോര�ഗി�കം-�ല� ത്വം�ടര് ചി�കം�ത്സയ ക്കു� ജോപു�കം�ത്തവാര�ല� ജോര�ഗി�വാസ്ഥത്വം�ര�ച്ച<
വാജോന്നക്കു�.
ചി�കം�ത്സത്വം�ടര�n ജോര�ഗി�കംണ്ടെ- ജോപ്രപുര�+�ച്ച ചി�കം�ത്സയ�l സംഹാ�യ�ക്കു�ന്നത്വം�ല/ണ്ടെട പുര�ചി�രകംര്ക്കു ജോര�ഗി�കം-<ണ്ടെട
�'വാ�ത്വം ണ്ടെമച്ചണ്ടെ+ട�ത്ത�ന�കം�.
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TIPS TO CARE TAKERS
ഊര്ജ്ജസം�ലത്വംജോയ�ണ്ടെട �'വാ�ക്കു�n പുര�ചി�രകംr ജോര�ഗി�കംണ്ടെ- ജോപ്രപുര�+�ക്കുണ്
പുര�ചി�രകംr �യയ�പ്രശുദ്ധിയ�മ�ള്ളവാര�കംണ്
മര�ന്ന�കം• കം�ത്വം�മ�യ� കംഴി�ക്കു�n ജോര�ഗി�കംണ്ടെ- ജോപ്രപുര�+�ക്കുണ്
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TIPS TO CARE TAKERS
ജോര�ഗി�കം-�l ആത്മഹാത്വം��പ്രപുവാണ്ത്വംയ�ണ്ടെട
എണ്ടെന്തങ്കു�ല� സം/ചിനകം• കം�ണ്�കംയ�ണ്ടെണ്ങ്കു�l അക്കു�ര� ഉടന്ത്വംണ്ടെന്നചി�കം�ത്സ�ക്കു�ന്ന ജോJ�കം ടണ്ടെറിഅറി�യ�ജോക്കു)ത്വം�ണ് .
പുര�ചി�രകംr ജോര�ഗി�കം-<ണ്ടെട നല്ല പ്രപുവാ�ത്ത�കംണ്ടെ- അഭ�നന്ദി�ക്കു�കംയ�അത്തര പ്രപുവാ�ത്ത�കം•
ത്വം�ടര്ന്ന� ണ്ടെചിയ്യാം�n അവാണ്ടെര ജോപ്രപുര�+�ക്കു�കംയ�ജോവാണ്.
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TIPS TO CARE TAKERS
€nMYÁ‚AVm B±j„ieL UˇÉM„€ eeVKARiK aTum � ViMr†Nj• oÅPAlSAHNm ÅPAryN dM amGÁKARm
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LIFE SKILLS Decision making
Creative thinking
Effective communication
Self awareness
Coping with emotions
Problem solving
Critical thinking
Interpersonal relationship skills
Empathy
Coping with stress
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S]MXP-P\ ]¦M-FN¯W
Xt±i `c-W-tI-{µ-§Ä aX-t\-Xm-¡Ä k¶-²-tk-\mw-K-§Ä IpSpw-_{io Ab¡q«w km£-cXm {]hÀ¯-IÀ XpS-§n-b-hÀ hnZymÀ°n-IÄ
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RABBIT & TORTOISE
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“Education is not the amount of information, that is put into your brain and runs riot there undigested”
- Swami Vivekananda