19: PSYCHIATRY

Published on 27/05/2015 by admin

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Last modified 27/05/2015

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CHAPTER 19 PSYCHIATRY

DEPRESSION

Depression is the most common psychiatric problem of general practice. There are well over 5000 suicides in the UK each year, three-quarters of them among men.

Management

ANXIETY

True anxiety neurosis interferes with the patient’s normal daily activities. Milder forms of anxiety are extremely common, may accompany physical illness and can cause a variety of symptoms.

OBSESSIVE–COMPULSIVE DISORDER

Obsessive–compulsive disorder (OCD) is a neurobiological condition that causes the patient to feel compelled repeatedly to think, speak or act-out irrational rituals, such as hand washing, touching objects or chanting mantras. The spectrum of severity is wide, with the mildest form almost going unnoticed by the patient and family. The most severe cases are disablingly time-consuming and can provoke extreme anxiety.

INSOMNIA

Insomnia can be divided into acute and chronic. The chronic variety is more common in the elderly.

PSYCHOSOMATIC ILLNESS

Patients with psychosomatic illnesses all share the belief that they are physically unwell. The frequent attender, chronic somatiser and heartsink patient may all come under this heading.