Knowledge of psychiatric disorders is inadequate in our country. So much so that often mental problems like hysteria, depression, suicidal tendencies and schizophrenia are considered as manifestations of evil spirits, fruits of bad actions, etc. Instead of taking the patient to a doctor, a Tantric or mantra-vadi consulted.
This book seeks to provide scientific information on many common mental disorders like depression, obsessive compulsive disorder and mania. More serious mental disorders like sehizophrenia and suicidal tendencies are also covered in an easily comprehensible manner. The author stresses that if personal, familial, social, financial and legal complications can be provented.
The author is Professor and Head, Department of Psychiatry, University College of medical Science, University of Delhi and GTB Hospital, Delhi. he has authored a number of books on related topics.
In our country, Psychiatry is still in underdeveloped stage. The knowledge of a common person about mental disorders is full of misconceptions. It is really sad that in the present scientific age, evil-spirit, devil, God-Goddesses, climate, astrology, luck, fruit of bad actions etc are considered to be the causes of mental disorders. Therefore, in our country, traditional therapist, priest, Muslim priest, sadhu, faked physicians, tantriks, unskilled sex-therapists etc are working as psychiatrists. Common physicians and specialists are incapable of recognizing mental disorders and referring them to psychiatrists. There are many reasons for this, out of which important are insufficient knowledge, insufficient experience, craze for money, deficiency of psychiatrists, stigma, poverty, inability of patient or his relatives to accept mental disorder etc.
The global burden of disease due to neuro-psychiatric disorders was measured to be 6.8% worldwide in 1990. This is projected
to increase to 15% by the year 2020. Psychiatric disorders account for 5 of the 10 leading causes of disability across the world Mental-
health disorders account for nearly a sixth of all related disorders. Yet we have just 0.4 psychiatrists and 0.02 psychologists per
100,000 people and 0.25 mental health beds per 10,000 population. The psychiatric treatment is available in few general hospitals. But mostly, the time of psychiatrists and majority of the fund is utilized in the care of drug addicts. Newspapers and audiovisual media has also failed in providing correct information about mental disorders. The result is that in people, the fear and lack of knowledge about these disorders could not be removed.
To provide correct information about mental disorders is the first aim of this book so that mental disorder can be recognized timely and treated correctly and personal, familial, financial, social and legal complications of these disorders can be prevented in time.
If the popular misconceptions about the mental disorders in common public can be removed, the possibility of curative treatment becomes high. By this book, even if a single psychiatric patient is able to lead a normal life, then this book will be successful in fulfilling its objectives. Important tips for caretakers and patients are given in each chapter.
All suggestions for future revision are welcome and will be duly acknowledged.
Let us first get to know in brief the definitions of different technical words associated with mental disorders and those related to meanings to understand the subject in depth.
- id: This is that part of the mind in which primitive desires (eg repressed sexuality, aggressiveness, food related desires) are found which require immediate gratification and are based on "Pleasure-Pain principle". These desires are unjustified and unexpressed, which do not enter the consciousness.
- Ego: This is the conscious part of the mind which controls the primitive desires according to reality.
The half part of it is conscious and half is unconscious. Its main function is to save human being from stress or tension. Freud's daughter Anna Freud, said that this part of the mind develops by the age of 15 years and the evidence for this is that after this age, the child starts recognising his body parts and the feeling of self arises.
- Superego: This is that part of the mind which develops according to social and moral needs and becomes component of experience. The unconscious part of it is called ego ideal and conscious past is conscience.
The main functions of ego are development of reality, intelligence, consciousness, memory, judgement, desires, favourable adjustment, to differentiate etc.
William C. Meninger's (President of Meninger Foundation, Topeka, America) prepared mental health questionnaire .
Behaviour Related Characteristics of Mentally Healthy Person :
The development of psychiatric treatment can be explained in following phases :-
Social and Legal Aspects
In 1795, a person named Pinel started the humane treatment of mental patients in Paris. They were given freedom to roam and do
work, due to which they started improving. Before this, mental patients were tied, due to which they became excessively excited and violent. By treating with love and sympathy, peace prevailed in the hospital and the patients started improving early. By motivating through the social reform, Benjamin Rush in USA and Connolly and Tuke in Britain laid the foundation of social psychiatric treatment for mental patients.
In 19th century Britain, many big hospitals were open for mental patients and in 1890, Lunacy Act was enacted by which reception
order from the court regulated the admission of psychiatric patients. In 1930, by amending the Act, the patients were given the right to
be admitted themselves. In 1959 an amendment removed the need of certificate and the discrimation between mental patient and
other patients was stopped legally.
The Indian Lunacy Act was passed in 1912 under which the treatment of mental patients was available only in asylums but in 1987, through Mental Health Act, treatment of these patients has become much easier. Under this, self-admission, emergency admission, admission in general (governmental or private) hospitals etc are now available.
Development of Psychological Procedures :- Paracelsus, a psychologist, in 15th century has opined that health and diseases
are controlled by astrological positions e.g. controlled by moon and stars. The word lunacy has been derived from Lunar (moon),
the meaning of which is that man is affected by moon.
A scientist, named Mesmer has expressed a view that mental disorders arise due to a liquid in body (Animal-magnetism). Based on this principle, the method of hypnosis was devised by which neurosis (mainly hysteria) has been treated successfully. Charcot, a neurologist, has said that hypnosis and suggestion are the keys to successful treatment.
After this, a psychologist named Sigmund Freud (Freud is known as "Father of Psychology") has given new direction to psychology.
He has given the structural and functional definitions of mind, hypnosis and psychoanalysis, dream interpretation, psychosexual stage of development and properties of cocaine. He described the psychoanalytic causes of many mental disorders.
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