Beruflich Dokumente
Kultur Dokumente
Axis I
F 00 09 Organic mental disorder behavior & mental disorder due to general medical conditions, head trauma, neoplasm brain dysfuntion F 10 - 19 Behavior & mental disorder due to psychoactive substance use
Axis I
F 20 29
Schizophrenia, Schizotipal disorder (axis II), delusional disorder, schizoaffective disorder Psychotic disorder
F 30 39
Mood disorder depression / elation with or without psychotic symptom
Axis I
F 40 48
Neurotic disorder, Somatoform & Stress related disorder
F 50 59
Behavior syndrome related to physiological disorder & physical factor Psychosomatic disorder
F 99
Axis I
F 80 89
Psychological developmental disorder autism
F 90 98
Behavior & emotional disorder with onset at child and adolescent
Axis II
F 60 - 69
Personality disorder
F 70 - 79
Mental retardation
Schizophrenia
Thought / perceptional distortion Inappropiate/dull affect Clear consciousness, intelectual capacity
within normal limit. Prevalence 1-1,5% in family, 8% in sibling, 47% identic twins (US) =; highest onset 15-25 years, 25-35 years
Schizophrenia Diagnosis
- One or more symptoms :
a. Thought echo, Thought insertion / withdrawl, Thought broadcasting b. Bizzare delusions c. Auditory hallucinations talking about patients behavior
Schizophrenia
- Two or more symptoms within interval
more than 1 month : d. Other hallucinations e. disorganized speech (eg, frequent derailment or incoherence) f. grossly disorganized or catatonic behavior g. negative symptoms, i.e, affective flattening, alogia, or avolition
Schizophrenia
Type :
Delusional Disorder
Nonbizarre delusions of at least 1 month's
duration that cannot be attributed to other psychiatric disorders. With or without auditory hallucination Onset at middle age.
Panic Disorder
The occurrence of three or more panic attacks within a
3-week period. These attacks cannot be precipitated only by exposure to a feared situation, cannot be due to a physical disorder. These attacks must be accompanied by at least four of the following symptoms: dyspnea, palpitations, chest pain, smothering or choking, dizziness, feelings of unreality, paresthesias, hot and cold flashes, sweating, faintness, trembling or shaking. Genetik factor (+)
Somatoform Disorder
recurrent somatic complaints + asking for physical examination even theres no abnormality Somatisation Disorder:
- > , onset young adult age. - family history - Several somatic complaints, change of origin, chronic ( 2 years), fluctuative
Hypochondric Disorder
= Preoccupation with the fear of developing a serious disease or the belief that one has a serious disease. Chest pain, torturing, persistent, without organic / physiologic disorders Psychic stressor background (+)
(depression/elation) + appropriate behavior, +/psychotic symptom Chronic relapsing disease Depression : - Bipolar I,II - Depressive episode - Repeated depressive disorder - Persistant mood disorders (cyclothymic, dysthymic)
depressive mood, retardation in thinking, speech and behavior, retardate / agitate psychomotor
personal hygiene health problem, including dental health suicide attempt, dyssomnia (mid and terminal insomnia), decreased weight 5% in a month, negative thought / pessimistic, etc
Endocrine
emotional conflict pituitary gland metabolism of Ca++, carbohydrate gingivitis
Resistency to infection
emotional / psychic problem resistency to infection (depression, weak, fatigue, tense, restlestness, stress) oral infection oral flora
Blood circulation
- anxiety, tense blood flow bleeding tendency - depression blood flow gingival condition
- final phase of swallowing conscious / unconscious swallowing disorder (globus hystericus etc), nausea, vomitting with psychiatrical background (tense, rejection, aggressivity, hostility)
Children
(+) Oral hygiene awareness (family support) Sense of well being, Self worth, self care (-) Guilty feeling, anger (rejection, family punishment)
self blame
Self destructive behavior
Adult
Loss of old friend
Morphologic abnormality heavy emotional consequence for the patient (low self-esteem antisocial behavior) therapy : recovered self-esteem Anxiety pratherapy evaluation
2. Phantom teeth
- unable to receive reality lost of teeth and senility process.
3. Implanted teeth
could stimulate the wish to go back to infant phase (regression)
4. Thumb sucking
experience of breastfeeding, less pleasure) sucking time = infants right too early discontinuation of breastfeeding : excessive optimism, narcissism, pessimism, envy, jealousy, excessively dependent and require others to give to them and to look after them
rearing. Early intervension, strong, suddenly stuttering, delinquency, enuresis, sticking out the tounge, nail biting Therapy: the child talk about his/her feeling, good rearing, chewing training (food, drink), social contact & better attention (for lonely child) Residue in adult : smoking, candy chewing, mustache playing.
5. Caries
- stress increase of intake (carbohydrate)
6. Gingivitis
- Need of oral dependency >> + anxiety precipitation : acute anxiety
7. Morphologic abnormality
Social stigma impulsive and asocial behavior corrective action could help patients personality development (decrease anxiety, and low self esteem)
8. Bruxism
Separation
movement in tongue jaw movement of breatfeeding in infant Anxiety contact / pressure within teeth self confidence Anger displacement of restrained anger
10. Oral pain Patient with complaint of pain without organic origin : a. repression & anger denial emerged from doctor-patient relationship. b. Displacement / escape from certain problem pain : - family support - doctor-patient relationship substitution - disturbed real relationship
c. Fail to control anger / aggresivity to another person hyposensitive to self inflicted pain but hypersensitive to pain caused by other person (dentist)