Category Archives: Psychological Medicine

Molluscum Contagiosum

AETIOLOGY  This infection is usually grouped with other diseases caused by the poxviruses, but the virus is antigenically different. Atopic individuals appear to be especially prone to infection and in such persons lesions may be more numerous and difficult to eradicate. CLINICAL FEATURES Flesh-coloured, umbilicated papules are seen. They are usually not more than 5 mm in diameter, but the size may vary. Children

Viral infections

Herpes simplex There are two types  of herpes simplex virus (HSV) infection-HSV types I and II. CLINICAL FEATURES Primary herpes gingivostomatitis (HSV-1) may be asymptomatic in children, but others can experience severe stomatitis associated with buccal ulceration, marked local lymph node enlargement and systemic features. Trauma to the skin may introduce the virus, as in glad iatoral or ‘scrumpox’. D

Psychiatry and the Law

At the heart of the relationship between psychiatry and the law is the issue of responsibility. Mental disorder, by virtue of its severity and/or quality, may impair individuals’ responsibility for their thinking and actions. The law in most Western countries provides for the compulsory admission and/or treatment of mentally disordered persons for their own protection and/or the protection of others and for

Gender Role Disorders

Transsexualism involves a disturbance in sexual identity. The criteria for establishing sexual identity are described . In transsexualism, there is no evidence as yet of abnormality in the chromosomal or phenotypic sex; social sex conforms to biological sex. There is, however, a severe disturbance in psychosexual differentiation. A person’s gender identity refers to the individual’s sense of masculin

Psychosexual Disorders

Sexual disorders can be divided into sexual dysfunctions, sexual deviations and gender role disorders . Sexual dysfunctions Sexual dysfunction in men refers to repeated inability to achieve normal sexual intercourse, whereas in women it refers to a repeatedly unsatisfactory quality of sexual satisfaction. Problems of sexual dysfunction can usefully be classified into those affecting sexual desire, those affecting

COURSE AND PROGNOSIS

The condition runs a fluctuating course, with exacerbations and partial remissions. Long-term follow-up suggests that about two-thirds of patients maintain normal weight and that the remaining one-third are split between those who are moderately underweight and those who are seriously underweight. Indicators of a poor outcome include: • A long initial illness • Severe weight loss • Bulimia, vomiting or purgin

Eating Disorders

Obesity The majority of cases of obesity are caused by a combination of constitutional and social factors that encourage overeating. It is relatively infrequent for psychological causes to be involved. However, even when obesity is not due to definite psychological causes, it may itself produce a psychological reaction of depression and tension, particularly if attempts by the patient to lose weight are repeatedly

Amphetamines and Related Substances

These have temporary stimulant and euphoriant effects that are followed by depression, anxiety and irritability. Psychological rather than true physical dependence is the rule. In addition to restlessness, over-talkativeness and overactivity, amphetamines can produce a paranoid psychosis indistinguishable from acute paranoid schizophrenia. Ecstasy is another amphetamine derivative (see below). Cocaine Cocaine is a

Drug Abuse and Dependence

In addition to alcohol and nicotine, there are a number of psychotropic substances that are used for their effects on mood and other mental functions . Solvents Adolescents engage in glue-sniffing for the intoxicating effects produced by the solvents inhaled. The glue is sniffed directly from tubes, plastic bags or smears on pieces of cloth. Tolerance develops over weeks or months. Intoxication is characterized by

Alcohol Dependence Syndrome

The alcohol dependence syndrome is usually very much easier to identify than problem-related drinking. Figure 19.3 outlines the main characteristics of the syndrome but these do not necessarily present in any particular order. Symptoms of alcohol dependence in a typical order of occurrence are shown in Table 19.27. Unable to keep to a drink limit Difficulty in avoiding getting drunk Spending a considerable time dri