Psychiatrics overview

practice 수업 가기 전 lecture 요약

1. 핵심 심리이론 요약

[Freud’s Psychosexual Stages]

- Oral (0–1 yr): Fixation dependency, smoking, overeating

- Anal (1–3 yr): Fixation obsessive, controlling (OCPD)

- Phallic (3–6 yr): Oedipus complex, guilt, sexual identity

- Latency (6–12 yr): Social development, same-gender peers

- Genital (12+): Mature relationships

[Erikson’s Psychosocial Stages]

- Infancy (0–1): Trust vs. Mistrust Hope

- Early Childhood (1–3): Autonomy vs. Shame Will

- Preschool (3–6): Initiative vs. Guilt Purpose

- School Age (7–11): Industry vs. Inferiority Competence

- Adolescence (12–18): Identity vs. Role Confusion Fidelity

- Early Adult (19–29): Intimacy vs. Isolation Love

- Middle Adult (30–65): Generativity vs. Stagnation Care

- Late Adult (65+): Integrity vs. Despair Wisdom

[maslow’s hierarachy of needs]

2. ASD (Autism Spectrum Disorder)

DSM-5 Criteria:

1. Persistent deficits in social communication (e.g., poor eye contact, lack of reciprocity)

2. Restricted, repetitive behaviors or interests (e.g., routines, flapping, sensitivity)

Must be early onset & functionally impairing.

Severity Levels:

- Level 1: Needs support

- Level 2: Needs substantial support

- Level 3: Very substantial support

Treatment:

- Behavioral: ABA(applied behavior analysis), CBT(cognitive behavior therapy)

- Speech/OT: Language & sensory therapy

- Medications: Risperidone / Aripiprazole (aggression), SSRIs(selective serotonin reuptake inhibitors) (repetitive behaviors)

3. ADHD & Enuresis

ADHD: Inattention, hyperactivity, impulsivity

Comorbid: Enuresis, ODD(oppositional defiant disorder), learning issues

Treatment:

- Stimulants: Methylphenidate, Amphetamine

- Non-stimulants: Atomoxetine, Guanfacine

Enuresis:

- Primary: Never dry

- Secondary: Dry 6 mo stress

- Tx: Alarm (1st), DDAVP(reduce production urinate during nighttime), Oxybutynin(relaxation bladder muscle), Imipramine(anti-depression)

4. Mental Health Systems & Laws

WHO Plan:

1. Leadership

2. Community services

3. Prevention & promotion

4. Research/data

No-Restraint Policy:

- No ropes or chains

- Open-door, humane care (Pinel & Connolly)

5. Depression in Children

Symptoms: Sadness, fatigue, withdrawal, irritability

Risks: Suicide, academic decline

Causes: Hormonal, brain development, peer issues

Tx: CBT, SSRIs (Fluoxetine)

6. Triangle of Needs

- Physical: food, shelter

- Psychological: emotion & cognition

- Social: belonging, interaction

Unmet mental health issues

7. Stigma Cycle

Label - Stigma - Discrimination - Low self-esteem - Isolation - Worse illness

8. Mentally Healthy Person

Emotional regulation, good relationships, stress coping

Mini Tip: 기억 키워드

Oral = Overeating / Anal = Obsessive / Erikson last = Wisdom / ASD = Social + Repetition / ADHD = Stimulant / Enuresis = DDAVP / Depression = CBT + SSRI / Stigma = Self-esteem Isolation