Insight Health Dictionary

The collection of extensive narrative data on many variables over an extended period of time in a naturalistic setting in order to gain insights not possible using other types of research. For this type of research, observations are undertaken at particular points of time. Data would include observations, recordings and interpretations of what is seen.... ethnographic research

(African) One who has good judgment and keen insight Maiza, Mayzah, Mayzah, Maeza, Maezah... maizah

An overall title for a group of psychiatric disorders typ?ed by disturbances in thinking, behaviour and emotional response. Despite its inaccurate colloquial description as ‘split personality’, schizophrenia should not be confused with MULTIPLE PERSONALITY DISORDER. The illness is disabling, running a protracted course that usually results in ill-health and, often, personality change. Schizophrenia is really a collection of symptoms and signs, but there is no speci?c diagnostic test for it. Similarity in the early stages to other mental disorders, such as MANIC DEPRESSION, means that the diagnosis may not be con?rmed until its response to treatment and its outcome can be assessed and other diseases excluded.

Causes There is an inherited element: parents, children or siblings of schizophrenic sufferers have a one in ten chance of developing the disorder; a twin has a 50 per cent chance if the other twin has schizophrenia. Some BRAIN disorders such as temporal lobe EPILEPSY, tumours and ENCEPHALITIS seem to be linked with schizophrenia. Certain drugs – for example, AMPHETAMINES – can precipitate schizophrenia and DOPAMINE-blocking drugs often relieve schizophrenic symptoms. Stress may worsen schizophrenia and recreational drugs may trigger an attack.

Symptoms These usually develop gradually until the individual’s behaviour becomes so distrubing or debilitating that work, relationships and basic activities such as eating and sleeping are interrupted. The patient may have disturbed perception with auditory HALLUCINATIONS, illogical thought-processes and DELUSIONS; low-key emotions (‘?at affect’); a sense of being invaded or controlled by outside forces; a lack of INSIGHT and inability to acknowledge reality; lethargy and/or agitation; a disrespect for personal appearance and hygiene; and a tendency to act strangely. Violence is rare although some sufferers commit violent acts which they believe their ‘inner voices’ have commanded.

Relatives and friends may try to cope with the affected person at home, but as severe episodes may last several months and require regular administration of powerful drugs – patients are not always good at taking their medication

– hospital admission may be necessary.

Treatment So far there is no cure for schizophrenia. Since the 1950s, however, a group of drugs called antipsychotics – also described as NEUROLEPTICS or major tranquillisers – have relieved ?orid symptoms such as thought disorder, hallucinations and delusions as well as preventing relapses, thus allowing many people to leave psychiatric hospitals and live more independently outside. Only some of these drugs have a tranquillising e?ect, but their sedative properties can calm patients with an acute attack. CHLORPROMAZINE is one such drug and is commonly used when treatment starts or to deal with an emergency. Halperidol, tri?uoperazine and pimozide are other drugs in the group; these have less sedative effects so are useful in treating those whose prominent symptoms are apathy and lethargy.

The antipsychotics’ mode of action is by blocking the activity of DOPAMINE, the chemical messenger in the brain that is faulty in schizophrenia. The drugs quicken the onset and prolong the remission of the disorder, and it is very important that patients take them inde?nitely. This is easier to ensure when a patient is in hospital or in a stable domestic environment.

CLOZAPINE – a newer, atypical antipsychotic drug – is used for treating schizophrenic patients unresponsive to, or intolerant of, conventional antipsychotics. It may cause AGRANULOCYTOSIS and use is con?ned to patients registered with the Clorazil (the drug’s registered name) Patient Monitoring Service. Amisulpride, olanzapine, quetiapine, risperidone, sertindole and zotepine are other antipsychotic drugs described as ‘atypical’ by the British National Formulary; they may be better tolerated than other antipsychotics, and their varying properties mean that they can be targeted at patients with a particular grouping of symptoms. They should, however, be used with caution.

The welcome long-term shift of mentally ill patients from large hospitals to community care (often in small units) has, because of a lack of resources, led to some schizophrenic patients not being properly supervised with the result that they fail to take their medication regularly. This leads to a recurrence of symptoms and there have been occasional episodes of such patients in community care becoming a danger to themselves and to the public.

The antipsychotic drugs are powerful agents and have a range of potentially troubling side-effects. These include blurred vision, constipation, dizziness, dry mouth, limb restlessness, shaking, sti?ness, weight gain, and in the long term, TARDIVE DYSKINESIA (abnormal movements and walking) which affects about 20 per cent of those under treatment. Some drugs can be given by long-term depot injection: these include compounds of ?upenthixol, zuclopenthixol and haloperidol.

Prognosis About 25 per cent of sufferers recover fully from their ?rst attack. Another 25 per cent are disabled by chronic schizophrenia, never recover and are unable to live independently. The remainder are between these extremes. There is a high risk of suicide.... schizophrenia

 1545-1611. Elizabethan physician. Born at Nantwich, Cheshire. Writer of the famous herbal: “Anatomie of Plants” (1597) in which is revealed considerable scientific insight into the medicinal character of plants. Herbalist to James I. Shakespeare must have visited his garden in Holborn, subsidised by the King. Also a surgeon, becoming a Master of Chirurgy. He was one of the first to discover the ‘companionship of plants’, referring to the affinities and antipathies in the plant kingdom.

First to grow potatoes in England. His garden at Holborn, London, and now Fetter Lane, was then a village. ... gerard, john

The process by which knowledge or abilities are acquired, or behaviour is modified. Various theories about learning have been proposed. Behavioural theories emphasize the role of conditioning, and cognitive theories are based on the concept that learning occurs through the building of abstract “cognitive” models, using mental capacities such as intelligence, memory, insight, and understanding.... learning

Treatment of mental and emotional problems by psychological methods. Patients talk to a therapist about their symptoms and problems, with the aim of learning about themselves, developing insights into relationships, and changing behaviour patterns.... psychotherapy

n. 1. a method of approaching psychological difficulties in adjustment that aims to help the client work out his own problems. The counsellor listens sympathetically, attempting to identify with the client, tries to clarify current problems, and sometimes gives advice. It involves less emphasis on insight and interpretation than does psychotherapy or psychoanalytic therapy. See also client-centred therapy. 2. see genetic counselling.... counselling

a *delusion in which the patient believes that unsuspicious occurrences refer to him or her in person. Patients may, for example, believe that certain news bulletins have a direct reference to them, that music played on the radio is played for them, or that car licence plates have a meaning relevant to them. Ideas of reference differ from delusions of reference in that insight is retained.... delusion of reference

a technique for encouraging users to talk about their experience of health care in subjective terms, thereby enabling providers to reflect on their practice and improve care delivery. Users are asked to talk about certain key moments of contact with the service (e.g. arrival on the ward, waking after an operation) and to characterize their experience using a selection of emotional words. The goal is to help staff to understand how users felt at these moments and thereby to develop more compassionate, holistic, and insightful care.... emotional touchpoints

an Act of Parliament to govern the treatment of people with a mental disorder, which is defined as including *mental illness, *personality disorder, and *learning disability. For England and Wales the Mental Health Act 1983 has been amended by the Mental Health Act 2007. The legislation provides for the voluntary and compulsory (involuntary) assessment and treatment of patients with a diagnosis or symptoms of a mental disorder. The purposes of involuntary admission are both to act in patients’ best interests, providing treatment for them when they have lost *insight into their illness, and to manage the risk that may arise from a mental disorder to the patients themselves or to others. One of the principal amendments in the 2007 Act is the introduction of Community Treatment Orders, which provide for the involuntary treatment of patients who have left hospital. Another, more controversial, change was the introduction of *sexual deviancy as a mental disorder to which the Act applies. In Scotland the current legislation is the Mental Health (Care and Treatment) (Scotland) Act 2003, which came into effect in April 2005. See section.... mental health act

(MSE) a full psychiatric examination of signs and symptoms, which takes place during a psychiatric interview and should apply only to signs and symptoms elicited at that time; it should not take into account historical information. The examination is usually divided into the following subheadings: appearance and behaviour, speech, mood, *affect, thought and perception, *insight, and orientation. Usually it also includes a *risk assessment.... mental state examination

a condition marked by a persistent delusion not associated with any other *mental illness. It is often of a *paranoid or persecutory nature, but can have any delusional content. Treatment is often difficult because patients commonly lack insight and refuse to try medication. When compliance can be achieved, the majority of patients respond well to antipsychotic medication.... monodelusional disorder

n. a form of group psychotherapy in which individuals acquire insight into themselves by acting out situations from their past with other group members. See group therapy.... psychodrama