learning Objectives - List various mental disorders and describe their mental and psychiatric and nursing management.
Hours - 25
Teaching and Learning Activities - Lecture cum discussions Case study Case Presentation Process recording Videos Role plays Field visitsDe-addiction centers, Alcohol Anonyms group, Adolescent clinics, Child guidance centers etc
Assessment Methods - Short answers Essay types Case Study Case Presentation
Content of the chapter
a) Psycho-Pathophysiology of human behavior
b) Etiological theories (genetics, biochemical,
psychological etc)
c) Classification of mental disorders.
d) Disorders of thought, motor activity,
perception, mood, speech, memory,
concentration, judgment
e) Prevalence, etiology, signs and symptoms,
prognosis, medical and Nursing
management
f) Personality & types of personality related to
psychiatric disorder
g) Organic mental disorders: Delirium,
Dementia
f) Psychotic disorders:
– Schizophrenic disorders
– Mood (affective) disorders: Mania
depression, Bipolar affective
disorders(BPAD)
h) Neurotic disorders: Phobia, anxiety
disorders,obsessive compulsive disorders,
depressive neurosis, conversion disorders,
dissociative reaction, psychosomatic
disorders, post traumatic stress disorder
i) Substance use and de-addiction: alcohol,
tobacco and other psychoactive substance
j) Child and adolescent psychiatric disorder;
– Sleep disorder
– Eating disorders
– Sexual disorders
k) Nursing Management: Nursing process and
process recording in caring for patients with
various psychiatric disorders
Mental Disorders and Nursing Interventions
Mental disorders result from disturbances in biological, psychological, and social functioning. Nurses play a vital role in assessment, treatment, rehabilitation, and prevention using a holistic approach.
a) Psycho-Pathophysiology of Human Behavior
Psychopathophysiology explains how biological processes influence abnormal behavior.
Key Factors:
- Neurotransmitter imbalance (dopamine, serotonin, norepinephrine)
- Structural brain abnormalities
- Endocrine disturbances
- Genetic vulnerability
- Stress response (HPA axis dysfunction)
Example:
- Excess dopamine → Schizophrenia
- Low serotonin → Depression
b) Etiological Theories of Mental Illness
1. Genetic Theory
- Mental illness may be inherited
- Seen in schizophrenia, bipolar disorder
2. Biochemical Theory
- Neurotransmitter imbalance
- Hormonal dysfunction
3. Psychological Theory
- Freud’s psychoanalytic theory
- Unresolved conflicts
- Defense mechanisms
4. Behavioral Theory
- Learned maladaptive behaviors
- Reinforcement and conditioning
5. Social Theory
- Poverty, abuse, trauma
- Family conflict
- Stressful life events
c) Classification of Mental Disorders
(Based on ICD-10 / DSM-5)
- Organic mental disorders
- Substance use disorders
- Schizophrenia and other psychotic disorders
- Mood (affective) disorders
- Neurotic, stress-related disorders
- Personality disorders
- Childhood and adolescent disorders
d) Disorders of Mental Functions
Disorders of:
- Thought: Delusions, flight of ideas, obsession
- Motor activity: Catatonia, agitation, retardation
- Perception: Hallucination, illusion
- Mood: Depression, mania
- Speech: Mutism, pressured speech
- Memory: Amnesia, dementia
- Concentration: Distractibility
- Judgment: Poor decision-making
e) Prevalence, Etiology, Signs & Symptoms, Prognosis and Management
General Signs & Symptoms:
- Altered behavior
- Emotional instability
- Disturbed sleep and appetite
- Poor self-care
- Social withdrawal
Prognosis:
- Depends on early diagnosis, treatment compliance, family support
Medical Management:
- Antipsychotics
- Antidepressants
- Mood stabilizers
- Anxiolytics
- Psychotherapy
- ECT (when indicated)
Nursing Management:
- Observation and assessment
- Medication administration
- Therapeutic communication
- Health education
- Family counseling
- Rehabilitation
f) Personality and Types Related to Psychiatric Disorders
Personality:
Pattern of thinking, feeling, and behaving.
Types:
- Paranoid
- Antisocial
- Borderline
- Histrionic
- Obsessive-compulsive
- Avoidant
- Dependent
Personality disorders lead to maladaptive interpersonal functioning.
g) Organic Mental Disorders
Delirium
- Acute, reversible
- Causes: infection, drugs, metabolic imbalance
- Symptoms: confusion, disorientation, hallucinations
Dementia
- Chronic, progressive
- Causes: Alzheimer’s disease
- Symptoms: memory loss, impaired judgment
Nursing Care:
- Safety
- Orientation
- Assistance with ADLs
- Family support
h) Psychotic Disorders
Schizophrenia
- Disturbance in thought, perception, affect
- Delusions, hallucinations
Mood Disorders
- Mania: Elevated mood, hyperactivity
- Depression: Sadness, hopelessness
- BPAD: Alternating mania and depression
Nursing Interventions:
- Reality orientation
- Medication supervision
- Suicide precautions
- Structured environment
i) Neurotic Disorders
Includes:
- Phobia
- Anxiety disorders
- OCD
- Depressive neurosis
- Conversion disorder
- Dissociative disorders
- Psychosomatic disorders
- PTSD
Management:
- Psychotherapy
- Relaxation techniques
- Behavioral therapy
- Supportive nursing care
j) Substance Use and De-addiction
Substances:
- Alcohol
- Tobacco
- Opioids
- Cannabis
- Sedatives
De-addiction Phases:
- Detoxification
- Rehabilitation
- Relapse prevention
Nursing Role:
- Withdrawal monitoring
- Motivation
- Health education
- Family involvement
k) Child & Adolescent Psychiatric Disorders
Disorders:
- Sleep disorders
- Eating disorders (anorexia, bulimia)
- Sexual disorders
- Behavioral and emotional disorders
Management:
- Counseling
- Family therapy
- Behavioral modification
- School coordination
l) Nursing Management: Nursing Process
Nursing Process in Psychiatric Care
- Assessment
- History
- Mental status examination
- Nursing Diagnosis
- Anxiety
- Disturbed thought process
- Risk for violence
- Planning
- Goal setting
- Individualized care plan
- Implementation
- Therapeutic communication
- Medication administration
- Milieu therapy
- Evaluation
- Improvement in symptoms
- Goal achievement
Process Recording
- Written account of nurse-patient interaction
- Used to evaluate communication and care effectiveness
Conclusion
Mental disorders require early identification, multidisciplinary treatment, and compassionate nursing care. Psychiatric nurses play a crucial role in assessment, therapeutic intervention, rehabilitation, and mental health promotion, ensuring holistic patient care.