8 MINOR DISORDERS ANXIETY DEPRESSION OBSESSIVE COMPULSIVE DISORDER Apprehension about future, On the edge, Somatic Symptoms, AvoidanceDEPRESSIONSustained Change of Mood, Inability to enjoy, Negative Cognitions, Lack of Interest, Sleep and Appetite DisturbanceOBSESSIVE COMPULSIVE DISORDERRepetitive intrusive thoughts recognized to be absurd have to be controlled by either doing something or avoiding somethingDISORDER OF SEXUAL FUNCTION
9 DIAGNOSING PSYCHIATRIC DISORDER APPEARANCE AND BEHAVIORSPEECHMOODTHOUGHTPERCEPTIONCOGNITION
10 HOW TO ANALYSE? WHAT ARE THE AREAS OF DISTURBANCE? IN WHAT AREA IS THE KEY DISTURBANCE?WHAT AREA DID THE DISTURBANCE START FROM?WHAT AREA IS THE MOST DISTRESSING?ARE THERE ANY CAUSATIVE RELATIONSHIPS?
11 HISTORY I/D CHIEF COMPLAINTS IN CHRONOLOGICAL ORDER HOPI SPONTANEOUS CHRONOLOGICAL ACCOUNTCOMPLETE THE SYNDROMENEGATIVE HISTORYTREATMENT HISTORY
12 HISTORY PAST PSYCHIATRIC HISTORY PAST MEDICAL HISTORY FAMILY HISTORY PERSONAL HISTORYBIRTHCHILDHOODADULTRELATIONSHIPS WORK LEISUREPRESENT LIVING CIRCUMTANCESPRESENT FAMILY
18 BASICSALWAYS TRY TO EXPLAIN ALL SYMPTOMS WITH ONE DIAGNOSIS/HYPOTHESISBUT CO-MORBIDITY IS A REALITYCONSIDER A DIAGNOSIS OF PERSONALITY DISORDER IF THERE IS NO CLEAR CUT ONSET/ THERE ARE PATTERNS IN INTER PERSONAL RELATIONSHIPS
19 BASICS RULE OUT LEARNING DISORDER RULE OUT ORGANIC DIAGNOSIS RULE OUT SUBSTANCE ABUSERULE OUT MOOD DISORDERRULE OUT SCHIZOPHRENIACONSIDER MINOR PSYCHIATRIC DISORDER
20 WHAT WORKS?MEDICINEPSYCHOLOGICAL TREATMENTSSOCIAL SUPPORTS
21 How to explore? Active Listening Explore triggers and patterns in psychosocial contextDo not ask whyDo not suggest that symptoms are functionalLook out for key symptoms
22 Depression is treatable Antidepressants and not benzodiazepinesAdequate dosagesAdequate timeWhen to refer?
23 Which antidepressant? Conventional Least side effects Same as the one that worked last timeDifferent from the ones which have already been tried without a positive resultExplore causes of non response
24 Is psychotherapy possible at the level of general practice? YesWhat methods?Cognitive Behaviour TherapySupportive Therapy
25 Cognitive Behaviour Therapy We ThinkWe FeelWe ActIf we change the way we think we can change the way we act
26 How to change thinking? Identify negative thoughts Identify patterns in themLearn methods of challenging the patternsReplace these with lesser negative thoughts
27 Physician heal thyself What are my needs?What are my need fulfilling activities and how much time do I spend in trying to do them?What are the obstacles?What can I do about the obstacles?