1. Nutritional Therapy For psychiatric patient Prepared by Mrs/ HAMDIA MOHAMMED

2. Learning Objectives Describe the importance of nutritional therapy through the introduction. List the component of nutrition. Identify how to assess nutritional status.

4.  Carbohydrate major source for energy.  Protein: essential for growth and repair of body tissues; energy source  Complete protein: contains all essential amino acids (high biologic value proteins). Meat, fish, poultry or ch…, milk, eggs  Fat: main source of fatty acids essential for normal growth and development  Required amounts of (vitamins/ minerals)  Essential for growth/development and metabolic processes

5. Vitamins :- Deficiencies of several vitamins are known to be associated with irritability. These include niacin, pantothenic acid, thiamine, vitamin B6 and vitamin C. Under laboratory conditions, adverse behavioral changes precede specific clinical findings in a number of vitamin deficiencies.

6. Little researches has been published to prove a relationship between the aggressive behavioral syndrome in humans and marginal vitamin nutriture, Lonsdale and Shamberger, writing in The American Journal of Clinical Nutrition, reported on twenty people eating "junk food" diets who were found to have biochemical evidence of marginal thiamine deficiency. Their subjects, and particularly the adolescents, were impulsive, highly irritable, aggressive and sensitive to criticism.

7. Mental retardation can result from chronic vitamin B6 and zinc deficiency as well as hyperactivity, epilepsy. Effective treatment is done with extra vitamin B6 and zinc.

8. The most important vitamins are Bl (thiamine) and B3 (niacin) and the antioxidant nutrients, vitamins C, E and selenium. Vitamin Bl deficiency has long been known to result in brain damage. Nicotinic a cid or niacin is crucial for oxygen utilization.

9. Following thiamine supplementation, their behavior improved concurrent with laboratory evidence of improved thiamine nutriture.

10. 2. Minerals Iron The most common nutritional deficiency in industrialized societies, 10% of American males and 3% of American females are overtly iron-deficient (ferritin less than 10 mg/mL. A deficiency of iron is known to interfere with proper brain function.

11. Dopamine is a major neurotransmitter in the brain, iron is highly concentrated in the dopamine pathways, and animal studies have shown that iron deficiency may cause learning deficits and consequent behavioral impairment by diminishing dopamine neurotransmission. Iron is also needed as a co-factor for the enzymes but also serotonin and norepinephrine, which also have a potent influence on behavior. etabolize not only dopamine,

12. Magnesium magnesium deficiency, which enhances catecholamine secretion and sensitivity to stress.The aggressive behavior may promote by take 50 milligram per day is helpful to counter the voluntary motion causing incomplete or partial movement in a patient with tardive dyskinesia.

13. (TD) is a syndrome of permanent involuntary movements. This is most commonly caused by the long-term use of :- antipsychotic drugs. There is no treatment available. The symptoms of TD include involuntary movements of the tongue, facial, and neck muscles, upper and lower extremities, and truncal musculature. Tongue thrusting and protruding, lip smacking, blinking, grimacing, and other excessive

14. Manganese Manganese is an essential trace mineral. Massive overexposure produces "manganese madness" which may initially be marked by violence, criminal acts and a state of mental excitement; later, neurological impairment slowly develops, with signs and symptoms which resemble Parkinson's disease.

15. General appearance/level of orientation Inspect skin: characteristics, hydration, lesions Inspect hair/nails: appearance/texture Inspect eyes: surface characteristics Inspect oral cavity: dentition/mucous membranes Inspect/palpate extremities: shape, size, coordinated movement, sensation Focused Nutritional Exam