تفاصيل المقرر

المقدمة


The human being is one unit composed of body and mind (soma & psyche). The concept of whole or “oneness” puts in perspective the importance of mental health as an integral part of human well-being.
Mental illness is a great disability both to the individual affected, his family and the community he lives in. The disability is multiple in the form of personal and family stress, loss of productivity, disruption of persinal life and the illness itself.
There is an unjustified bias against mental illness in most societies leading to misconcepts and a lack of mental health services which are given a low priority in the planning of health services. However, the problems of urbanization, economic development migration and social change are causing more awareness into the role and need for mental health services in developing countries. This is more so as infections and nutritional disorders are becoming increasingly under control.
Until recently, the interest and concern in mental illness was mainly left to religious and traditional healers as the late professor Tigani El Mahi stated, ``It will be true to generalize that in the Sudan psychiatric work is under religious hand almost completely “Modern their work and should try to encourage the good qualities and pracices they have while at the same time try to change or get rid of the hurmful and faculty practices forming part of their approach to the management of mental illness. Thus it is important to accept the friending approach pioneered by Tigani El Mahi from the dawn of modern psychiatry in the Sudan.
It is fortunate that this school has included an appreciable content of psychiatric instruction in previous relevant courses. This it so as to present a comprehensive course offering knowledge and skills in the handing and management of psychiatric problems



المحتويات


1 History of Psychiatry
2 Symptomatology & Classification
3 Social work in Psychiatry
4 Interviewing & history taking
5 The Schizophrenia
6 Affective Disorders
7 Anxety disorder and phobias
8 Obsessive compulsive discorde
9 Personality Disorders
10 Psychopharmacology
11 Organic Mental disorders
12 Social & community Psychiatry
13 Psychopharmacology
14 Suicide & Parasuicide
15 Epilepsy & Psychiatry
16 Drug Abuse and dependence
17 Child & Adolescent Psychiatry
18 Clinical Psychology
19 The Psychotherapies
20 Psychiatric Emergencies
21 Native & Religious Healing
22 Mental Handicap



المنسقون



المطلوبات


None


الأهداف


1) GENERAL OBJECTIVES:

By the end of this clerkship the student should acquire knowledge and develop skills in the following areas:
1.1 The concepts of mental health, mental ill health and mental hygiene (i.e. prevention)
1.2 The role of positive and negative factors affecting the mental and psycho-social well-being of the individual
1.3 Knowledge of the history of psychiatry in general and the history and development of psychiatric services in th Sudan in particular
1.4 The concept of community psychiatry care, and the role of professions related to psychiatry. The structure and development of mental health services and institutions in the Sudan e.g. hospitals, prisons, secure units and traditional healers.
1.5 The practice of psychiatry in the general hospital and the diagnosis, management and prevention of common mental health problems, in particular the major psychoses and incapicitating neurotic disorders.

2) SPECIFIC OBJECTIVES

2.1 Mental Health set up and Associated Disciplines problems Commonly encountered:- A difficult case for referral

Level I:

2.1.1 Describe the set up of psychiatric services and the role of the doctor in this system
2.1.2 Outline in general terms the concepts of clinical psychology relevant to psychiatric problems
2.1.3 Discuss the role of the following associated professions in the identification of cases and the delivery of services through mental health delivery systems
* Psychologist
* Social worker
* Community psychiatric nurse and other community workers e.g.
community health worker, midwives birth attendants
* Teachers
* Police, the courts and law enforcement personnel
* Medical assistants
* Religious and traditional healers

2.2 Discuss the rationale, principles, resources, application and practical aspects of social and community psychiatry

2.3 Definitions and symptomatology:
Define the following terms:

Level I:

* Delusions, hallucination, illusion
* Psychosis, neurosis
* Personality disorder, psychopathy
* Affect, mood, emotions, incongruity, depression elation, hypomania, grandiosity
* Thinking disorders, incoherence, perseveration, circumstanciality
* Perception and its disorders
* Paranoid - insight
* Fugue - amnesia - confusion - automatism

Level II:

* Confabulations
* De ja vu
* Hypnagopic and hypnapomic
* Delirium
* Cognitive functions

2.4 Psyciciatric disorders and their classification common psychiatric problems
- Schizophrenia in its various forms and presentations
- Manic-depressive psychosis
- Anxiety neuroses, hysteria and neurotic depression
- Alcoholism and drug addiction including cannabis abuse and glue-sniffing
- Suicide and attempted suicide
- The acutely disturbed patient and psychiatric emergencies
- Organic states
- Psychiatric disorders in childhood

Level I:

2.5 Discuss the importance of each of the following aetiological factors in the causation of mental illness, genetic, constitutional, biochemical, physical, environmental, psycho-social and toxic factors

Given a patient with a problem from the above list the student should be able to:
2.5.2 Take a proper history: family, developmental personal and social
2.5.3 Generate a list of relative problems and hypothesis
2.5.4 Perform a proper physical examination, if necessary, illiciting physical signs and carry out a reasonable mental state examination
2.5.5 Modify or summarise the findings to a simple management plan following proper assessment
2.5.6 Request the necessary investigations as required and be ready to discussthe initial treatment under supervision

2.6 Organic psychiatry
Level I:

* Diagnose and discuss the aetiology, epidemiology and management of the following conditions:
* Epilepsy: controlled & uncontrolled
* Psychological complications of head injury
* Organic brain syndromes e.e. dementia, delirium, toxic confusion states, puerperal psychosis

Level II:

Outline the clinical features and management of
1 Korsakoff psychosis
2 Frontal lobe syndrome
3 Huntington's chorea
4 Down's syndrome (mongolism)

2.7 Nurosis: Discuss the presentation, aetiology diagnosis, epidemiology and management of:
Level I:

* Anxiety states
* Hysteria (dissociative and conversion disorders)
* Neurotic depression (reactive)
* Phobic states

Level II:

* Hypochondriasis
* Obsessive - compulsive disorders

2.8 Psychoses: Discuss the presentations, aetiology, diagnosis, epidemiology management of:
Level I:

* The schizophrenias and their classification
* Paranoid psychoses
* Differentiate organic and functional psychoses

2.9. Affective disorders
Level I:

Discuss the presentation, aetiology, diagnosis, epidemiology, complications and management of:
* Depression episode
* Manic episode
* Mixed affective state

2.10. Alcohol and Drug Abuse: Discuee the features , aetiology, diagnosis, epidemiology and management of:
Level I:

* The Alcohol dependence syndrome
* Hashish (bango, cannabis) abuse
* Glue-sniffing and benzine sniffing

Level II:

* Features and management of opiate addiction
* Features and management of barbiturate dependence
* Features and management of other drugs of abuse

2.11 Psychiatric emergencies
Level I:

The diagnosis of
1 The acutely disturbed patient
2 The suicidal patient and the overdose
3 Hysterical conversions e.g. hyperventilation, fits, fugues
4 Delirium tremens

2.12 Treatment in psychiatry
Level I:

2.12.1 The classification of drugs in psychiatry
2.12.2 The use, actions and side effects of the following drugs:
* Major tranquillizers e.g. phenothiazines, butrophenones
* Anti-depressants e.g. tricydics, .A.O.I. litheium
* Minor tranquillizers e.g. benzodiazepines
* Hypno-sedatines e.g. barbiturates
* Anti-convulsants e.g. barbiturates, benzodiazepines, sodium valproate, caramazepine
2.12.3 ECT
Historical development, indications, application, and complications of electro-convulsive therapy

Level II:

2.12.4 Psychosurgery
2.12.5 The psychotherapies
2.12.6 Legal and forensic psychiatry. Common problems encountered e.g. the mentally abnormal offendder, suicide, guardianship, court procedures, delinquency

2.13 Child and Adolescent psychiatry and mental handicap:
Level I

* The diagnosis, aetiology, epidemiology management of a mentally retarded child and advice to parents
* Enuresis and encopresis.
* School non-attendance
* Neruotic disorders in childhood

Level II:

* Sleep walking, nightmares and nightterrors
* Stutoring and stammering

2.14 Psychopathy and personality disorders :
Level I:

Outline the classification and management of personality disorders
including psychopathy and its classification.



طرق التدريس


1 Lectures
2 Seminars
3 Tutorials
4 Clinical rounds and outpatient clinics
5 PBL
6 Visits to traditional healing centers



المصادر


1) Human resources

* Psychiatrists 4
* Clinical psychologist
* Medical assistant
* Social workers
* Legally qualified staff (layer and judge)

2) Physical resources

* Lecture room to accommodate students
* Transport to hospital and during visits
* Transport of visiting staff
* Overhead projector
* Slide projector



وسائل التقويم


1 attendances and prefumance 10%
2 written examination
- MCQs 30%
- Short essay questions & clinical problem 20%
3 OSCE 20%
4 Clinical examination 20%



المراجع



الجدول الزمني

Sun 6/11/2016 9:00 – 10:30 Introduction :Definition & Classification of Mental Disorders Dr. Adil Ali
11:00 – 12:30 Symptoms & Signs of mental disorders Dr. Adil Ali
1:00 -2:30 Interviewing & History Taking Dr. Adil Ali
Mon 7/11/2016 9:00 – 10:30 Etiology of Mental Disorders Dr. Nosiba Soliman
11:00 – 12:30 Affective Disorders Dr. Nosiba Soliman
1:00 -2:30 Conversion & Dissociative Disorders Dr. Nosiba Soliman
Tues 8/11/2016 9:00 – 10:30 Personality Disorders Dr. Adil Ali
11:00 – 12:30 Anxiety& Phobias Dr. Nosiba Soliman
12:30 – 2:00 Somatoform Disorders Dr. Nosiba Soliman
Wed 9/11/2016 9:00 – 10:30 Obsessive – Compulsive Disorders Dr. Inshirah Mustafa
11:00 – 1:00 Psychotherapy Dr. Inshirah Mustafa
Thurs. 10/11/2016 9:00 - 11:00 Childhood Disorders Dr. Taiseer Abdellah
12:00 – 2:00 Psycho-Sexual Disorders Dr. Taiseer Abdellah
Sun 13/11/2016 9:00 – 11:00 Schizophrenia Dr. Nosiba Soliman
12:00 – 2:00 Presenting clinical problem (1 & 2) Distribution of Groups , Assignments & Logbooks Dr. Adil Ali
Mon 14/11/2016 8:00 – 11:00 Case Studies (Hassan Allawb Hospital) Dr. Adil Ali
12:00 – 2:00 Social Work in Psychiatry Dr. Nagat Hussain
Tues. 15/11/2016 8:00 – 11:00 Case Studies Mental Health Hospital (Referred) (Hassan Allawb Hospital) Dr. Nosiba Soliman Dr. Adil Ali
12:00 – 1:30 Drug abuse & Dependence Dr. Nosiba Soliman
Wed 16/11/2016 9:00 – 3:00 Discussion of cases
Thurs. 17/11/2016 9:00 – 11:00 Discussion of cases Dr. Nosiba Soliman
11:30 – 1:30 Tutorial : Drug Abuse & Dependence Dr. Nosiba Soliman
Sun 20/11/2016 8:00 – 11:00 Case Studies Mental Health Hospital (Referred) (Hassan Allawb Hospital) Group Work & Clinical Problem 2 Dr. Nosiba Soliman Dr. Adil Ali
Mon 21/11/2016 Case Studies- Traditional healing Center( Wad Elobayid Village( Discussion of cases Dr. Nagat Hussain
Tues 21/11/2016 8:00 – 11:00 Case Studies Mental Health Hospital (Referred) (Hassan Allawb Hospital) Tutorial :Psychiatric Patient & Law Dr. Nosiba Soliman Dr. Adil Ali Dr Nadia Kambal
Wed 23/11l2016 9:00 – 11:00 11:30 – 1:30 Cases Discussion
2:00 – 3:30 Tutorial &Clinical Problem Dr. Anas Ibnauf
Thud 24/11/2016 9:00 – 10:30 Cases Discussion & Clinical Problem Dr. Adil Ali
11:00 – 1:00 Handing Assignments & Logbooks Dr. Adil Ali
Sun 27/11/2016 ELECTIVE
Mon 28/11/2016 Written Exam (MCQs & Short Assay(
Tues 29/11/2016 OSCE
Wed 30/11/2016
Thurs 1/12l/2016 Clinical & Oral Exam

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