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Samenvatting Klinische psychiatrie Psychologie
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Samenvatting Klinische psychiatrie Psychologie
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Klinische psychiatrie - PsychologieInhoud
H1: Inleiding: gebruik van de DSM-5..........................................................................................................8
1.1 Inleiding............................................................................................................................................8
1.1.1 Psychopathologie.......................................................................................................................8
1.1.2 Psychiatrische stoornis...............................................................................................................8
1.2 Classificatie.......................................................................................................................................9
1.2.1 DSM/ICD.....................................................................................................................................9
1.2.2 DSM: voor- en nadelen............................................................................................................10
1.2.3 Geschiedenis............................................................................................................................10
1.3 Diagnostiek.....................................................................................................................................10
1.4 Opzet DSM-5...................................................................................................................................10
1.4.1 Classificatiecriteria...................................................................................................................10
1.4.2 Classificatiecategorieën...........................................................................................................11
1.4.3 Deel III: aandoeningen die verder onderzoek behoeven.........................................................11
1.5 Globale veranderingen DSM-5.......................................................................................................12
1.6 Stellingen........................................................................................................................................12
1.7 Conclusie.........................................................................................................................................13
H2: Inleiding Klinische psychiatrie............................................................................................................14
2.1 Normaliteit en psychopathologie...................................................................................................14
2.1.1 Normaliteit...............................................................................................................................14
2.1.2 Criteria normaliteit..................................................................................................................14
2.1.3 Probleem van de subjectiviteit................................................................................................14
2.2 Epidemiologie.................................................................................................................................15
2.2.1 Psychiatrische epidemiologie..................................................................................................15
2.2.2 Algemene prevalentie..............................................................................................................16
2.3 Geschiedenis van de psychiatrie.....................................................................................................16
2.3.1 Hippocrates (ca.460-366 v.C.)..................................................................................................16
2.3.2 Exorcisme en heksenvervolgingen (drijftest, ca Middeleeuwen)............................................16
2.3.3 Gekkenhuizen...........................................................................................................................16
2.3.4 Vanaf 1800: hervormingen......................................................................................................17
2.3.5 Tweede wereldoorlog..............................................................................................................17
2.3.6 De anti-psychiatrische beweging.............................................................................................17
2.3.7 Evidence-based medicine.........................................................................................................17
2.3.8 Geschiedenis van de psychiatrie..............................................................................................17
2.4 Etiopathogenese (= verklaringsmodel)...........................................................................................18
2.5 Fysiopathogenese...........................................................................................................................18
2.5.1 Genetica...................................................................................................................................18
, 2.5.2 Epidemiologische studies.........................................................................................................19
2.5.3 Gen-omgeving-gen..................................................................................................................19
2.5.4 Heritabiliteit.............................................................................................................................19
2.5.6 Neurotransmitters....................................................................................................................20
2.6 Psychopathogenese........................................................................................................................20
2.6.1 Psychologisch perspectief........................................................................................................20
2.6.2 Psychische functies...................................................................................................................20
2.6.3 Het psychiatrisch onderzoek....................................................................................................23
H3: Neurocognitieve stoornissen.............................................................................................................25
3.1 Algemeen........................................................................................................................................25
3.1.1 Epidemiologie..........................................................................................................................25
3.1.2 Het geheugen...........................................................................................................................25
3.1.3 Ouderdom................................................................................................................................26
3.1.4 Neuropsychologische testen....................................................................................................26
3.2 Dementie.........................................................................................................................................28
3.2.1 Informatie netwerk..................................................................................................................28
3.2.2 Geheugen en veroudering.......................................................................................................28
3.2.3 Dementie: epidemiologie – expertisecentrum dementie Vlaanderen....................................28
3.2.4 Klinische kenmerken................................................................................................................28
3.3 Dementie – indeling........................................................................................................................30
3.3.1 Ziekte van Alzheimer................................................................................................................30
3.3.2 Vasculaire dementie................................................................................................................31
3.3.3 Frontotemporale dementie......................................................................................................32
3.3.4 Dementie met Lewy Bodies (DLB)............................................................................................32
3.3.5 Andere vormen van dementie.................................................................................................32
3.3.6 Dementie- diagnostiek.............................................................................................................33
3.3.7 Dementie - depressie...............................................................................................................33
3.3.8 Dementie – behandeling..........................................................................................................33
3.4 Delirium...........................................................................................................................................34
3.4.1 Epidemiologie..........................................................................................................................34
3.4.2 DSM - Delirium.........................................................................................................................34
3.4.3 Subtypes...................................................................................................................................35
3.4.4 Delirium – dementie - depressie..............................................................................................35
3.4.5 Oorzaken delier : I WATCH DEATH..........................................................................................35
3.4.5 Delirium: behandeling.............................................................................................................35
3.5 Amnestische stoornissen................................................................................................................35
H4: Middelengerelateerde en verslavingstoornissen..............................................................................36
4.1 Stoornissen in het gebruik..............................................................................................................36
4.1.1 Middelenmisbruik....................................................................................................................36
, 4.1.2 Middelenafhankelijkheid.........................................................................................................36
4.2 Stoornissen door het gebruik.........................................................................................................36
4.2.1 Intoxicatie door een middel.....................................................................................................36
4.2.2 Onthouding van een middel....................................................................................................36
4.3 Psychoactieve stoffen.....................................................................................................................37
4.3.1 Indeling - algemeen.................................................................................................................37
4.3.2 Alcohol.....................................................................................................................................37
4.3.3 Alcoholgebruik - epidemiologie...............................................................................................37
4.3.4 Alcoholgebruik – richtlijnen alcohol........................................................................................38
4.3.5 Stoornissen door gebruik.........................................................................................................38
4.4 Diagnostiek.....................................................................................................................................39
4.5 Etiopathogenese (= verklaringsmodel)...........................................................................................39
4.6 Prognose – preventie - behandeling...............................................................................................40
4.6.1 Prognose..................................................................................................................................40
4.6.2 Preventie..................................................................................................................................40
4.6.3 Behandeling.............................................................................................................................40
H5: Schizofrenie en andere psychotische stoornissen.............................................................................41
5.1 Psychotische stoornissen................................................................................................................41
5.2 Schizofrenie.....................................................................................................................................41
5.2.1 Klinische criteria.......................................................................................................................41
5.2.2 Algemene Kenmerken..............................................................................................................41
5.2.3 Comorbiditeit, DD, diagnostiek...............................................................................................43
5.2.4 Epidemiologie..........................................................................................................................44
5.2.5 Etiopathogenese......................................................................................................................45
5.2.6 Behandeling.............................................................................................................................46
5.2.7 Prognose, beloop – 4 fasen......................................................................................................48
5.3 Schizofreniforme stoornis...............................................................................................................48
5.4 Shizoaffectieve stoornis..................................................................................................................48
5.5 Waanstoornis..................................................................................................................................48
5.6 Kortdurende psychotische stoornis................................................................................................49
5.7 Gedeelde psychotische stoornis.....................................................................................................49
H6: Stemmingsstoornissen.......................................................................................................................50
6.1 Definities episodes..........................................................................................................................50
6.1.1 Depressieve..............................................................................................................................50
6.1.2 (Hypo)manische.......................................................................................................................50
6.1.3 Gemengde................................................................................................................................51
6.2 Kenmerken stemmingsstoornissen................................................................................................51
6.2.1 Uni : depressie, dysthymie.......................................................................................................51
6.2.2 Bi : Bip st type 1, 2, cyclothymie..............................................................................................52
, 6.3 Diagnostiek, DD en comorbiditeit..................................................................................................52
6.3.1 Diagnostiek..............................................................................................................................52
6.3.2 Differentiële diagnose & comorbiditeit...................................................................................53
6.4 Epidemiologie & etiopathogenese.................................................................................................53
6.4.1 Epdemiologie...........................................................................................................................53
6.4.2 Etiopathogenese / fysiopathogese..........................................................................................53
6.5 Stress, HPA en depressie................................................................................................................54
6.5.1 Etiopathogenese /psychopathogenese...................................................................................54
6.5.2 Automatische gedachten.........................................................................................................54
6.5.3 Verklaringsmodel..............................................................................................................55
6.5.4 Prognose depressieve stoornis – Beloop.................................................................................55
6.6 Behandeling....................................................................................................................................55
6.6.1 Psychotherapie.........................................................................................................................55
6.6.2 Psychofarmaca.........................................................................................................................56
6.6.3 Andere......................................................................................................................................56
6.7 Suïcide.............................................................................................................................................56
6.7.1 Suïcidaal proces.......................................................................................................................58
6.7.2 Ontremmende factoren...........................................................................................................58
6.7.3 Beschermende factoren...........................................................................................................58
6.7.4 Waarschuwingssignalen..........................................................................................................58
6.7.5 Exploratatie suïcidaliteit..........................................................................................................59
6.7.6 Ernst van suïcidale ideatie.......................................................................................................59
6.7.7 Tussen zorgen, beschermen en bewaken................................................................................59
H7: Angst- en eetstoornissen...................................................................................................................60
7.1 Angststoornissen............................................................................................................................60
7.1.1 Begrip angst.............................................................................................................................60
7.1.2 Angststoornissen......................................................................................................................60
7.1.3 Behandeling.............................................................................................................................60
7.1.4 Beschrijving angststoornissen.................................................................................................60
7.1.5 Angststoornissen - epidemiologie...........................................................................................66
7.2 Eetstoornissen................................................................................................................................66
7.2.1 Anorexia Nervosa.....................................................................................................................66
7.2.2 Bulimia Nervosa.......................................................................................................................67
7.2.3 Eetstoornissen - diagnostiek....................................................................................................67
7.2.4 Eetstoornissen - etiopathogenese...........................................................................................67
7.2.5 Eetstoornissen - behandeling...................................................................................................68
H8: Ontwikkelings- en gedragsstoornissen..............................................................................................69
8.1 ADHD...............................................................................................................................................69
8.1.1 Klinische kenmerken................................................................................................................69
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