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Theme 5: Psychiatry II. A complete summary of all exam material! $5.43   Add to cart

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Theme 5: Psychiatry II. A complete summary of all exam material!

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  • January 23, 2023
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Theme 5:


Psychiatry II
Summary




1

,Inhoud
Week 17: MUS (medically unexplained symptoms), PPS (persistent physical symptoms) and somatic
symptom disorder..................................................................................................................................4
Introduction........................................................................................................................................7
Somatic symptom and related disorders............................................................................................9
Syndromes......................................................................................................................................9
Development, course and impact.................................................................................................11
Diagnosis.......................................................................................................................................11
Differential diagnosis....................................................................................................................12
Epidemiology................................................................................................................................12
Aetiopathogenesis........................................................................................................................12
Treatment.....................................................................................................................................13
Factitious disorders..........................................................................................................................15
Syndromes....................................................................................................................................15
Development, course and impact.................................................................................................15
Diagnosis.......................................................................................................................................15
Differential diagnosis....................................................................................................................15
Aetiopathogenesis........................................................................................................................16
Treatment.....................................................................................................................................16
Functional neurological disorder......................................................................................................17
History..........................................................................................................................................17
Definition of FND..........................................................................................................................17
Pathophysiology...........................................................................................................................18
Treatment.....................................................................................................................................18
Occupational medicine.....................................................................................................................20
The insurance physician and the assessment of occupational disability......................................20
The absenteeism and occupational disability in social context....................................................20
Week 18: Psychosis..............................................................................................................................22
Psychosis spectrum disorders...........................................................................................................22
Introduction..................................................................................................................................22
Syndromes....................................................................................................................................22
Development, course and impact.................................................................................................26
Diagnosis.......................................................................................................................................27
Differential diagnosis....................................................................................................................27
Epidemiology................................................................................................................................28
Aetiopathogenesis........................................................................................................................28

2

, Treatment.....................................................................................................................................29
Psychiatry and the law......................................................................................................................32
The medical treatment contracts act (WGBO)..............................................................................32
The psychiatric hospitals (Compulsory admission) act (Wet BOPZ)..............................................33
Medicines in psychiatry....................................................................................................................35
Antidepressants............................................................................................................................35
Antipsychotics...............................................................................................................................36
Benzodiazepines...........................................................................................................................37
New pharmaceuticals, like es-ketamine and psylocibin................................................................37
Week 19: Stagnation............................................................................................................................38
Personality disorders........................................................................................................................38
Introduction..................................................................................................................................38
Syndromes....................................................................................................................................38
Development, course and impact.................................................................................................44
Diagnosis.......................................................................................................................................44
Differential diagnosis....................................................................................................................45
Epidemiology................................................................................................................................45
Aetiopathogenesis........................................................................................................................46
Treatment.....................................................................................................................................47
Neurodevelopmental disorders........................................................................................................49
Introduction..................................................................................................................................49
Syndromes....................................................................................................................................49
Development, course and impact.................................................................................................54
Diagnosis.......................................................................................................................................55
Differential diagnosis....................................................................................................................55
Epidemiology................................................................................................................................56
Aetiopathogenesis........................................................................................................................56
Treatment.....................................................................................................................................57




3

, Week 17: MUS (medically unexplained symptoms), PPS
(persistent physical symptoms) and somatic symptom
disorder
MUS = physical symptoms that last for longer than a few weeks and which cannot be
satisfactorily explained after adequate medical examination.
40% of consultations about certain symptoms cannot be explained by a medical condition
MUS = not a specific disease  focuses on the symptoms that cause persistent functional
impairment
Steps in treatment:
1. The GP treats the patient
2. The GP works together with or sends the patient to other primary care providers 
physiotherapists or psychologists
3. Treatment provided by multidisciplinary teams or treatment centres




After 12-15 months: symptoms improved in 50-75% of patients  10-30% have an increase
in symptoms
A good doctor-patient relationship is important  improves prognosis
 Relationship is often pressured due to rising frustration
Non-specific symptoms:
 Fatigue
 Headache
 Dizziness
 Lack of concentration
 Memory problems
Assessment of MUS is based on 5 dimensions: SCEGS
1. Somatic  tells the patient that the symptoms and their burden are taken seriously
4

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