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Samenvatting - Klinische psychiatrie (1002768BER)
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  • Course
  • Klinische psychiatrie (1002768BER)
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  • Vrije Universiteit Brussel (VUB)

Deze samenvatting bevat alle leerstof te kennen in het vak Klinische psychiatrie. Ik maakte deze op basis van mijn lesnotities, de slides van de prof en handboeken uit mijn vooropleiding. Ik slaagde meteen van de eerste keer voor dit vak gezien mijn samenvatting uitgebreid maar toch ook beknopt is....

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  • August 6, 2024
  • 106
  • 2023/2024
  • Summary

Subjects

  • dsm 5
  • stemmingsstoornissen
  • angst en eetstoornissen
  • neurocognitieve stoornissen
  • middelengerelateerde stoornissen
  • schizofrenie en andere psychotische stoornissen
  • ontwikkelings en gedragsstoornissen
  • ex

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  • Vrije Universiteit Brussel (VUB)
  • Psychologie
  • Klinische psychiatrie (1002768BER)
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KLINISCHE PSYCHIATRIE
2022-2023


INHOUDSOPGAVE
1. INLEIDING: GEBRUIK VAN DE DSM-5 ................................................................................................................................ 4
1.1. INLEIDING: PSYCHOPATHOLOGIE / PSYCHIATRISCHE STOORNIS ............................................................................ 4
1.2. CLASSIFICATIE ......................................................................................................................................................... 5
1.3. DIAGNOSTIEK .......................................................................................................................................................... 7
1.4. GLOBALE VERANDERINGEN DSM-5......................................................................................................................... 7
1.5. OPZET DSM-5 .......................................................................................................................................................... 8
1.6. STELLINGEN............................................................................................................................................................. 9
1.7. CONCLUSIE .............................................................................................................................................................. 9
2. INLEIDING ....................................................................................................................................................................... 10
2.1. NORMALITEIT EN SUBJECTIVITEIT ......................................................................................................................... 10
2.2. EPIDEMIOLOGIE .................................................................................................................................................... 11
2.3. PREVALENTIE......................................................................................................................................................... 12
2.4. GESCHIEDENIS VAN DE PSYCHIATRIE .................................................................................................................... 12
2.5. ETIOPATHOGENESE ............................................................................................................................................... 14
2.5.1. FYSIOPATHOGENESE ................................................................................................................................... 14
2.5.2. PSYCHOPATHOGENESE................................................................................................................................ 17
2.6. HET PSYCHIATRISCH ONDERZOEK ......................................................................................................................... 20
3. NEUROCOGNITIEVE STOORNISSEN ................................................................................................................................. 22
3.1. EPIDEMIOLOGIE .................................................................................................................................................... 22
3.2. HET GEHEUGEN..................................................................................................................................................... 22
3.3. OUDERDOM .......................................................................................................................................................... 23
3.4. DEMENTIE ............................................................................................................................................................. 23
3.4.1. KLINISCHE KENMERKEN............................................................................................................................... 24
3.4.2. INDELING DEMENTIE ................................................................................................................................... 25
3.4.3. ZIEKTE VAN ALZHEIMER (Dementie van het Alzheimer-Type) .................................................................... 25
3.4.4. VASCULAIRE DEMENTIE............................................................................................................................... 27
3.4.5. FRONTOTEMPORALE DEMENTIE ................................................................................................................. 27
3.4.6. DEMENTIE MET LEWY BODIES (DLB) ........................................................................................................... 27
3.4.7. ANDERE VORMEN VAN DEMENTIE.............................................................................................................. 28
3.4.8. DIAGNOSTIEK .............................................................................................................................................. 28
3.4.9. BEHANDELING ............................................................................................................................................. 29
3.5. DELIRIUM .............................................................................................................................................................. 30
3.6. AMNESTISCHE STOORNISSEN ............................................................................................................................... 31
4. MIDDELENGERELATEERDE STOORNISSEN ...................................................................................................................... 32
4.1. STOORNISSEN IN HET GEBRUIK............................................................................................................................. 32
4.1.1. MIDDELENMISBRUIK ................................................................................................................................... 32
4.1.2. MIDDELENAFHANKELIJKHEID ...................................................................................................................... 32
4.2. STOORNISSEN DOOR HET GEBRUIK ...................................................................................................................... 33
4.2.1. INTOXICATIE ................................................................................................................................................ 33
4.2.2. ONTHOUDING ............................................................................................................................................. 33
4.3. PSYCHOACTIEVE STOFFEN .................................................................................................................................... 34
4.3.1. INDELING ..................................................................................................................................................... 34
4.3.2. ALCOHOL ..................................................................................................................................................... 34
4.3.3. DRUGS: STOORNISSEN DOOR HET GEBRUIK ............................................................................................... 36
4.4. MIDDELENGERELATEERDE EN VERSLAVINGSSTOORNISSEN ................................................................................. 37
4.4.1. DIAGNOSTIEK .............................................................................................................................................. 37
4.4.2. ETIOPATHOGENESE ..................................................................................................................................... 37

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, 4.4.3. PROGNOSE .................................................................................................................................................. 38
4.4.4. BEHANDELING ............................................................................................................................................. 38
5. SCHIZOFRENIE EN ANDERE PSYCHOTISCHE STOORNISSEN ............................................................................................ 40
5.1. PSYCHOTISCHE STOORNISSEN .............................................................................................................................. 40
5.2. SCHIZOFRENIE ....................................................................................................................................................... 40
5.2.1. KENMERKEN ................................................................................................................................................ 40
5.2.2. COMORBIDITEIT EN DIAGNOSTIEK .............................................................................................................. 43
5.2.3. EPIDEMIOLOGIE........................................................................................................................................... 44
5.2.4. ETIOPATHOGENESE ..................................................................................................................................... 44
5.2.5. BEHANDELING ............................................................................................................................................. 46
5.2.6. PROGNOSE EN BELOOP ............................................................................................................................... 48
5.3. SCHIZOFRENIFORME STOORNIS ............................................................................................................................ 48
5.4. SCHIZOAFFECTIEVE STOORNIS .............................................................................................................................. 48
5.5. WAANSTOORNIS ................................................................................................................................................... 49
5.6. KORTDURENDE PSYCHOTISCHE STOORNIS ........................................................................................................... 49
5.7. GEDEELDE PSYCHOTISCHE STOORNIS ................................................................................................................... 49
6. STEMMINGSSTOORNISSEN ............................................................................................................................................. 50
6.1. DEFINITIES EPISODES ............................................................................................................................................ 50
6.1.1. DEPSRESSIEVE EPISODE ............................................................................................................................... 50
6.1.2. HYPO-MANISCHE EPISODE .......................................................................................................................... 51
6.1.3. GEMENDE EPISODE ..................................................................................................................................... 52
6.2. KENMERKEN STEMMINGSSTOORNISEN................................................................................................................ 52
6.2.1. UNIPOLAIRE STEMMINGSSTOORNIS ........................................................................................................... 52
6.2.2. BIPOLAIR...................................................................................................................................................... 53
6.3. DIAGNOSTIEK EN COMORBIDITEIT ........................................................................................................................ 54
6.4. EPIDEMIOLOGIE EN ETIOPATHOGENESE .............................................................................................................. 55
6.5. BEHANDELING ....................................................................................................................................................... 57
6.6. SUÏCIDE ................................................................................................................................................................. 59
7. ANGST- EN EETSTOORNISSEN ......................................................................................................................................... 61
7.1. INLEIDING.............................................................................................................................................................. 61
7.2. ANGSTSTOORNISSEN ............................................................................................................................................ 62
7.2.1. SPECIFIEKE/ENKELVOUDIGE FOBIE .............................................................................................................. 62
7.2.2. PANIEKSTOORNIS EN AGORAFOBIE ............................................................................................................. 63
7.2.3. SOCIALE FOBIE ............................................................................................................................................. 65
7.2.4. OBSESSIEVE-COMPULSIEVE STOORNIS (OCD) ............................................................................................. 65
7.2.5. GEGENERALISEERDE ANGSTSTOORNIS........................................................................................................ 66
7.2.6. POSTTRAUMATISCHE STRESSTOORNIS ....................................................................................................... 67
7.2.7. ACUTE STRESSSTOORNIS ............................................................................................................................. 69
7.3. EETSTOORNISSEN.................................................................................................................................................. 69
7.3.1. ANOREXIA NERVOSA ................................................................................................................................... 69
7.3.2. BULIMIA NERVOSA ...................................................................................................................................... 70
7.3.3. DIAGNOSTIEK .............................................................................................................................................. 71
7.3.4. ETIOPATHOGENESE ..................................................................................................................................... 71
7.3.5. BEHANDELING ............................................................................................................................................. 72
8. ONTWIKKELINGS- EN GEDRAGSSTOORNISSEN ............................................................................................................... 73
8.1. INLEIDING.............................................................................................................................................................. 73
8.2. ADHD: ONTWIKKELINGSSTOORNIS ....................................................................................................................... 74
8.2.1. KLINISCH BEELD ........................................................................................................................................... 74
8.2.2. CLASSIFICATIE .............................................................................................................................................. 76
8.2.3. EPIDEMIOLOGIE........................................................................................................................................... 76
8.2.4. DIAGNOSTIEK .............................................................................................................................................. 77
8.2.5. BEHANDELING ............................................................................................................................................. 77
8.3. ASS: ONTWIKKELINGSSTOORNIS ........................................................................................................................... 78
8.3.1. KLINISCHE KENMERKEN............................................................................................................................... 78


2

, 8.3.2. VERKLARINGSMODEL: ETIOPATHOGENESE EN FYSIOPATHOGENESE ......................................................... 79
8.3.3. COMORBIDITEIT .......................................................................................................................................... 80
8.3.4. BEHANDELING ............................................................................................................................................. 80
8.4. EXTERNALISERENDE STOORNISSEN: GEDRAGSSTOORNISSEN .............................................................................. 81
8.4.1. ALGEMEEN .................................................................................................................................................. 81
8.4.2. OPPOSITIONELE-OPSTANDIGE STOORNIS ................................................................................................... 82
8.4.3. NORMOVERSCHRIJDEND-GEDRAGSSTOORNIS............................................................................................ 82
8.4.4. ETIOPATHOGENESE ..................................................................................................................................... 84
8.4.5. PREVENTIE ................................................................................................................................................... 85
8.4.6. BEHANDELING ............................................................................................................................................. 86
9. GEDWONGEN OPNAME ............................................................................................................................................. 86
10. SLAAP- EN SEKSUELE STOORNISSEN .......................................................................................................................... 87
10.1. SLAAPSTOORNISSEN......................................................................................................................................... 87
10.1.1. HET SLAAPPROCES....................................................................................................................................... 87
10.1.2. DYSSOMNIA: VERSTOORD SLAAPPROCES ................................................................................................... 87
10.1.3. PARASOMNIA: NORMAAL SLAAPPROCES .................................................................................................... 90
10.1.4. BEHANDELINGEN......................................................................................................................................... 91
10.2. SEKSUELE STOORNISSEN .................................................................................................................................. 92
10.2.1. SEKSUELE DISFUNCTIES ............................................................................................................................... 92
10.2.1. SEKSUELE DISFUNCTIES: DIAGNOSTIEK, ETIOPATHOGENESE, BEHANDELING .................................................... 94
10.2.2. PARAFILIEËN ................................................................................................................................................ 95
11. PERSOONLIJKHEIDSSTOORNISSEN ............................................................................................................................. 98
11.1. ALGEMEEN ....................................................................................................................................................... 98
11.2. CLUSTER A ........................................................................................................................................................ 99
11.2.1. PARANOÏDE PERSOONLIJKHEIDSSTOORNIS................................................................................................. 99
11.2.2. SCHIZOÏDE PERSOONLIJKHEIDSSTOORNIS ................................................................................................... 99
11.2.3. SCHIZOTYPISCHE PERSOONLIJKHEIDSSTOORNIS ....................................................................................... 100
11.3. CLUSTER B ...................................................................................................................................................... 100
11.3.1. ANTISOCIALE PERSOONLIJKHEIDSSTOORNIS ............................................................................................. 101
11.3.2. BORDERLINE PERSOONLIJKHEIDSSTOORNIS ............................................................................................. 101
11.3.3. THEATRALE PERSOONLIJKHEIDSSTOORNIS ............................................................................................... 102
11.3.4. NARCISTISCHE PERSOONLIJKHEIDSSTOORNIS ........................................................................................... 102
11.4. CLUSTER C ...................................................................................................................................................... 102
11.4.1. ONTWIJKENDE PERSOONLIJKHEIDSSTOORNIS .......................................................................................... 103
11.4.2. AFHANKELIJKE PERSOONLIJKHEIDSSTOORNIS........................................................................................... 103
11.4.3. OBSESSIEVE-COMPULSIEVE PERSOONLIJKHEIDSSTOORNIS ...................................................................... 103
11.5. PREVALENTIE, BELOOP, DIAGNOSTIEK, ETIOPATHOGENESE EN BEHANDELING ............................................ 104




3

, 1. INLEIDING: GEBRUIK VAN DE DSM-5
1.1. INLEIDING: PSYCHOPATHOLOGIE / PSYCHIATRISCHE STOORNIS
Psychopathologie:
→ Wetenschap of studie van het geestelijk of psychisch lijden
→ Logie = de leer
→ Pathos = last, lijden die patiënt zelf of omgeving heeft, een absolute vereiste om te kunnen spreken over
een psychiatrische aandoening.
→ Psyche = psychisch functioneren

→ Twee benaderingen :
1) Syndroombenadering
= psychologie van het pathologische (gegroepeerde entiteiten)
= samenhangend geheel van klachten en symptomen
Bv. wat een dokter doet bij een zieke patiënt, doet hier een psychiater met een cliënt.

2) Symptoombenadering
= pathologie van het psychische (algemene psychische processen of functies)
= psychisch functioneren van die specifieke patiënt gaan bestuderen

→ Twee typen diagnosen:
o Syndroomdiagnose of descriptieve diagnose
= deze diagnose is alleen beschrijvend en geeft geen informatie over de redenen en
manier van ontstaan

o Structuurdiagnose
= deze diagnose geeft naast een beschrijving van de symptomatologie aan waardoor
en op welke wijze het syndroom ontstaan is
1) Predisponerende of voorbeschikkende factoren
= Factoren die iemand kwetsbaar maken (genetica)
2) Precipiterende of uitlokkende factoren
= Factoren die de stoornis uitlokken
bv. cannabis die een psychose kan triggeren, die al een kwetsbaarheid voor psychosen heeft

3) Perpetuerende of onderhoudende factoren
= Factoren die de stoornis onderhouden


Psychiatrische stoornis:
→ Abnormaal’ verschijnsel
= Afwijkend van de sociale norm of van wat in de cultuur als ‘normaal’ gedrag geldt
→ Veroorzaakt ongemak, lijden of bezorgdheid bij de betrokkene en/of de omgeving
Zonder dit luik kan je niet spreken over een psychiatrische stoornis, dan is het een psychische klacht.




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