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Samenvatting kinderpsychiatrie
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Hoofdstuk 1: Inleiding ............................................................................................................ 91.1 Voorkomen van psychiatrie ..................................................................................... 9
1.1.1 De prevalentie .................................................................................................. 9
1.1.2 Oorzaken ......................................................................................................... 9
1.1.3 Modellen (ter info) ...........................................................................................10
1.2 Psychiatrie: een probleem? ....................................................................................10
1.3 Geestelijke gezondheidszorg (GGZ): resources? ...................................................10
1.4 Stigma ....................................................................................................................11
1.5 Psychiatrische stoornis: hoe diagnosticeren? .........................................................12
1.5.1 Waarop letten bij onderzoek? ..........................................................................12
1.5.1.1 Algemene verschijning en gedrag ............................................................12
1.5.1.2 Spraak en taal ..........................................................................................13
1.5.1.3 Stemming en emotie ................................................................................13
1.5.1.4 Denken ....................................................................................................13
1.5.1.5 Waarneming .............................................................................................14
1.5.1.6 Cognitief functioneren ..............................................................................14
1.5.1.7 Inzicht ......................................................................................................14
1.5.2 Anamnese .......................................................................................................15
1.5.3 Bijkomend onderzoek (ter info) ........................................................................15
1.5.4 De psychiatrische diagnose.............................................................................15
Hoofdstuk 2: Schizofreniespectrum en andere psychotische stoornissen .............................16
2.1 Klinische kenmerken van schizofrenie ....................................................................16
2.1.1 Andere psychotische stoornissen ....................................................................17
2.1.1.1 Schizofreniforme stoornis .........................................................................17
2.1.1.2 Schizo-affectieve stoornis ........................................................................17
2.1.1.3 Waanstoornis ...........................................................................................17
2.1.1.4 Kortdurende psychotische stoornis...........................................................18
2.1.1.5 Katatonie bij andere psychotische stoornis/veroorzaakt door somatische
aandoening ................................................................................................................18
2.1.1.6 Psychotische stoornis door een somatische stoornis................................18
2.1.1.7 Psychotische stoornis door een middel ....................................................18
2.2 Epidemiologie van schizofrenie ..............................................................................19
2.3 Etiopathogenese van schizofrenie ..........................................................................19
2.4 Oorzaken van schizofrenie .....................................................................................19
2.5 Verloop van schizofrenie .......................................................................................20
2.6 Behandeling van schizofrenie .................................................................................21
Hoofdstuk 3: Persoonlijkheidsstoornissen ............................................................................22
3.1 Persoonlijkheid .......................................................................................................22
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, 3.2 Persoonlijkheidsstoornissen ...................................................................................22
3.3 Classificatie ............................................................................................................22
3.4 Diagnose ................................................................................................................23
3.4.1 Cluster A .........................................................................................................23
3.4.1.1 Paranoïde persoonlijkheidsstoornis ..........................................................23
3.4.1.2 Schizoïde persoonlijkheidsstoornis...........................................................24
3.4.1.3 Schizotypische persoonlijkheidsstoornis...................................................24
3.4.2 Cluster B .........................................................................................................25
3.4.2.1 Antisociale persoonlijkheidsstoornis .........................................................25
3.4.2.2 Borderline persoonlijkheidsstoornis ..........................................................25
3.4.2.3 Histrionische persoonlijkheidsstoornis ......................................................26
3.4.2.4 Narcistische persoonlijkheidsstoornis .......................................................26
3.4.3 Cluster C .........................................................................................................27
3.4.3.1 Vermijdende persoonlijkheidsstoornis ......................................................27
3.4.3.2 Afhankelijke persoonlijkheidsstoornis .......................................................27
3.4.3.3 Dwangmatige persoonlijkheidsstoornis ....................................................28
3.5 Epidemiologie.........................................................................................................28
3.6 Oorzaken ...............................................................................................................28
3.7 Prognose................................................................................................................29
3.8 Behandeling ...........................................................................................................29
Hoofdstuk 4: Eetstoornissen .................................................................................................30
4.1 Gemeenschappelijke kenmerken eetstoornis .........................................................30
4.2 Criteria voor stoornis ..............................................................................................30
4.3 Prevalentie .............................................................................................................30
4.4 Anorexia nervosa (AN) ...........................................................................................30
4.4.1 DSM-5 .............................................................................................................30
4.4.2 Verschillende types .........................................................................................31
4.4.3 Lichamelijke complicaties van AN ...................................................................31
4.4.4 Differentiaal diagnose......................................................................................31
4.4.5 Risicofactoren .................................................................................................31
4.5 Boulimia nervosa (BN) ...........................................................................................32
4.5.1 DSM-5 .............................................................................................................32
4.5.2 Bijkomende kenmerken ...................................................................................32
4.5.3 Lichamelijke gevolgen .....................................................................................32
4.5.4 Differentiaaldiagnose.......................................................................................33
4.5.5 Risicofactoren .................................................................................................33
4.6 Eetbuistoornis ........................................................................................................33
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, 4.6.1 DSM-5 .............................................................................................................33
4.6.2 Bijkomende kenmerken ...................................................................................34
4.6.3 Differentiaal diagnose......................................................................................34
4.6.4 Risicofactoren .................................................................................................34
4.7 Verklarend onderzoek ...........................................................................................35
4.8 Ethiopathogenese ..................................................................................................35
4.9 Behandeling van patiënten met een eetstoornis .....................................................35
4.9.1 Eetpatroon en gewicht bij anorexia nervosa ....................................................35
4.9.2 Psychotherapie ...............................................................................................35
4.9.2.1 Anorexia nervosa .....................................................................................35
4.9.2.2 Boulimia nervosa......................................................................................36
4.9.3 Farmacotherapie .............................................................................................36
4.9.3.1 Anorexia nervosa .....................................................................................36
4.9.3.2 Boulimia nervosa en eetbuistoornis ..........................................................36
4.10 Prognose................................................................................................................36
4.11 Herkenning .............................................................................................................36
Hoofdstuk 5: Middelen gerelateerde en verslavingsstoornissen ...........................................37
5.1 Classificatie en definities ........................................................................................37
5.1.1 Stoornis in gebruik van een middel..................................................................37
5.1.1.1 Kenmerken...............................................................................................37
5.1.2 Stoornis door een middel ................................................................................38
5.1.2.1 Alcoholintoxicatie .....................................................................................38
5.1.2.2 Alcoholonttrekkingssyndroom...................................................................38
5.1.2.3 Delirium tremens ......................................................................................39
5.1.2.4 Wernicke – Korsakoff syndroom ...............................................................39
5.2 Epidemiologie.........................................................................................................39
5.3 Ontwikkeling, beloop en gevolgen ..........................................................................40
5.4 Diagnostiek alcohol en middelen ............................................................................40
5.4.1 Vermoeden .....................................................................................................40
5.4.2 Screening ........................................................................................................40
5.4.3 Bespreekbaar maken van alcoholprobleem .....................................................40
5.4.4 Diagnostiek .....................................................................................................40
5.5 Ethiopathogenese/oorzaken ...................................................................................41
5.5.1 Neurobiologische factoren ...............................................................................41
5.5.2 Psychologische factoren .................................................................................41
5.5.3 Sociale factoren ..............................................................................................41
5.5.4 Individuele factoren .........................................................................................42
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, 5.5.5 Omgevingsgebonden factoren ........................................................................42
5.6 Alcohol-gerelateerde stoornissen ...........................................................................42
5.6.1 Lichamelijke aandoeningen .............................................................................42
5.6.2 Leverstoornissen .............................................................................................42
5.6.3 Psychosociale problemen ...............................................................................42
5.7 Alchoholpromillage .................................................................................................42
5.8 Preventie ................................................................................................................43
5.9 Behandeling ...........................................................................................................43
5.9.1 Psychosociale interventies ..............................................................................44
5.9.1.1 Motivationeel interview .............................................................................44
5.9.1.2 Cognitief gedragstherapeutische interventies (CGT) ................................44
5.9.2 Behandeling alcohol ........................................................................................44
Hoofdstuk 6: Medische ziekten .............................................................................................45
6.1 DSM-5 ....................................................................................................................45
6.2 Psychiatrische stoornissen met vooral lichamelijke klachten ..................................45
6.3 Somatisch-symptoomstoornis en verwante stoornissen .........................................45
6.3.1 Somatisch-symptoomstoornis .........................................................................45
6.3.2 Ziekteangststoornis .........................................................................................46
6.3.3 Conversiestoornis (functioneel neurologisch klachten stoornis) .......................46
6.3.4 Psychische factoren die somatische aandoening beïnvloeden ........................47
6.3.5 Nagebootste stoornis (pathomimie) .................................................................47
6.3.5.1 Nagebootste stoornis opgelegd aan zichzelf ............................................47
6.3.5.2 Nagebootste stoornis opgelegd aan een ander ........................................47
6.3.6 Oorzakelijke modellen .....................................................................................48
6.3.7 Diagnostiek/behandeling .................................................................................48
6.3.7.1 Diagnostiek ..............................................................................................48
6.3.7.2 Behandeling .............................................................................................48
6.4 Psychiatrische en somatische co-morbiditeit: diagnostiek ......................................49
6.5 Prevalentie van psychiatrische stoornissen in algemene ziekenhuizen ..................49
6.6 Belang van snelle diagnostiek en behandeling .......................................................49
6.7 Screening ...............................................................................................................50
6.8 Euthanasie .............................................................................................................50
Hoofdstuk 7: Stemmingsstoornissen ....................................................................................52
7.1 Depressieve stoornis .............................................................................................52
7.1.1 DSM-5 criteria .................................................................................................52
7.1.2 Risicofactoren .................................................................................................52
7.1.3 Neurobiologische afwijkingen ..........................................................................53
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