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The Three D’s in Psychopathology

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The term psychopathology may refer to the “systematic study of abnormal experience, cognition and behaviour; the study of the products of a disordered mind” (Andrew Sims, “Symptoms in the Mind: An Introduction to Descriptive Psychopathology,” Third Edition, p. 2) or to “such psychological and behavioral dysfunction occurring in mental disorder (The Merriam-Webster OnLine Dictionary). Using either definition, three circumstances in psychopathology deserve mention here – delirium, delirium tremens, and depression.

It used to be that delirium, delirium tremens, and depression all fall under the general term “insanity.” However, this term is deemed too informal and unscientific that the medical profession now prefers to use the term psychopathology when referring to mental disorders in general terms.

In delirium, a psychopathology that is considered a form of excitement, the individual acts out of context to reality and may experience hallucinations (as in hearing and seeing things that are not real). There are several possible causes of delirium, and these include severe infections with fever, head injury, organic brain disorders, early stages of recovery from surgery, and influence of drugs. In treating an individual suffering from delirium, the physician will first give attention to the underlying cause of the condition and remedy it if possible. Beyond this, constant supervision must be given to prevent the patient from harming him/herself.

In delirium tremens, a psychopathology that is a complication of chronic alcoholism, the individual experiences nervousness and emotional disturbance; his/her muscles tremble excessively. The patient usually has hallucinations, in which he/she “sees” things that are absurdly incongruous. Most people who suffer from delirium tremens respond favorably to good nursing care and a diet high in vitamins, particularly vitamin B. A few, however, are not as fortunate as they succumb to the condition. Physicians are firm in saying that all cases of delirium tremens should be placed in the hospital for appropriate treatment.

In depression, the individual slows down both mentally and physically. The patient has poor appetite and loses interest in surrounding activities; usually, he/she is fearful and troubled with sleeplessness. Possible suicidal attempt is the greatest danger in depression; any mention of this by the patient should be taken seriously. Treatment of an individual suffering from depression requires close nursing supervision, preferably in a hospital.

People who have to deal with an individual suffering from such psychopathology in the meantime that a physician’s advice is being sought should be deliberately positive and calm. Those caring for a patient must realize that the victim is not responsible for his/her present conduct and, therefore, should not resort to harshness or derision; dealing with the patient kindly and firmly is very important. But while coercion and physical restraint are to be avoided if possible, such emergency measures may be necessary in extreme cases, for which the help of a professional should be sought at once.

Sources:

1. “Symptoms in the Mind: An Introduction to Descriptive Psychopathology” (Third Edition) by Andrew Sims

2. “Delirium” from Health A to Z – www.healthatoz.com/healthatoz/Atoz/ency/delirium.jsp

3. “Delirium Tremens” by William G. Gossman, MD, Associate Clinical Professor of Emergency Medicine, Creighton University School of Medicine; Consulting Staff, Department of Emergency Medicine, Creighton University Medical Center – http://www.emedicine.com/emerg/TOPIC1123.HTM

4. About.com.: Depression – http://depression.about.com/

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