Reactions to stress Many psychiatric conditions can be precipitated by ‘stress’ or adverse ‘life events’, but usually the individuals affected have some vulnerability to the mental illness as a result…

Child psychiatry II Conduct disorder The main features of conduct disorders are persistent antisocial behaviours such as fighting, bullying, severe temper tantrums, damaging property, starting fires, stealing, truancy, and persistent…

Personality disorders – management The management of patients with personality disorders can be enormously challenging. They may be extremely distressed and demanding, and often disagree with the treatment plan offered….

Anxiety disorders – clinical presentation and aetiology The term ‘neurotic’ has slipped from popularity in psychiatry because of difficulties in agreeing upon a precise and useful definition, and because it…

Psychosexual disorders Psychosexual disorders fall into three main groups in ICD10: sexual dysfunction, gender identity disorders and disorders of sexual preference (Table 1). Sexual dysfunction is the most common of…

Anxiety disorders – management Assessment Assessment of a person presenting with anxiety begins with a full psychiatric history. The history of the presenting complaint should establish whether the symptoms of…

Dissociative and somatoform disorders Dissociative (conversion) disorders Dissociative disorders present with physical or cognitive signs that have no organic cause. They have a sudden onset and are triggered by a…

Bipolar disorder – clinical presentation and management Clinical presentation of mania In manic episodes, there are characteristic changes in mood, biological functions and thinking, and in severe cases psychotic symptoms…

Substance misuse Psychoactive drug users come into contact with medical services when acutely intoxicated, dependent or mentally ill. Acute intoxication is a transient alteration in the level of consciousness, accompanied…

Diagnosis and classification of schizophrenia Schizophrenia is the illness most readily associated with psychiatry. It has a variable course and in some cases may involve only a few short episodes…