Commonly used tests are Rorsharch test, Thematic Apperception test

treatment. Causes of mental disorders: The development of psychiatric disorders depends upon an interaction between predisposing, and precipitating factors. Predisposing factors -These determine an individual's inlnerability to develop psychiatric disorders. Many of these operate from early life. Some of the predisposing factors are - (a) Biological factors - heredity, constitution, metabolic and biochemical abnormalities, physical defects and illnesses. (b) Psycho-social factors - personality traits, faulty parent-child relationships, psychologically traumatic experiences during early years, socioeconomic conditions, adverse lite events. Precipitating factors - These are events that occur before the onset of a psychiatric disorder and appear to have induced its onset. These could be - (i) Physical - Puberty, pregnancy, childbirth, menopause, systemic disease, drugs, etc. (ii) Psychological - Disturbed interpersonal relationships, marital disharmony, financial difficulties, occupational maladjustments, etc (iii) Environmental - Calamities: War, famine, earthquakes, cyclones, etc (iv) Sociocultural factors - Sexual discrimination, racial discrimination, migration, etc. Dynamics of mental illnesses - The predisposing factors determine an individual's susceptibility to mental illness. Individuals who are less susceptible can bear a greater severity of stress. Their capacity to handle tension (i.e the emotional counterpart of unresolved conflicts or diemmas) is high and their threshold to tolerate stress is high. Individuals who have a low threshold to tolerate stress are more susceptible to the development of menial disorders. Any stress -Physical, physiological ant/or psychological - acting as "the last, straw on the camel's back", exacerbates this tension can result in onset of a psychiatric disorder which may manifest as disturbances in physiological, psychological and/or social functioning. If. DIAGNOSIS AND INVESTIGATION OF A PSYCHIATRIC PATENT The diagnosis of a mental illness is arrived at by carrying out the following: 1. HISTORY - (a) Chief complaints with their origin, duration and progress. (b) Associated symptoms related to physical or psychological dysfunction, (disturbances in sleep, appetite, bowel functions, etc.) (c) Past history of similar illness or any other mental and/or major physical illness. (d) Family history, (e) Personal history - regarding information about stressful situations during childhood, adolescence, school and college life, occupational, social, marital and psychological difficulties. (f) Clinical assessment of dominant personality traits. 2. PSYCHIATRIC EXAMINATION - to delect disturbances in thinking, emotion, behaviour, orientation, perception, memory, intelligence, insight, judgment. 3. PHYSICAL EXAMINATION. 4. INVESTIGATIONS - (a) Laboratory investigations - Blood, urine, stool examination, radiological studies, ECG, liver and kidney function tests, etc. to rule out physical disorders. (b) Special investigations - (I) Social or environmental investigations done by the Psychiatric Social Worker through interviews with the patient, relatives, friends and employers, held either in the hospital or by paying a visit to the home or the place of work. The aim is to study the mileu or the environment in which the patient has lived before becoming sick. An attempt is made to understand the role of various factors like cultural and religious background, family and social relationship, childhood experiences, school and college life, occupational adjustments, financial problems, marital and sexual difficulties, etc. in the development ol the individual's personality and his illness. (ii) Psychological investigations done by the Clinical Psychologist with the help of standardised tests. The types of psychological tests used are: 1. Intelligence tests -(Verbal and performance tests) to assess intelligence. The commonly used tests are Kamath's test, Shukla's test, Bhatia's test, adult intelligence scale, intelligence scale for children, Goddard form board. Ravin's progressive matrices. Wechsler's Intelligence Tests for adults and children. 2. Personality tests - to assess the pre-sickness personality traits, the psychological conflicts and the nature of personality disturbance. Commonly used tests are Rorsharch test, Thematic Apperception test, Minnesota Multiphasic Personality Inventory and Eysenck Personality Inventory. 3. Aptitude tests - to find out the natural likes and dislikes of the patient and his proficiency in any particular field This Information helps in vocational and educational guidance and rehabilitation of the patient. 4. Neuro psychological tests - to assess an individual's higher mental functions. Tests used for this purpose include Wechsler Memory Scale, Bender-Gestalt visual motor co-ordnation test, etc (iii) Observations by an Occupational Therapist are sometimes necessary to get an objective evaluation of the (a) Patient's mental state, particularly behaviour, and (b) progress in the recovery of the patient undergoing treatment, (iv) Observations by a psychiatric nurse on the patient's ward behaviour Classification of psychiatric disorders: (t) Psychosis. (2) Mood disorders. (3) Neurosis. (4) Psychophysiological disorders. (5) Personality disorders. (6) Psychosexual disorders. (7) Substance use disorders. (8) Eating disorders. (9) Psychiatric disorders first seen In infancy, childhood or adolescence. 1. PSYCHOSIS Definition - Psychosis is a