Personality and Personality Disorders:Revisited

The word “Personality” is derived from the Latin and Greek word “persona” or “prosopon”, meaning a mask worn by an actor to play certain roles or characters! The personality disorders conceptually from the ancient time until modern time, has meant deviation from the normal personality! But what has been considered a “normal personality” has been the big, not yet answered question throughout the time.

The ancient Greek philosophers such as Theophrastus described 29 ‘character’ or personality types, deviations from the norm, and Hippocrates 4 humours or character types. Physicians in the early 19th century expanded the concept to include some forms of insanity involving disturbed emotions and behaviors but seemingly without significant intellectual impairment, delusions or hallucinations, e.g. ‘manie sans délire’ or “insanity without delusion”, “moral insanity”, arguably based in part on religious, social and moral beliefs! Later on as we move into 20th century, these moral judgments are expanded to many deviations from normal personality or behavior, mostly biased by cultural factors, e.g. the use of labels such as “psychopaths”, sadists and masochists!

Read the full text here:

https://medicinerevisited.com/psychiatry/personality-and-personality-disordersrevisited/

 

Preventive Medicine

By “Preventive Medicine” here, we do not mean only discussion of the preventable diseases caused by preventable factors, e.g. sedentary life style, diet, etc. that causes obesity, high blood sugar, cholesterol and so on. But by Preventive Medicine, we mean that the whole field of Medicine should be principally preventive and not management and treatment that is now! By Preventive Medicine, we do not mean screening everybody blindfoldly to find out diseases. By Preventive Medicine, we mean to concentrate primarily on the etiology and more importantly the pathophysiology of disorders and identify the causes and the process of disease formation. For disorders with know causes and pathophysiology, the physicians and the public need to be trained and educated on identifying those causes and taking preventive measures, e.g. promoting healthy life styles and diet to prevent obesity, high blood sugar and cholesterol and hence cardiovascular disorders.

For disorders that preventive causes are not well defined and known, we need to shift the focus of research in medicine more on the preventive side than on the treatment! For example we need to validate the theory of trauma/insult as a main cause of cancer development as discussed in the section of oncology on this website by conducting the proper research on every tissues and organs cancer, then initiate the preventive measures. Along this line, we need to identify what other disorders have preventive causes and do the same with each disorder. In a better word we need to search for preventive causes in every single disease based on the null hypothesis that every disease has a preventable cause unless proven otherwise!

In fact this whole website could be called a “Preventive Medicine Site” as we believe that every single disease has preventable causes, but we need to identify them if not known yet! Therefore in each article, there will be an attempt to critic the current medicine research and practice in every single disorder for identification of such causes and factors and promote the shift of the current “treatment oriented medicine” to “prevention oriented medicine”!    

Dr.Mostafa Showraki, MD, FRCPC                                                               Lecturer, University of Toronto,School of Medicine,Author: “ADHD:Revisited” Book “adhdrevisited.com”/”medicinerevisited.com”

Psychiatry or Neuroscience?!

The term “psychiatry” like “psychology” derive from the greek word “psych” meaning “soul”! For ages, before the inception of “psychiatry” and even to this date, the field has been conceived as a specialty to treat the “soul” first by priests, then witches, philosophers, psychics, rituals, incarcerations, burnings, etc.  That has been so much that patients even with common illnesses such as depression were thrown into “asylums” instead of hospitals and chained instead of treatment with medicines.  The patients were labeled “mentals”, “psychos”, “cuckoos”, and the psychiatrists as “shrinks”!    

This is while psychiatry is perhaps the medical speciality mostly contributing to the neuroscience and the scientific studies of our brain. In fact the “psych” is the function of the brain in different domains, e.g. behavioural, emotional, cognitive and so on.  But now it is the time that the field “psychiatry” that does not deal with “psych” any longer, changes its title to “Neuroscience” or else to fit the current position of the speciality.  This is perhaps the only way of salvation of this important field of medicine to get its true identity among the other medical specialties and get rid of an ancient aged stigma for itself and its patients!

Dr.Mostafa Showraki, MD, FRCPC                                                               Lecturer, University of Toronto,Head, Community Psychiatrists Association of Toronto (CPAT),Author: “ADHD:Revisited” Book “adhdrevisited.com”/”medicinerevisited.com”

Depression: Revisited

https://youtu.be/463ivQBnzYY

Depression or a depressed state of mind and emotions has existed since antiquity and has been described by the father of medicine, Hippocrates(460-370 BC) as “melancholia” that was a common term to describe and label until the modern time and the advent of DSM and ICD systems. DSM (Diagnostics and Statistical Manual) of APA (American Psychiatric Association) and ICD (International Classification of Diseases) while prior to 1980 had a distinction between the reactive and endogenous depression including the old melancholia, to reach validity and reliability among experts, took on a non-etiological approach. Hereby depression became a descriptive or symptomatic diagnosis and the only differences among the different types of depression were laid in the difference in severity, e.g. minor vs. major depression, spectral e.g. unipolar vs. bipolar, associative with other symptoms e.g. with psychotic feature or melancholia. This happened at the era where psychiatry had started to become largely biological and a condition such as  depression became to known as a “chemical imbalance” and its mainstay treatment was with anti-depressants to fix such imbalance! This way any depression even an acute one as long as it had been going on for 2 weeks, justified the use of anti-depressants and was considered a “chemical imbalance”, even if reactive to a situation and short-lived!

Read the full text here:

https://medicinerevisited.com/psychiatry/depression-revisited/

 

Attention Deficit Hyperactivity Disorder(ADHD)

ADHD is a unique brain disorder that shows signs and symptoms as early as age 4, but perhaps as early as infancy, but diagnosed a long time later and continues with its course throughout the rest of life like a river wild. At the same time, ADHD while is the most treatable condition in the whole psychiatry, it has been the most misunderstood and unrecognized condition for its true nature! ADHD is a disorder of developing brain and at the same time is an evolutionary condition of the brain,as in contrast to the currently held beliefs even in medical literature, it is associated with high intelligence than learning disabilities, autism and mental retardation and alike!

To read more, visit “adhdrevisited.com” and the book, ADHD:Revisited” available at Amazon, Kindle books.      

Prescription Narcotics for pain management

Pain that is perhaps the most common symptom of human’s illnesses and sufferings is only a symptom and sign, not a disease. Although many practitioners and over-the-counter business focusing on symptomatic treatments, the real and scientific medicine aims to identify the causes of a disease and treat or remove the causative agent of an illness. For example in medicine, we do not treat the “cough” by “cough medicines”, but we treat the microbes causing the cough and upper respiratory infections by antibiotics, or if viral, we may use vaccines for prevention, or simply let the body immune system work out the infection, if there is not proper anti-viral medication for the illness.

The history of pain treatment has been perhaps the worst such bad medicine in the whole field as instead of identifying the cause(s) of pains, many practitioners, on the top “Physiatrists” prescribe narcotic medications to alleviate pains. Physiatry or Physical medicine and rehabilitation is a branch of medicine aims to restore functional ability and quality of life to those with physical injuries, impairments or disabilities. The term “Physiatry” was coined by Dr. Frank Kursen in 1938 and was accepted by the American Medical Association in 1946 after the World War II to accommodate the large number of injured soldiers. Pain medicine that is a branch of Physiatry, over years has dominated this field and the focus of the physiatrists at least in the primary care clinics have become mostly controlling chronic pains by the use of prescription narcotics.

Read the full text here:

https://medicinerevisited.com/pain-medicine/prescribing-narcotics-for-pain-management/

 

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