2e bachelor Ergotherapie Psychopathologie
Nina Van Ginneken
Psychopathologie
Inhoud
Introductie psychopathologie............................................................................................................6
Psychiatrie en maatschappij...............................................................................................................6
Diagnose.............................................................................................................................................8
DSM-IV............................................................................................................................................8
DSM-5.............................................................................................................................................8
Kritische bedenkingen bij classificatie van psychopathologie of bij het ‘categoriale’ denken........9
Dimensionele versus categoriale classificatie.............................................................................9
De geschiedenis van de DSM: van categoriaal naar dimensioneel en weer terug....................10
Triomf van de lobby..................................................................................................................10
Psychiatrisering van het dagelijks leven....................................................................................11
Verklaring (= etiologie).....................................................................................................................12
Biologische verklaringen...............................................................................................................12
Psychologische verklaringen.........................................................................................................13
Sociale verklaringen......................................................................................................................14
Behandeling......................................................................................................................................14
Biologische behandeling...............................................................................................................14
Psychotherapie.............................................................................................................................15
Psychodynamische therapie.....................................................................................................16
Cliëntgerichte therapie.............................................................................................................16
Gedragstherapie.......................................................................................................................17
Cognitieve therapie..................................................................................................................17
Systeemtherapie.......................................................................................................................17
Speltherapie..............................................................................................................................18
Sociale psychiatrie........................................................................................................................18
Verloop en preventie........................................................................................................................18
Epidemiologie...............................................................................................................................18
Preventie......................................................................................................................................19
Schizofrenie(spectrumstoornis).......................................................................................................20
Inleiding............................................................................................................................................20
Wanen en hallucinaties....................................................................................................................20
Schizofrenie(spectrumstoornis)........................................................................................................22
Kenmerken...................................................................................................................................22
Verklaring.....................................................................................................................................26
1
,2e bachelor Ergotherapie Psychopathologie
Nina Van Ginneken
Verklaring 1: diathese-stressmodel..........................................................................................27
Verklaring 2: erfelijkheid...........................................................................................................27
Verklaring 3: hersenafwijkingen...............................................................................................27
Verklaring 4: neurobiochemische processen............................................................................28
Verklaring 5: gezinsfactoren (schizofrenogene moeder/ ijskastmoeder).................................28
Verklaring 6: emotionele gezinsklimaat....................................................................................28
Verklaring 7: belastende factoren bij reeds kwetsbaar individu...............................................28
Verklaring 8: bepaalde risicofactoren.......................................................................................28
Verklaring 9: maatschappelijke factoren..................................................................................28
Behandeling..................................................................................................................................29
Optie 1: antipsychotica of neuroleptica....................................................................................29
Optie 2: psychosociale aanpak..................................................................................................30
Niet-schizofrene psychotische stoornissen......................................................................................32
Inleiding............................................................................................................................................32
Kenmerken.......................................................................................................................................32
Waanstoornis...............................................................................................................................32
Kortdurende psychotische stoornis..............................................................................................33
Schizofreniforme stoornis.............................................................................................................34
Gedeelde psychotische stoornis...................................................................................................34
Verklaring.........................................................................................................................................34
Waanstoornis...............................................................................................................................34
Schizofreniforme stoornis.............................................................................................................35
Kortdurende psychotische stoornis..............................................................................................35
Gedeelde psychotische stoornis...................................................................................................35
Behandeling......................................................................................................................................35
Waanstoornis...............................................................................................................................35
Schizofreniforme stoornis.............................................................................................................35
Kortdurende psychotische stoornis..............................................................................................35
Gedeelde psychotische stoornis...................................................................................................35
Dubbeldiagnose: psychose + toxicomanie........................................................................................36
Angststoornissen.............................................................................................................................37
Inleiding............................................................................................................................................37
Angst en angststoornissen................................................................................................................37
Fobieën en sociale angsten...............................................................................................................39
Kenmerken...................................................................................................................................39
Specifieke fobie........................................................................................................................39
2
,2e bachelor Ergotherapie Psychopathologie
Nina Van Ginneken
Sociale-angststoornis of sociale fobie.......................................................................................39
Verklaring.....................................................................................................................................40
Specifieke fobie........................................................................................................................40
Sociale angststoornis................................................................................................................40
Behandeling..................................................................................................................................40
Specifieke fobie........................................................................................................................40
Sociale angststoornis................................................................................................................41
Paniekstoornis en agorafobie...........................................................................................................41
Kenmerken...................................................................................................................................41
Verklaring.....................................................................................................................................42
Hyperventilatie.........................................................................................................................42
Behandeling..................................................................................................................................43
Gegeneraliseerde-angststoornis GAS...............................................................................................43
Kenmerken...................................................................................................................................43
Verklaring.....................................................................................................................................44
Behandeling..................................................................................................................................44
Dwangstoornissen...........................................................................................................................45
Dwang...............................................................................................................................................45
Obsessieve-compulsieve stoornis.....................................................................................................46
Kenmerken...................................................................................................................................46
Verklaring.....................................................................................................................................47
Behandeling..................................................................................................................................47
Andere dwangstoornissen................................................................................................................47
Kenmerken...................................................................................................................................48
Verklaring.....................................................................................................................................49
Behandeling (minder belangrijk)..................................................................................................49
Trauma- en stressorgerelateerde stoornissen.................................................................................49
Stress en aanpassing.........................................................................................................................49
Aanpassingsstoornis.........................................................................................................................52
Kenmerken...................................................................................................................................52
Verklaring.....................................................................................................................................53
Behandeling..................................................................................................................................54
Posttraumatische-stressstoornis (PTSS)............................................................................................54
Kenmerken...................................................................................................................................54
Verklaring.....................................................................................................................................56
Behandeling..................................................................................................................................56
3
, 2e bachelor Ergotherapie Psychopathologie
Nina Van Ginneken
Depressieve- en bipolaire stemmingsstoornissen............................................................................57
Stemming en emotie........................................................................................................................57
Depressieve stemmingsstoornissen.................................................................................................59
Kenmerken...................................................................................................................................59
Verklaring.....................................................................................................................................62
Biologische verklaringen...........................................................................................................62
Psychosociale factoren.................................................................................................................63
Behandeling..................................................................................................................................64
Biologische behandeling...........................................................................................................64
Psychotherapie.........................................................................................................................65
Cognitieve gedragstherapie......................................................................................................65
Interpersoonlijke therapie........................................................................................................65
Bipolaire stemmingsstoornissen.......................................................................................................66
Kenmerken...................................................................................................................................66
Verklaring.....................................................................................................................................68
Behandeling..................................................................................................................................68
Stoornissen in het gebruik van alcohol en drugs..............................................................................70
Drugs en afhankelijkheid..................................................................................................................70
Stoornissen door gebruik van alcohol...............................................................................................74
Kenmerken...................................................................................................................................74
Verklaring.....................................................................................................................................76
Behandeling..................................................................................................................................77
Stoornissen door gebruik van drugs.................................................................................................78
Kenmerken...................................................................................................................................78
GHB (dempend)........................................................................................................................78
Cocaïne/ coke (stimulerend......................................................................................................78
Amfetaminen (stimulerend).....................................................................................................79
Heroïne (dempend)..................................................................................................................80
Legale stimulerende middelen: cafeïne en nicotine.................................................................80
Ter afronding............................................................................................................................81
Verklaring.....................................................................................................................................82
Behandeling..................................................................................................................................82
Persoonlijkheidsstoornissen............................................................................................................84
Normale en gestoorde persoonlijkheid............................................................................................84
Persoonlijkheidsstoornissen.............................................................................................................85
Cluster A: vreemd en excentriek gedrag.......................................................................................87
4
Nina Van Ginneken
Psychopathologie
Inhoud
Introductie psychopathologie............................................................................................................6
Psychiatrie en maatschappij...............................................................................................................6
Diagnose.............................................................................................................................................8
DSM-IV............................................................................................................................................8
DSM-5.............................................................................................................................................8
Kritische bedenkingen bij classificatie van psychopathologie of bij het ‘categoriale’ denken........9
Dimensionele versus categoriale classificatie.............................................................................9
De geschiedenis van de DSM: van categoriaal naar dimensioneel en weer terug....................10
Triomf van de lobby..................................................................................................................10
Psychiatrisering van het dagelijks leven....................................................................................11
Verklaring (= etiologie).....................................................................................................................12
Biologische verklaringen...............................................................................................................12
Psychologische verklaringen.........................................................................................................13
Sociale verklaringen......................................................................................................................14
Behandeling......................................................................................................................................14
Biologische behandeling...............................................................................................................14
Psychotherapie.............................................................................................................................15
Psychodynamische therapie.....................................................................................................16
Cliëntgerichte therapie.............................................................................................................16
Gedragstherapie.......................................................................................................................17
Cognitieve therapie..................................................................................................................17
Systeemtherapie.......................................................................................................................17
Speltherapie..............................................................................................................................18
Sociale psychiatrie........................................................................................................................18
Verloop en preventie........................................................................................................................18
Epidemiologie...............................................................................................................................18
Preventie......................................................................................................................................19
Schizofrenie(spectrumstoornis).......................................................................................................20
Inleiding............................................................................................................................................20
Wanen en hallucinaties....................................................................................................................20
Schizofrenie(spectrumstoornis)........................................................................................................22
Kenmerken...................................................................................................................................22
Verklaring.....................................................................................................................................26
1
,2e bachelor Ergotherapie Psychopathologie
Nina Van Ginneken
Verklaring 1: diathese-stressmodel..........................................................................................27
Verklaring 2: erfelijkheid...........................................................................................................27
Verklaring 3: hersenafwijkingen...............................................................................................27
Verklaring 4: neurobiochemische processen............................................................................28
Verklaring 5: gezinsfactoren (schizofrenogene moeder/ ijskastmoeder).................................28
Verklaring 6: emotionele gezinsklimaat....................................................................................28
Verklaring 7: belastende factoren bij reeds kwetsbaar individu...............................................28
Verklaring 8: bepaalde risicofactoren.......................................................................................28
Verklaring 9: maatschappelijke factoren..................................................................................28
Behandeling..................................................................................................................................29
Optie 1: antipsychotica of neuroleptica....................................................................................29
Optie 2: psychosociale aanpak..................................................................................................30
Niet-schizofrene psychotische stoornissen......................................................................................32
Inleiding............................................................................................................................................32
Kenmerken.......................................................................................................................................32
Waanstoornis...............................................................................................................................32
Kortdurende psychotische stoornis..............................................................................................33
Schizofreniforme stoornis.............................................................................................................34
Gedeelde psychotische stoornis...................................................................................................34
Verklaring.........................................................................................................................................34
Waanstoornis...............................................................................................................................34
Schizofreniforme stoornis.............................................................................................................35
Kortdurende psychotische stoornis..............................................................................................35
Gedeelde psychotische stoornis...................................................................................................35
Behandeling......................................................................................................................................35
Waanstoornis...............................................................................................................................35
Schizofreniforme stoornis.............................................................................................................35
Kortdurende psychotische stoornis..............................................................................................35
Gedeelde psychotische stoornis...................................................................................................35
Dubbeldiagnose: psychose + toxicomanie........................................................................................36
Angststoornissen.............................................................................................................................37
Inleiding............................................................................................................................................37
Angst en angststoornissen................................................................................................................37
Fobieën en sociale angsten...............................................................................................................39
Kenmerken...................................................................................................................................39
Specifieke fobie........................................................................................................................39
2
,2e bachelor Ergotherapie Psychopathologie
Nina Van Ginneken
Sociale-angststoornis of sociale fobie.......................................................................................39
Verklaring.....................................................................................................................................40
Specifieke fobie........................................................................................................................40
Sociale angststoornis................................................................................................................40
Behandeling..................................................................................................................................40
Specifieke fobie........................................................................................................................40
Sociale angststoornis................................................................................................................41
Paniekstoornis en agorafobie...........................................................................................................41
Kenmerken...................................................................................................................................41
Verklaring.....................................................................................................................................42
Hyperventilatie.........................................................................................................................42
Behandeling..................................................................................................................................43
Gegeneraliseerde-angststoornis GAS...............................................................................................43
Kenmerken...................................................................................................................................43
Verklaring.....................................................................................................................................44
Behandeling..................................................................................................................................44
Dwangstoornissen...........................................................................................................................45
Dwang...............................................................................................................................................45
Obsessieve-compulsieve stoornis.....................................................................................................46
Kenmerken...................................................................................................................................46
Verklaring.....................................................................................................................................47
Behandeling..................................................................................................................................47
Andere dwangstoornissen................................................................................................................47
Kenmerken...................................................................................................................................48
Verklaring.....................................................................................................................................49
Behandeling (minder belangrijk)..................................................................................................49
Trauma- en stressorgerelateerde stoornissen.................................................................................49
Stress en aanpassing.........................................................................................................................49
Aanpassingsstoornis.........................................................................................................................52
Kenmerken...................................................................................................................................52
Verklaring.....................................................................................................................................53
Behandeling..................................................................................................................................54
Posttraumatische-stressstoornis (PTSS)............................................................................................54
Kenmerken...................................................................................................................................54
Verklaring.....................................................................................................................................56
Behandeling..................................................................................................................................56
3
, 2e bachelor Ergotherapie Psychopathologie
Nina Van Ginneken
Depressieve- en bipolaire stemmingsstoornissen............................................................................57
Stemming en emotie........................................................................................................................57
Depressieve stemmingsstoornissen.................................................................................................59
Kenmerken...................................................................................................................................59
Verklaring.....................................................................................................................................62
Biologische verklaringen...........................................................................................................62
Psychosociale factoren.................................................................................................................63
Behandeling..................................................................................................................................64
Biologische behandeling...........................................................................................................64
Psychotherapie.........................................................................................................................65
Cognitieve gedragstherapie......................................................................................................65
Interpersoonlijke therapie........................................................................................................65
Bipolaire stemmingsstoornissen.......................................................................................................66
Kenmerken...................................................................................................................................66
Verklaring.....................................................................................................................................68
Behandeling..................................................................................................................................68
Stoornissen in het gebruik van alcohol en drugs..............................................................................70
Drugs en afhankelijkheid..................................................................................................................70
Stoornissen door gebruik van alcohol...............................................................................................74
Kenmerken...................................................................................................................................74
Verklaring.....................................................................................................................................76
Behandeling..................................................................................................................................77
Stoornissen door gebruik van drugs.................................................................................................78
Kenmerken...................................................................................................................................78
GHB (dempend)........................................................................................................................78
Cocaïne/ coke (stimulerend......................................................................................................78
Amfetaminen (stimulerend).....................................................................................................79
Heroïne (dempend)..................................................................................................................80
Legale stimulerende middelen: cafeïne en nicotine.................................................................80
Ter afronding............................................................................................................................81
Verklaring.....................................................................................................................................82
Behandeling..................................................................................................................................82
Persoonlijkheidsstoornissen............................................................................................................84
Normale en gestoorde persoonlijkheid............................................................................................84
Persoonlijkheidsstoornissen.............................................................................................................85
Cluster A: vreemd en excentriek gedrag.......................................................................................87
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