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Medico Macha
  • 3 months ago
Transcript
00:00Friends, now the very important part of the forensic psychiatry is phobia.
00:04Phobia is a fear.
00:09Phobia is a fear.
00:10Fear for something which is exaggerated.
00:13This is known as phobia.
00:15Phobia.
00:16Now agoraphobia.
00:18What is agoraphobia?
00:20It is phobia from public places or phobia from crowded places.
00:28This is known as agoraphobia.
00:32C for claustrophobia and C for it is phobia from closed and closed spaces.
00:42Like you have phobia from the lift.
00:44It's a closed space.
00:45It's a claustro.
00:46C, C.
00:48Acro.
00:49We use a word acromegaly.
00:51Acro.
00:52It is acromegaly.
00:54That's related with this.
00:55Phobia from height.
00:57Acromegaly is an increase in height.
00:58Acrophobia.
00:59This one.
00:59Nycto.
01:00How would you remember nycto?
01:01Nycto is a phobia from night.
01:05Actually, it's not a phobia from night.
01:06This is the trick to remember.
01:07It is phobia from darkness.
01:11That's a trick.
01:12Very simple.
01:12Darkness.
01:13Miso.
01:14It's a phobia from dirt or you would use a word germs.
01:19Phobia from germs or dirt.
01:21It's a miso.
01:21Hydro.
01:22It's very simple.
01:23Very commonly seen in rabies.
01:25It is phobia from water.
01:28Glosso.
01:29Glosophobia.
01:31Glosso.
01:32Those people who can speak in public, that's a glossy people.
01:35That's very simple.
01:35Glossy.
01:36Glosso.
01:36Glosophobia.
01:37That is having a phobia in public speaking.
01:43If you have phobia in public speaking, that's a glossophobia.
01:47Trepano.
01:49Trepanophobia is phobia from injection.
01:52Needles.
01:55Phobia from injection of needles.
01:56It's a trepanophobia.
01:58Arachinophobia.
01:59Arachino.
02:00It's a phobia from spiders.
02:03Arachino.
02:05Normophobia.
02:06It's a phobia.
02:08You are without mobiles.
02:09If you are being without mobiles.
02:11So, if you are not with mobile and without mobile, if you feel, that's very common.
02:19It is known as nomophobia.
02:21Nomophobia.
02:23Thanatophobia.
02:25Thanatophobia.
02:27Thanato is used for death.
02:29Thanatophobia is phobia from death.
02:33So, these are some phobia you can get in your exam.
02:35So, if you are without mobile and you feel fear, that's a nomophobia.
02:40And there is one more word.
02:41Phobophobia.
02:43Phobophobia.
02:44Phobophobia.
02:45It's a phobia from phobia.
02:48Phobophobia.
02:49Impulse.
02:50My dear friend.
02:51Impulse is irresistible.
02:53Any sudden and irresistible force.
02:55Something which is a force.
02:57And it is irresistible.
02:58Compelling a person to do some action consciously.
03:03Consciously.
03:04I am telling you.
03:04It's a consciously you are doing some action.
03:06It means, sir.
03:07Here, insight is present.
03:11Here, insight is present.
03:14Insight means awareness of being ill.
03:16It is present.
03:17And without any motive or forethought.
03:20There is no pre-planning.
03:22There is no motive.
03:23But still some irresistible force comes inside your body.
03:26And you are doing something.
03:29You have to do something.
03:30It's a compelment.
03:32It is known as impulse.
03:33Insight is present.
03:35No motive.
03:36No forethought.
03:37Example.
03:38Number one impulse is.
03:40Number one impulse is kleptomania.
03:45It is desire to steal articles of little value.
03:48We are not going to like take expensive things.
03:51Desire to steal articles.
03:53So, there will be impulse.
03:54Like put this.
03:55Take this.
03:55And put in your pocket.
03:57This is kleptomania.
03:59So, desire to steal article of little value.
04:01It's a kleptomania.
04:02Kleptomania.
04:03Second, oniomania.
04:05It is impulse to buy things.
04:10Irregistible desire to buy few things.
04:12It's very common in female.
04:13But that is not an impulse.
04:14But here, irregistible desire comes to buy things.
04:16It's an oniomania.
04:17You can remember onion.
04:18Onion, you can remember.
04:19You are going to buy onion.
04:21Oniomania.
04:22Dipso.
04:22D-P.
04:23D-P.
04:23D-P.
04:24D-P.
04:25D-P.
04:26Drinking at periodic.
04:27Drinking at periodic interval.
04:29D-P.
04:30Dipsomania.
04:32Pyromania, I already told you.
04:33Pyro is related with fire.
04:34It's a desire to set fire to the things.
04:38Mutilomania mutilate the animals.
04:41Destroying the animals.
04:43Mutilomania.
04:44Trichotillomania.
04:46Trichotillomania is pulling out your own hair.
04:50Or plucking out of your hair.
04:53So, pulling out of your hair.
04:55Plucking out of your hair.
04:57This is an impulsive, uncontrolled disorder.
05:01This is trichotillomania.
05:02Pulling out of your hair.
05:03Common in female.
05:06Trichotillomania.
05:06It is also classified in the OCD in psychiatry.
05:09But it's an impulsive disorder.
05:11Trichotillomania.
05:11Pulling out of your own hair.
05:13It's a trichotillomania.
05:15Now, sir.
05:16For insane.
05:17Very, very potential word.
05:18We have an act.
05:22Which is Mental Health Care Act.
05:25In 2017.
05:28Mental Health Care Act.
05:30Now, there are some changes according to this act.
05:33What is the first change?
05:34What is the definition of mental illness?
05:38What is the definition of mental illness?
05:39Now, we don't use the word lunatic or like some other.
05:42We use the word mental illness or mentally ill person.
05:45What is the definition of mental illness?
05:48Disorder of mood.
05:49Disorder of thought.
05:50Disorder of perception.
05:53Orientation.
05:54And memory.
05:55Remember, my dear friend.
05:56Five components are involved.
05:57Number one, mood, thought, orientation, perception and memory.
06:02Which causes significant distress to a person.
06:07Significant distress to a person.
06:09After mood disorder, perception disorder, thought disorder.
06:12There is a significant distress.
06:14First.
06:15Second.
06:16Impairs person's ability to meet the demand of daily life.
06:20The person is not able to fulfill the demand of the daily life.
06:23The person is not able to fulfill the demand of the daily life.
06:25Distress is there.
06:26Demand of the daily life is hampered.
06:29Third one.
06:30Include mental condition associated with abuse of alcohol and other drugs.
06:35It means, sir.
06:37Like, with the alcohol and drugs, there are some mental condition.
06:40We all know we stop the alcohol.
06:42There is a delirium tremens.
06:43By chronic cannabis, we have run amok.
06:46It means these are included.
06:47The condition which are related with the alcohol and drugs, these will be included.
06:51But, but, but, but, my dear friend, mental retardation is not included.
06:56Yes.
06:57Everyone knows the mental retardation is a IQ below 70.
07:01This is not included.
07:03This is not included.
07:04According to the mental illness, Mental Health Care Act.
07:09Okay.
07:09Now, my dear friend, it's very, very important.
07:12Mental Health Care Act 2017.
07:14What are the changes?
07:15Now, psychiatric hospital has given a word, Mental Health Establishment.
07:21Now, we don't use a word, Pagal Khana or psychiatric hospital.
07:24We use a word, Mental Health Establishment.
07:26Now, very, very important.
07:29Decriminalization of Suicidal Attempt.
07:31In IPC, 309 IPC, IPC.
07:34For punishment of committing or attempt of the suicide.
07:37But, now, 309 IPC has been removed.
07:41Because, why?
07:43Because when the person commits suicide, when the person commits suicide, we presume severe stress.
07:52We presume severe stress.
07:56That's why we are not going to punish this person.
07:58And, it is given in section 115 of Mental Health Care Act.
08:04So, 309 is no more punishable.
08:06It is given in section 115 Mental Health Care Act.
08:10Now, sir.
08:11These four prohibitions.
08:14These four prohibitions.
08:16Prohibition of ECT.
08:17What is ECT?
08:18Electroconvulsive therapy.
08:20Or, electroconvulsive treatment.
08:22Now, prohibition of ECT without the use of anesthesia and muscle eluxent.
08:28It means, sir.
08:29Every electroconvulsive therapy has to be with anesthesia and muscle eluxent.
08:34For major.
08:35For minor, there is no ECT.
08:37It means, sir.
08:37For minor, less than 18, there is no ECT.
08:41Otherwise, we will use the muscle eluxent and anesthesia.
08:43First, prohibition.
08:43Second, protection of the right of person with mental illness.
08:48There are some rights of mental.
08:49The patient is having mental illness.
08:52Like, rights of confidentiality.
08:56Rights of confidentiality for mentally ill person.
09:00First, right has to be preserved.
09:01Every mental person has a right of confidentiality.
09:04Every mental person has a right to access.
09:08Right to access medical records.
09:12MR is medical records.
09:14Every mental person has a right to access the medical records.
09:17And my dear friend, we can, we should get the informed consent.
09:24Informed consent.
09:28From mentally ill person or mentally ill health review board.
09:33So, we can get informed consent from mentally ill person if he or she is capable.
09:39But otherwise, most of the time, it is by mental health review board.
09:49Mental health review board will give you consent.
09:51So, it is, again, I am telling you three things.
09:54First, first, confidentiality.
09:58Rights of confidentiality.
10:00Second, every mentally ill person has the right to access the mental record.
10:04And third, which is a very, very important, informed consent has to be obtained.
10:10So, here you can write down three things.
10:12Number one, right to confidentiality.
10:15Number two, right to access mental record.
10:17And number three, the last but not the least, informed consent from mentally ill person or medical health review board.
10:26Yes.
10:26This right has to be maintained.
10:28Now, prohibition of sterilization, sir, of men and women as a mode of treatment of mental illness.
10:35Now, sterilization is not done as a mode of treatment for mental illness.
10:39Now, it has been removed.
10:39And last, prohibition, any chaining of the persons.
10:43Chain, meaning, janjiro se baan dena.
10:46Chains.
10:47To bind a person, to bind a person is not allowed.
10:50Chaining is prohibited.
10:51So, chaining, sterilization, ECT for not for minor, for major with muscle elux and anesthesia.
10:58And you have to preserve the rights of mentally ill person.
11:02Establishment of central and state mental health authority.
11:09Both central and state mental health authority.
11:12These are very, very important.
11:13But, my dear friend, now I am coming to a very, very important word.
11:17What is advanced directive?
11:18What is advanced directive?
11:20If you are major, if you are major, what is the meaning of major?
11:26Your age is above 18 or 18.
11:29You can write advanced directive.
11:31You can write advanced directive.
11:34You can write direction in advance for mental illness.
11:38You don't have the mental illness.
11:39But, you can write down the direction.
11:42You can write down the direction for the mental illness, which is upcoming.
11:46This is known as advanced directive.
11:47Direction in advance.
11:49Direction in advance.
11:50Now, what is there in this?
11:52To specify an individual's health care decision.
11:56Means, if you are a major, you can write down the advanced directive and you can specify the health care decision.
12:02The way you want to be treated, the way you want to be treated, the way you want to be cared by someone for mental illness, the way you don't want to be treated or cured.
12:23Means, you can decide the way you want to be treated or cured or the way you don't want to be treated.
12:32First, so this is specify health care decision, number one.
12:37Second, sir, you can identify the person.
12:40I am coming to very, very important.
12:42You can identify the person who will take all the decisions, my dear friend.
12:46You require caretaker or decision taker for your mental illness.
12:53Caretaker or decision taker for said individual in the event, if he is unable to communicate his wishes to doctor in future.
13:02It means, sir, you can decide your caretaker, decision taker, that is known as nominated representative.
13:13That is known as nominated representative.
13:16Look, sir, these are two very important components.
13:19The way you want to be treated or cured for the mental illness, the way you don't want to be treated.
13:23Or cured.
13:24And if you want a nominated representative, you can decide the name of that nominated representative.
13:31We will take all the decision.
13:34Now, my dear friend, sometime a question comes, how to differentiate insanity and feign insanity?
13:43Feign means it's a motive is present.
13:45In feign insanity, you are acting like insane.
13:48So, my dear friend, if you had a question, in which insanity motive is present, some wrong intention is present, the answer will be feign insanity.
13:57Here, in feign insanity, it is a sudden onset with some motive.
14:02Very, very important.
14:03Here, it is gradual with no motive.
14:06Gradual with no motive.
14:07If you are really insane, there will be no motive.
14:09And it's a gradual because insanity is not an event.
14:11It's a process.
14:12It slowly comes.
14:13But it's a sudden.
14:14And with motive, it's a feign insanity.
14:16My dear friend, sign and symptom, it would be uniform if you are insane.
14:21Uniform.
14:21There will be like thought disorder, like process disorder, perception disorder.
14:25And present whether he is observed or not.
14:28It means, sir, if he is not observed, there will be some sign.
14:31But, but, but, but, but.
14:32In feign insanity, because I told you, it's a sudden and motive is present.
14:35It is present only when the consciously being observed.
14:40When you are conscious and you are being observed, then you will show the sign.
14:43You have the wrong intention.
14:44Frequent examination of the insane person doesn't mind.
14:47But, sir, here, recent of fear for detection.
14:52So, on frequent examination, there will be fear of detection.
14:55Like, my motive can be detected.
14:57Facial expression.
14:58Peculiar vacant look.
15:00Insane will see, oh, peculiar vacant look.
15:03But, here, no peculiarity.
15:06Mood, sleep pattern and habit.
15:11These are abnormal, my dear friend.
15:13There will be insomnia.
15:14There will be other problem.
15:15There will be problem in the habit, mood and other.
15:20Like, appetite.
15:22Lack of appetite.
15:23It's very common.
15:24For many days.
15:26So, even if you see the lack of appetite for many days, that is common in insane.
15:32But, not in, if your appetite is, appetite is lost.
15:37That is in insane.
15:38But, it is not seen in faint insanity.
15:40So, the sleep pattern, the mood pattern and your habits are abnormal in true insanity.
15:45Normal in faint insanity.
15:48Predisposing factor.
15:49Definitely, most of the people commit the mistake.
15:51Predisposing factor.
15:52Like, there will be some personal factor.
15:55There will be some family factor.
15:56There will be some financial factor.
15:58That will predispose the true insanity.
16:01It is absent in faint insanity.
16:04It is absent in faint insanity.
16:06So, doctor, this is a very important table.
16:08How to differentiate true insanity with faint insanity.
16:12Very, very important.
16:14Now, sir, criminal responsibility in few cases.
16:17I am coming to discuss these few cases.
16:20Few cases.
16:22Delirium tremens.
16:23First, what is delirium tremens?
16:25After, like, you are consuming alcohol for 15, 20, 10 years.
16:30Suddenly, you stop alcohol.
16:33Consuming alcohol.
16:34So, this is alcohol withdrawal symptom.
16:37So, I would use a word.
16:40Delirium tremens is alcohol withdrawal symptom.
16:46It is seen in D.
16:47D for 2.
16:48Yes.
16:49T tremens.
16:50After 2 to 3 days of alcohol withdrawal.
16:53D.
16:54T.
16:543.
16:55And if you commit crime.
16:56Very, very potential MCQ.
17:00If you commit crime in delirium tremens.
17:02Delirium is like altered sensorium.
17:05Disorientation to the time, place, and person.
17:07If you commit crime.
17:09You are not responsible for delirium tremens.
17:14You are not responsible.
17:17Second, run amok.
17:19What is run amok?
17:21Actually, friends.
17:22It is a chronic cannabis abuse symptom.
17:29If you are chronically using cannabis for a long time.
17:32There can be a homicidal tendency.
17:38This is run amok.
17:40Again, my dear friend.
17:41If you commit homicide.
17:43You are not liable or not responsible.
17:46So, in both cases, you are not liable or not responsible for crime.
17:53Not liable or not responsible for crime.
17:56Now, somnambulism.
17:58It's a sleepwalking.
18:02And you commit the crime.
18:04Sleepwalking.
18:05Sleeping.
18:07Drunkenness.
18:07It is known as somnolentia.
18:11It is known as somnolentia.
18:15When you wake up from the sleep.
18:16When you are awake from the sleep.
18:19And you feel drowsy for a long time.
18:22You feel confused for the long time.
18:25This is known as somnolentia.
18:27Or sleep drunkenness.
18:29In both conditions.
18:30Sleepwalking.
18:31And in this both condition.
18:32If you commit crime.
18:34You are not liable.
18:36Not responsible.
18:37But my dear friend.
18:39Kleptomania.
18:39As I told you.
18:41You steal the article of little value.
18:43Kleptomania is impulse.
18:45But as I told you.
18:46In kleptomania.
18:50Insight is present.
18:51You know like what you are doing.
18:53Insight is present.
18:54Your awareness about the ill is there.
18:56So, you will be liable.
18:58You will be responsible.
19:01Hypnosis.
19:02You are hypnotized by someone.
19:03Both will be liable.
19:04The people.
19:07Both.
19:08Will be liable.
19:10The person who is hypnotizing you.
19:12And the person you are.
19:14You are going to be hypnotized by that person.
19:16So, both people.
19:18The person who is hypnotizing.
19:20And you are hypnotized.
19:21Both will be liable.
19:22This is criminal responsibility.
19:24In these cases we can get.
19:26But just remember.
19:28In kleptomania.
19:29And hypnosis.
19:30Both condition kleptomania.
19:32You are liable.
19:33And in hypnosis.
19:34Both are liable.
19:35Both are liable.
19:36So, my dear friend.
19:38This is all about.
19:39A very very important chapter.
19:41Forensic psychic.
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