Selección de la metodología para el caso de estudio

DELIRIOUS VISUAL HALLUCINATIONS ………. ………… (67) 14C. OTHER HALLUCINATIONS

……… CUT OFF/ ………

OLFACTORY HALLUCINATIONS ……….. (68) DELUSION THAT SUBJECT SMELLS ……….. (69) OTHER HALLUCINATIONS AND DELUSIONAL ELABORATION (70)

PRIMARY DELUSIONS ……… (82)

15F. OTHER DELUSIONS SUBCULTURALLY INFLUENCED DELUSIONS……….... (83)

MORBID JEALOUSY ………..…… . (84)

DELUSION OF PREGNANCY ………. (85)

SEXUAL DELUSIONS …………..………..………. (86)

FANTASTIC DELUSIONS, DELUSIONAL MEMORIES, DELUSIONAL CONFABULATIONS………. (87)

15G. SIMPLE DELUSIONS BASED ON GUILT DEPERSONALIZATION, HYPOCHONDRIASIS, ETC ……… DELUSIONS OF GUILT ……….……….. (88)

SIMPLE DELUSIONS CONCERNING APPEARANCE ……….. (89)

DELUSIONS OF DEPERSONALIZATION….……….. (90)

HYPOCHONDRIACAL DELUSIONS ……… ……….. (91)

DELUSIONS OF CATASTROPHE ……….….……….. (92)

15H. GENERAL RATINGS OF DELUSIONS AND HALLUCINATIONS SYSTEMATISATION OF DELUSIONS…….……….. (93)

EVASIVENESS……… ……….. (94)

OVERALL RATING OF PREOCCUPATION WITH DELUSIONS AND HALLUCINATIONS ………. ………….. (95)

ACTING OUT DELUSIONS ………….……… ……….. (96)

16. SENSORIUM AND FACTORS AFFECTING FUGUES, BLOCKOUTS, AMNESIA LASTING MORE THAN ONE HOUR ………...………. (97)

DRUG ABUSE DURING MONTH ……….. (98)

ALCOHOL ABUSE DURING PAST MONTH ………. (99)

DISSOCIATIVE STATES DURING PAST MONTH ……….. (100)

CONVERSION SYMPTOMS………. (101)

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CLOUDING AND STUPOR AT EXAMINATION………. (102)

ORGANIC IMPAIRMENT OF MEMORY………. (103)

17. INSIGHT PSYCHOTIC SYMPTMS ……….……….. (104)

NEUROTIC SYMPTOMS ………. (105)

SOCIAL IMPAIRMENT DUE TO NEUROTIC CONDITION…….. (106)

SOCIAL IMPAIRMENT DUE TO PSYCHOTIC CONDITION…….. (107)

END OF THE INTERVIEW 18-20 BEHAVIOUR, AFFECT AND SPEECH Behaviour During Interview Self Neglect ………..……….……….. (108)

Bizarre Appearance ……… ………. (109)

Slowness and under activity ……….. (110)

Agitation ……….…….. (111)

Gross Excitement and Violence ……… (112)

Irrelevant behavior ………..……….……….. (113)

Distractibility……… .…… ………. (114)

Embarrassing behavior …… ……….. (115)

Mannerisms and Posturing ….……….…….. (116)

Stereotypes ……… ……… (117)

Behaves as if hallucinated ….……….…….. (118)

Catatonic Movement ……… ……… (119)

Affect during interview Observed anxiety…… .…… ………. (120)

Observed depression … …… ……….. (121)

Histrionic ………. ….……….…….. (122)

Hypomanic affect……… ……… (123)

Hostile Irritability………… ….……….…….. (124)

Suspicion ……… .…… ………. (125)

Perplexity ………… … …… ……….. (126)

Liability of mood …………. ….……….…….. (127)

Blunted affect ……..……… ……… (128)

Incongruity of affect ……… ….……….…….. (129)

Speech During interview Slow Speech …….…… .…… ………. (130)

Pressure of Speech .. … …… ……….. (131)

Non-social speech …………. ….……….…….. (132)

Muteness ………..……… ……… (133)

Restricted quantity of speech ….……….…….. (134)

Neologisms and Idiosyncratic use of Words or phrases … … …… ……….. (135)

Disorder of Content of Speech Incoherence of speech………. ….……….…….. (136)

Flight of ideas ……..……… ……… (137)

Example ………….. ……… ….……….…….. Poverty of Content of Speech ….……….…….. (138)

Misleading answers ..……… ….……….…….. (139)

Re-rate Adequacy of Interview .… ….……….…….. (140)

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APPENDIX 4

ICD – 10 DIAGNOSTIC GUIDELINES Mild Depressive Episode (F32.0)

For a definite diagnosis, at least two of the following symptoms: depressed mood, loss of interest and enjoyment, and increased fatiguability; plus at least two of the following other common symptoms:

(a) Reduced concentration and attention (b) Reduced self-esteem and self-confidence

(c) Ideas of guilt and unworthiness (even in a mild type of episode);

(d) Bleak and pessimistic views of the future (e) Ideas or acts of self-harm or suicide (f) Disturbed sleep

(g) Diminished appetite

None of the symptoms should be present to an intense degree, and they should have been present for a minimum duration of two weeks.

Generalized Anxiety Disorder (F41.1)

The sufferer must have primary symptoms of anxiety most days for at least several weeks at a time, and usually for several months. These symptoms should usually involve elements of:-

(a) apprehension (worries about future misfortunes, feeling “on edge”, difficulty in concentrating, etc);

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(b) motor tension (restless fidgeting, tension headaches, trembling, inability to relax);

and

(c) autonomic over-activity (lightheadedness, sweating, tachycardia or tachypnoea, eipgastric discomfort, dizziness, dry mouth, etc)

Neurasthenia (F48.0)

Definite diagnosis requires the following:

(a) Either persistent and distressing complaints of increased fatigue after mental effort, or persistent and distressing complaints of bodily weakness and exhaustion after minimal effort;

(b) At least two of the following:

- Feelings of muscular aches and pains - Dizziness

- Tension headaches - Sleep disturbance - Inability to relax - Irritability - Dyspepsia

(c) Any autonomic or depressive symptoms present are not sufficiently persistent and severe to fulfil the criteria for any of the more specific disorders in this classification

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Moderate depressive episode (F32.1)

At least two of the three most typical symptoms noted for mild depressive (F32.0) should be present, plus at least three (and preferably four) of other symptoms. Minimum duration of the episode is two weeks.

An individual with moderate depressive episode will usually have considerable difficulty in continuing with social, work or domestic activities.

Mixed anxiety and depressive disorder (F41.2)

This mixed category should be used when symptoms of both anxiety and depression are present, but neither set of symptoms, considered separately, is sufficiently severe to justify a diagnosis. Some autonomic symptoms (tremor, palpitations, dry mouth, stomach churning, etc) must be present, even if only intermittently; if only worry or over-concern is present, without autonomic symptoms, this category should not be used.

Paranoid Schizophrenia (F20.0) The clinical picture is dominated

- by paranoid delusions such as delusions of persecution, reference, special mission, etc.

- hallucinatory voices that threaten the patient or give commands - hallucinations of smell or taste, or of sexual or other bodily sensations

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- thought disorder such as though echo, thought insertion, or withdrawal and thought broadcasting

- visual hallucinations but are rarely predominant

- affect which is usually less blunted then in other varieties of schizophrenia - the symptoms should be present for a period of 1 month or more

Hyponamia (F30.0) There is:

- Persistent mild elevation of mood (for at least several days) - Increased energy and activity

- Others include increased sociability, talkativeness, overfamiliarity, increased sexual energy, decreased need for sleep, etc.

Obsessive–compulsive disorder, predominantly obsessional thoughts or ruminations (F42.0)

For a definite diagnosis of obsessive – compulsive disorder, obsessional symptoms or compulsive acts, or both, must be present on most days for at least 2 successive weeks and be a source of distress or interference with activities. The obsessional symptoms should have the following characteristics:

(a) They must be recognized as the individual’s own thoughts or impulses;

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(b) There must be at least one thought or act that is still resisted unsuccessfully, even though others may be present which the sufferers no longer resists;

(c) The thought of carrying out the act must not in itself be pleasurable (simple relief of tension or anxiety is not regarded as pleasure in this sesnse);

(d) The thoughts, images, or impulses must be unpleasantly repetitive.

In the case of obsessive – compulsive disorder, predominantly obsessional thoughts or ruminations, obsessional thoughts or ruminations predominate and may take the form of ideas, mental images, or impulses to act. They are very variable in content but nearly always distressing to the individual. They are also often associated with an inability to make trivial but necessary decisions in day-to-day living.

APPENDIX 5

INFORMED CONSENT FORM FOR SUBJECTS

Dear respondent,

You are being invited to participate in the study titled “A Comparative Study Of Psychiatric Morbidity Among Secondary School Teachers In Mainland Local Government Area Of Lagos State” The purpose of this study is to find out about psychiatric problems in secondary school teachers and staff of the Local Government.

The result of the study will help to make suggestions on how to prevent these psychiatric problems. You will be asked a set of questions and all information will be treated with strict confidentiality. Your name will not be used on any report that may come out of this study. Your participation in this exercise is voluntary and you may withdraw at anytime and that will in no way affect your occupational status.

If you agree to the statements above, please sign below.

I hereby accept to participate in the study

……… ………

Signature Date

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