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  1. Most imp. feature is sadness or loss of interest in all activities. Other features are - early morning awakening, decreased appetite and weight (>5% weight loss in 1 month), psychomotor agitation or retardation, loss of sexual drive
  2. In severe depression there may be anhedonia (inability to experience pleasure)
  3. Suicidal ideas (risk more in males >40 years, unmarried/ divorced/ widowed, early stage, recovery phase, marked hopelessness)
  4. Delusion of nihilism (Cotard’s syndrome)
  5. Severe depressive episode is a/w OCD, post partum psychosis
  6. Decreased serotonin

a. Dysthymia is sub – syndrome depressive symptoms lasts for two years or more.


Phobic disorders or phobia

  1. In phobias insight is present.
  2. In phobia primary defense mechanism is repression and secondary defense mechanism is displacement
  3. Agoraphobia is commonest type of phobia char/by irrational fear of being in unfamiliar places (crowd/ public places! open spaces) from where it is not easy escape to a safe place (e.g. in lift).
  4. Claustrophobia is fear of closed spaces
  5. Social phobias - Irrational fear of activities or social interactions, Erythrophobia (fear of blushing), shy bladder (Urinating in public lavatory).
  6. Acrophobia (fear of high places)
  7. Claustrophobia. (fear of closed spaces)
  8. Xenophobia (fear of strangers)
  9. Behaviour therapy (esp. systemic desensitization) is TOC. Among SSRI is DOC systematic desensitization is based on reciprocal inhibition (Wolfe principle) & consists of 3 main steps.

a. Relaxation training

b. Hierarchy construction

c. Systematic desensitization proper.


Relaxation training include Jacobson's progressive muscular relaxation, hypnosis, yoga, shavasna,

biofeedback, yog nindra. pranayama, vipasna.

Relaxation techniques are also an integral part of majority of behaviour therapy


Psycho-somatic disorders

Bronchial asthma, Ulcerative Colitis, Rheumatoid Arthritis, Peptic ulcer, Essential hypertension, Neurodermatitis.

Sexual Disorders

Erectile dysfunction

Inability to have or sustain penile erection till the completion of satisfactory sexual activity.

Early morning erections and nocturnal penile tumescence are usually preserved (they are lost in organic impotence)

Premature ejaculation

Performance anxiety is m/c cause of it

Seman's squeeze technique is used

i. Sensate focus technique is used for treatment of impotence (Erectile dysfunction)

ii. Master’s and Johnson’s technique is most popular tit method for psychosexual dysfunction. In this both the partners are treated together (dual sex therapy)

iii. Excessive sexual drive is called satyrism in men and nymphomania in women.



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