cours 3: mental illnesses and mental health care · cours 3: mental illnesses and mental health...

Ronéo 3 UE1 Cours 3

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UE1 Anglais

Pr.Wilks-Docteur

11/10/19

Ronéotypeuse: Sophia Courage

Cours 3:

Mental Illnesses and Mental Health Care

Dans les tableaux de vocabulaire j’ai mis uniquement les mots en gras qui sont ceux à savoir pour le CC et les

partiels. Les numéros des définitions sont ceux qui leur sont attribués dans le poly.


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PLAN:

I/ A social history of mental illnesses

1. Vocabulary

2. Fill in the gaps

3. Reading Corner

4. True or False

5. Language corner

6. Form

7. Fill in the charts with the appropriate form of “BE”

8. Use

9. Grammar Trick

10. Exercise

II/ Treatment of mental illnesses: somatic and psychotherapeutic treatments

1. Vocabulary

2. Fill in the gaps

3. True or False


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I - A Social History of Mental Illnesses

1. Vocabulary

Definition Anglais Français

1. The overall condition of an organism at a given time.

Freedom from (absence of) disease or abnormality.

A condition of optimal well-being : health la sante

2. A pathological condition of mind or body. An

abnormal physical or mental condition : disorder un trouble

4. 1.An intense mental state that arises subjectively

rather than through conscious effort and is often

accompanied by physiological changes; a strong feeling

2.The part of the consciousness that involves feeling;

sensibility :

emotion

une emotion, un

sentiment

5. The manner of conducting oneself. The actions or

reactions of persons in response to stimuli :

behavior (US) /

behaviour (UK) le comportement

6. Disease of body or mind; poor health; sickness : illness une maladie

8. A place for the care of persons who are destitute,

disabled, or mentally ill : institution

un établissement

psychiatrique

9. Having an intended or expected effect. Producing a

definite effect : effective efficace

13. To raise to a more desirable or more excellent

quality or condition; make better : improve (s’) améliorer

17. Suffering from a disease or ailment of long duration

or frequent recurrence : chronic(ally) chronique

20. A physician who practices the specialty of family

medicine. Also called family physician, family

practitioner, general practitioner :

family doctor médecin de famille,

médecin traitant

21. To restore to good health or useful and constructive

activity through therapy and education : rehabilitate rééduquer,

réinsérer

22. To have a high probability of : be likely to avoir des chances

de

23. To release, as from confinement, care etc. To let go : discharge

libérer, laisser

sortir, remettre en

liberté

25. Treatment in which a patient is not hospitalized

overnight but visits a hospital, clinic, or associated

facility for diagnosis or treatment :

Outpatient program

(≈ partial

hospitalization)

l'hôpital de jour,

un traitement

ambulatoire (pour

patients

psychiatriques)

26. Institutional health care of patients during the day.

The patients return home at night :

day care (day

treatment)

un service de

traitement

ambulatoire

(≈ partial

hospitalization)


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30. A group of people organized to work together. The

doctors and surgeons regularly attached to a hospital and

helping to determine its policies and guide its activities : staff le personnel

31. A form of psychotherapy that involves sessions

guided by a therapist and attended by several clients who

confront their personal problems together. The

interaction among clients is considered to be an integral

part of the therapeutic process. Therapy in the presence

of a therapist in which several patients discuss and share

their personal problems :

group therapy

la thérapie de

groupe

32. A rehabilitation center where people who have left

an institution, such as a hospital (as for mental disorder

or drug addiction) are helped to readjust to the outside

world and private life :

halfway house

un appartement

associatif, une

maison

communautaire

(centre de

réadaptation)

35. To place in or commit to an institution offering

specialized care (as for mental illness, substance abuse,

or epilepsy) :

institutionalise

(UK) /

institutionalize

(US)

interner, placer

dans un

établissement

(médical ou

médico-social)

36. The mental faculty by which one deliberately

chooses or decides upon a course of action; volition. A

desire, purpose, or determination :

will

la volonté, le gré de

quelqu'un

37. Having no place to live : homeless sans abri, sans

domicile

38. The rights belonging to an individual by virtue of

citizenship, fundamental freedoms and privileges : civil rights les droits civils, les

droits civiques

2. Fill in the gaps

o Mental health disorders (psychiatric disorders) involve disturbances in thinking, emotion, and

behaviour. These disorders are caused by complex interactions between physical, psychologic, social,

cultural, and hereditary influences.

o The 20th century and the deinstitutionalisation movement :

A movement in recent decades to bring mentally ill patients out of institutions has been made possible by the

development of effective antipsychotic drugs. With the deinstitutionalization movement, greater emphasis has

been placed on viewing mentally ill people as members of families and communities.

Research has demonstrated that certain interactions between families and patients can improve or worsen

mental illness. Therefore, family therapy techniques have been developed that dramatically prevent the

chronically mentally ill from needing to be reinstitutionalised. Today the family of a mentally ill patient is

more involved than ever as an ally in treatment. The family doctor also plays an important role in rehabilitating

a patient into the community. In addition, mentally ill people who must be hospitalized are less likely to be

isolated and restrained than in the past, and they are often discharged early into partial hospital programs and

day treatment centres. These settings are less expensive because fewer staff are involved, the emphasis is on

group therapy rather than individual therapy, and patients sleep at home or in halfway houses.


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However, the deinstitutionalization movement has had its share of problems. Because mentally ill people who

are not a danger to themselves or society can no longer be institutionalized or treated against their will, many

have become homeless. Although these legal measures protect people's civil rights, they make it more difficult

to provide needed treatment to many patients, some of whom may be extremely irrational.

3. Reading Comprehension

1. Explain the objectives and methods of the deinstitutionalisation movement

- Family therapy : support system and compliance

- New drugs

- Treat them as humans

- Reintegrate them in the society, help the live a normal life thanks to drugs

- Family doctor for the follow up

2. Explain the inherent difficulties the deinstitutionalisation movement has encountered

- Some of the patients become homeless

- Important noncompliance when the patients are outside of the institution

3. Describe the advantages of partial hospital programs and day treatment centres

- Family therapy

- Humanization

- Control the compliance

- Less expensive

- Group therapy

- Reintegrate

- Don’t fill like an outcast

4. True or False

i.Deinstitutionalization relies on family therapy and rehabilitation as alternatives to drug therapy.

FALSE. The drug therapy can’t be replaced.

200 years ago TODAY

Societal attitudes Seen as animals – locked away Attempt to reintegrate

Seen as having an illness / disease

like other physical problems

Facilities Asylums – institutions

Chains and straitjackets

Psychiatric hospitals/clinics

(inpatient)

Outpatient

Diagnosis Believe to be humoral imbalance Observation of behaviour

Science and genetics

Treatment Purging : forced vomiting, bleeding

Sedation

A two pronged approach : talking

therapy and medical therapy

Prognosis Bad

Stay till end of life and shortened

life expectancy

Good if patient is compliant with

medication

Regular monitoring


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5. Language corner

DEFINITION NOUN VERB ADJECTIVE GROUP OF

PEOPLE

1. a. Relating to the mind; Intellectual.

b. Relating to, or affected by a

disorder of the mind :

mind

mental Mentally-ill people

The mentally-ill

2. Relating to the branch of

medicine that deals with the

diagnosis, treatment, and

prevention of mental and

emotional disorders :

psychiatry

psychiatric psychiatrists

3.Mental or emotional

unbalance or disorder : disturbance to disturb disturbed

4. Powerful tranquilizers used

especially to treat psychotic

disorders, such as

schizophrenia, paranoia, and

manic-depressive psychosis

and believed to act by blocking

dopamine nervous receptors.

Also called neuroleptic :

antipsychotics

antipsychotic

5.The release of

institutionalized individuals

from institutional care (as in a

psychiatric hospital) to care in

the community :

Désinstitutiona

lisation

The

deinstitutionalized

Use of English: Explain how the shift from adjective to group of people works:

o The + adjective : The mentally ill people

o Noun + -s : Psychiatrists

6. Form

They are often discharged early into partial hospital programs → present simple

A movement in recent decades to bring mentally ill patients out of institutions has been made possible by the

development of effective antipsychotic drugs. → present perfect (begin in the past and doesn’t stop or impact

in the present)

Treatment for the "insane" (i.e. mentally ill patients) until the 18th and early 19th centuries was dominated by

the attempt to rectify (…) → preterit passive

James Norris, who had been restrained in chains for fourteen years (…) → past perfect passive


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7. Fill in the chart with the appropriate form of “BE”

TENSE BE PAST PARTICIPLE (diagnose)

Present simple am/is/are diagnosed

Present continuous am/is/are being diagnosed

Present perfect has/have diagnosed

Present perfect continuous has/have been being diagnosed

Past simple was/were diagnosed

Past continuous was/were being diagnosed

Past perfect had been diagnosed

Past perfect continuous was/were been being diagnosed

Future simple will be diagnosed

Future continuous will been being diagnosed

Future perfect will have been diagnosed

Modals (can, could, may, might,

must, should, shall, ought to)

can be diagnosed

8. Use

THE TYPICAL FORM OF THE PASSIVE VOICE: BE + Past participle

The passive mode is used in sentences that emphasize the action or a procedure and not the subject that

accomplishes it, and as such, its use is crucial in scientific English. When transforming an active sentence into the

passive mode, the object of the original sentence becomes the subject of the passive sentence, while the person

accomplishing the action is introduced into the sentence as a complement to the verb, preceded by the preposition by.

Example

Active: The parliament has adopted a new piece of legislation in order to deinstitutionalise patients.

Passive: A new piece of legislation has been adopted by the parliament in order to deinstitutionalise patients.

9. Grammar trick

I → Think of using the passive mode when in French you would use the general subject ‘ON’.

Example: On enferme les patients jugés dangereux dans des cellules sécurisées.

Patients who are deemed dangerous are locked up in secure cells.

II → Verbs with a double complement f. ex. give something to somebody/ somebody something, prescribe, tell

etc. can be transformed into the passive voice in two ways.

Example

Active voice: The medical team gave a powerful sedative to the patient.

Passive voice: A powerful sedative was given to the patient (by the medical team.) / The patient was given a powerful

sedative (by the medical team.)


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10. Exercise

Poor Kevin, he had been hallucinating for months: he thought the Guardian Angels of the Nation, a secret alien

species had been watching him and putting thoughts in his head. Finally, he was institutionalized last month where

he was diagnosed with paranoid schizophrenia. Unfortunately, the Clozapine he had been prescribed first didn’t

work and he had to be put in a straitjacket, because he was acting out so wildly that he was deemed dangerous to

himself and to others: he alleged that the medical team were part of a secret plot planning to assassinate the president

of the United States and himself, because he was the only person able to prevent the attack. Finally, he was switched

to Iloperidone which finally reduced his symptoms: he admitted that the Guardian Angels were an imaginary species

and was less eager to protect the president. He was released from the institution last week and he has been living in a

halfway house ever since.

II -Treatment of mental illnesses: somatic and psychotherapeutic treatments

1. Vocabulary

Definition Anglais Français

41. Relating to, or affecting the body, especially as distinguished

from a body part, the mind, or the environment; corporeal or

physical :

somatic

somatique,

(un traitement)

organique

42. Relating to treatment of mental or emotional disorder or

maladjustment by psychological means especially involving verbal

communication (as in psychoanalysis, nondirective psychotherapy,

re-education, or hypnosis) :

psychotherapeutic psychothérap(eut)ique

44. Treatment in which a person takes regular doses of a

prescription medication, such as antipsychotics, antianxiety

medications, antidepressants, or antimanic medications, intended

to reduce symptoms of mental illness :

drug therapy

la thérapie

médicamenteuse, par

les médicaments, la

pharmacothérapie

45. Administration of electric current to the brain through

electrodes placed on the head in order to induce unconsciousness

and brief convulsions, used in the treatment of certain mental

disorders, especially acute depression. Also called electroshock

therapy. ECT :

electroconvulsive

therapy

la thérapie par

électrochocs, la

sismothérapie

46. Treatment of mental or emotional disorder or maladjustment

by psychological means especially involving verbal

communication (as in psychoanalysis, nondirective psychotherapy,

re-education, or hypnosis) :

psychotherapy la psychothérapie

47. Repetition so as to develop a skill. Instruction as to a mode of

behavior : training

l'entraînement, la

formation

48. A state that resembles sleep but is induced by a person whose

suggestions are readily accepted and in which the subject may

experience forgotten or suppressed memories or hallucinations :

hypnosis l'hypnose

50. Very much; very; extremely. To an elevated degree : highly extrêmement


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51. Extensively, over a great distance. Including many. widely largement

52. A physician who specializes in the diagnosis, treatment, and

prevention of mental and emotional disorders : psychiatrist un psychiatre

53. Chiefly; mainly. For the greater or larger part : primarily principalement

54. A drug used to prevent or relieve mental depression : antidepressant un antidépresseur

55. To identify a person as having a particular disease or

condition by means of a diagnosis :

diagnose a patient

with X

diagnostiquer X chez

qqn

58. To react positively or favorably : respond to réagir positivement

59. Tending to prevent or relieve anxiety antianxiety drugs: antianxiety un anxiolytique

60. An anxiety neurosis characterized by the occurrence of

intense attacks of anxiety (recurrent unexpected panic attacks)

followed by a month or more of worry about their recurrence,

implications, or consequences or by a change in behavior related

to the panic attacks, usually resulting in the development of one

or more phobias :

panic disorder le trouble panique

61. A psychiatric medication such as lithium carbonate, valproic

acid, or carbamazepine used to treat mood disorders characterized

by rapid and unstable mood shifts (e.g. bipolar disorder, and

borderline personality disorder). Most are anticonvulsants, with

the important exception of lithium :

mood stabilizer

un

antimaniacodepressif,

un psychorégulateur

62. The uppermost part of the body, containing the brain and the

eyes, ears, nose, mouth, and jaws : head la tête

63. A number of objects or events arranged or coming one after

the other in succession : series une série

64. Sudden stimulation of the nerves or convulsive contraction of

the muscles accompanied by a feeling of concussion that is

caused by the discharge through the animal body of electricity

from a charged source :

electric shock une décharge

électrique

67. A sudden attack, spasm, or convulsion, as in epilepsy or

another disorder : seizure

une attaque

convulsive

68. With coherence, reliability or uniformity. Regularly,

constantly : consistently

constamment,

régulièrement

70. Not causing harm or injury; especially having a low incidence

of adverse reactions and significant side effects and having a low

potential for harm. Without significant danger or risk, inoffensive

safe sûr, sans danger

71. An agent that causes loss of sensation with or without the loss

of consciousness : anesthetic

un anesthésique, un

anesthésiant


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72. A substance (as a drug) that relaxes; specifically, one that

relieves muscular tension : muscle relaxant

un myorelaxant, un

décontractant

74. To bring down in extent, amount, or degree; diminish,

decrease :

reduce réduire

75. A person engaged in work intended to advance the social

conditions of a community, and especially of the disadvantaged,

by providing psychological counselling, guidance, and assistance,

especially in the form of social services :

social worker une assistante sociale,

un travailleur social

76. A person who is skilled or trained in caring for the sick or

infirm especially under the supervision of a physician : nurse une infirmière

77. A person engaged in guidance of the individual by utilizing

psychological methods : counselor

un conseiller, un

éducateur spécialisé

79. A person specializing in therapy; especially one trained in

methods of treatment and rehabilitation other than the use of

drugs or surgery :

therapist un (psycho)thérapeute

81. Psychotherapy using Freudian principles. cf. psychoanalysis : dynamic

psychotherapy

la psychothérapie

dynamique,

(≈la thérapie

psychanalytique)

82. A method of analyzing psychic phenomena and treating

mental and emotional disorders that is based on the concepts and

theories of Sigmund Freud, that emphasizes the importance of

free association and dream analysis, and that involves treatment

sessions during which the patient is encouraged to talk freely

about personal experiences and especially about early childhood

and dreams :

psychoanalysis la psychanalyse

83. Occurring in the absence of conscious awareness or thought.

Without conscious control; involuntary or unintended : unconscious inconscient

84. A model. A mode of behavior or cluster of mental attitudes,

beliefs, and values : pattern un modèle, un schéma

85. A form of psychosocial therapy that assumes that

maladaptive, or faulty, thinking patterns cause maladaptive

behavior and "negative" emotions. The treatment focuses on

changing an individual's thoughts (cognitive patterns) in order to

change his behavior and emotional state. Psychotherapy

especially for depression that emphasizes the substitution of

desirable patterns of thinking for undesirable ones (in order to

substitute desirable responses and behavior patterns for

undesirable ones) :

cognitive

(behavioral)

therapy

la psychothérapie

cognitive

(cognitivo-

comportmentaliste)

86. A misrepresentation, a misinterpretation or deformation. An

incorrect, abnormal perception : distortion une déformation


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87. A form of psychotherapy that uses basic learning techniques

to substitute desirable responses and behavior patterns for

undesirable ones : behavioral therapy

la (psycho)thérapie

comportementale

(comportementaliste)

89. To forget or try to forget (something learned). To undo the

effect of; put aside (lose) the practice of : unlearn désapprendre

90. Associated with a secondary stimulus through frequent

repetition :

conditioned conditionné

92. Psychotherapy that focuses on a patient's interpersonal

relationships and that is used especially to treat depression. IPT : interpersonal

therapy

la (psycho)thérapie

interpersonnelle

2. Fill in the gaps

o Treatment of Mental Illness

Most psychiatric treatment methods can be categorized as either somatic or psychotherapeutic. Somatic include

drug therapy and electroconvulsive therapy. Psychotherapeutic treatments include psychotherapy (individual,

group, or family), and behavioral therapy techniques (such as relaxation training and hypnosis). Most studies

suggest that for major psychiatric disorders, a treatment approach involving both drugs and psychotherapy is more

effective than either treatment method used alone.

o Drug Treatment

Over the last 40 years, a number of psychiatric drugs have been developed that are highly effective and widely

used by psychiatrists and other doctors. These drugs are often categorized according to the disorder for which they

are primarily prescribed. For example, antidepressants, are used to treat depression. Antidepressants work to

balance neurotransmitters such as serotonin, norepinephrine, and dopamine. The most common types of

antidepressants are called selective serotonin reuptake inhibitors (SSRIs). Serotonin helps with the modulation of

anger, appetite, sexuality, sleep, mood, etc. This chemical is found in very low amounts in people diagnosed with

depression. SSRIs increase the level of serotonin by inhibiting its reuptake (reabsorption by neurons). Antipsychotic drugs are helpful for people with psychotic disorders such as schizophrenia. All antipsychotic

drugs tend to block D2 receptors in the dopamine pathways of the brain, where excess dopamine has been linked

to psychotic experiences. New "atypical" antipsychotic drugs may be useful for some patients who have not

responded to other antipsychotic drugs. Atypical antipsychotics (a.k.a. second-generation antipsychotics) are a

diverse group of drugs that work differently from typical antipsychotics, but most share a common attribute of

working on serotonin receptors as well as dopamine receptors. Antianxiety drugs may be used to treat anxiety

disorders such as panic disorder and phobias. They work by increasing the efficiency of a natural brain chemical,

GABA5, to decrease the excitability of certain neurons. This reduces the communication between neurons and

therefore has a calming effect. Mood stabilizers have been used with some success in patients with manic-

depressive illness. Most mood stabilizers (e.g. carbamazepine) are anticonvulsants, with the important exception

of lithium, which is the oldest and best-known mood stabilizing drug.

o Electroconvulsive Therapy

With electroconvulsive therapy, electrodes are attached to the head and a series of electric shocks are delivered to

the brain to induce seizures. This therapy has consistently been shown to be the most effective treatment for

severe depression. Contrary to its portrayal in the media, electroconvulsive therapy is safe and rarely causes any

serious complications. The modern use of anaesthetics and muscle relaxants has greatly reduced any risk to the

patient.


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o Psychotherapy

In recent years, significant advances have been made in the field of psychotherapy. Psychiatrists are not the only

mental health professionals trained to practice psychotherapy. Others include clinical psychologists, social

workers, nurses, and counsellors; however, psychiatrists are the only mental health professionals licensed to

prescribe drugs.

Although individual psychotherapy is practiced in many different ways, most therapists are affiliated with one of

four schools of psychotherapy: dynamic, cognitive-behavioral, interpersonal, or behavioral. Dynamic

psychotherapy is derived from psychoanalysis and is based on helping the patient understand unconscious

conflicts and patterns that may be creating symptoms and difficulties with relationships. Cognitive behaviorial

therapy (CBT) focuses primarily on distortions in the patient's thinking. Behavioral therapy is geared toward

helping patients unlearn conditioned ways of reacting to events around them. Interpersonal therapy focuses on

how a loss or change in a relationship affects the patient. In practice, many psychotherapists combine techniques,

depending on a patient's needs.

3. True or False

ii. The goal of psychotherapy is to discover unconscious components of patients' mental processes.

FALSE. Dynamic psychotherapy.

iii. Dynamic psychotherapy focuses on unconscious conflicts, whereas CBT focuses on conscious patterns of thinking.

TRUE. They help the patient with a diary where they write what was stressful for example.

iv. Family therapy can help psychotic patients get off their medications.

FALSE. Some diseases will always require medication. Family therapy completes the use of antipsychotic drugs. The

family job is mainly following up and ensuring the compliance.

v. Antidepressants (SSRIs) contain the hormone “serotonin”, the lack of which is usually responsible for depressive

episodes.

FALSE. There is no hormone in antidepressants. Serotonin is a neurotransmitter.

vi. Antianxiety drugs reduce the amount of GABA in the brain, a neurotransmitter the overproduction of which leads

to an increase in excitability of neurons and ultimately to anxiety disorders.

FALSE. GABA decreases the excitability of certain neurons.

vii. Electroconvulsive therapy has been proven to be efficient in treating severe mood disorders by voluntarily

inducing seizures in the brain with the help of electrodes.

TRUE.

cours 3: mental illnesses and mental health care · cours 3: mental illnesses and mental health...

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