procrastination, stubborness, dawlling, deliberate inefficiency or a pretence of forgetfulness.. Treatment: of personality disorders

for example, procrastination, stubborness, dawlling, deliberate inefficiency or a pretence of forgetfulness.. Treatment: of personality disorders: 1. Drugs - have little part to play. Anxiolytic or neuroleptic drugs may have to be given for short periods, especially during times of undue stress. 2. Supportive psychotherapy - is often beneficial in some personality disorders. 3. Psychoanalysis. 6. PSYCHOSEXUAL DISORDERS This group of disorders is characterised primarily by disturbances of sexual function. Classification: 1. Gender identity disorders: TRANSSEXUALISM - Here the individual desires to be of the sex opposite to that indicated by his normal external genitalia. In addition, the person feels estranged from his body, has an overpowering desire to live as a member of the opposite sex and seeks to alter the body appearance and genitalia to confirm to those of the opposite sex. This gratification, or (b) abnormality in the manner of sexual gratification. ETIOLOGY - (1) Psychogenic factors are probably the only causes in all perversions. (2) Primitive people and persons with low intelligence show perversions more often. (3) Psychoanalytical schools regard perversions as the result of regression or arrested emotional development at earlier stages of psychosexual development. (4) More common in men than women. TYPES - Some examples of sexual deviations: Homosexuality (lesbianism in women) - Sexual gratification through persons of own sex. Varying degrees exist. According to some, heredity plays an important role: others believe in psychogenic basis - disturbed emotional relationship between child and parents like overattachment to mother, and poor identification with the father. Homosexuality is designated as asexual deviation only if a person is disturbed by, and wants to change his homosexual orientation. Bestiality - Sexual gratification with animals. Exhibitionism - Sexual gratification through showing of genitals by men to the members of opposite sex. Fetishism - Sexual stimulation obtained by men from inanimate objects, e. g. underclothes, shoes of women. When the object is a - statue, it is called pygmalionism Gratification is obtained by masturbation, while looking at these articles. Voyeurism - Sexual gratification by watching other people nude or having sexual intercourse. Sadism and masochism - Sexual gratification through inflicting or suffering pain either during sexual intercourse with the member of the opposite sex or totally replacing the urge for heterosexual relations. Transvestism - Sexual gratification through putting on clothes of other sex. Paedophilia - Repeated sexual activity with pre-pubertal children, as a preferred or exclusive method of obtaining sexual excitement. TREATMENT: On the whole unsatisfactory. Psychotherapy helps in better social adjustments rather than in changing the sexual orientation. Behaviour therapy has been used with some success. Hormonal treatment, to reduce the sexual drive, is of limited value. 7. SUBSTANCE USE DISORDERS (Drug dependence) Definition: Substance use disorders are characterised by the consumption of certain drugs or substances at those dose levels and under those circumstances and settings that significantly augment the potential for harm, whether or not such use is legal, and whether it is intended to be therapeutic, pleasurable or physician-prescribed. The term 'drug-dependence1 is sometimes used synonymously. This term refers to a state arising from repeated administration of a drug on periodic or continuous basis. Two kinds of dependence are described - (a) Psychological dependence - which is defined as the development of a craving for a drug because its effects are perceived as pleasurable. (b) Physical dependence - which implies occurrence of a physiological or biochemical change produced by drugs due to which the body requires the continuous presence of the drug if a withdrawal syndrome is to be avoided after discontinuation of the drug. Central to the concept of drug dependence or abuse, is the phenomenon of tolerance i. e. on repeated administration of the same dose of a drug, there is a declining effect of the drug. Drugs on substances liable for abuse: and which can produce dependence are - 1. Ethyl alcohol. 2. Opiates such as morphine, pethidine. heroin. 3. Sedative-hypnotic drugs - Barbiturate, methaqualone and benzediazepines. 4. CNS stimulants -amphetamine. 5. Cannabis preparations - Charas, ganja. 6. Hallucinogenic substances - LSD. 7. Other substances like tobacco, caffeine, phencyclidine and organic solvents. Etiology: Several factors have been suggested - 1. Genetic factors - especially in alcoholism, but the exact mode of inheritance is not known. 2. Biochemical factors - Deficiency of endogenous opiates (endorphins) has been incriminated as a possible etiological mechanism in opiate dependency Similarly, abnormalities in alcohol dehydrogenase have been postulated for the etiology of alcoholism. 3. Learning factors - e. g. relief of withdrawal symptoms by ingestion of a drug may act as a re-inforcer for further dependence on the drug. 4. Personality factors - Many alcohol and drug users appear to have some degree of an underlying personality disorder. A number of them possess self-indulgent tendencies or a sense of inferiority which makes them incapable to face stresses of daily life. 5. Psychiatric disorder - Many alcoholics or drug