Neurotic Disorders in Mental Health Nursing – Important for Competitive Exams

Neurotic disorders are mental disorders without psychosis, where a person remains in touch with reality but experiences distress and impaired functioning. These disorders are mainly characterized by excessive anxiety, fear, or distressing thoughts.

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1️⃣ Definition of Neurotic Disorders

✅ Neurosis is a group of functional mental disorders where the individual has distress but retains insight into their condition.
✅ It does not involve hallucinations, delusions, or gross personality disorganization.
✅ Also known as “Non-Psychotic Disorders” or “Anxiety Spectrum Disorders.”

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2️⃣ Classification of Neurotic Disorders (ICD-11 & DSM-5)

According to ICD-11 & DSM-5, neurotic disorders fall under the category of Anxiety and Stress-Related Disorders:

🔹 Major Types of Neurotic Disorders:

1️⃣ Generalized Anxiety Disorder (GAD)
2️⃣ Phobic Disorders (Specific Phobia, Social Phobia, Agoraphobia)
3️⃣ Panic Disorder
4️⃣ Obsessive-Compulsive Disorder (OCD)
5️⃣ Post-Traumatic Stress Disorder (PTSD)
6️⃣ Somatic Symptom Disorder (Hypochondriasis, Conversion Disorder)
7️⃣ Dissociative Disorders
8️⃣ Adjustment Disorder

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3️⃣ Detailed Explanation of Each Neurotic Disorder

1️⃣ Generalized Anxiety Disorder (GAD)

✅ Persistent and excessive worry about daily life events.
✅ Symptoms: Restlessness, fatigue, muscle tension, sleep disturbances.
✅ Treatment: CBT, SSRIs, Benzodiazepines, Relaxation therapy.

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2️⃣ Phobic Disorders

✅ Specific Phobia: Intense irrational fear of an object or situation (e.g., heights, snakes).
✅ Social Phobia: Fear of social interactions or public speaking.
✅ Agoraphobia: Fear of open or crowded places.
✅ Treatment: Exposure therapy, systematic desensitization, beta-blockers.

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3️⃣ Panic Disorder

✅ Sudden episodes of intense fear (“panic attacks”).
✅ Symptoms: Rapid heartbeat, shortness of breath, dizziness.
✅ Treatment: CBT, SSRIs, benzodiazepines.

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4️⃣ Obsessive-Compulsive Disorder (OCD)

✅ Obsessions: Repeated intrusive thoughts (e.g., fear of contamination).
✅ Compulsions: Repetitive behaviors (e.g., excessive handwashing).
✅ Treatment: CBT (Exposure and Response Prevention), SSRIs (Fluoxetine, Fluvoxamine).

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5️⃣ Post-Traumatic Stress Disorder (PTSD)

✅ Occurs after experiencing trauma (e.g., war, accident, assault).
✅ Symptoms: Flashbacks, nightmares, emotional numbness, hypervigilance.
✅ Treatment: Trauma-focused CBT, EMDR, SSRIs, Prazosin (for nightmares).

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6️⃣ Somatic Symptom & Related Disorders

✅ Conversion Disorder (Functional Neurological Disorder)

• Neurological symptoms (paralysis, blindness) without medical cause.
  ✅ Illness Anxiety Disorder (Hypochondriasis)
• Excessive worry about having a serious illness despite normal medical tests.
  ✅ Treatment: Psychotherapy, reassurance, behavioral therapy.

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7️⃣ Dissociative Disorders

✅ Dissociative Amnesia: Sudden memory loss without brain injury.
✅ Dissociative Identity Disorder (DID): Presence of two or more distinct personalities.
✅ Depersonalization/Derealization Disorder: Feeling detached from oneself or surroundings.
✅ Treatment: CBT, grounding techniques, hypnosis, trauma therapy.

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8️⃣ Adjustment Disorder

✅ Emotional distress following a major life change (e.g., divorce, job loss).
✅ Symptoms: Anxiety, depression, social withdrawal.
✅ Treatment: Supportive therapy, stress management, counseling.

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4️⃣ Nursing Management of Neurotic Disorders

✅ Assessment:

• History of stressors, anxiety levels, coping mechanisms.
• Use of Hamilton Anxiety Rating Scale (HAM-A) for GAD.
• Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) for OCD.

✅ Nursing Interventions:

• Establish therapeutic communication.
• Encourage relaxation techniques (deep breathing, meditation).
• Educate on coping skills and stress management.
• Support medication adherence (SSRIs, benzodiazepines).
• Provide psychoeducation for patients and families.

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📝 Frequently Asked Questions in Competitive Exams:

✔ Most Common Neurotic Disorder? – Generalized Anxiety Disorder (GAD)
✔ Best Treatment for OCD? – CBT + SSRIs (Fluoxetine, Fluvoxamine)
✔ Which Disorder Involves Flashbacks? – PTSD
✔ Phobia Treatment? – Exposure Therapy (Systematic Desensitization)
✔ Which Disorder Shows Physical Symptoms Without Medical Cause? – Conversion Disorder

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This topic is highly important for psychiatric nursing and general nursing competitive exams! 📚 Let me know if you need MCQs or case studies on this! 🚀