New Mod: PSYCHIATRY

Hey guys,

I'm already working on a new department mod and started with a Psychiatry, I already got it running but I would like to ask for your help:

- Can you suggest the symptoms and tretments for the department?

- Can someone design new icons for the department? And also for the reatments, symptoms and deseases.



Cheers,

Andy

Hi DrAndy, it's great to see the initiative!

Let me add a few comments regarding the current status of the support for adding departments (I see you've already commented on the mod support roadmap: https://projecthospital.forumotion.com/t1843-mod-support-roadmap).

The TL/DR would be: feel free to continue working on the mod, but there's a few bits that will change or need to be implemented on our side before it can be easily shared.
One of the biggest limitations at this point is that every examination has a list of rooms where it can be done - so when adding a department, its rooms need to be filled in all existing examinations that can be done there. We'll be changing the system to something more universal, like tags, so for example blood pressure can be taken in any room tagged as "basic_examinations" etc.
Another feature is the support for custom icons - we've recently implemented it for graphical assets, but it still needs to be added for items in the 'medical database'.

We'll need all this to work before we start releasing new departments as DLC, so it's definitely coming (and relatively soon), although there are other features that will most likely get a higher priority.

jan.oxymoron wrote: One of the biggest limitations at this point is that every examination has a list of rooms where it can be done - so when adding a department, its rooms need to be filled in all existing examinations that can be done there. We'll be changing the system to something more universal, like tags, so for example blood pressure can be taken in any room tagged as "basic_examinations" etc.

haha, I already saw that issue ... and also started to implement the department in all examinations, realized it would be a lot of work and stoped for a while. Happy to read you're already working on it I'm also waiting for andyking233's PH Database Editor. This tool will change everything

Till then I'll swim through your xmls and have fun.


Greetings,
Andy

I'd be very interested in helping you plan and make this mod. Adding an entire new department isn't going to be easy at all but I feel like this game will really shine when the steam workshop comes to life with some major mods. I'm going to help you come up with  the symptoms, treatments and diagnoses relevant to psychiatry. In the United States, the Diagnostic and Statistical Manual of Mental Disorders, which is now in its fifth edition (DSM 5) is considered to be the bible of psychiatry by the American Psychiatric Association. The DSM is widely used by psychiatrists all around the world. It describes close to 300 psychiatric conditions so trying to model every condition in your mod is going to be nearly impossible. For simplicity's sake, I'm going to list the 'bread and butter' of what psychiatrists typically treat on a daily basis in their practice and exclude the more rare and uncommon illnesses.

The DSM 5 lists each diagnosis under a certain category. I'm going to list the main categories and the most common disorders in each one along with their typical symptoms, the relevant examinations and treatments. I realize listing everything in one post would turn this into a gigantic block of text so I'm going to split up the categories into separate posts.

It's important to note that the majority of psychiatric examinations and evaluation is clinical; this means that most of the symptoms are going to be obtained by focused history taking (interview). Having said that, the majority of diagnoses can only be made once substance abuse and medical causes have been ruled out first. So for example, a diagnosis of schizophrenia which is typically characterized by auditory hallucinations (hearing voices in your head), paranoid delusions and bizarre behavior cannot be made before first ruling out the use of illicit drugs which can cause similar symptoms. Similarly, certain medical conditions like low thyroid hormone, or high levels of cortisol in the blood stream can cause depression and other mood symptoms and so blood tests are very frequently obtained by psychiatrists early on in the diagnosis of patients to rule out other causes first. As such, you'll find that "Interview", "Blood testing" and "Drug Screen" are going to pretty much be the main in-game examinations used in the psychiatry department. I'm also going to highlight symptoms that can lead to a "collapse" in red. These are the dangerous symptoms that should warrant hospitalization in real life.

Speaking of hospitalization, I'm not sure if you can actually exclude surgery from a department when you make a new department mod. The reason I say this is because there are no 'psychiatry surgeries' in modern psychiatric practice. Back in the day, surgeons used to perform lobotomies to treat mental illness but that practice has been buried a very long time ago. Additionally, there are some treatments used in psychiatry such as Electroconvulsive Therapy that would be difficult to include in your mod without adding new graphical assets - like an actual new room with a machine that sends electricity through the brains of patients. Perhaps one of the most important aspects of treatment in the field of psychiatry is psychotherapy. I'm not sure how you would model this because psychotherapy isn't something a patient does only once. Psychotherapy involves patients setting up appointments over a period of time and seeing their therapist multiple times.  Of course you can choose to exclude these details entirely but I'm just mentioning all these things because I don't know what the limitations are.  What I do know is a lot of the game's core systems are compatible with having a psychiatry department. Most patients are only going to be seen in an outpatient setting (clinics only) and the few that get hospitalized will be discharged eventually just like patients in other departments.

I hope you stay interested in working on this mod and if it turns out to be a success maybe we can work on new mods for more departments. I'll end this post here and make new posts for each of the categories of psychiatric illnesses I mentioned earlier.

Mood Disorders:

The two most common mood disorders are Major Depressive Disorder (commonly known as depression) and Bipolar Disorder. As I mentioned in my previous post, there are close to 300 diagnoses in the DSM 5 and there are often many subtypes for each disorder (e.g. Bipolar I, Bipolar II, Rapid Cycling Bipolar Disorder etc.) so to keep things simple and non-convoluted I'm only going to mention the most common illnesses. Symptoms highlighted in red are symptoms that can lead to a "collapse". Generally speaking patients who are at high risk of harming themselves or others are the ones that get hospitalized (often involuntarily). I'll add a short description to each symptom, examination or treatment (similar to the ones you see when you scroll over the icons in-game) unless if they already exist in the game.

1. Major Depressive Disorder

Symptoms:
- Insomnia
- Hypersomnia (This patient reports an excessive amount of time spent sleeping throughout the day)
- Anhedonia (This patient has an inability to experience pleasure in normally pleasurable activities)
- Guilt (Feelings of worthlessness or inappropriate guilt)
- Fatigue
- Poor Concentration
- Psychomotor Retardation (The patient reports physical and mental sluggishness; their thought process and movement has slowed down)
- Decreased Appetite
- Increased Appetite
- Suicidal Ideation (This patient has been thinking about committing suicide.)

Examinations:
- Interview
- Speech Listening
- Physical Exam
- Neurological Exam
- Blood test

Treatment:
- Antidepressants (A class of drugs used for the treatment of major depressive disorder and of other conditions, including some anxiety disorders, some chronic pain conditions, and to help manage some addictions)
- Psychotherapy (The use of of psychological methods by a clinical psychologist to help the patient modify their behavior, cognition or emotions)
- Electroconvulsive Therapy (I'm not sure if you want to add this to your mod because it would require a new machine and I don't know if it's possible to actually add that in a mod at the moment. Not to mention ECT is only used as a very last resort in depression refractory to medication)

2. Bipolar Disorder

Bipolar Disorder is a mood disorder characterized by the presence of symptoms of mania and depression that are not due to a substance or medical condition.

Symptoms:
- Distractibility (The patient is constantly sidetracked and is unable to pay attention, concentrate or stay on task)
- Insomnia
- Grandiosity (This patient is experiencing feelings of an unrealistic sense of superiority over others and views others as inferior)
- Pressured Speech (The patient speaks very loud and fast and is difficult to keep up with)
- Impulsive (The patient is constantly involved in high risk behavior such as reckless driving, excessive spending and excessive sexual activity)
- Confusion
- Aggression (The patient exhibits uncharacteristic periods of anger and aggression posing a great risk of harm to self and others)

The above symptoms together are referred to as 'mania' which is also described as elevated mood. Bipolar Disorder is characterized by fluctuation between states of mania and depression. The following symptoms are the symptoms of depression.

- Insomnia
- Hypersomnia
- Anhedonia
- Guilt
- Fatigue
- Poor Concentration
- Psychomotor Retardation
- Decreased Appetite
- Increased Appetite
- Suicidal Ideation (This patient has been thinking about committing suicide.)

Examinations:
- Interview
- Speech Listening
- Physical Exam
- Neurological Exam
- Blood Tests

Treatment:
- Antipsychotics ( A class of medication primarily used to manage psychosis which includes delusions, hallucinations, paranoia or disordered thought)
- Mood Stabilizers (Drugs given to help control symptoms of mania and depression particularly in Bipolar Disorder)


I'll continue to post different diagnoses if you find this actually useful. Let me know if there's anything I can help you with or add to the current format.

CAN YOU SHOW ME THE CODING FOR THE MOD ?

Suggestions:

Alcocholism

1st stage (easy):

Symptoms:

- Face redness;
- Over-Confidency; (Patient is more confident than ever, sometimes a little narcassist.)
- Social (Patient is very talkative, even if shy before);
- Alcochol in blood;
- Alcochol in urine;
- Dehydration;
- Large amount of urine disposal;
- Smelly urine;

Examination:

- Interviev;
- Blood test;
- Urine test;
- Physical test;

Treatment:

- Recomendations;
- Hydration;

2nd stage(Medium):

Symptoms:

- Tiredness;
- Blurred vision;
- Standing/balance problems;
- Imparied speech;
- Confusion;
- Dizzinees;
- Vomiting;
- Staggering;
- Agression;
- Alcochol in blood;
- Alcochol in urine;
- Dehydration;
- Large amount of urine disposal;
- Smelly urine;

Examination:

- Interviev;
- Speech listening
- Psychical exam;
- Eye test OR vision test (Doctor makes the patient look at his finger and the doctor moves the finger, if eyes not following, drunk.)
- Urine Test;
- Blood Test;

Treatments:

- Recomendaction;
- Hydration;
- Tranqilizer;
- Rehab (Room hospitalization);

3rd stage(The hardest)

- CAN COME WHIT AN AMBULANCE -

Symptoms:

[Every symptom from stage 2];
- Amnesia (Memory loss);
- Alcochol poisoning;
- Liver overextension; (Liver isn't functioning, most cases need an transplant);
- Faint;
- Coma;
- Hyperventilation;
- No breath;
- Arytmia;

Examinations:

[Same from stage 2]
- Gastroscopy;
- Breath listening;

Treatments:
[Same from stage 2]
- First aid;
- Respiration;
- Liver transplant;
- Speech therapy;

Pica

Dieseases associated:
- Autism;
- Major Depressive Disorder;
- Schizofremia;

[Can come by ambulance]

Symptoms:
- Stomach Ache;
- Bad breath;
- Stomach Deep Breathing;
- Vomiting;
- Impaling or non-edible things in stomach;
- Stool whit impaling objects;

Diagnosis:

- Breath Exam;
- Physical Exam;
- Abdominal palpitalion; (I think it is called like that, but the pic has two hands);
- Stool analysis;
- Barium swallowing;

Treatment:

- Rehab;
- Physical prevention;
- Physical teaching: (Eg. water mist in face after attempted to eg. eat a nail);
- Negative practice (Non-edible object held against patient's mouth without allowing ingestion);
- "Doggy treatment" - (Eg. positive consequences when good, and negative when bad);


[Btw usually kids have pica].

i mean the actual xml coding - can u show mean that instead.

How were you able to populate a staff list for a custom room in custom department, I can't seem to do it!

MoominLittlesocks wrote:How were you able to populate a staff list for a custom room in custom department, I can't seem to do it!

Hi, let me reply here - I also got your PM, but this could be useful to other modders in the future

Basically there's two main steps: the rooms need to have the tag 'doctor_workspace', this will allow you to hire doctors for the room. Then in the xml with the department itself make sure you have the FirstDoctorSpecialization set correctly. Next step, if things don't seem to work, is always to look at the log file for errors.

Also, let me mention that we're close to releasing some changes that will help with adding departments:
- the list of allowed rooms in examinations and treatments will get replaced by tags so it will be possible to allow existing examinations in rooms of a new modded department (this was a big change, but we've been already testing it for a few weeks)
- custom icons for items in the medical side of the database
- and a complete guide for the whole process

Hi Jan,

Thanks for your response. Sadly those are two things I had already implemented and it still isn't populating the candidate list. The log doesn't seem to be showing anything abnormal either.

Psychiatric illness:
PTSD (Post Traumatic Stress Disorder)
Autism
ADHD (Attention deficient hyperactivity disorder)
Anorexia Nervosa
Schizophrenia
Cocaine addiction
Borderline Personality Disorder
Psychosis
Anxiety Disorder
Phobias

Hey guys, I was gone for quite some time, after I've got stuck in the limitations of the modding support back then, but since Jan released even more Updates to the game and gave us the opportunity to add own departments, I am back at this project I also read all your messages and hope to upload a working prototype, where we can feed symptoms and treatments.

Cheers,

Andy

DrAndy, I can also help you with icons and decals. I'm the creator of the ENT mod. If you need some help you can ask me if you want. I'm happy to help

so some of you already posted some diagnoses which I really like. I already set up the requirements for the department and are working on diagnoses and symptoms, which will be implemented in the CRP (Community Ressource Pack). What you guys think about that symptom of depression? It's already a non-main-symptom in the base game? Should I switch it? Or should I implement some variations of depressions and also different kinds of antidepressants as treatments?

James Buckham wrote:DrAndy, I can also help you with icons and decals. I'm the creator of the ENT mod. If you need some help you can ask me if you want. I'm happy to help

nice! I'll contact you when I have a couple of things ready.

Hi, DrAndy how's your mod going?

working on it

@DrAndy We would like to invite you to the Project Hospital Modders Discord, may you give us your Discord username and number?