0528 - Impact of the psychological II - AF

Question 1

What is potentially a mental disorder?

Answer 1

Achieving “abnormal” in 2 of the 5 following criterion: 1. Statistical infrequency (2 standard deviations above or below the mean) 2. Unexpectedness (psychology or behaviour you would not expect given the circumstances) (situationally and culturally dependent) 3. Violation of (social/cultural) norms (behavior which causes distress and anxiety in others or threatens their feeling of safety) (historically, situationally and culturally relative) 4. Personal distress (psychology or behavior which causes distress or suffering to the person) 5. Disability (psychology or behavior that makes it difficult or impossible to pursue a goal)

Question 2

List some somatic symptom disorders.

Answer 2

• Somatic symptom disorder- Factitious disorders (Munchausen’s, Munchausen’s by proxy)- Conversion disorder

Question 3

List some cognitive disorders.

Answer 3

• Alzheimer’s- Retrograde amnesia- Anterograde amnesia

Question 4

List some neurodevelopmental disorders.

Answer 4

• Dyscalculia- Dyslexia

Question 5

List some common mental illnesses that may present in general practice.

Answer 5

• major depressive disorder- bipolar disorder- agoraphobia- OCD- bulimia nervosa- schizophrenia

Question 6

Outline the diagnostic criteria for major depressive disorder.

Answer 6

1 or more episodes with at least 2 weeks depressed mood, and 5 or more of the following symptoms (that are abnormal to person’s “baseline” state):- depressed mood/irritability- loss of interest/pleasure in most activities- feelings of worthlessness/excessive guilt- diminished ability to think/concentrate- recurrent thoughts of death/suicide or suicide attempt/plan- weight loss or change in appetite- insomnia/hypersomnia- fatigue- psychomotor retardation/agitation

Question 7

Outline the diagnostic criteria for bipolar (majority of time spent in depressive phase, but time also spent in manic phase).

Answer 7

As for major depressive disorder (above), plus mania (a distinct period of abnormally and persistently expansive or irritable mood and increased goal-directed activity/energy) lasting at least 1 week and present most of the day, nearly every day, and 3 or more of the following symptoms:- inflated self-esteem- talkative- racing ideas- distractibility- increased goal-directed activity- excessive involvement in pleasurable activities with high potential for negative consequences- decreased occupational/social functioning- decreased need for sleep- psychomotor agitation

Question 8

Outline the diagnostic criteria for agoraphobia.

Answer 8

As an anxiety disorder, it is characterised by irrational fears and increased feelings of anxiety; initiates fight or flight autonomic response; diagnosed by having anxiety about or avoidance of situations from which escape may be difficult or help not available if have a panic attack lasting at least 6 months, and at least 2 of the following symptoms:- fear or anxiety about using public transport, being in open spaces, being in enclosed spaces, standing in line or in a crowd, being alone outside of home- restlessness- irritability- extreme fear/dread- difficulty concentrating- muscle tension- sleep disturbance

Question 9

Outline the diagnostic criteria for obsessive compulsive disorder.

Answer 9

Distressing intrusive obsessive thoughts and/or repetitive compulsive actions that are clinically significant.Obsession symptoms - persistent and recurrent ideas/thoughts/impulses that are not real-life worries; experienced as intrusive and unwanted so cause marked anxiety/distressCompulsion symptoms - repetitive behaviours or mental acts designed to prevent or reduce anxiety/distress caused by the obsession(s); do not provide pleasure or gratification, have rigid rules and take up a significant amount of timeObsessions –> anxiety –> compulsions –> relief –> obsessions –> etc.

Question 10

How is obsessive compulsive disorder (OCD) different from obsessive compulsive personality disorder (OCPD)?

Answer 10

People with OCD are often aware that their obsessions are abnormal, but are compelled to perform them anyway; people with OCPD, however, believe their need for strict order and rules is perfectly normal.

Question 11

Outline the diagnostic criteria for obsessive compulsive disorder.

Answer 11

Bulimia nervosa - recurring episodes of binge-eating characterised by eating larger than “normal” amounts of food in a discrete period of time and a sense of lack of control over eating during the episode, for at least once a week on average for 3 months; symptoms = recurrent inappropriate compensatory behaviour to prevent weight gain and self-evaluation unduly influenced by body shape and weight.

Question 12

What are negative symptoms? Positive symptoms?

Answer 12

Negative: “taken away” from normal thoughts, feelings and behaviourPositive: “added to” normal thoughts, feelings and behaviour

Question 13

How are schizophrenia spectrum and other psychotic disorders characterised?

Answer 13

Characterised by abnormalities in one or more of the following domains:- delusions (+ve symptom)- hallucinations (+ve)- disorganised thinking (+ve)- grossly disorganised motor behaviour (+ve)- flat affect (-ve symptom)- alogia (-ve)- avolition (-ve)- social/occupational/self-care dysfunction (-ve)

Question 14

Outline the diagnostic criteria for schizophrenia disorder.

Answer 14

2 or more of the following symptoms for most of the time during a one month period (and at least 1 of the first three):- delusions- hallucinations- disorganised speech- disorganised/catatonic behaviour

Question 15

How can mental illness express itself in physical symptoms?

Answer 15

E.g. withdrawal, weight loss, chest pain, fatigue, stomach aches, tooth decay (from stomach acid - bulimia - vomiting), sleep disturbances.

Question 16

How can mental illness impact upon a person’s physical health and well-being?

Answer 16

E.g. 1: major depressive disorder; sleep disturbances lead to increased risk of physical illness (compromised immunity) and accidents; fatigue and social isolation lead to lack of exercise, which leads to lower overall health and well-being; changes to diet lead to weight loss, lack of nutrients and thus illness; increased risk of suicide; increased substance abuse which can affect organs.E.g. 2: anxiety disorders; lack of exercise and exposure to sunlight leads to vitamin D deficiencies and poor physical health; inability to travel alone leads to may not seek health care assistance or struggle grocery shopping; anxiety linked with GI problems, chronic respiratory disorders, heart disease.E,g. 3: some OCD compulsions may produce physical problems, e.g. dermatitis from excessive washing.