11 Flashcards
components of mental state examination
- appearance
- behaviour
- mood (apparent and subjective)
- speech (normal, slow, pressured)
- thought (form and content)
- beliefs
- perceptions
- cognitive function
- insight
- risk
how long does typical depression episode last
4-6 months
management depression
CBT medication SSRI -> TCA -> MAOI family therapy ECT psychosurgery
describe risk component MSE
risk of harming themselves/ others
- thoughts
- ideation
- intent
- plans
2nd line management OCD in PC
SSRIs
takes up to 12 weeks to see a response
1st line management OCD in PC
CBT
including exposure + response prevention
resist their compulsions/ urges
management social anxiety disorder
1st - CBT
2nd - sertraline/ escitalopram
continue for 6 months after treatment has become effective
consider a diagnosis of GAD in patients who
- present with anxiety/ significant worry
- frequent attendees with chronic health problem
- frequent attendees seeking advice about somatic symptoms
- frequent attendees repeatedly worrying about a range of different issues
length of time 3rd depression treatment
discuss lifelong prophylaxis
min length of time 2nd antidepressant treatment
2 years
min length of time for first antidepressant treatment
6 months
define trial of adequate length for depression treatment
at least 2 months
in cases of antibiotic resistance, what methods should be considered
switching combining SSRI with mirtazapine adjunctive with lithium adjunctive with atypical antipsychotic ECT
typical LD prison representation
- arson
- sexual (normally exhibitionism)
describe over-activity syndrome in children with learning disability
many severe LD are overactive but not the extent that would indicate ADHD diagnosis
causes of stigma
past experience
culture
older white males tend to be the worst
questions for assessing insight
- do you know why you’re here
- are your symptoms due to an illness
- Is this a mental illness
- do you agree with the treatment plan
cognitive function MSE
- orientation
- attention/ concentration
- short and long term memory
depression diagnosis tools
- ICD10
- SCID
- SCAN
depression differential diagnosis
- normal reaction to life events
- bipolar
- anxiety
- hypothyroidism
- chronic Hep B
- SAD
- hyperparathyroidism
presentation social sphere of dementia
- isolation
- loss of interests
- irritability
- apathy
- withdrawal
- loss of confidence
- indecisive
- concentration, registration and memory loss
MSE abnormal perceptions
- illusions
- hallucinations
