1b Psychiatry intro Flashcards
what is an adjustment reaction?
- states of subjective distress and emotional disturbance
- interfering with social functioning/performance
- arising in a period of adaptation to a significant life change or stressful life event
what is an organic delusional disorder?
a disorder in which persistent or recurrent delusions dominate. there may be hallucinations, thought disorders too
what is the prevalence of post stroke psychosis?
delusions 4.7%
hallucinations 5.1%
more common in right hemisphere strokes (5:1)
what is post stroke psychosis?
psychosis following a stroke
common delusional themes: persecutory, jealousy, environmental
what is the point prevalence of mental illness in england?
20%
what is a significant risk factor for mental illness?
having a long term physical condition
what is the morbidity rate of mental illness?
takes 20 years off life expectancy
what is the MoCA?
montreal cognitive examination
highly sensitive
what are the types of delirium?
hypoactive - depressed, withdrawn and subdued
hyperactive - aggressive, loud presentation
what is delirium?
psychiatric manifestation of physical illness
what is the range of delirium causes?
very large - change in environment, surgery, medications, constipation, hypoxia etc
what are the predisposing factors to delirium (9)?
advanced age, dementia, impaired AoDL (activities of daily living), immobility, sensory impairment, urinary catheterisation, malnutrition, alcohol, depression
how does one manage delirium?
anticipate, modify risk factors & early diagnosis
treat the cause, good nursing, medication (often not helpful), wait it out
what is mental health stigma?
challenges faced by mentally ill people related to: poor understanding, negative attitudes towards mental illness, social exclusion
what is intrapersonal stigma?
internalised discrimination compounded by the direct effects of the illness
what is interpersonal stigma?
stigma from friends, family, colleagues which may cause social isolation
what is structural stigma?
poor resources/funding and access to physical health care compounding social stigma
give examples of illnesses causing mental deficits
thyrotoxicosis - mania, anxiety
hypothyroidism - depression, dementia
cushings - depression
infections - depression
cancer - depression
parkinsons - depression, anxiety, dementia
Outline the prevelance of delirium (5).
- 20% of acute hospital patients > 65 have delirium on admission
- 30% of patients on wards have delirium
- 80% of patients in intense care have delirium
- 50% of delirium patients are hypoactive
- 50% of delirium patients go undetected
What are the causes of delirium (14)?
- P - Pain
- I - Infection (urine / pneumonia / cellulitis / wound etc.)
- N - Nutrition (Hyponatraemia)
- C - Constipation
- H - Hydration/ Hypoxia
- E - Endocrine + Electrolyte (urine detection), Encephalitis
- S - Stroke/ surgery
- M - medication (opiates / anticholinergics / steroids) and Alcohol withdrawal
- E - Environmental changes (ITU / HDU / ward)
+ Liver / Renal impairement
What are the causes of stigma (3)?
- Poor understanding of mental health
- Negative attitude
- Social exclusion
What are the 3 types of stigma?
- Intrapersonal stigma
- Interpersonal stigma
- Structural stigma
What is delirium?
- Organic syndrome characterised by concurrent disturbances of consciousness and attention, perception, thinking, memory, psychomotor behaviour, emotion and the sleep-wake schedule
- The duration is variable and the degree of severity ranges from mild to very severe
