additional liason psych

Question 1

assesment of mentla capacity

Answer 1

– Understand
– Retain
– Weigh information
– Communicate the decision

Question 2

key principles of mental capacity act

Answer 2

 Presumption of capacity
 Task and time-specific
 Individuals should be supported as much as possible to
make their own decisions
 Unwise decisions do not necessarily indicate lack of
capacity
 Acts/decisions made on behalf of a person who lacks
capacity must be done in their best interests
 Anything done for or on behalf of a person who lacks
capacity should be the least restrictive of their basic
rights and freedoms

Question 3

what is OCD

Answer 3

ICD-10 F42:
A disorder of recurrent obsessional
thoughts and/or compulsive acts.
Must have been present on most days for at least 2
successive weeks.
The thought or act must be resisted unsuccessfully
Thoughts must be unpleasantly repetitive

Question 4

what are the obsessional thoughts of OCD

Answer 4

“Ideas, images or impulses entering the
mind again and again in a stereotyped form

DISTRESSING
Often because they can be violent or obscene
RECOGNISED AS OWN THOUGHTS

Question 5

what are compulsive acts

Answer 5

Rituals or Stereotyped Behaviours repeated again and again
Viewed as able to prevent some objectively
unlikely event.
NOT INHERENTLY ENJOYABLE
Do not result in completion of useful tasks

Question 6

epidem of OCD

Answer 6

Prevalence in adults: 0.6% - 2.5% 1
Higher in children
Average age of onset: 26
Male : Female 1:1 (although men present earlier)
Up to 80% concordance in identical twins

Question 7

treatment of OCD

Answer 7

• Psycho-education (Explain symptoms, Simple strategies
Point towards other organisations (e.g. Mind))
• Psychotherapy (• CBT,• CAT• MBT• Psychodynamic)
• Medication (• SSRIs (selective serotonin reuptake inhibitors) e.g. Sertraline) • Clomipramine (tricyclic antidepressant))

Question 8

what causes the symptom of anxiety

Answer 8

sympathetic activation - causes the psychological, behavioural and at least the somatic effects. thus the differential for anxiety is wide. it can include plenty of cardiac, neoplastic (phaeochromo), drug/toxin, metabolic (thyrotoxicosis) causes etc. need to rule these out.

Question 9

what are the anxiety disorders?

Answer 9

several. its an umbrella term. inc PTSD, GAD (generalised), panic disorder, agoraphobia, social phobias, phobias about specific things e.g. arachnophobia.

the main features are chronic, inappropriate/disproportionate, and disabling often via the avoidance strategies developed.

Question 10

treatment for specific phobias e.g. arachnophobia

Answer 10

graded exposure therapies and habituation. many organisations run courses tailored to this.

Question 11

steps of treating anxiety

Answer 11

step 1 - identify that a disorder is there, what are they anxious about? educate, gives resources and then actively monitor.

step 2 - self help. follow up. leaflets, online info, self help groups, anxiety uk helpline.

step 3 - psychological or pharmacological intervention. can skip to this stage if very severe on presentation. CBT. applied relaxation. SSRIs, SNRIs.