An overview of mental illnesses

Question 1

What is the aetiology of anxiety?

Answer 1

There are several theories including genetic, familial history, neurochemical (imbalance of the neurotransmitter serotonin), social/cultural factors and upbringing.

Question 2

What are the characteristics of generalised anxiety disorder?

Answer 2

Generalised anxiety disorder is characterised by persistent and troublesome worrying for a period of more than six months independent of other MH conditions.

Question 3

What are the signs and symptoms of generalised anxiety?

Answer 3

Feeling of being constantly on edge
Irritability
Poor concentration
Physical tension

Question 4

What is the definition of panic disorder?

Answer 4

Sudden attacks of fear and nervousness, as well as physical symptoms such as sweating and a racing heart for more than a month’s duration, accompanied by significant behavioural changes due to the attacks and a preoccupation of concern or worry about having another attack.

Question 5

What is a phobia?

Answer 5

Marked and persistent fear that typically lasts more than six months. Exposure to the phobic stimulus results in extreme anxiety.
Persistant
Handicapping-restricting lifestyle
Object/situation
Behaviour (avoidance)
Irrational fears (recognised as such by consumer)
Anxiety response

Question 6

Define OCD

Answer 6

OCD is characterised by obsessions (persistent and recurrent intrusive thoughts or feelings perceived to be inappropriate by the person) and compulsions (thoughts, actions and behaviours that the person feels compelled to undertake in order to reduce the anxiety experienced)..

Question 7

What is the treatment for COPD?

Answer 7

CBT with medications (antidepressants)

Question 8

Define PTSD

Answer 8

PTSD can follow any traumatic event, particularly if the event was life-threatening. Diagnosis is made if symptoms persist for more than one month and are associated with significant impairments or distress to the person.

Question 9

What are the symptoms of PTSD?

Answer 9

Intrusion, avoidance, negative alterations in cognitions and mood, alterations in arousal and reactivity. Persistent and distorted blame of self or others, reckless or destructive behaviour.

Question 10

Define schizophrenia

Answer 10

A severe mental disorder affecting approximately 1% of the population worldwide. High levels of dopamine and serotonin.

Question 11

What is the diagnostic criteria for schizophrenia?

Answer 11

Two or more of the following for a significant proportion of time in the preceding month:
Delusions, hallucinations, disorganised speech (at least one)
Grossly disorganised behaviour
Negative symptoms (flat affect, lack of volition)
Social and occupational dysfunction
Evidence of dysfunction in the pervious six months

Question 12

What are the positive symptoms of schizophrenia?

Answer 12

Hallucinations, delusions, thought disorder, disorders of movement

Question 13

What are the negative symptoms of schizophrenia?

Answer 13

Flat affect (immobile facial expressions, monotone voice)
Lack of pleasure in everyday life
Diminished ability to initiate and sustain planned activity
Speaking infrequently, even when forced to interact
Neglect personal hygiene

Question 14

Define schizoaffective disorder

Answer 14

The presence of symptoms of schizophrenia with an abnormal (elevated or lowered) mood

Question 15

Define schizophreniform

Answer 15

Duration of symptoms is less than six months and functioning has not been negatively affected in the person

Question 16

What is the criteria for major depressive disorder?

Answer 16

At least five of the following present in the preceding two weeks, with a significant reduction in functioning:
Depressed mood (has to be present)
Loss of pleasure in activities that were previously pleasurable (has to be present)
Significant changes in weight (up or down)
Sleep disturbances
Psychomotor agitation or retardation
Loss of energy/fatigue
Feelings of worthlessness
Impaired concentration
Suicidal ideation

Question 17

Define bipolar disorder

Answer 17

Bipolar is characterised by episodes of depression and mania. Must last at least one week.

Question 18

What are manic episodes?

Answer 18

Characterised by: insomnia
irritability
boundless energy
inability to concentrate
persistently elevated mood
irritability
labile mood

Question 19

What is the difference between bipolar I and bipolar II?

Answer 19

Bipolar I- experience at least one lifetime episode of mania and usually episodes of depression
Bipolar II- experience episodes of depression plus episodes of mid form of mania called hypomania (persistent elevation of mood, energy and activity),

Question 20

What are the main symptoms that are common to post-natal depression?

Answer 20

Low mood, poor appetite, altered sleep pattern and low self-esteem.

Question 21

What is the criteria for ADHD?

Answer 21

Behaviours below before the age of 12, with a duration of longer than six months:
Lack of attention to detail with school work and other activities
Trouble organising tasks and activities
Lose things needed for task or activities
Has trouble sticking to tasks or play activities
Does not seem to listen when spoken to directly
Does not follow though on instructions that they are able to understand and does not finish tasks
Tries to get out of doing things that require a lot of attention and concentration.
Is easily distracted and forgetful

Hyperactivity/impulsivity which includes:
Fidgeting of the hands or feet, squirming in their seat
Being unable to remain seated in the classroom when asked to
Running about or climbing excessively
Trouble playing quietly
Talking all the time
Difficulty waiting their turn
Interrupting conversations

Question 22

What are the two types of anorexia?

Answer 22

Restricting: where the person inhibits food overall, is less impulsive and there are fewer self-harming and suicide attempts
Bingeing/purging type: which is characterised by family history of obesity or being overweight prior to the condition developing, use of vomiting and medications to decrease weight, self-harm and suicidal behaviours

Question 23

What is the criteria for Anorexia?

Answer 23

Persistent restriction of energy intake leading to significantly low body weight (in context of what is minimally expected for age, sex, developmental trajectory and physical health)
Either and intense fear of gaining weight or of becoming fat or persistent behaviour that interferes with weight gan (even though significantly low weight).
Disturbance in the way one’s body weight or shape is experienced, undue influence of body shape and weight on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight

Question 24

What are the physical symptoms:

Answer 24

Loss of muscle mass
Fine downy body hair
Hypotension
Bradycardia
Anaemia 
Eroded teeth enamal

Question 25

Mental health symptoms

Answer 25

Low self-esteem
Poor concentration
Depression
Insomnia
Loss of appetite
Poor memory
Lack of energy
Social withdrawal 
Obsessive behaviour around food

Question 26

What is Bulimia Nervosa?

Answer 26

An eating disorder where the person has patterns of bingeing, purging, causing emotional distress, preoccupation with body weight, and often normal body weight.

Question 27

What is the criteria for Bulimia Nervosa?

Answer 27

Craving for food
Preoccupation with eating
A pattern of overeating followed by compensatory behaviour to reverse food intake (exercise, purging, self-induced vomiting) etc.

Question 28

What are the symptoms of bulimia?

Answer 28

Often normal body weight
Stomach ulcers
Tooth decay
Irregular heart beat
Oesophageal/gastric perforation
Constipation
Electrolyte imbalance.

Question 29

Define personality disorder

Answer 29

Abnormal, extreme, inflexible and pervasive variations from the normal range of one or more personality attributes, causing suffering to the person as well as those around them. Can be diagnosed by about 16 where personality has formed.

Question 30

What are the three groups of personality disorders?

Answer 30

Cluster A- the odd or eccentric: paranoid, schizoid, schizotypal.

Cluster B: the dramatic or emotional: Borderline, narcissistic, antisocial, histrionic

Cluster C: The anxious or fearful: Avoidant, obsessive-compulsive, dependent.

Question 31

What are the characteristics of paranoid personality type?

Answer 31

Distrusting, suspicious, highly sensitive

Question 32

What are the characteristics of schizoid personality type?

Answer 32

Cold and unemotional
Lack of interest in other people
Very introspective

Question 33

What are the characteristics of schizotypal personality type?

Answer 33

Socially isolative
Unusual ideas
Odd behaviours or appearance

Question 34

What are the characteristics of borderline personality type?

Answer 34

Unstable relationships with other people
Poor self-image
Unpredictable and erratic moods
Impulsive substance use and abuse
Impulsive self-harming behaviour

Question 35

What are the characteristics of narcissistic personality type?

Answer 35

Strong sense of entitlement
Grandiose
Seeks admiration
Lack of empathy for others

Question 36

What are the characteristics of antisocial personality type?

Answer 36

Tendency to violate the boundaries of others
Superficial charm
Poor behaviour control: expressions of irritability, threats, aggression, verbal abuse

Question 37

What are the characteristics of histrionic personality type?

Answer 37

Excessive attention-seeking behaviour
Egocentric
Highly emotional

Question 38

What are the characteristics of avoidant personality type?

Answer 38

Insecure

Social isolation due to fears of rejection or humiliation by others

Question 39

What are the characteristics of obsessive-compulsive personality type?

Answer 39

Preoccupation with orderliness and control over situations
Rigid behaviour
Perfectionism

Question 40

What are the characteristics of dependent personality type?

Answer 40

Excessive need to be taken care of
Clinging, submissive
Feels helpless when not in relationship

Question 41

What is delirium?

Answer 41

Reversible clinical syndrome, marked by acute disturbance in attention and thinking. Can be precipitated by: pain, alcohol or drug withdrawal, infections, dehydration, constipation, other disorders (cancer/neurological), immobility, kidney or liver problems, lack of sleep.

Question 42

What is the diagnostic criteria for delirium?

Answer 42

Rapid onset of symptoms
Fluctuating mental state
Attention span impairment
Change in cognitive function/altered perception- eg hallucinations, thought disorders

Question 43

What are the characteristics of dementia?

Answer 43

Difficulties with speech
Disturbance of memory
Loss of motor control
Decline from previous level of functioning
Impaired social or occupational abilities and performance

Question 44

What is the diagnostic criteria for substance abuse?

Answer 44

A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:
1- recurrent substance use resulting in failure to fulfil major role obligations at work, school or home
2- recurrent substance-related legal problems
3- recurrent substance use in situations in which it is physically hazardous
4- continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance- (eg arguments with spouse about consequences of intoxication, physical fights).