An Overview of Psychiatric Conditions Flashcards
What are some general concepts on mental illness that we have come to accept?
- Mental illness is not due to external factors such as parasites, possession, infectious agents
- Emotions, thoughts, and behaviours originate within the brain, therefore disorders of thoughts, emotions, and behaviours are disorders of the brain
- Mental illness is not a sign of personal deficit (such as moral weakness)
Give 2 examples of the boundaries of mental illness
- Hallucinations are a sign of mental illness - but they can also be completely normal (e.g. hypnogogic sleep-related hallucinations, natural part of grieving process)
- Paranoid and grandiose beliefs that persist despite concrete evidence against them are typically sign of mental illness - unless they are shared and culturally sanctioned religious or personal beliefs
Is mental illness just an extreme degree of human behaviour?
No - there are clear pathologies in psychiatry
Describe the event that opened our eyes to the possibility of medicine to cure/manage mental illness?
A patient named Jacques Lh was given Chlorpromazine and 3 weeks later was discharged from an asylum and ready to resume “normal life”
Name a few controversial points in psychiatry that existed today
- Mental illness is a myth and labelling mental illness is just another example of society trying to control people
- Psyciatry takes normal human fallibility or deviant behaviour and medicalizes it
- Electroconvulsive therapy is used as a tool for discipline
- Conflict of interest - psychiatry is paid by pharmaceutical companies to prescribe certain meds
What did a psychiatric epidemiology study done in the US in 2005 show in terms of prevalence of mental illness?
That atleast 50% of people would meet criteria for mental illness at some point in their lives.
What disorders were most common in the study that identified mental illness prevalence in the US?
- Anxiety disorders (as a group)
- Alcohol use
- Major depressive disorder
Name 2 mental illnesses that are more common in women
depression and anxiety
Name 2 mental ilnesses that are more common in men
Alcohol use
Antisocial personality disorder
Name 2 mental ilnesses that are more common in men
Alcohol use
Antisocial personality disorder
At what age does 75% of the population see their first symptoms of mental illness by?
Age 24
What percentage of people who had an active disorder sought treatment?
19%
How common is it to have 2 concurrent disorders?
60% of ppl with a psychiatric condition have 2 concurrent disorders
What is the Mental Status Exam?
A key component of psychiatric evaluation
A cross-sectional description of patient’s mental state - provides data necessary for diagnosis
Name some sections of the mental status exam
- General appearance, accessibility, rapport, behaviour
- Mood and affect
- Speech
- Thought process
- Thought content
- Perceptions
- Cognition
- Insight and judgement
Why do psychiatrists look at general appearance?
Typically ppl with more severe mental illness will look dishevelled/unkempt
Why is establishmet of rapport so important for the Mental Satus Exam?
Because it will produce more reliable results, the person will be more likely to be honest with you
What are some abnormal behaviours that could be observed during meeting with a client?
- social disinhibition (inappropriate or intrusive behaviour)
- irritability and aggression, agitation
- loss of motivation
- social withdrawal
- mental slowing, motor slowing
- abnormal voluntary postures/movements
What is the difference between mood and affect?
Affect - emotional foreground, what is objectively observed
Mood - emotional background, subjective internal feeling state as described by the patient
What components of affect are evaluated during the Mental Status Exam?
- Quality (happy, sad, angry, afraid)
- Range (expanded, narrow, normal)
- Intensity (flattened, normal, exaggerated)
- Stability (fixed or labile)
- Appropriateness (e.g. do they laugh and giggle when talking about upsetting thing?)
How is mood described in the Mental Status Exam?
- Quality (euthymic, dysthymic, euphoric, irritable)
- Stability (does the mood change form one day to the next)
- Reactivity (how responsive is mood to extrinsic factors)
Why is speech examined in the Mental Status Exam?
Quality of speech can reveal a lot about underlying pathology
What are 3 aspects of speech that may be observed during Mental Status Exam?
- Amount (e.g. short responses vs. over-inclusive)
- Rate and pressure (is the speech “pressured” or can the patient be interrupted)
- Prosody (does the speech have a normal range of emotional tone?)
What are 3 aspects of speech that may be observed during Mental Status Exam?
- Amount (e.g. short responses vs. over-inclusive)
- Rate and pressure (is the speech “pressured” or can the patient be interrupted)
- Prosody (does the speech have a normal range of emotional tone?)
What is prosody?
The emotional tone in speech
How does the mental status examination evaluate “thought process”?
By seeing the degree to which thoughts are interconnected and the flow of thoughts
- Normal thoughts are considered to be goal directed
- In mental illness, thoughts can become increasingly disorganized
Define circumstantial thought process
Going into excessive, unecessary detail, but eventually returning to the point
Define tangential thought process:
Wandering form topic to topic and never returning to the original point
Define derailment thought process
Can be referred to as “knights move”
- Slips from one topic to another that is unrelated
e. g. “I don’t think they’ll make the playoffs, they’re not ready. The television is always on the same channel.”
Define incoherent thought process
Unintelligible speech - they are saying real words but none of them are connected
What are the 2 types of hallucinations?
- True hallucinations (perceived as originated outside the body)
- Pseudohallucinations (perceived as originating in the head)
What is a non-psychotic hallucination?
When the person recognizes that they are a product of their own mind
What is not considered a mental disorder in the DSM 5?
Socially deviant behaviour
How does the DSM 5 define mental disorder?
Clinically significant disturbance in cognition, emotion, or behaviour
Usually associated with significant distress or disability
When do neurodevelopmental disorders typically manifest?
Early in development - symptoms seen in grade school
Examples of neurodevelopmental disorders?
ASD
ADHD
Range of neurodevelopmental disorders?
From specific learning disorders to global intellectual challenges
What are the 5 domains of psychosis?
- Delusions
- Hallucinations
- Disorganized thought
- Disorganized behaviour
- Negative symptoms (lol, what?)
How are schizophrenia disorders and other psychotic disorders defined?
By the presence of psychosis (one of the 5 domains of psychosis must be present)
What is a delusion?
Fixed belief that something is true despite contrary evidence
Delusions cannot be corrected despite compelling evidence that they are false
What are some of the discrete types of delusions?
- Persecutory delusions (paranoid)
- Referential delusions
- Grandiose delusions
- Somatic delusions
What is an example of a bizarre delusion?
Clearly implausible (e.g. all of your organs have been removed without you knowing and no scar was left)
What is an example of a non-bizarre delusion?
That you are being surveilled by the police
Example of a persecutory delusion?
e.g. fear that government has installed cameras in your apartment
What are the most common types of delusions?
Persecutory (paranoid) - belief that one is going to be harmed
Example of referential delusions?
Belief that particular gestures or comments are targetted at oneself
e.g. the song on the radio had a message for me, or you were sending me a message when you scratched your nose
Example of grandiose delusions?
Belief that one has exceptional abilities, wealth, or fame
e.g. you are the reincarnation of a religious figure, or you control a large multinational corporation
Example of somatic delusions?
Preoccupation with health and organ function
E.g. the belief that your body is infested with parasites
Name a few additional common delusions to Schizophrenia
Thought insertion (alien thoughts being implanted) Thought withdrawal (thoughts are being removed by outside force) Delusions of control (that your body is being manipulated by an outside force)
What is a hallucination?
A perception that occurs in the absence of external stimulus
What are the most common types of hallucinations in Schizophrenia?
Auditory
hallucinations can occur in any of the senses though
What types of hallucinations are not considered pathological?
Hypnogogic (sleeping)
Hypnopompic (occur in the morning as you’re waking up)
What defines disorganized thought form?
Disorganization of speech - it must be disorganized enough to prevent effective communication
Name a few examples of disorganized behaviour
Negativism
Catatonic posturing
Mutism or stupor
Catatonic excitement
What is negativism?
resistance to instructions