Assessment and intervention Flashcards
What is some information as assessor needs when asking about past psychiatric history?
When assessing, do you normal do mental state before or after history?
ordinarily, you get it after the history.
What are the parts of the mental state observed or questions when assessing mental state?
If the history contains the story, what does the mental state contain?
One is static and the other one is..
The phenomenology
dynamic
Odd ideas aren’t enough to conclude someone is delusional. Delusions must be….
and culturally inappropriate beliefs.
Feelings of being….
Sense of things….
Sense of having…
What is passivity phenomena?
What is ideas of reference?
What are thought
- insertion
- withdrawal
- broadcasting
- echo
What is it called when someone has a sense of thoughts being implanted into their brain?
thought insertion.
What is it called when someone has a sense of thoughts being taken out from their brain?
thought withdrawal
What is it called when someone has a feeling that one’s thoughts can be heard by other people?
Thought broadcasting
What is it called when someone has a feeling that one’s thoughts echoing around one’s head?
thought echo
What is it called when someone has difficulty in conveying thoughts in a logical linear nature?
Formal thought disorder.
In formal thought disorder, is there an issue with form or content?
Form. The content hasn’t changed, what changes is the ability to convey it in a logical linear manner.
What is a third person hallucination?
The hallucination talks about the person. ‘he’s useless’
What is a command hallucination?
A voice that tells an individual to do something.
What is a second person hallucination?
A voice that talks to an individual
What are the ….
What does the medication, Haloperidol do and what is it effective for?
It blocks amphetamine, and is a highly-effective medicine for schizophrenic psychoses. In small doses it’s a powerful treatment against hallucinations, delusions and agitation.
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Chlorpromazine and haloperidol could inhibit learning in animals, a process called….
conditioned avoidance.
What can a test for conditioned avoidance be used for?
The ability to disrupt conditioned avoidance was a marker of a drug with antipsychotic activity in man.
Is dopamine a fast or slow neuromodulator?
Slow
What are examples of fast neurotransmitters?
Summarise the difference between fast and slow neuromodulators
fast neuromodulators act quickly to modulate synaptic transmission and are involved in rapid neural communication, while slow neuromodulators have a more protracted impact, influencing higher-order brain functions and long-term behavioral regulation.
Discuss
**Slow Neuromodulators:
**
Speed:
Function:
Examples:
Duration:
Slow Neuromodulators:
Speed: Slow neuromodulators work at a slower pace, taking longer to exert their influence on neural circuits.
**Function: **They regulate more complex, long-lasting processes such as learning, memory, mood, and arousal.
Examples: Neurotransmitters like serotonin, dopamine, and norepinephrine are considered slow neuromodulators due to their role in modulating mood and behavior.
Duration: Their effects are enduring and can last from minutes to hours or even longer.
Discuss
**Fast Neuromodulators:
**
Speed:
Function:
Examples:
Duration:
**Fast Neuromodulators:
**
**Speed: **Fast neuromodulators work rapidly and have immediate effects on neuronal activity.
Function: They primarily modulate the strength of synaptic transmission between neurons, affecting the intensity of signals between nerve cells.
Examples: Neurotransmitters like glutamate, which excite neurons, and GABA (gamma-aminobutyric acid), which inhibits neurons, are considered fast neuromodulators.
Duration: Their effects are short-lived and brief, typically lasting milliseconds to seconds.
Dopamine is involed in how the higher circuits….
adapt and learn e.g conditioned avoidance.
Dopamine is a teaching signal, which adjusts the…
strength of connections in the higher circtuits
The striatum is a critical site for learning ….
new habits of thought and movement.
In the awake brain, how often do dopamine neurons ‘spike’?
Every second or so.
What mode do the dopamine neurons enter into when they encounter a new stimulus? What does this pattern of firing adjust?
What happens to dopamine neuron firing when an anticipated and predictable reward fails to materialise?
it switches off for several seconds
All antipsychotic drugs work by blocking what?
dopamine type 2 receptor D2
Quetiapine and chlorpromazine have a strong what effect, and what is the result?
Histamine effect, which sedation is attributed to.
What is the main emphasis of antipsychotic drug in the maintenance phase?
It is on avoiding side-effects so the patient sticks with treatment and is at lower risk of relaps.
what % of patients do not getter better with antipsychotic treatment and what is this called?
10-20% treatment resistant
what medication can help treatment resistant patients?
clozapine?
How does clozapine work?
After 6 weeks, what % of treatment resistant patients will improve with clozapine use?
30% get better
After 6 weeks, what % of treatment resistant patients will improve with clozapine use?
60-70%
What are some of the strengths of clozapine treatment?
What are some of the weaknesses of clozapine treatment?
What difference is seen in relapse rates between patients using long-acting injectable risperidone and oral risperidone
