behavorial health 1 Flashcards
Axiom #1
mental and medical conditions often co exist
-Co occurrence of disorders is called comorbidity. Successfully addressing one requires addressing both disorders.
Axiom #2
many mental disorders present with chronic and disabling physical sx.
-physical sx obscure psychological sx
-pts will talk about what hurts and the more severe, chronic and disabling the physical sx–> more likely there is an associated mental disorder
-psychological sx become apparent when providers have a suspicion of them
Axiom #3a
mental disorder paired with a chronic medical dx.
severe physical sx become a red flag for associated mental disorder
Axiom #3b
chronic MUS that have little to non identifiable disease or pathoph. basis
patients dont express their psychological and physical sx at the same bc?
-the stigma of mental disorders
-providers not interested
-not aware of their disorder
chronic dx leads to
mental disorder
mental disorder leads to
chronic dx
what dx tx leads to the mental disorder of depression and anxiety
-steroids
-HRT/OCP
-digoxin
-metaclopramide
what dx tx leads to the mental disorder of depression
-BB
-clonidine
-opiates
what dx tx leads to the mental disorder of anxiety?
-albuterol
-dicyclomide
SSRI causes
-obesity
-tremor
-Sex dys
-nausea
SNRI
-HTN
-tachcardyia
-sex dys
Bupropion
-lower seizure threshold
-anxiety
-night sweats
Mirtrazapine
-sedation
-obesity
Lithium
-thyroid dys.
-ECG changes
Lamotrigine
-hepatitis
-skin changes
antipsychotics
-obesity/hyperlipidemia
stimulants
-HTN
-insomnia
-MI
pyschological sx =
mental disorder
physical sx
medical disorder
MUS
-94%
no medical explanation
-medical disorder sx are more severe than expected
-unclear etiology
RE FLAG FOR MENTAL DISORDER
person had chronic nack pain, poor control of DM, opioid misuse = ex?
depression
mental health model:
this is a biopsychosocial model too!!!
-establish communication and effective pt provider relationship
-educate pt
-obtain pt commitment
-determine pt goal
-negotiate a plan
patient centered
-self determination
-shared decision making
-motivational interviewing
-social cognitive theory
-chronic care model
MHCM
-values pt autonomy and emphasizes that while provider is expert of the dx/tx…. patient is the expert on their life and their needs
focuses on:
-self management
-fostering
-pt self efficacy
MHCM emphasizes:
a negotiated approach w pt provider relationship, applicable to ALL DISORDERS
PCI
-commitment
-education
-negotiate a plan
-goals
-emphasizes empathy and maximize communication and clinical pt relationship
How do u show empathy
NURS
PCI: Education
-not enough to state diagnosis of plan
-ask pt of their understanding of problem
-tell pt the facts of the diagnosis and recommend tx plan
-ask pt again about their understanding
PCI: committment
pt must take responsibility and partner in
PCI: goals
setting goals is important to effective mental health
-patients often overwhelmed SO it PROVIDER guides pt for reasonable goals
PCI: negotiate
-medications
-inc. physical activity
-inc social activity
-sleep hygiene
-relax tech
-F/u
Somatic Disorders:
somatic sx is diagnosed when a person has a significant focus on physical sx such as pain, SOB–> results in major distress and problems fxning
DSMD
handbook for providers in US to guide mental disorders
somatic sx disorder DSM-5
a. 1 or kore somatic sx result in distress in life
b. excessive thoughts, feelings, behaviors associated to somatic disorders:
[persistant thoughts about sx, high lvl of anxiety, excessive time and energy devoted to health concern]
C. more than 6 months
Somatic sx disorders ex.
hypohondria (excessice worry about medial issue when there is not)
hysteria( over exaggerated)
grand hysteria(natural disaster)
MUS
functional neurological disorder
-one or more sx of altered voluntary motor or sensory fxn
somatic disorders occur bc:
-illness allow socially isolated person access to a social support system
-illness =nurture
-illness=manipualtion
-cry for help
