Chapter 7- Mental Health Flashcards
What’s the four headings on the mental health continuum model
Healthy
Reacting
Injured
ill
What model can be used to demonstrate stress ins and outs and acute crisis
Bucket model of stress-vulnerability
Clinically significant distress relies on what?
Perspective of the treatment provider
Diagnosis of mental health conditions is based on what
DSM-V
ICD-10
What are the characteristic symptoms of schizophrenia
Delusions Hallucinations Disorganised speech Grossly disorganised behaviour Negative symptoms Social/occupational dysfunction Signs for at least 6months
List positive symptoms of schizophrenia
Hallucinations
Delusions
Thought disorder
Passivity phenomena (chip in brain)
What can delusions entail in schizophrenia
Paranoia
Grandiose
Ideas of reference (bus top numbers)
List negative symptoms of schizophrenia
Slowed down thought and movement
Indifferent to social contact
Lack of interest in previously pleasurable things
What’s more difficult to treat in schizophrenia.. positive or negative symptoms?
Negative
What are the long term treatment goals of schizophrenia
Symptom control Prevent relapse/re-admission Ensure tolerability/safety Improve quality of life Improve social functioning Reduce cost
What are the three key symptoms of depression
Lowered mood
Anergia (lethargy)
Anhedonia (no pleasure from activities)
The new DSM-V criteria has taken out what and what problem could this cause
Bereavement exclusion
–> medicalising normal life
What’s a big problem with SSRIs
Vomiting/nausea
True/false: SSRIs are safer in overdose than TCAs
Yeh
Three side effects of SSRIs
Nausea/vom
GI
Sexual dysfunction
Side effects of TCA
Postural hypotension
Sedation
Anticholinergic effects
TCAs are more toxic in overdose what two things can occur
Cardiac toxicity
Seizures
Why is mirtazapine often used in combination with other antidepressants?
Different mechanisms of action
After recovery how long should antidepressants be continued for
6months
Why is alternate day dosing not a good idea with e.g venlafaxine
Short half life
List the antidepressant discontinuation symptoms
Flu like symptoms Insomnia Nausea Imbalance Sensory disturbances Anxiety/ agitation
Which type of antipsychotic is more targeted?
Atypical
What do you need to consider when choosing antipsychotic medication
Metabolic
Extrapyramidal
Cardiovascular
Hormonal
Risk of clozapine
Serious blood disorders
Trial of antipsychotic medication should continue for how many weeks
4-6 weeks
Half life of fluoxetine
Approx 1 week
Why caution from switching to a TCA from fluoxetine/paroxetine
They inhibit metabolism of TCA start lower dose of TCA
3 ways of switching medication
1) taper down drug and simultaneously start low and increase new drug(cross-tapering)
2) taper down and stop one then start another after gap
3) stop one and start another
Symptoms of severe serotonin syndrome
Fever
Seizures
Irregular heartbeat
Unconscious
Side effects of typical antipsychotics
Hypotension
EPSE
abticholinergic effects
3 examples of typical antipsychotics
Chlorpromazine
Haloperidol
Perphenazine
Side effects of atypical antipsychotics
Diabetes
Sexual dysfunction
Weight gain
Examples of atypical antipsychotics
Olanazpine
Quetiapine
Clozapine
Risperidone
What score on the PHQ-9 indicates moderate-severe depression
> 10
True false: PHQ-2 questionnaire can be an enhanced service and you have to be trained whereas PHQ-9 isn’t
False it’s the other way round
PHQ-2 questionnaire asks about the past how many weeks?
2 weeks
PHQ-2 score ranges from what
0-6
PHQ-2 asks what 2 questions
1) little interest/pleasure in doing things
2) feeling down, depressed or hopeless
What’s HADS
Hospital anxiety and depression score used in hospitals
GADS7
Generalised anxiety and depression score 7
