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THINKGP - Mental Health > Core Module Training > Flashcards

Core Module Training Flashcards

1
Q

Who can someone contact in a mental health emergency?

A
  1. Emergency Services - 000
  2. Mental Health Line - 18000 011 511 - they can organise urgent after hours assessment by acute mental health services if necessry.
  3. Attend any Hospital Emergency Department.
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2
Q

What are some crisis support phone services or website contacts?

A
  • After hours Suicide Support Service - 1800 859 585
    • 5pm to 9am everyday.
  • Suicide Call back Service - 1300 659 467
  • Lifeline- 13 11 14
  • Salvo Care Line - 1300 363 622
  • SANE helpline - 1800 187 263
  • Mensline Australia 1300 789 978
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3
Q

What does SET A PACE stand for?

A
  • S -
  • E - Education
  • T- Therapeutic Relationship
  • A
  • P
  • A
  • C
  • E
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4
Q

What are some web-based resources that can be used in mild-moderate depression?

A
  • MoodGYM - teaches the principles of CBT, relaxation and meditation.
  • CRUfAD - THIS WAY UP CLINIC - an online CBT program - requires a GP referral and involves a small cost.
    • 6 Online Modules and Homework involves CBT.
    • Website: https://thiswayupclinic.org/users/clinicianDashboard
    • Login - Irondukesteve@gmail.com
    • Password - Richard6259
  • E-Couch - self- help interactive program with modules for depression, anxiety, relationship breakdown, loss and grief.
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5
Q

After how many weeks should you stop an antidepressant if it doesn’t appear to be working?

A

6 weeks

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6
Q

After how many months, should you consider referring to a specialist if the patient doesn’t respond to antidepressants?

A

3 months

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7
Q

How long should antidepressants be prescribed for a first episode of depression?

A

6-12 months

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8
Q

How long should antidepressants be prescribed for recurrent episodes?

A

2-3 years

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9
Q

What are the diagnostic criteria for GAD (Generalized Anxiety Disorder)?

A
  1. Excessive anxiety and worry occuring more days than not for >= 6 months about a number of activities.
  2. They find it difficult to control the worry.
  3. The Anxiety is associated with >3 of the following 6 symptoms for 6 months:
    1. Restlessness
    2. Easily fatigued
    3. Difficulty concentrating or mind going blank.
    4. Irritability
    5. Muscle tension
    6. Sleep disturbance.
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10
Q

Excessive or unreasonable fear of circumscribed object or situation, usually associated with avoidance of a feared object.

A

Specific phobia

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11
Q

Excessuve or unrealistic fear of social or performance situations; intolerance of embarassment or scrutiny by others.

A

Social anxiety disorder (SAD)

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12
Q

Recurrent unexpected panic attacks without situational triggers; the patient may actively avoid situations where PA are predicted to occur.

A

Panic disorder.

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13
Q

What questionnaire is used to help diagnose GAD?

A

GAD-7

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14
Q

What is the psychological management for specific phobias?

A
  1. Psycahological interventions - CBT
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15
Q

What is the psychological treatment of choice for social anxiety disorder?

A

CBT with exposure based therapy and social skills training.

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16
Q

What is the psycholgical treatment of choice for panic disorder?

A

CBT

Panic control treatment - exposure to deliberately induced symptoms plus trechniques to control the symptoms.

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17
Q

What is the firstline psychological management technique to deal with generalised anxiety disorder (GAD)?

A

Psychoeducation and relaxation techniques in the form of CBT provided by trained clinicians.

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18
Q

What is the first line pharmacological treatment for aniety related disorders?

A
  1. SSRI/SNRI are first line.
  2. Benzodiazepines can occasionally be used but should not be prescribed for longer than 4 weeks.
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19
Q

When should we review patients after starting SSRIs/SNRIs for aniety?

A

Every 2-4 weeks during the first 3 months.

And then every 3 months thereafter.

20
Q

What is the first line pharmacological management for specific phobias?

A

Generally only psychotherapy is needed.

Sometimes short term diazepam use can be required.

21
Q

What is the first line pharmacotherapy for Social Anxiety Disorder?

A

SSRIs or venlafaxine for 6-12 months.

For non-generalised SAD - propranolol can be prescribe to help.

22
Q

What is the first line pharmacoptherapy for panic disorder?>

A

SSRIs/Venlafaxine or TCAs for 6-12 months.

23
Q

What i the first line pharmacotherapy used in generalised anxiety disorder?

A

SSRIs

Venlafaxine and duloxetine are efficacious.

Short term Benzos may bee needed.

24
Q

What is the number for the OCD and anxiety helpline

A

1300 269 438

Good for patients and family and friends.

25
Q

What are the two types of bipolar depression and how are they different?

A

Bipolar Depression 1 - swings between mania and depression.

Bipolar Depression 2 - hypomania and depression.

26
Q

Why shouldn’t only antidepressants be used for bipolar depression?

A

It can exacerbate manic episodes.

27
Q

When can antidepressants be used in bipolar disorder?

A

They can be used in conjunction with lithium, sodium valproate or an antipsychotic (e.g. an atypical antipsychotic such as quetiapine)

28
Q

If drug therapy fails, what can be an effective treatment in bipolar depression?

A

ECT

29
Q

When symptoms of depression have resolved in bipolar disorder, when is it ok to withdraw antidepressants?

A

2-3 months after the depression resolves.

30
Q

What is the first line drug of choice in bipolar disorder?

A

Lithium

31
Q

If a patient fails to respond to monotherapy with lithium, what can be done?

A

Combination therapy:

  • Lithium + Sodium Valproate.
32
Q

How long should treatment continue after the first episode of acute mania?

A

6-12 months

33
Q

When should a patient with bipolar disorder be referred to secondary care?

A
  • There is poor/partial response to treatment.
  • The person’s function declines significantly.
  • Treatment adherence is poor.
  • The person develops intolerable/medically important side effects.
  • Alcohol or drug misuse is suspected.
  • The person is considering stopping their medication.
  • A woman with bipolar disorder is pregnant or planning a pregnancy.
34
Q

What are the positive symptoms and what are the negative symptoms in schizophrenia?

A
  • Positive symptoms -
    • Hallucinations
    • Delusions.
  • Negative symptoms
    • Emotional apathy
    • Lack of drive,
    • Poverty of speech
    • Social withdrawal
    • Self Neglect
35
Q

There can sometimes be called a third syndrome in schizophrenia…what is this?

A

Disorganisation

36
Q

How should GPs monitor patients with schizophrenia?

A

Review at least annually.

  • Weight
  • Waist circumference
  • Pulse and Blood Pressure
  • Fasting Blood Glucose, HBA1C, Blood Lipid Profile & Prolactin Levels.
  • Assessment of any movement disorders.
  • Assessment of nutrional status, diet and level of physical activity.
37
Q
A
38
Q

What is the HEADSS approach to questioning?

A

HEADSS

  • Home
  • Education and Employment
  • Activities
  • Drugs
  • Sexuality
  • Suicide Risk/Depression
39
Q

What can be used to screen for anxiety and depression in young people?

A

The Revised Children’s Anxiety and Depression Scale

RCADS

40
Q

In psychosis, why are atypical antipsychotics prescribed over typical antipsychotics?

A

Atypical antipsychotics have a reduced risk of extrapyramidal side effects.

41
Q

Antipsychotics should be started by a psychiatrist, but here are some examples of starting doses of antipsychotics.

A
  • Risperidone 0.5-1mg/day
  • Quetiapine 25-50mg/day
  • Amisulpride 50-100mg/day
  • Aripriprazole 5-10mg/day

Depending onacuiy and risk - doses should be adjusted every 2-3 weeks until desired effects are reached.

42
Q

What are some side effects of atypical antipsychotics?

A
  • Extrapyramidal side effects
  • Weight gain
  • Hypertension
  • Diabetes
  • Hypercholesterolaemia
  • Erectile Dysfunction
43
Q

Describe the 3 types of extrapyramidal side effects which may occur in the initial reatment period:

A
  1. Acute dystonic reactions - oculgyric crisis.
  2. Pseudo-parkinsonism - muscle stiffness, tremor and hypokinesia.
  3. Akathisia - feeling of motor restlessness.
44
Q

How should patients with psychosis be monitored whilst being treated with antipyshcotics?

A
  • Beginning - Weight, BMI, BP, Smoking status.
  • Monthly for the first 3 months and then 3 monthly thereafter
    • Weight and abdominal circumference.
    • Total cholesterol and triglyceride levels
    • Blood Glucose
    • White cell and neutrophil counts
    • LFTs
    • U&Es
    • Prolactin Levels
    • Check for extrapyramidal side effects
45
Q

What screening tool is used to assess for drug use and its severity?

A

CRAFFT

THINKGP - Mental Health (1 decks)

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