Dentistry and Mental Illness 1 Flashcards
Name 3 affective disorders?
Depression
Anxiety
Bipolar / mania
What study was done which shows it is not easy to diagnose mental illness?
8 normal people presented at 12 psychiatric hosps “hearing voices”
all 8 were admitted and they behaved normally after that
diagnosed with schizophrenia / manic depression
only the patients in the hospital were suspicious
Who works with mental illness?
psychiatrists
psychiatric nurses
psychiatric social workers
clinical psychologists
What is the incidence of mental illness in the UK?
1/7 suffer from mental disorder (55% female)
3/10 with poor mental health
What are the 5 models of psychiatric disorders?
Historical - witchcraft, demons Biomedical - physiological / biochemical Psychological - experiences and associated responses Extreme forms of normal behaviour Biopsy chosocial - all of the others
What is the relationship between GDP/GP visits and mental health?
Inverse
What are the professional barriers to mental health?
Poor knowledge Poor attitudes Low tolerance Poor communication Poor diagnostic reliability Poor cultural variation in interpretation
Describe depression?
Lack of insight Temporal differences - morning or eve Anxious, irritable - cant concentrate / relax Adverse reaction to stress Lack of interest, lethargy, apathy Sleep disturbances Decreased apatite , weight loss Exacerbation of pain
What are the oral manifestations of depression?
Chronic facial pain
Oral ulcers - onset with emotional problems and marked decrease after treatment with tricyclic antidepresants
Describe biploar / mania?
Extreme elation and depression - mood, thought and behaviour, unpredictable, hyperactive, excessive, depressed
ORALLY - xerostaemia
Describe anxiety?
Unpleasant feeling / mood, unease, fearful, inability to concentrate. Acute or chronic, pain attacks, specific focus - eg needles
How does substance abuse affect emotional stability?
Decreased self image, depression, lack of motivation, mechanism for getting analgesics
Describe the effects of alcohol?
Alcohol is most widely used substance
Chronic, progressive and potentially fatal
Increased tolerance of LA and drugs
Nutritional deficiency - problems with absorption and metabolism
Increased bruxism and craniofacial trauma
Describe the effects of cannabis?
Effects in cardiovascular, respiratory, and immune systems
Chronic inflammation of the oral mucosa
Adverse effects on gingivae
Xerostaemia, Caries, Perio and plaque (C. albicans)
Describe the effects of cocaine?
> 900,000 users in UK (snort or smoke)
Bruxism, rhinitis, sinusitis
Perforation of the septum and palate
Often mix cocaine with sugar so increased caries
Describe “meth mouth”?
Oral, inhaled, snorted, smoked, injected
Hyper alert, paranoia, anxiety, depressed, mood swings
Decreased motor function and impaired verbal learning
Social, psychological and physical issues
Xerostaemia, caries, bruxism, halotosis, perio
Care when prescribing analgesics!
What is dependence?
Compulsion to use
Physically unpleasant withdrawal - further use for relief
Increased tolerance
Neglect other interests - substance use is most important
What is addiction?
In addiction to dependence: poor compliance
Substances mask dental pain, dental fear and low pain threshold (tolerance to drugs)
What is the treatment for mental illness?
Counselling
After illicit drug use - no treatment for >6 hrs because of ischaemia, dysarrhythmia, hypertension, MI
Why is mental health in dentists quite poor?
Drug of choice
Less control
Stress
