Diagnosis Flashcards
what do organic disorders tend to present with?
Changes to cognition
Delirium
Dementia
What are 3 examples of causes of organic disorders?
Head injury
Tumours
Endocrine disorders
What category on the hierarchy model does alcohol withdrawal fit into? symptoms?
Organic disorders
Delirium tremens
Confusion, tremor, shivering, irregular HR, sweating
2 examples of psychotic disorders?
Schizophrenia
Schizoaffective disorder
2 examples of mood disorders?
Unipolar depressive illness
Bipolar
6 examples of anxiety disorders?
GAD Phobias Hypochondriasis OCD Panic disorders Maladaptive behaviour
7 types of personality disorders?
Psychopathy Dependant Anankastic Borderline Cyclothymic Narcissistic Anxious
What does phenomenology refer to?
Investigation and description of a patient experience without assumptions being made regarding causation
How do you interpret someones Appearance and Behaviour in the MSE?
Greeting Hygiene - groomed, clean, dressed Face - Eye contact, expression Body - Posture, expressive movement, scars and tattoos How do they talk towards the examiner?
Thought form is analysed how?
how they speak Rate of speech Tone of voice Volume of speech Coherence Spontaneity
Thought form looks at the coherence of speech, what 3 different disordered aspects of this can occur?
Flight of ideas
Knights Move
Neologisms
Difference between mood and affect?
Mood - climate
Affect - weather
How is mood commented on in the notes?
Subjectively in patients own words
Objectively in examiners interpretation
3 aspects of thought content that are looked into in MSE?
flow
passivity
content
What does flow look at in MSE thought content?
knights move
flight of ideas
thought block
perservation
What are 3 aspects of passivity that are analysed in thought content analysis of MSE?
thought insertion
thought withdrawal
Thought broadcast
Aspects of content within thought content MSE?
preoccupations Ruminations obsessions delusions themes of conversation Abnormal beliefs Overvalued ideas
Difference between obsession and delusion?
Obsessions are forceful or intruding thoughts that the patient knows are irrational and often associated with compulsive acts
Delusions are false fixed beliefs which cant be shaken by argument
what does perception in MSE mainly investigate?
Hallucinations
Difference between hallucinations and delusions?
Hallucinations are perception in the absence of external stimulus whereas delusion is a correctly sensed stimulus that is given additional significance
Hypnogogic hallucinations vs hypnapompic hallucinations?
Hypnogogic = hallucinations as you go to sleep Hypnapompic = hallucinations as you wake up
Screening questions for cognition?
time, place, person
concentration and attention
Memory of newly presented information
Mood symptoms of depression in present thinking?
Anhedonia Loss of concentration Lethargic Low mood - diurnal variation Low appetite Memory difficulties Reduced functioning
Biological effects of depression?
Loss of libido
Sleep effects
Appetite
Weight loss
5 features of anxiety manifestations?
Free floating situational Depersonalisation Derealisation Phobias Panic attacks
Physiological effects of anxiety?
Tremor Butterflies SOB Heart palpitations - chest pain Sweating Headaches Sensitive to light Dry mouth Tingling Tinnitus Diarrhoea and nausea Vertigo Blushing
Mood symptoms in mania and hypomania?
increased energy decreased need for sleep increased libido restless sensitive to noise grandiosity
What does Schneiders first rank symptoms look at?
Insertion, withdrawal, broadcast
Voices - third person, running commentary
Audible thoughts
Somatic passivity
3 features of psychosis?
Loss of touch with reality
hallucinations
delusions
Cotards syndrome?
Walking corpse
Othello syndrome?
Delusions of infidelity
Ertomania/ de clerambault’s syndrome?
delusion that someone famous is in love with you
Folie a deux?
Shared delusions
What are the 3 types of psychotherapy available?
Supportive psychotherapy
Cognitive and behavioural therapies
Psychodynamic and psychoanalytical therapies
Examples of supportive psychotherapies?
Group counselling
Support groups
Motivational counselling
Ventilaton of emotions
4 situations where psychotherapy is contraindicated?
Acute psychosis
severe depression
Drug abuse
Dementia or Delirium
How many weeks of CBT does a person usually undergo?
12-16 weeks
What 5 categories does CBT look at?
Thoughts Feelings Behaviours Bodily reaction Environment
What is the aspect of CBT implemented in solving OCD?
exposure and response prevention
What is interpersonal psychotherapy and what is it used to treat? 16 sessions
Emotional difficulties cause as a result of interpersonal issues
Used to treat - depression, eating disorders, diabetes compliance
16 sessions
To assess a person’s interpersonal relationships what questions can you ask?
Who is the most important person in your life?
Who do you see most in your life?
How does depression effect your relationships?
Is there a relationship precipitant? resolution?
What does cognitive analytical therapy aim to do? how many sessions?
16 sessions
Aims to understand how problems have developed from events and experiences
Looks at current coping mechanisms and aims to change them
What does mentalisation based therapy aim to do? how long do sessions extend for?
Aims to help individual understand their own mind and the mind of those around them
Made up of 90 minute group sessions and 50 minute individual sessions
18-24 months programme
What is dialectical behavioural therapy mainly used to treat?
What is made during the therapy to guide patient?
Personality disorders
Make a list of behaviours to decrease and list of behaviours to increase, modified CBT
Contract and telephone support
What are the 3 stages of dialectical behavioural therapy?
1 = commitment, safety and stability 2 = symptom management 3 = REACH (regulating emotions through acceptance and change)
What does psychoanalytical therapy and psychodynamic psychotherapy base their management on? How many sessions usually spanning over what time period?
Unconscious thoughts, feeling and fears which are repressed and therefore lead to symptoms
Usually over 20 sessions over more than a year period
What is eye movement desensitisation and reprogramming used for treatment of primarily?
PTSD
Helps the brain process flashbacks
What is motivational interviewing mainly used in the treatment of? What kind of tools does it use?
Tackling addiction
Looks at pros and cons, confidence and important to individual, looking at the past and future, exploring goals
Main two forms of therapy in personality disorders?
Mentilsation based therapy
Interpersonal behavioural therapy
Main two forms of therapy for eating disorders?
CBT and systemic therapy (family)
Main 2 forms of therapy for addictions?
CBT and motivational interviewing
Main 2 forms of therapy for PTSD?
CBT and eye movement desensitisation and reprogramming (EMDR)
