Exam 14: Psychiatric Disorders (Part 1) Flashcards
mental health definition
a state of being, relative rather than absolute; ability to cope with the stresses of life; work productively, contribute to community
mental health deficits definition
- difficulty controlling feelings, thoughts, and behaviors
- difficulty doing everyday activities/ tasks
- disordered patterns of relating to others
mental health disorder definition
- behavioral or psychological syndrome that causes significant stress
- impairs function
- increases the risk of death, pain, or loss of freedom
- can be caused by a medical condition (undiagnosed)
- manifestation of behavioral, psychological, or biological dysfunction
diagnosis definition
- ongoing process
- the process of determining, through examination and analysis, the nature of a patient’s illness
impact of mental health disorders
- can cause physical, emotional, interpersonal discomfort
- poor emotional regulation
- impairment in ability to function/ work
- increases risk of self harm and imprisonment
- creates difficulty in relationships
least stigma to most stigma
- physical
- cognitive
- mental health
DSM definition
diagnostic and statistical manual of mental disorders
ICD definition
international classification of disease
symptom definition
subjective indicator of disease
sign definition
objective indicator of disease (lab values, X-ray/ MRI)
syndrome definition
a cluster of commonly co-occurring symptoms
sub-syndromal definition
- does not rise to threshold of diagnosis
- could also be called “sub-clinical)
co-morbidity definition
two or more disorders that occur together
- “dual-diagnoses
differential diagnosis definition
the process of determination between similar diagnoses
unspecified definition
symptom clusters may vary from typical descriptions
depressive mood disorders definition
- disturbance of mood that is not because of any other physical or mental disorder
- prolonged
- affects all aspects of daily living
- depression
major depression symptoms (5+ present over 2 week period)
- depressed mood
- anhedonia (lack of pleasure in things you typically would)
- anorexia (absence of appetite/ eating)
- appetite/ weight change
- psychomotor retardation/ agitation
- insomnia/ hypersomnia
- worthlessness/ guilt
- recurrent thoughts of death/ suicide
- indecisiveness; inability to think/ concentrate
functional deficits in major depression
- social, work, leisure roles
- possible ADL and IADL deficits
- habits, roles, routines deteriorate during episode
- motor, process, and communication slowing
- changes in cognitive function
- all deficits improve between episodes
etiology of mood disorders
- biological
- genetic
- environmental
biological cause of mood disorders
- changes in brain chemistry
- imbalance in neurotransmitters/ hormones
(serotonin, norepinephrine, acetylcholine, and melatonin)
genetic cause of mood disorders
- family link
- connected through twins
environmental cause of mood disorders
- stress as a contributing factor
- traumatic events increase risk
facts about major depressive disorder
- onset may be gradual
- often unrecognized and untreated
- may be irritable
- less social, withdrawn
- disinterest
- tired; not yourself
- affect
- sadness
- hopelessness
- guilt
- cognitive impairments
- (poor concentration; difficulty making decisions)
major depressive disorder symptoms
- psychomotor agitation
- unintentional and purposeless motions
- wandering
- wringing hands
- psychomotor retardation
- slow physical movements
- difficulty carrying out automatic tasks
- difficulty performing tasks that require little thought
what is electro convulsive therapy? (ECT)
- important treatment for persistent or treatment resistant depression or anxiety
- can be done on outpatient basis
- initially 6-12 treatments
- maintenance ECT weekly and then monthly
side effects of ECT
- headache, nausea, flu-like symptoms
- short term memory loss
- decrease in inhibitions
- disorganization or ADHD like symptoms
- must have 24 hr supervision following an ECT treatment
what is dysthymic disorder
- milder, chronic depressive disorder
- at least 2 years
- Eeyore
seasonal affective disorder
- SAD
- fall/ winter short days and long nights may trigger feelings of depression, lethargy, and fatigue
- light therapy, melatonin
OT intervention for depression
- TUS
- don’t make decisions for client
- reality orientation (done with adequate rapport)
“what could be some other reasons” never talk a person out of their feeling though; always validate them
risks for suicide
- high stress
- mental illness
- chemical abuse
- history of impulsive behavior
- chronic physical illness or sudden onset disability
- age: adolescents & elderly
types of self harm
- cutting, burning, eating disorders, chemical abuse +
- can be cause of accidental death
all about panic disorder
- panic attacks can become a panic disorder if recurrent/ severe
- sympathetic nervous system
- neuroplasticity to break the cycle
- symptoms:
- apprehension, dyspnea, dizziness, nausea, chest pain, hot flashes, numbness, feeling of doom
agoraphobia
fear of leaving a familiar environment
- can also begin to occur with early dementia
obsessive-compulsive disorder (OCD)
- obsessions = intrusive thoughts
- compulsions = required behaviors
post traumatic stress disorder (PTSD)
- common following traumatic incident
- genetic component
- impairments in sleep, can become hyper-alert, can dissociate, nightmares, anxiety, agitation, volatile temper
conversion disorder (PTSD)
neurologic symptoms that are real, but no diagnosable physical condition; can present as seizures, paralysis, blindness, weakness, sensory loss
reactive attachment disorder (RAD)
- disorder consistent pattern of inhibited, emotionally withdrawn behaviors toward adult caregiver
- persistent social and emotional disturbance
- experienced a pattern of extremes in lack of care
- stems from lack of consistent caregiving
- fear, sadness, irritability
- 9 months +
- foster care, addicted/ abusive parents, institutionalized care
etiology of dissociative disorders
believed to be related to extreme psychosocial stress, shock, or trauma
etiology of dissociative identity disorder (DID)
believed to be related to the above or physical, emotional, or sexual abuse occurring early in childhood
depersonalization disorder
feeling of detachment or estrangement from one’s self, body or mind
personality disorders
- when personality traits become maladaptive and cause significant functional impairment
- cluster A, B, & C
paranoid personality disorder
- pattern of pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent
- not related to other disorders
antisocial personality disorder
- occurs with onset or before 15, but is at least 18
- pervasive pattern of disregard for and violation of the rights of others
- not exclusively with other disorders
histrionic personality disorder
pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts
dependent personality disorder
pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts
- lots of symptoms
borderline personality disorder
- identity disturbance
- self-damaging actions
- impulsive
- self-mutilating behavior
- affect/ demeanor
- extrinsic vs. intrinsic locus of control
specific skill sets to address with personality disorders
- ability to accurately identify emotions
- ability to accurately identify and verbalize needs
- improvement in self-awareness: think MOHO
eating disorders definition
characterized by severe disturbances in eating or eating related behavior that results in the altered consumption or absorption of foods and that significantly impacts physical health
common comorbidities with eating disorders + treatment
- depression
- anxiety
- personality disorder
- substance abuse
- internal > external locus of control
etiology for eating disorders
- unknown
- possible role in genes/ serotonin
- possible OCD, perfectionism, low self-esteem, PTSD
- possible standards
anorexia nervosa signs & symptoms
- refuses to maintain minimum body weight
- afraid to gain weight
- body dysmorphia
- inconsistent periods (amenorrhea)
anorexia nervosa subtypes
- restricting type
- binge-eating/ purging type
anorexia nervosa course and prognosis
- day-to-day fight recovery
- treatment can last years to lifetime
- increased mortality rate due to complications
bulimia nervosa
- recurrent episodes of binge eating
- recurrent inappropriate compensatory behavior to prevent weight gain
bulimia nervosa subtypes
- purging: vomiting
- nonpurging: vomiting, exercise
self-medicating examples, goal, diagnoses
- chemical use/ abuse
- physical self-harm
- eating disorders
- destructive relationships
- risky behavior
- goal: temporary emotional regulation
- diagnoses: bipolar, BPD, history of chemical abuse
consequences of negative coping strategies
- higher risk of injury and death
- accidental death due to self harm
- decreased impulse control
- higher risk of assault
- diminishes support system
- increases deficits in self-esteem
- becomes part of the person’s identity
- offers no long term solutions
- delays recovery
chemical abuse/ dependency risks
- imitate neurotransmitters
- flood the brain with dopamine
- slow down or block the neurons from communicating
stimulants (sympathetic)
- caffeine
- nicotine
- cocaine
- ecstasy
- ADHD drugs
depressants (parasympathetic)
- marijuana
- alcohol
- pain pills
- anti-anxiety pills
psychological withdrawal symptoms
- anxiety
- restlessness
- agitation
- looks like mania or ADHD (off stimulants)
- depression
- fatigue
- paranoia
physical withdrawal symptoms
- tremor
- high or low bp
- headaches
- nausea/ vomiting
- hallucinations
- chest pain
- sweating
- cravings for drug
bipolar disorder symptoms/ prognosis
- one or more episodes of mania, hypomania, or mixed mood states
- onset around 18 years
- high risk of suicide
- BPD I & BPD II
- prodromal period: time before full onset
- at first the elevated periods are very productive
- persistently elevated, expansive or irritable mood lasting at least 1 week
BPD I
manic then hypomanic then major depressive
BPD II
hypomanic then major depressive
- no mania
what is a manic episode
period of abnormally and persistently elevated, or irritable mood lasting at least 1 week
- 3-4 symptoms
manic episode symptoms
- inflated self-esteem or grandiosity
- decreased need for sleep (3 hrs)
- excessively talkative
- racing thoughts
- flight of ideas
- distractibility
- excessive in goal directed activity or psychomotor agitation
- impulsive; self-destructive activities
cyclothymic disorder
- milder, chronic manic/ depressive disorder
- at least 2 years with symptom-free intervals of no more than 2 months
what you might see with mania
- person talks really fast and switches topics quickly
- content may not make sense
- often become religiously preoccupied
- can be delusional or hallucinate
- may be impatient with others around them
- makeup might be excessive or grooming and clothing generally odd
- psychomotor agitation
challenges with psychosis
- do not stay on their meds (insight is poor or effects are upsetting)
- patients become preoccupied with their internal stimuli
- numerous functional deficits
- can be difficult to redirect
- difficulty discriminating between psychosis and reality
what is psychosis
can be a comorbidity with other conditions
- major depression
- postpartum depression
- mania
- chemical use
- schizophrenia
- dementia (lewy body & alzheimer’s)
- acquired brain injury
psychotic symptoms
- hallucinations
- delusions
- paranoia
- disorganization
secondary cognitive issues when psychotic
- disorganized
- variable moods
- difficulty communicating
- difficulty with attention and concentration
types of schizophrenic disorders
- schizophrenia
- schizoaffective disorder
- delusional disorder
- brief psychotic disorder
definition of schizophrenia
- delusions, hallucinations, disorganized thinking (speech, grossly disorganized or abnormal motor behavior and negative symptoms
- progressive, chronic, treated > cured
- affects brain (insight, impulse control, judgment, affect, social skills)
signs & symptoms premorbid or pre illness
- learning problems in school
- change in activity level
- hypo/hyperactive
- changes in mood
- euphoric or depressed
- complaints about the body
- obsessiveness
- guilt
- unpredictable or odd behavior
- anxiety, fearfulness
positive schiz symptoms
excess of behavior
- hallucinations
- delusions
- disorganized speech
- disorganized or lack of motor
- catatonia
negative schiz symptoms
absence of function
- anhedonia (lack of pleasure in typical things that would be)
- avolition (no motivation)
- flat or blunted affect
- alogia (no speech flow/ logic)
cognitive schiz symptoms
- reduced ability to process information
- lack insight or awareness of disorder
affective (affect) schiz symptoms
- inappropriate emotional response
- mood disturbances
- dysphoria
echolalia definition
the repetition of vocalizations made by another person
echopraxia
involuntary repetition or imitation of the observed movements of another
schizoaffective disorder
uninterrupted period of illness during which, at some time, there is either a major mood (depressive) episode, a manic episode, or a mixed episode concurrent with 6 that meet for criteria for schizophrenia
etiology of schizophrenia disorders
- unknown
- genetic
- environmental
- structural changes
neurological theories
many have a higher sensitivity to sensory input, difficulty tuning things out, functional deficits
- peripheral vision
- reticular activating system
- neuroplasticity and schizophrenia
brief psychotic disorder
1 or more of:
- delusions
- hallucinations
- disorganized speech
- grossly disorganized or catatonic behavior
1 day - 1 month, person returns back to normal level of function
delusional disorder
- non bizarre delusions of at least 1 month
- may be tactile and olfactory hallucinations related to the delusional theme
- functioning is not markedly impaired
