General/definitions Flashcards
What are the 5Ps of formulation?
what are they used for?
RF and management plan
Presenting complaint
Predisposing
Precipitating
perpetuating
protective
what do each of the 5Ps mean?
Presenting complaint - the problem they came in with
Predisposing - RF from before causing PC
Precipitating - Event causing Sx to occur
Perpetuating - what is keeping PC in the loop, perpetuating PC
Protective - things keeping them going
what is the biopsychosocial model?
it is used for risk factors and Tx
Biological, psychological and social RF
what are some Biopsychosocial RF?
Biologic - genetics, birth complications (eg. hypoxic ischemic injury), past MHx, DHx
Psychological - Trauma, abuse, self esteem, mood, personality
Social - relationships, finances, stress, culture
what is included in a psych Hx?
same as general Hx +
PERSONAL Hx - Timeline from childhood to now
Suicide and self harm
Forensic Hx (legal involvement)
what is the acronym for the Mental state exam?
ASEPTIC
What does ASEPTIC stand for?
Appearance and behaviour
(dressing, eye contact, body language)
Speech
(rate, rhythm, tone, volume)
Emotion
(mood - ask directly how they are, Affect - appearance, voice + behaviour matches that)
Perception
(delusion, delperc)
Thought
(formation, stream of thoughts)
Insight
(reality awareness)
Cognition
(high in agitation, low/slow)
Definitions:
Mental health disorder?
Disorder of mind, EXCLUDING ALCOHOL + DRUGS
psychosis?
Loss of touch with reality and impaired function
Neurosis?
Mood disorder (anx/depression) with NO REALITY loss but IMPAIRED FUNCTION
hallucination?
UNREAL interpretation of an unreal stimulus eg. hearing voices
Illusion?
UNREAL interpretation of a REAL stimulus
Delusion?
FIXED FALSE UNSHAKABLE BELIEF OUT OF KEEPING WITH SOCIAL NORMS
Overvalued idea?
strong belief but CAN BE CHALLENGED
Delusional perception?
‘If A happens, B will happen’
Pathognamonic for schizophenia
Flight of ideas?
Rapid stream of consciousness - jump between ideas
Formal thought disorder?
Disordered pattern of speech as a result of disordered thoughts
Knight move?
Illogical jumps between topics
eg. toys to weather
Tangentiality?
DEVIATING FROM A POINT + NOT returning
Circumstantiality?
DEVIATING FROM A POINT but RETURNS
Speech types?
PRESSURE (mania = rapid)
POVERTY (Depression = less speech)
Munchenhausen?
Fabricating investigations and Sx to play SICK ROLE
mallingering?
Fabricating mental health issues for secondary gain (eg, avoid jail time)
Folie a deux?
stored delusion by 2 Px at the same time
Tx = separate the Px
clang?
Neologisms?
Echolalia?
Confabulation?
Word salad?
severe flight of ideas - words sound similar
New words
repeat words back
making things up
random words
Anhedonia?
ideas of reference?
loss of interest in things prev interested in
widespread eg. TV news message self directed
Depersonalisation?
thinks they’re NOT REAL - nihilistic delusion
Derealisation?
thinks world around them isn’t real
obsession?
Mental preoccupation, pervasive (eats into time), recurrent
Compulsion?
urge + action on obsession to obtain relief
eg. OCD
Thought problems?
(schiz)
Insertion
withdrawal
broadcast
Passivity (external force controlling how u act)
Somatoform disorder?
Medically unexplained Sx
(eg. IBS - No explanation)
hypochondriasis?
mental preoccupation that Px has cancer or severe illness despite multiple negative tests
Conversion disorder?
Neuro Sx (eg. weakness) in absence of pathology therefore put down to psych
What are 4 types of delusion?
Persecutory (MC) - Points the finger to blame others
Grandiose (mania)
Guilt and worthlessness
Nihilistic (think you don’t exist)
Eponymous:
capgras?
fregoli?
Othello?
close relative replaced with imposter
everyone is 1 person with masks
partner unfaithful
De cleraumbault?
Ekbom?
Cotard?
erotomania (high status person M in love with Px F)
Restless leg syndrome (painless calf cramping, ‘creepy crawly’) - often associated with Fe def anemia (Fe role in DA pathway)
Tx = propanolol
Belief Px is dead and rotting
When was the mental health act instated?
1983
to detain under the mental health act, what must be provided?
evidence of mental health condition and risk (society), will benefit from admission + Tx available
what principles are followed when detaining someone under the mental health act?
least restrictive
Px is safe
good wellbeing
give good and effective treatment
When can the mental health act override the mental capacity act 2005?
Patient may be detained even is capacious
what is section 2 of the mental health act?
Detained for how long?
approval from?
Renewable or non renewable?
28 day detained for investigations (non renewable)
2 Dr (1 S12 approv doc - ST4+) + Advanced mental health practitioner (AMHP - social worker)
Non renewable
What is section 3 of the mental health act?
Held for how long?
Approval from?
renewable or non renewable?
6 months for Tx
2 - doctor (as before) and AMHP
Renewable (6 months, therefore 12m increments)
what sections can be used in patients and federal?
section 5 (2) by Dr and nurse
section 135 and 136 by police
What is section 5 (2) for Dr vs Nurses?
time held?
awaiting?
72hr - Dr holding power (await S12 AMHP)
6hr - Nurse holding power (await dr)
section 135 + 136
how long do they have to admit?
why?
135: 24-36 hr admit Px to access home
136: 24-36 hr admit Px with suspected mental health illness in a public place
