General Hospital Psychiatry Flashcards
How can mental disorders affect the management of physical conditions in hospital?
May affect compliance with medication, speed of recovery, nutritional intake etc.
Why is the prevalence of mental health problems increased in the hospital population?
Psychological stresses of treatment & diagnoses
(e.g. treatment may be disfiguring)
Increased physical morbidity in those with mental health problems
Physical health problems have a direct impact on brain function
Medications may impact emotions (ESP steroids)
What are somatoform disorders?
Medically unexplained syndromes
How many times more common is depression in the hospital population as compared to the general population?
2x
In patients with which conditions is depression more common?
Chronic illness, e.g. diabetes, rheumatoid arthritis, chronic renal failure
Neurological disease, e.g. MS, Parkinson’s, stroke
Those with previous hx of depression
What features are characteristic of delirium?
Acute/subacute onset Global cognitive impairment Disorientation in time/place Fluctuating levels of arousal Impaired attention/concentration Disordered sleep/wake cycle Increased/decreased motor activity Disordered thinking Perceptional abnormalities Changes in mood
What can cause delirium?
Infections Medications Alcohol/drug withdrawal Drug abuse Metabolic Vitamin Deficiencies Endocrinopathies Neurological causes Toxins/industrial exposures SLE Cerebral vasculitis Paraneoplastic syndromes
What is the commonest reason for admission in females <65y?
Self harm
What assessment to does admitted with self harm require?
Pscyho-social (psychiatric) assessment
What is the commonest drug taken in OD?
Paracetamol
How might substance misuse/dependence present?
Physical complications Intoxication withdrawal Trauma/accident Drug induced psychosis Feigned illness in order to obtain drugs
What’s important in the management of medically unexplained physical symptoms?
Don’t subject to unnecessary treatment/investigations
It’s a real problem for them
May have underlying psychiatric disorder (phobia, anxiety, affective disorder)
What are the principles causes of admission in dementia population?
UTI or pneumonia
