General Hospital Psychiatry, Functional Disorders and Organic Disorders

Question 1

What is meant by an emotional disorder?

Answer 1

Delirium or cognitive impairment
Mental disorder due to primary or secondary insult

E.G. primary= as a result of a brain injury
secondary= as a result of endocrine disorder

Question 2

Give some examples of organic mental disorders.

Answer 2

Delirium
Dementia
Amnesic syndromes

Question 3

What causes an emotional disorder?

Answer 3

It’s a reaction to an illness or treatment for an illness

Question 4

What are the main features of delirum?

Answer 4

Impairment of consciousness and attention
Global disturbance of cognition
Psychomotor disturbances
Disturbances of sleep-wake cycle
Emotional disturbance

Question 5

Management of delirium?

Answer 5

Correct factors contributing to delirium.

Fix:
-disorientation
-dehydration
-constipation
-hypoxia
-immobility/limited mobility
-infection
-multiple meds
-pain
-poor nutrition
-sensory impairment e.g. giving glasses, hearing aid
-sleep disturbance
-education of patients/relatives/staff

Medicines after but environmental and supportive measures first if suitable. Medicine do not treat delirium. They treat the symptoms of delirium. Better to treat the problem causing delirium.

Question 6

RECAP- types of dementia?

Answer 6

Alzheimer’s
Vascular
Mixed
Leys-Body
Frontotemporal

Question 7

Difference between dementia and delirium?

Answer 7

Dementia- slower onset, more noticeable at day, sleep cycle usually okay

Delirium- faster onset, more noticeable at night, sleep cycle always disrupted

Question 8

What are amnestic syndromes?

Answer 8

Syndromes of impairment of recent and remote memory

Immediate recall is preserved
New learning is reduced

Question 9

What causes Korsakoff’s sydnrome?

Answer 9

Thiamine deficiency (Vitamin B1)

It is an amnestic syndrome

->can be associated with alcohol

Question 10

Which triad of symptoms are seen in Wernicke’s encephalopathy, another type of amnestic syndrome?

Answer 10

Acute confusioned state
Ataxia
Ophthalmoplegia

Question 11

What is Wernicke’s encephalopathy associated with?

Answer 11

Acute deficiency of vitamin B1 (thiamine)

Question 12

Treatment of Wernicke’s encephalopathy?

Answer 12

High potency Vitamin B1 replacement

Question 13

What are some of the characteristics of Alcohol Amnesic Syndrome (Korsakoff’s psychosis)?

Answer 13

Impairment to learn new information
Disturbance in time sense
Personality changes

Question 14

List some of the physical illnesses which can cause depression?

Answer 14

Cerebral tumour
Traumatic brain injury
Stroke
Multiple sclerosis
Parkinson’s disease
Neurodegenerative conditions
Cushing’s disease
Hyperparathyroidism
Hypothyroidism
Low folate/Vitamin B12
Addison’s disease
Malignancy

Question 15

List some of the medications which can cause depression.

More to be aware, don’t worry too much about memorising :)

Answer 15

Corticosteroids
Digoxin
Levodopa
Beta-blockers
Benzodiazepines
Antipsychotics
Interferon-α
Isotretinoin
Chemotherapy
Anticonvulsants
Alcohol
Recreational Drugs

->lecturer does not recommend using beta blockers for anxiety, even if it helps with symptoms.

Question 16

RECAP- symptoms of depression

Answer 16

Low mood
Suicidal thoughts
Hopelessness
Appetite changes
Poor sleep
Poor concentration
Lack of energy

Question 17

Which drug is the most common drug taken in overdose?

Answer 17

Paracetamol

Question 18

What % of self-harm patients go on to die by suicide within one year?

Answer 18

1%

Question 19

Factitious disorders?

Answer 19

Deliberately producing, feigning or exaggerating symptoms due to a pathological need to for the sick role

Question 20

Malingering?

Answer 20

Deliberately producing, feigning or exaggerating symptoms to escape duty, work or for financial gain

Question 21

Hypochondrial disorder?

Answer 21

Persistent preoccupation with the possibility of having one or more serious and progressive physical disorders

Question 22

What is a functional disorder?

Answer 22

Basically, the cause of the patient’s syndrome isn’t fully understood.

Examples include IBS, chronic fatigue syndrome, fibromyalgia

Question 23

What are some of the issues patients face having functional disorders?

Answer 23

Lack of diagnosis limits access to support
Feel blamed or not listened to
Can feel ‘traumatised’ by experiences from the health services