HD 3 - Psychiatry in Dental Practice Flashcards
What is psychiatry?
Dealing with mental disorder and its treatment
How many people attend a GP with a psychological problem?
1 in 3, with 1 in 9 needed specialist treatment
How many suicides attend primary care 1 month prior to treatment?
50%
What is psychology?
Science that investigates behaviour, experience, and normal functioning of the mind
What is psychotherapy?
Treatment of psychological issues by non-physical means
What is psychoanalysis?
Sort of psychotherapy, or means of exploring the unconscious mind
What are the barriers that psychological patients present with?
Present complaint and demand treatment, can be aggressive
Stigma and shame
Believe illness cannot be cured, think drugs are mind-altering and addictive
What are the barriers that psychological dentists present with?
Lack time Fear of embarrassment Uncertainty Lack of knowledge Feeling must do something for patient, as patient has expectations
How to act as a dentist in a psychiatric patient?
- Putting the patient at ease
- Patient & you seated – good eye contact
- Explain what you are going to do – i.e. maybe not pull a tooth out!
- Be prepared to discuss emotional issues
- Referral – liaise with GMP or referral to hospital services
- Never ignore threats of self-harm (or to others)
- Record everything
Define ambivalence?
Conflicting emotions about same someone/issue
Define catalepsy?
Trance like, holding one pose for a long time
Define delusional?
False belief
Define psychosis?
Extreme disordered, thinking but not aware of it
Define neurosis?
Disordered thinking (disabling anxiety) and aware of it
What percentage of over 65s and over 80s have dementia?
Over 65s - 5%
Over 80s - 20%
What happens to the brain in dementia? and what are the symptoms?
Cerebral atrophy (brain shrinks in size) Happens over time with age, but can be more than normal Reduced, Social function, intellect, speech, memory and concentration Onset insidious (gradual) and patient unaware of impairment
When is best to carry out dental treatment for dementia patients?
First thing in the morning
What are the symptoms of toxic confusion state under alcohol/drug intoxication?
- Disturbance of consciousness
- Impairment of memory and intellectual functions
- Disorientation for time and place
- Mood disturbance (anxiety or depression)
- Hallucinations (most commonly visual)
What are complications that occur with alcohol consumption?
- Injuries
- Social
- Liver damage = CLOTTING PROBLEMS
- Nutritional defects
- Pancreatitis
- Gastritis
- Cardiomyopathy
- Brain damage, epilepsy and myopathy
What is deficient in Korsakoff’s Psychosis?
B1/THIAMINE DEFICIENCY
How is Korsakoff’s Psychosis brought about?
Most frequently associated with chronic alcoholism
What are the effects of Korsakoff’s Psychosis on the body?
- Amnesia for recent events
- Impaired ability to learn new tasks
- Fabricated descriptions of recent events
- Otherwise alert and normal behaviour
What are the medical complications of bulimia?
- Dehydration/weight fluctuations
- Low potassium and muscle cramps
- Dental erosion
- Oesophagitis
- Poor muscular tone in the colon from laxative abuse
What signs do you look out for in self induced vomiting?
- Look for calluses on back of fingers
* Traumatic lesions on back of palate
Define sociopathy.
Anti-social behaviour
What are the symptoms of schizophrenia?
- Hallucinations: Which may be in the form of imagined inner voices that direct the patient’s life
- Psychosis: Extreme disordered thinking that interferes with the patient’s ability to complete activities of daily living
- Somatoform Disorder = preoccupied with imagined physical defects in their body
What is psychiatric treatment?
- Medication
- Psychoanalysis
- Psychological Cognitive Behavioural Therapy (CBT)
- Group Therapy
- Family support
