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Nursing and Mid Y2 > HNN222 Mental Health Conditions > Flashcards

HNN222 Mental Health Conditions Flashcards

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1
Q

PSYCHOSIS

A

Psychosis is a term to describe the collection of symptoms of impaired or disturbed sense of reality.

People experiencing psychosis lose touch with the mutual consensus of reality. Impacts their social and occupational relationships.

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2
Q

Causes of Psychosis

A

Causes of Psychosis
* Alcohol & illicit substances can induce (LSD, ICE) or cause withdrawal psychosis
* Medical conditions: brain tumours, brain disease, dementia, UTI
* Genetic predisposition
* Mental illness (schizophrenia, depression, bipolar, borderline personality disorder, postpartum psychosis)
* Medication: steroids, stimulants

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3
Q

Components of Psychosis

A
  1. Delusions
  2. Hallunciations
  3. Disorganised behaviour and thinking
  4. Agitation, aggression, anxiety
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4
Q

Hallucinations

A

Seeing, feeling, or hearing things that aren’t there. Perceptions in a conscious and awake state in the absence of external stimuli which have quality of real perceptions.

* Auditory: commentary, spoken command
* Visual: often simple e.g. flashes of colour
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5
Q

Delusions

A

Beliefs that aren’t true when compared to the same culture. FIXED FALSE BELIEF. The content of delusions are impossible, implausible, bizarre, or patently true.

* Delusions of reference: belief that events are aimed at the person (e.g. newspaper article is directly targeting them)
* Grandiose delusion: person believes they have unique significance or power 
* Paranoid delusions: belief that a person is being harmed or watched by a group of people 
* Delusions of control: belief that thoughts, feelings, or actions are being controlled 
* Erotomania: belief that someone of high status/stranger is in love with them

Bizarre vs Non-Bizarre Delusions
* Non-Bizarre: within the realms of being plausible but often quite exaggerated
* Bizarre: implausible and not linked to life experiences

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6
Q

Disorganised behaviour and thinking

A
  • Poverty of content: don’t give much information or give more detail than necessary
    • Tangential speech: get off topic
    • Thought blocking: lose train of thought
    • Word salad: non-sensical combination of words
    • Preservation: words or ideas are repeated even when the topic has changed
    • Clanging associations: words chosen because of the catchy way they sound, not because of what they mean
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7
Q

Postpartum Psychosis

A
  • Incidence of 0.1% of the population
    • Onset: first two weeks following birth
    • Duration: weeks to months
    • Management: hospitalisation, pharmacological treatment, education, mother-baby bonding
    • Symptoms: hallucinations, delusions, confusion, suicidal thoughts, severe mood swings, paranoia, insomnia
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8
Q

Schizophrenia

A
  • Psychotic disorder characterised by significant disturbances in thinking, emotions, and behaviour.
  • Positive symptoms: hallucinations, delusions, disorganised speech and thoughts.
  • Negative symptoms: anhedonia, asociality, alogia, avolition, blunted affect.
  • Cognitive symptoms: memory issues, inability to process social cues, impaired sensory perception.

Avolition is a total lack of motivation that makes it hard to get anything done.

Anhedonia refers to the loss of ability to feel pleasure.

Blunted affect is a decreased ability to express emotion through your facial expressions, tone of voice, and physical movements.

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9
Q

Phases of Schizophrenia

A
  1. Prodrome: The early of emerging stage of schizophrenia. May notice emerging bizarre behaviours. Attenuated symptoms. Slow and gradual. Not yet psychotic.
  2. Active phase: Experiencing acute psychosis. The person may required treatment to support the management and care of acute symptoms.
  3. Residual phase: “Recovery stage”, more intense symptoms begin to decrease, however, the person still exhibits symptoms.
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10
Q

Depression (DSM)

A

DSM-5 cites 9 symptoms, patients must have at least 5 lasting at least 2 weeks:
1. Depressed mood
2. Loss of interest or pleasure in activities (anhedonia)
3. Significant change in weight (5%)
4. Insomnia/hypersomnia
5. Psychomotor agitation or impairment
6. Loss of energy (anergia) and motivation (avolition)
7. Feeling worthless
8. Loss of concentration
9. Thoughts of death and suicide

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11
Q

Depression pathophysiology

A

Smaller hippocampus

Abnormalities with serotonin, noradrenaline, and dopamine

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12
Q

Depression Aetiology

A

Aetiological Factors
* Biological factors (changes in neurotransmitter activity; dopamine, serotonin and norepinephrine)
* Comorbid chronic illness
* Genetic vulnerability (family history of mental illness or depression)
* Sleep disruptions (insomnia or history of poor sleep)
* Altered hormonal regulation
* Psychosocial stressors (relationship breakdown, loss of employment)
* Cultural aspects (migration, loss or change of identity, discrimination)

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13
Q

Bipolar Disorder

A

Mental health condition that causes intense shifts in mood from manic to depressive.

Bipolar I: characterised by episodes of severe mania and depression.
* Must have an episode of mania
* Likely to have a depressive episode

Bipolar II: characterised by episodes of hypomania (not requiring hospitalisation) and depression.
* Must have an episode of mania & depression

Euthymia = normal period between hypomania and depression

Cyclothymia: don’t meet the criteria for bipolar but has ups and downs (not as extreme as BPAD)

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14
Q

Characteristics of BPAD

A

Low moods present in the same way as major depressive disorder.

Manic episodes: high energy, overly happy/optimistic, euphoric, high self-esteem. Persistent irritated, elevated mood.
○ Pressured speech.
○ Talkative.
○ Racing thoughts/flight of ideas.
○ Delusions of grandeur.
○ Poor decision making.
○ Psychotic behaviour.
○ Reduced need for sleep.
○ Hedonism.
○ Disinhibited.
○ Distracted.
○ Increased goal directed activity.

* Mixed episodes.
* Rapid cycling: four or more episodes of depression or mania within a year.
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15
Q

BPAD Aetiology

A

Contributing Factors
* Family history
* Trauma (ACEs)
* Drug or medication (e.g. SSRI) use
* Comorbidities (additional psych disorders)

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16
Q

Anxiety

A

Intense worry, apprehension or unease regarding a particular situation or outcome.

Experience symptoms of anxiety most of the time with the absence of a trigger. Excessive, persistent, and cause significant distress and disability

17
Q

Anxiety Aetiology

A

Contributing Factors
* Genetics
* Environmental factors
* Childhood trauma and adversity
* Parenting style
* Temperament
* Conflict
* Loss
* Chronic pain
* Physical illness

18
Q

SUBSTANCE USE

A

see padlet table

19
Q

Personality Disorders

A

Impairment in cognition, affectivity, impulse control, and interpersonal functioning.

These patterns are enduring and result in significant impairment in the individual’s ability to function successfully in a social, occupational, and interpersonal manner.

Cluster A,B,C - see onenote table

20
Q

Borderline Personality Disorder

A

Diagnostic Criteria
A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts.

(5+)

1. Frantic efforts to avoid real or imagined abandonment. 
2. Unstable and intense interpersonal relationships - extremes of idealization and devaluation. 
3. Identity disturbance: unstable self-image or sense of self. 
4. Impulsivity in at least two areas that are potentially self-damaging.
	a. Sexual relationships
	b. Drug and alcohol abuse
	c. Violence
	d. Disregard for law 
5. Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour. 
6. Affective instability (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days). 
7. Chronic feelings of emptiness. 
8. Inappropriate, intense anger or difficulty controlling anger.
9. Transient, stress-related paranoid ideation or severe dissociative symptoms.
21
Q

Borderline Personality Disorder Aetiology

A

Contributing Factors
* Genetics
* ACEs
* Alcohol abuse
* Depression
* Bipolar
* Anxiety

22
Q

Anti-Social Personality Disorder

A

Diagnostic Criteria
A) A pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 years, as indicated by three (or more) of the following:
1. Failure to conform to social norms with respect to lawful behaviours, repeat arrests.
2. Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure.
3. Impulsivity or failure to plan ahead.
4. Irritability and aggressiveness, as indicated by repeated physical fights or assaults.
5. Reckless disregard for safety of self or others.
6. Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behaviour or honour financial obligations.
7. Lack of remorse.
B) The individual is at least age 18 years.
C) Evidence of conduct disorder with onset before age 15 years.
D) The occurrence of antisocial behaviour is not exclusively during the course of schizo­phrenia or bipolar disorder.

Conduct disorder
* Cruelty to animals or people
* Stealing violence
* Truancy
* Gang behaviour

23
Q

Suicidal Ideation and Self Harm

Risk Factors

A
  • Being male
    • Social isolation
    • Being Aboriginal or Torre Straight Islander
    • Socio-economic status
    • AOD use
    • Bereaved by suicide
    • LGBTQI+
    • Migrant or refugee population
    • Having a past attempt
    • Family violence
    • Recent discharge from a mental health facility
    • Chosen method and ability to access method
24
Q

Suicidal Ideation and Self Harm

Dynamic vs Static Factors

A

Dynamic
* Suicidal ideation and intent
* Hopelessness
* Problem solving deficits
* Active psychological symptoms
* Substance use
* Psychosocial stress
* Access to support and services

Static
* Hx of self injury
* Previous psychiatric admissions
* Hx of mental illness
* ACEs
* Hx of substance use
* Personality disorders/traits
* Age, gender, marital status

25
Q

Reasons for Self-Harm

A
  • Emotional dysregulation
    • Anger
    • Self-punishment
    • Prevent feeling numb
    • Release tension
    • Gain control
    • Visible
    • Local/systemic infection
26
Q

Anorexia Nervosa

A

Restrictive or binge eating/purge.

* Very low weight (<85% of normal)
* Fear of gaining weight 
* Body dysmorphia

Control. Will-power.

27
Q

Anorexia Nervosa

Physical Effects

A
  • Muscle loss
    ○ Low creatinine level
    ○ Weak muscles: can cause difficulty breathing
    • Cardiac issues
      ○ Bradycardia
      ○ Hypotension
      ○ Orthostatic hypotension
      ○ CHF
    • Electrolyte imbalance
      ○ Low potassium, magnesium, phosphate
    • Vitamin deficiencies
      ○ Thiamine
    • Amenorrhea
    • GIT disturbance
      ○ Bloating
      ○ Nausea
      ○ Constipation
    • Bone marrow
      ○ Low WBC = dampened immune response
      ○ Low RBC = low energy
      ○ Low platelets = easy bleeding and bruising
    • Osteoporosis/osteopenia
    • Dry skin
    • Brittle hair, hair loss, lanugo
    • Brain
      ○ Atrophy: decrease in tissue size
      ○ Encephalopathy: decrease in O2 supply
    • Hypothermia
28
Q

Re-Feeding Syndrome

A
  1. Refeeding stimulates release of insulin
    1. Cells take in K, Mg, PO4 = low serum levels = heart arrythmias
29
Q

AN/BN Aetiology

A
  • Genetics
    • Hormonal and metabolic
    • Social and environmental
    • Temperament
    • Trauma
    • Peer pressure and bullying
    • OCD, depression, anxiety
30
Q

Bulimia Nervosa

A

Rapid, out of control eating past the point of comfort, followed by purging.

* Normal weight or overweight. 
* Must repeat at least once a week for a period of 3 months.  
* Can develop into anorexia.

Lack of control.

31
Q

Bulimia Nervosa

Physical symptoms

A
  • Eroded enamel due to repeat vomiting
    • Sialadenitis = swelling of parotid gland
    • Oesophageal damage (potentially deadly)
    • Halitosis = very bad breath
    • Russel’s sign = mark on knuckle from inducing vomiting
    • Tears in the oesophagus and stomach
    • Dehydration > hypotension and tachycardia
    • Electrolyte imbalance (Na, Cl, Mg, Po4, K)
    • Metabolic alkalosis
    • Endocrine changes: menstrual irregularity
    • High risk of diabetes
    • Laxative abuse > chronic constipation

Nursing and Mid Y2 (10 decks)

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