HNN222 Mental Health Conditions Flashcards
PSYCHOSIS
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.
Causes of Psychosis
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
Components of Psychosis
- Delusions
- Hallunciations
- Disorganised behaviour and thinking
- Agitation, aggression, anxiety
Hallucinations
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
Delusions
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
Disorganised behaviour and thinking
- 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
Postpartum Psychosis
- 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
Schizophrenia
- 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.
Phases of Schizophrenia
- Prodrome: The early of emerging stage of schizophrenia. May notice emerging bizarre behaviours. Attenuated symptoms. Slow and gradual. Not yet psychotic.
- Active phase: Experiencing acute psychosis. The person may required treatment to support the management and care of acute symptoms.
- Residual phase: “Recovery stage”, more intense symptoms begin to decrease, however, the person still exhibits symptoms.
Depression (DSM)
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
Depression pathophysiology
Smaller hippocampus
Abnormalities with serotonin, noradrenaline, and dopamine
Depression Aetiology
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)
Bipolar Disorder
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)
Characteristics of BPAD
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.
BPAD Aetiology
Contributing Factors
* Family history
* Trauma (ACEs)
* Drug or medication (e.g. SSRI) use
* Comorbidities (additional psych disorders)