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KC2017 Behavioral Health > Intro > Flashcards

Intro Flashcards

1
Q

Mental Disorder (definition)

A

Illness with psychological or behavioral manifestations associated with significant distress and impaired functioning

Caused by biological, social, psychological, genetic, physical or chemical disturbance

Measured in terms of deviation from some normative concept

Ea. Illness has characteristics signs and symptoms

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2
Q

Official classification system used by mental health professionals to diagnose psychiatric illness

A

Diagnostic and Statistical Manual of Mental Disorders *DSM) 5th ed. (2013)

Has diagnostic criteria for 22 major categories of mental disorders (727 discrete illnesses)

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3
Q

Major Categories of Psychiatric Illnesses (9 in class)

A
  1. Schizophrenia Spectrum +
  2. Bipolar and related
  3. Depressive
  4. Anxiety
  5. Obsessive-compulsive +
  6. Trauma and stressor related
  7. Feeding and eating
  8. Substance related and addictive
  9. Personality disorders
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4
Q

Schizophrenia Spectrum and other Psychotic disorders

Defined by abnormalities in which domains:

A
  1. Delusions
  2. Hallucinations
  3. Disorganized thinking/speech
  4. Grossly disorganized or abnormal behavior
  5. Negative/positive symptoms
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5
Q

Bipolar and related disorders

A

defined by “manic episodes” and “depressive episodes”

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6
Q

Depressive disorders

A

Defined by presence of sad, or empty, or irritable mood

Accompanied by somatic and cognitive changes

Affects individuals capacity to function

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7
Q

Anxiety disorders

A

Excessive fear, anxiety and behavioral disturbances

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8
Q

Fear

A

Emotional response to real or perceived imminent threat

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9
Q

Anxiety

A

Anticipation of a FUTURE threat

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10
Q

Obsessive compulsive and related disorders

A

Presence of obsession and/or compulsion

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11
Q

Obsessions

A

Recurrent and persistent thoughts, urges, or images that experienced as intrusive and unwanted

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12
Q

Compulsions

A

Respective behaviors or mental acts that an individual feels driven to perform in response to an obsession

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13
Q

Trauma and stressor related disorders

A

Requisite exposure to trauma or stressful event

Variable symptoms (anxiety, anhedonia, dysphoria, externalized anger, aggressiveness, dissociativeness)

May have more than one

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14
Q

Somatic symptom and related

A

Prominence of somatic symptoms associated with significant stress and impairment

Abnormal thoughts, feelings, and behaviors in response to the symptoms

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15
Q

Feeding and eating disorders

A

Characterized by a persistent disturbance of eating and or eating-related behavior that results in the consumption or absorption of food that significantly impairs physical health or psychosocial functioning

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16
Q

10 classes of drugs – substance related and addictive disorders

A
  1. Alcohol
  2. Caffeine
  3. Cannabis
  4. Hallucinogens
  5. Inhalants
  6. Opioids
  7. Sedative, hypnotics, anxiolytics
  8. Stimulants
  9. Tobacco
  10. Other/unknown
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17
Q

Personality disorders

A

Enduring pattern of inner experience and behavior that deviates markedly from expectations of culture

Pervasive and inflexible

Onset in adolescence or early adulthood

Stable over time

Leads to distress or impairment

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18
Q

Psychotic

A

Loss of reality testing with delusions and hallucinations

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19
Q

Neurotic

A

No loss of reality testing

Based mainly on intrapsychic conflicts or life events that cause anxiety

Symptoms include obsessions , phobia, and compulsion

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20
Q

Functional

A

No known structural damage or clear cut biological cause to account for impairment

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21
Q

Organic

A

Illness caused by specific agent producing structural changes in the brain

Associated with cognitive impairment, delirium or dementia

NOT used in DSM

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22
Q

Primary

A

No known cause

Aka idiopathic

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23
Q

Secondary

A

Known to be a symptomatic manifestation of systemic, medical, or cerebral disorder (i.e. Delirium from fever)

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24
Q

Tangentially

A

Oblique, digressive, or even irrelevant manner of speech in which central idea is never communicated

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25
Q

Circumstantiality

A

Disturbance in associative thought and speech process in which a patient digresses into unnecessary details and inappropriate thought before communicated in the central idea

Seen in schizophrenia, obsessional disturbances, and certain cases of dementia

26
Q

Thought blocking

A

Abrupt interruption in training of thinking before a thought or idea is finished

After a brief pause, the patient indicates no recall of what is being said or was going to be said

Often indicates presence of mental illness such as schizophrenia

27
Q

Loosening of associations

A

Thinking or speech disturbance involving a disorder in logical progression of thoughts, manifested as a failure to communicate verbally adequately

Unrelated and unconnected ideas shift from one subject to another

28
Q

Flight of ideas

A

Rapid succession of fragmentary thoughts or speech in which content changes abruptly and speech may be incoherent

Seen in mania

29
Q

Word salad

A

Incoherent, essentially incomprehensible, mixture of words and phrases

commonly seen in far-advanced cases of schizophrenia

30
Q

Hallucinations

A

False sensory perception occurring in the absence of any relevant external stimulation of the sensory modality involved

31
Q

Delusions

A

A false belief, based on incorrect inference about external reality

Held firmly despite objective and obvious contradictory proof or evidence and despite the fact that other members of the culture do not share the belief

32
Q

Orientation

A

State of awareness of onself and one’s surroundings in terms of person, place, time and situation (Ox4)

33
Q

Insight

A

Conscious recognition of one’s own condition

In psychiatry refers to conscious awareness and understanding of one’s own psycho dynamics and symptoms of maladaptive behavior

Highly important in effecting changes in the personality and behavior of the person

34
Q

Judgement

A

Mental act of evaluating or comparing choices within the framework of a given set of values for the purpose of electing a course of action

If the course of action is consonant with reality or with mature adult standards of behavior, judgment is said to be intact or normal

Judgment is impaired if course is maladaptive, results from impulsive decisions based on need for immediate gratification, or is otherwise not consistent with reality as measured by mature adult standards

35
Q

Two sections of the psychiatric exam

A
  1. Complete medical history, pertinent PE

2. Psychiatric history

36
Q

Screening lab tests used in psych exams

A

Can’t determine specific psychiatric disorders

CBC

Renal and liver panel (creatinine/BUN/LFTs)

TSH

Lyres, blood sugar, RPR (syphilis), vitamin B12, UA, tox screen

37
Q

Thyroid function test

A

Depression with hypothyroidism

Lithium therapy can cause hypothyroidism

Subclinical hypothyroidism can cause depression (order TRH)

38
Q

Dexamethasone-suppression test

A

Used to confirm major depressive disorder

1mg p.o. At 11PM, blood level measured at 8a, 4p, 11p)

(Level >5mg/dl= + result or non-suppression (abnormal))

Not perfect — many false -/false +

39
Q

Catecholamines

A

5-HIAA elevated w/carcinoid tumors (urine)

+/- when on phenothiazines (urine)

In CSF: low in suicidal depressed patients

Decreased in all violent behaviors but increased in PTSD

40
Q

Renal function tests

A

Need to monitor in patient taking lithium

Creatinine/BUN

41
Q

LFTs

A

Need to monitor on patients taking phenothizine, tricyclic antidepressants, phenobarbital/carbamezpine (Tegretol) and valproate (Depakene)

42
Q

Lab tests related to medications

A

Plasma levels - lithium

Clozapine (clozaril) – WBC (risk of agranulocytosis)

Tricyclics/tetracycl drugs – EGC (conduction delays), blood levels for therapeutic range

43
Q

Drugs that you order plasma levels for

A

Imipramine/Tofranil

Nortriptyline/Pamelor

Desipramine/Norpramin

44
Q

Lithium lab tests

A

Thyroid function

Lytes

WBC

Renal function

ECG

45
Q

Sodium lactate

A

Can precipitate panic attack with sodium lactate IV

Can be used to confirm dx

46
Q

Types of psychotherapy

A
  1. Psychoanalysis
  2. Group therapy
  3. Family therapy
  4. Marital therapy
  5. Biofeedback
  6. Cognitive therapy
47
Q

Cognitive therapy

A

Patient’s problem is based on perception of their environment

Individual therapy sessions aimed at changing these perceptions

48
Q

Cognitive therapy is used in patients with which disorders

A

Depression

Panic disorder

OCD

Personality disorders

Somatoform disorders

49
Q

Cognitive triad of depression

A

Negative self perception

View world in negative manner

Expects world will not change

50
Q

8 main topics of mental status exam

A
  1. Appearance and behavior
  2. Speech
  3. Mood
  4. Thoughts
  5. Perception
  6. Cognition
  7. Insight
  8. Judgment
51
Q

Biofeedback

A

Brings autonomic nervous system under voluntary control

Patients then learn relaxation techniques

EMG often used

52
Q

Martial therapy goal

A

Alleviate emotional distress and disability

Promote levels of well being of both partners together and of ea. As an individual

53
Q

Martial therapy

A

Conflicts between married people involving social, emotional, sexual, or economic problems

Can be individual, couples, groups

CI if one person involved has psychosis

Doesn’t always result in couples remaining together

54
Q

Family therapy

A

Focused on improving relationships within family structure

Therapist trained for family therapy

Uses interview technique, sessions held weekly (1-2 hrs/session)

55
Q

Group therapy

A

8-10 patients with mental health disorders (can be a variety of disease, heterogeneous situations work best)

Meet weekly with a therapist present to change behavior

Can be inpatient or out patient

Contraindicated if social anxiety

56
Q

Psychoanalysis

A

Used by psychiatrists

Based on sigmund Freud

Patient lies on couch

57
Q

Psychoanalysis

Goals

A

Bring suppressed memories into present personality

Main emphasis on conflict between unconscious drives and moral judgments patient makes regarding their behavior

58
Q

Psychoanalysis

Indication

A

Psychoneuroses (anxiety disorders, compulsive behavior, conversion disorder, sexual dysfunction, personality disorders)

59
Q

Patient indications

Psychoanalysis

A

Genuine desire to gain self understanding of behavior

Able to handle emotions that emerge with psychoanalysis

Must be honest with analysis

60
Q

Psychoanalysis

Fundamental principle (second principle)

A

Free association

Second principle - analyst must remain neutral

KC2017 Behavioral Health (11 decks)

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