Intro to Psychiatry Flashcards
What is the incidence of depression? What is the incidence of suicide in depression?
- 5% incidence of depression
- 15% of the severely depressed commit suicide
What is the incidence of bipolar disorder?
1%
What is the incidence of schizophrenia? What % commit suicide?
- incidence is 1%
- 10% commit suicide
What is the incidence of general anxiety disorder?
- incidence is 5.1%
What is the primary goal in treating any major psychiatric disorder?
- working to minimize symptoms and prevent them from coming back
What is the statistical impact of psychiatric disorder?
one quarter of disability life years is attributable to mental health issues
What is the impact of bipolar disorder?
- its progressive and causes impairment of neuroplasticity and/or cellular resilience with systemic consequences
- higher incidence of substance abuse, suicidality, employment and family problems
If someone with bipolar disorder is left untreated, they have a ___ higher change of dying than the normal population?
2.5 (why there needs to be higher rates of diagnosing these patients)
35% of patients with bipolar disorder are symptomatic for more than _____ before the correct diagnosis
10 years
What are some of the other physical care issues that can be common in those that have psychiatric disorders?
- poverty
- unemployment
- homelessness
- violence
- incarceration
- stigma
- lifestyle
- suicide
- cardiovascular, metabolic, respiratory, endocrine, digestive health
- rising death rate
Contributors to morbidity and mortality of physical conditions in the mentally ill
- vulnerability genes
- smoking
- obesity
- diet
- sedentary
- diabetes
- stress
- polysubstance abuse
- poverty
- poor living conditions
- isolation
- access to medical care
- quality of medical care
- antipsychotic medications
What are the different ways that disease alters neurotransmission?
- modification of neurobiology
- loss of neuronal plasticity
- excitotoxicity
- absence of neurotransmission
- excess of neurotransmission
- imbalance in neurotransmitters
- wrong rate of neurotransmission
- wrong neuronal wiring
What is the mechanism of action for treating depression?
- increase neurotransmission: NE, 5HT, DA
What is the mechanism of action for treating psychosis?
- blocks neurotransmission: 5HT, DA
What is the mechanism of action of medications to treat bipolar disorder?
- increases GABA and its effects
- membrane stabilizers
What is the MOA of anxiety medications?
to enhance the effect of GABA
What NT becomes overly activated in the nigrostriatal pathway?
acetylcholine becomes blocked
Dopamine pathways can also be inhibited by other NTs such as what?
GABA and 5HT
What kind of medications lead to an increase in SE?
non-selective medications
What are the challenges associated with treating mental health issues?
- time to response
- effective regimen
- management of adverse effects
- drug interactions
- adherence
How long do antidepressants take to have full effect?
- take about 6-12 weeks to get to the full dose- need to also wait after the full dose is met for another 6-12 weeks after
What age group are more sensitive to the way the NTs are affected in the brain, causing you to need to start more slow at a low dose
elderly
What are some of the factors affecting adherence to treatment?
- insight into the disease and need for medication
- personal belief system about making meds
- therapeutic effects - acute vs chronic
- management of adverse effects
- complicated regimens
- quality of therapeutic relationship
What are some things that can be done to enhance adherence to treatment?
- enhance education
- enhane communication
- collaboration between clinicians and clients
- reminder systems
- medication reviews
- pharmacist assessment for potential drug related problems
