Intro to Psychiatry

Question 1

what is adjustment reaction?

Answer 1

States of subjective distress and emotional disturbance, usually interfering with social functioning and performance, arising in the period of adaptation to a significant life change or a stressful life event

Question 2

how does adjustment reaction manifest?

Answer 2

vary and include depressed mood, anxiety or worry (or mixture of these), a feeling of inability to cope, plan ahead, or continue in the present situation, as well as some degree of disability in the performance of daily routine

Question 3

organic delusional disorder

Answer 3

disorder in which persistent or recurrent delusions dominate the clinical picture. The delusions may be accompanied by hallucinations. Some features suggestive of schizophrenia, such as bizarre hallucinations or thought disorder, may be present.

Question 4

prevalence of post-stroke psychosis

Answer 4

Delusions 4.67%

Hallucinations 5.05%

Question 5

is post stroke psychosis more prevalent in left or right hemispheres strokes? ratio?

Answer 5

right

5:1 right:left

Question 6

common delusional themes in post-stroke psychosis

Answer 6

persecutory
jealousy
environment

Question 7

what % of those with a long term condition have a mental health problem?

Answer 7

30

Question 8

list examples of long term physical illness associated with mental health illness

Answer 8

CVD 3x risk depression + anxiety
diabetes 2x risk depression
COPD 10x risk of panic disorder
MSK disorders 2x risk of depression

Question 9

list examples of physical illness causing discrete mental illness

Answer 9

thyrotoxicosis > anxiety, mania
thyroid deficiency > depression, dementia
Cushing’s disease > depression
syphilis, HIV > psychosis
cancer > depression
Parkinson’s > depression, anxiety, dementia

Question 10

People with chronic mental illness are at _______ risk of physical illness

Answer 10

greater

Question 11

compare life expectancy of people with chronic mental illness with general population

Answer 11

People with chronic mental illness die 20 years younger than the general population.

Question 12

What factors may affect timely diagnosis of physical disorders in people with mental illness?

Answer 12

Illness behaviour
Diagnostic overshadowing
Stigma
Lack of resources

Question 13

what is delirium?

Answer 13

organic cerebral syndrome characterized by concurrent disturbances of consciousness and attention, perception, thinking, memory, psychomotor behaviour, emotion, and the sleep-wake schedule. The duration is variable and the degree of severity ranges from mild to very severe

Question 14

prevalence of delirium

Answer 14

20% acute hospital patients >65 on admission
20% more develop delirium after admission
Overall prevalence 30% on wards, 80% in intensive care
50% undetected
50% “hypoactive”

Question 15

consequences of delirium

Answer 15

psychiatric manifestation of a physical illness
Delays discharge
Increases mortality

Question 16

causes of delirium

Answer 16

Infection, Change in environment (ITU, HDU, ward), Medication (opiates, anticholinergics, steroids), Alcohol withdrawal, Surgery, Pain

Question 17

predisposing factors of delirium

Answer 17

Advanced age, Dementia (often undetected), Impaired activities of daily living, Immobility, Sensory impairment, Urinary catheterization, Malnutrition, Alcohol, Depression

Question 18

management of delirium

Answer 18

Anticipate
Modify risk factors if possible
Early diagnosis
Treat the causes
Good nursing
Single room, well lit, familiar staff/family (in an ideal world)
Medication
Wait!

Question 19

delirium is also known as?

Answer 19

acute confusional state