Introduction

Question 1

What is the ICD10?

Answer 1

The current version of the international classification of disease

Question 2

Which chapter of ICD 10 is relevant to mental and behavioural disorders?

Answer 2

Chapter V (5)

Question 3

What are the MH chapters within the ICD10?

Answer 3

• Organic disorders
• Disorders due to psychoactive substance abuse
• Schizophrenia/schizotypal/delusional disorders
• Mood disorders
• Neurotic/Stress related/somatoform disorders
• Behavioural syndromes
• Disorders of adult personality and behaviour
• Mental retardation
• Disorders of psychological development
• Child/adolescent onset behavioural/emotional disorders
• Unspecified mental disorder

Question 4

How have organic mental disorders been classified?

Answer 4

By common demonstratable etiology in cerebral disease, brain injury, or other insult leading to cerebral dysfunction

Question 5

What are some organic mental disorders?

Answer 5

Alzheimers
Dementia
Amnesia
Korsakov syndrome
Delerium

Question 6

What are functional mental disorders?

Answer 6

Those that do not have a clear physical pathophysiology that are the basis of diagnosis

Question 7

Name some functional mental disorders

Answer 7

Schizophrenia
Anxiety
Depression

Question 8

What are the 4 Ps of mental health disorders?

Answer 8

Predisposing factors
Precipitating factors
Perpetuating factors
Protective factors

Question 9

What is insomnia?

Answer 9

Condition of unsatisfactory sleep, either in terms of onset, maintenance, or early waking, causing subsequent daytime functionality impairment.

Question 10

What are over half of all insomnia cases related to?

Answer 10

A concurrent psychiatric disorder.

Question 11

What conditions can cause secondary insomnia?

Answer 11

Other sleep disorders
Stress
Psychiatric comorbidities
Medication or substance abuse
Medical comorbidities
Poor sleep hygeine or sleep environment

Question 12

What sleep disorders can cause insomnia?

Answer 12

• Sleep apnoea
• Circadian rhythm disorders (shift work, jet leg etc)
• Parasomnias
• Narcolepsy

Question 13

How should insomnia be assessed?

Answer 13

• Careful history to look for an underlying cause
• Physical and psychological examination
• Sleep diary
• Sleep studies

Question 14

How can insomnia be managed?

Answer 14

Treat the underlying cause
Sleep hygeine advice
CBT
Pharmacological interventions

Question 15

What are the main points of sleep hygiene advice?

Answer 15

• Limit caffeine intake
• Avoid napping in the day
• Regular exercise
• Reduce stimulation before bedtime
• Change bedroom surroundings if not conducive to sleep
• Avoid screen time before sleep
• Avoid staying in bed longer than total sleep time
• Regular wake up and bed times

Question 16

Should pharmacological interventions be used for insomnia?

Answer 16

Not really - little evidence that it does any good for long term insomnia, but may help with short term, acute insomnia.

Question 17

Which medications can be used for insomnia?

Answer 17

Benzodiazepines and "Z drugs"
Melatonin
Antidepressants and antipsychotics
Antihistamines
Herbal remedies

Question 18

What are the Z drugs?

Answer 18

Zopiclone
Zaleplon
Zolpidem

Question 19

Which benzos are used for insomnia?

Answer 19

The short acting ones:

• Nitrazepam
• Lorazepam
• Lormetazepam
• Temazepam

Question 20

When can melatonin be used for insomnia?

Answer 20

In patients over 55 in short term insomnia.