Introduction to Psychiatry I Flashcards
How many people will have a mental health disorder in their lifetime?
1 in 3
How many GP consultations have a mental health component?
1 in 3
Do most people fully recover?
Yes
How is the engagement with patients?
Poor engagement with patients sometimes
How many people feel stigmatised?
3 in 4
Many people are scared to discuss illness
How much of the NHS funding funds mental health?
10%
How can you treat mental illness?
Psychotherapies
Social therapies
Medication
(excellent evidence based)
What is the difference between mental and physical illness?
No scientific basis to diagnosis
Similar to 18th century medicine
Diagnose by symptom cluster- not aetiology or pathology
Uncertainty about diagnosis
Dispute about existence of mental illness
Perceived lack of treatment
Agents of social control
What are symptoms of anxiety? (9)
Psychic:
- Feeling fear or dread
Physical symptoms:
- Palpitations
- Sweating
- Dry mouth
- Splanchnic vasoconstriction (butterflies)
- Tremor
- Paraesthesia (pins and needles)
- Depersonalisation
- Syncope
What are symptoms of obsessive compulsive disorder- obsessions? (6)
Ego-dystonic thoughts
Repetitive, circular ruminations
May be bizarre and sound delusional
Insight maintained
Unbidden and resisted
Resistance leads to anxiety
What are symptoms of obsessive compulsive disorder- compulsions? (3)
Motor response to obsessional thoughts
Often ritualistic, stereotyped, precise
E.g.,:
- Handwashing
- Counting
- Arranging and symmetry
- Checking door locks
Start again if interrupted or doubt
How can anxiety be classified? (7)
Generalised anxiety disorder
Panic Disorder
Agoraphobia
Simple phobia
Social phobia
Obsessive compulsive disorder
Post traumatic stress disorder
What is anxiety’s epidemiology?
Anxiety is normal and useful.
Anxiety is only a disorder if it is excessive, impacts on life or out of context.
What are 4 facts about anxiety?
Most common cause of mental disorder
Estimates of lifetime prevalence between 14 and 33%
More common in females (2:1)
Median onset age is 11
What can you do to treat anxiety?
Course of cognitive behaviour therapy (CBT)
Clomipramine
(medication and psychological therapies)
What is the most common cause of mental illness?
Anxiety
What are the core features of depression?
Pervasive low mood/ sadness
Loss of energy (anergia)
Loss of enjoyment (anhedonia)
What are the physical symptoms of depression?
Loss of appetite
weight loss
Diurnal variation of mood
Poor sleep
Loss of libido
Constipation
Psychomotor slowing or agitation
What are the psychological symptoms of depression?
Poor concentration
Feelings of guilt
Feelings of hopelessness
Low self-esteem
Indecisive
Suicidal ideation
Delusions
How many suicides in the UK anually?
over 6000
What is the most common cause of death in young men?
Suicide
What is the male to female ratio of suicide?
3:1
Rates of suicide are rising in which group of people?
young and middle aged men
What is the most common method of suicide?
Hanging
What is suicide most commonly associated with
Drug and alcohol use disorders and depression
What is the treatment for depression?
Medication: antidepressants (response after 2-3 weeks)
Psychological therapies: (12 session of cognitive behavioural therapy)
Social prescribing: Exercise, company (90% of patients make a full recovery)
What are the symptoms of mania?
Elated mood
Irritability
Over-energized
Grandiose
Little need for sleep
Poor concentration
Poor judgement
Over-spending
Rapid speech
What are the symptoms of schizophrenia?
Hallucinations
Delusion
Abnormal Behaviour
Disorganised Speech
Disturbances of emotions
Passivity
Thought alienation
What are hallucinations?
Hearing, seeing or feeling things that are not there
What are delusions?
Fixed false beliefs not shared by others in the person’s culture and that are firmly held even when there is evidence to the contrary.
What is meant by abnormal behaviour?
Disorganised behaviour such as wandering aimlessly, mumbling or laughing to self, strange appearance, self-neglect or appearing unkempt
What is meant by disorganised speech?
Incoherent or irrelevant speech
what is meant by disturbances of emotions?
Marked apathy or disconnect between reported emotion and what is observed such as facial expression or body language
What is formal thought disorder (linked to schizophrenia)?
Failing to follow the semantic and syntactic rules of language
What are treatments for schizophrenia?
Antipsychotics
Psychological therapies
Family therapy
Arts therapies
What are the 4 key features of schizophrenia?
Delusions
Disorganised speech
Hallucinations
Negative symptoms
Key features of schizophrenia: delusions
Fixed false beliefs
Persecutory
Bizarre
Thought possession and passivity
Key features of schizophrenia: Disorganised speech
Neologisms
Formal thought disorder
What are the 4 key features of schizophrenia?
Delusions
Disorganised speech
Hallucinations
Negative symptoms
Key features of schizophrenia: Hallucinations
Second person
Third person
Tactile
Key features of schizophrenia: Negative symptoms
Apathy
Social withdrawal
Poor self care
What is the state of mind of depression?
horrible, corrosive state of mind
What is the lifetime risk of depression?
10% lifetime risk
Do most people make a full recovery with depression?
Yes
How many patients with schizophrenia develop chronic symptoms?
1 in 3
What is the lifetime risk of schizophrenia?
1%
