Lecture 5: Introduction to Psychiatry Flashcards
What are the differences between mental illness and physical illness?
- people often don’t perceive themselves to be ill (no ‘therapeutic contact’, reluctance to accept treatment, use of mental health act)
- no scientific basis to diagnose, diagnose by symptom cluster, uncertainty about diagnosis
- dispute about existence of mental illness
- perceived lack of treatment
- agents of social control
What are the symptoms of anxiety?
Psychic anxiety - feeling of fear or dread PHYSICAL SYMPTOMS: - palpitations - sweating - dry mouth - splanchnic vasoconstriction (Butterflies) - tremor - paraethesia (Pins and needles) - depersonalisation - syncope (fainting)
What are the symptoms of obsessive compulsive disorder?
OBSESSIONS: - ego-dystonic thoughts - repetitive, circular ruminations - may be bizarre and sound delusional - insight maintained - unbidden and resisted - resistance leads to anxiety COMPULSIONS - motor response to obsessional thoughts - often ritualistic, stereotypes, precise - e.g. handwashing, counting, arranging + symmetry, checking door locks - start again if interrupted or doubt
How can anxiety be classified?
- generalised anxiety disorder
- panic disorder
- agoraphobia
- simple phobia
- social phobia
- obsessive compulsive disorder
- post traumatic stress disorder
When does anxiety become a disorder?
if it is excessive, impacts on life or out of context
Who is anxiety more common in?
females
What is the most common cause of mental disorder?
anxiety
What is the median onset age of anxiety?
11
How is anxiety treated?
- cognitive behavioural therapy
- drugs like clomipramine (antidepressant)
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
What is the most common cause of death in young men?
suicide
What is the male to female ratio of suicide?
3:1 (rates are rising in young and middle aged men)
What is suicide most commonly associated with?
drug/alcohol use disorders and depression
How is depression treated?
- antidepressants (response after 2-3 weeks)
- psychological therapies (12 session CBT)
- social prescribing (exercise, company)
What percentage of patients with depression make a full recovery?
90%
What are the symptoms of mania?
- elated mood
- irritability
- over-energised
- grandiose
- little need for sleep
- poor concentration
- poor judgement
- over spending
- rapid speech
What are the symptoms of schizophrenia?
- hallucination
- delusion
- abnormal behaviour (disorganised, wandering aimlessly, mumbling to self, strange appearance, self-neglect)
- disorganised speech (Incoherent or irrelevant)
- disturbances of emotion (marked apathy or disconnect between reported emotion)
What is a hallucination?
hearing, seeing or feeling things that are not there
What is a delusion?
fixed false beliefs not shared by others in the person’s culture and that are firmly held even where there is evidence to the contrary (Passivity, thought alienation)
What is formal thought disorder in schizophrenia?
failing to follow the semantic and syntactic rules of language
What are the 2 major psychotic disorders?
schizophrenia and bipolar affective disorder (together described as severe mental illness, SMI)
How is schizophrenia treated?
- antipsychotics
- psychological therapies
- family therapy
- arts therapies
What are the key features of schizophrenia?
- delusions (fixed false beliefs, persecutory, bizarre, thought possession and passivity)
- disorganised speech (neologisms, formal thought disorder)
- hallucinations (second person, third person, tactile)
- negative symptoms (apathy, social withdrawal, poor self care)
