Liason psychiatry

Question 1

cartesian dualism

Answer 1

mind and body are completely different from one another and that each could exist by itself

Question 2

what are conditions that cartesian dualism might create difficulties

Answer 2

1. delirium
2. dementia
3. depression

Question 3

the overlap between long term conditions and psychiatric disorders

Answer 3

• 30% with long term conditions will have mental health problem
• 46% of people with mental health problem have long term conditions

Question 4

what is liaison psychiatry

Answer 4

intersection between the mind/psychiatry and body/ medicine and surgery

Question 5

effect of mental health problems on discharge, readmission, death

Answer 5

people with mental health problems are more likely to have delayed discharge, readmission and death

Question 6

association between schizophrenia and long term medical conditions

Answer 6

• in people with schizophrenia, death occurs 16-25 years earlier than matched individuals
• increased risk of cardiovascular disease, smoking, hyperlipidemia, T2DM, obesity, HIV, hepatitis, COPD

Question 7

relationship between depressive disorder and mortality in people with their first diabetic foot ulcer

Answer 7

Question 8

ICD-11 diagnostic criteria for depression

Answer 8

1. at least one of;
   - low mood
   - markedly diminished interest or pleasure in activities
2. others
   - reduced energy or fatigue
   - reduced ability to concentrate/ indecisiveness
   - beliefs of low self-worth or inappropriate guilt
   - hoplelessness re the future
   - recurrent thoughts of death or suicidal ideation
   - sleep disturbance
   - change in appetite and weight
   - psychomotor agitation or retardation

**5 or more of the symptoms
*symptoms present most of the day, for most days, minimum of 2 weeks

Question 9

screening questions for detecting depression:

Answer 9

• during the last month have you often been bothered by feeling down, depressed or hopeless?
• during the last month have you often been bothered by having little interest or pleasure in doing things?

Question 10

low mood in general hospital patient - differential diagnosis

Answer 10

• normal psychological process - appropriate adjustment
• hypoactive delirium
• adjustment disorder
• depressive episode

Question 11

typical illness responses

Answer 11

• people may have a variety of emotional responses to illness
• a typical illness response may range from stoicism, to sub-threshold symptoms of distress, mild depressive symptoms and major depression
• all of these responses need to be acknowledged and may benefit from support
• because of the impact of symptoms and repercussions for management, it is important to identify those with major depression
• spectrum from normal distress to sub-threshold symptoms, including adjustment disorder (a self-limiting response to a recent stressful event) and bereavement reactions, to a full blown depressive illness)