Lifespan of Mental Health Flashcards
Describe the difference in prevalence of mental and physical conditions across a patients life span?
Teen- young adult = high prevalence of mental disorders and low prevalence of physical health problems
Old age = high prevalence of physical health problems and lower rates of mental problems
What mental disorders can decrease a patient’s life expectancy and by how much?
Bipolar (9-20yrs)
Schizophrenia (10-20yrs)
Alcohol/drugs (9-24yrs)
Recurrent Depression (7-11yrs)
Why does mental health vary across the lifespan?
Onset often associated with periods of stress/ lack of supportive mechanisms
What protective mechanisms can offer support to patients who are struggling with their mental health?
Family/Friends Neighbourhood School/Work Church Health services inc. care services
What developments/ transitions in a patients life can be stressful and cause changes in their mental health?
- Birth
- Separating from parent
- Nursery-Primary-Secondary transition
- Developing adult thinking/ transitioning to being an adult
- Ageing and dying
What age do most mental disorders begin to present and when are most diagnosed?
Most are diagnosed in 20-30s but in hindsight patients recall episodes in their teens that probably stemmed from their mental illness
In what age groups is schizophrenia rarely diagnosed and why?
Early and late onset Schizophrenia are rare
- There is reluctance to diagnose children with schizophrenia
- increasing rates of dementia and psychosis in the elderly make diagnosis difficult
WHy is depression rarely diagnosed in the elderly?
- can be overlooked due to physical illness and loneliness
- Older patients also have “pride and stigma” stopping them from accessing services
Why is Bipolar Disorder rarely diagnosed in CAMHS?
- Rare due to assumptions that mood is labile in adolescence
- fear of medicalising normal adolescence
A diagnosis of Bipolar Affective Disorder in the elderly population is associated with what negative outcomes?
cognitive deficits
increased suicide risk and overall mortality
Personality disorders are usually diagnosed after what age?
18 (but earlier when symptoms are clear, persistent and impair functioning)
What presentations to mental health services are mainly seen in Children and Adolescents (0 – 18 years) ?
Disruptive/Behavioural Disorders
ADHD and Autism Spectrum Disorder
Separation anxiety (SAD) and school refusal
Trauma and Attachment Disorders
What disruptive/behaviour disorders usually present to CAMHS?
Oppositional defiant disorder (ODD) <12 yrs
Conduct disorder (CD) > 12yrs
Why do disruptive/behaviour disorders exist?
Children often cant articulate why they feel down
=> act out to show they are struggling
How are disruptive/behaviour disorders treated?
- Early intervention by parenting/social interventions is key
- Medication rarely required but can be consider in severe cases
What gender is more affected by Autism Spectrum disorder?
M:F = 4:1
How are the impairments of Autism Spectrum Disorder treated?
- through education and social interventions
- Medication rarely required other than to treat main comorbidities (depression, anxiety, psychosis)
How is ADHD treated?
- Medical treatment is key in moderate to severe cases
- MUST be accompanied by social, educational and parenting interventions
What is separation anxiety and when does it normally present?
- SAD and other anxiety disorders lead to school refusal (mostly seen during main transitions)
- Present normally from age 7 months through preschool years
What can occur during childhood to precipitate a trauma and attachment disorder?
- maltreatment and abuse during early childhood
What symptoms are seen in a trauma and attachment disorder?
- PTSD symptoms (anger, avoidance)
- General irritability, anxiety
- Oppositional behaviours
What developmental stages of young children appear similar to presentations of mental illness?
Hyperactivity and short attention span Strangers, separation, specific phobias overtalkativeness Imaginary friends Intense interests
What normal symptoms of secondary school age children may present like a mental disorder?
Mood swings
Sleep changes
Peer pressure influencing thoughts and behaviours
Rituals and OCD type behaviours
What differences are there between the treatment of child and adult mental disorders?
- Medications are commonly unlicenced for under 16s
- Children tend to have less predictable medication responses
- Young children less likely to talk about emotions in psychotherapy
What challenges present in early adulthood causing distress?
Leaving school
Getting a job
Establishing long-term relationships
Buying a house, having children
What challenges normally present in Middle Adulthood?
Maintaining professional/financial security
Managing relationships difficulties (divorce, separation, re-unified families)
Children leaving the home
What are the main challenges of late adulthood?
Preparing for retirement and change of role Dealing with deteriorating physical health Managing bereavements (death of parents)
What is the Puerperium period and why do new mental health diagnoses and existing relapses occur?
(after birth of a baby) Loss of independence/role Hormonal changes Unremitting demands Chronic loss of sleep May have stopped psychotropic meds
What is Puerperium Psychosis?
- Acute onset of psychotic symptoms, mania/disinhibition, confusion
- psychiatric emergency due to safeguarding risks
- presents between 2-4 weeks postpartum
What are the risk factors for developing Puerperium Psychosis?
previous thyroid disorder previous episode family history being unmarried first pregnancy c-section perinatal death
When does Postnatal Depression usually present?
onset 1-4 weeks postpartum
What are the risk factors for developing Post-Natal Depression?
- family or personal history of depression or anxiety
- complicated pregnancy
- traumatic birth
- relationship difficulties
- history of abuse or trauma
- lack of support
- financial difficulties
What mental health problems do the elderly usually have when in hospital?
Dementia
Delirium
What is meant by Pseudo-Dementia?
Fluctuating loss of memory, and vagueness insight into loss of memory Prominent slowing depressed mood improves with psych treatment
Above what age is depression considered late onset?
65
What risk factors are there for late onset depression?
- genetics
- life events (loss of spouse)
- social factors (i.e. Loneliness, financial hardship)
- poor physical health (e.g. vascular disease)
