Medical Disorders

Question 1

When should doctors get involved?

Answer 1

A medical doctor should evaluate clts if they have any of the following:
● Sudden cognitive or behavioral changes, e.g. mood or personality
● Hx of head trauma
● No prior hx of a psych disorder
● Symptoms w/o presence of a known medical dx, e.g. hyperactivity, inattentiveness, difficulty concentrating, irritability, sleeping issues, eating issues, pain, and/or restlessness
● Depression that occurs for the first time after age 55
● Rashes, swelling, drooping eyelid, facial tic

Question 2

Prader-Willi Syndrome

Answer 2

• Cause: Genetic Disorder that can result in intellectual disability
• Medical Symptoms: Muscle weakness, short stature, obesity, can cause child to experience extreme hunger resulting in childhood obesity and/or Type 2 Diabetes
• Psychiatric Symptoms: Temper outbursts, stubbornness, compulsive behaviors (e.g. skin picking), sleep abnormalities

Question 3

Hyperthyroidism

Answer 3

• Cause: Excessive thyroid hormones
• Medical Symptoms: Weight loss or increased appetite, palpitations, heat intolerance
• Psychiatric Symptoms: Anxiety, depression, hyperactivity, restlessness, agitation, fatigue

Question 4

Hypothyroidism

Answer 4

• Causes: Reduced thyroid activity and lower hormone levels
• Medical Symptoms: Weight gain, cold intolerance, psychomotor retardation, muscle cramps
• Psychiatric Symptoms: Fatigue, apathy, depression, anxiety, irritability, impaired memory, rapid onset of hypothyroidism can also cause delirium and psychosis

Question 5

Vitamin Deficiencies (e.g. vitaminD, B-1, B-12, and Folate)

Answer 5

• Causes: Limited sunlight exposure (D), unbalanced diets or vegan/vegetarian diets (Folate and B-1), alcoholism (B-1), and malabsorption due to medications (B-12)
• Psychiatric Symptoms: Fatigue, depressed mood, anxiety, agitation, memory loss; Mania and psychosis can accompany a B-12 deficiency

Question 6

Sleep Disorders

Answer 6

• Medical Symptoms: difficulty falling asleep, waking up early, having trouble staying
  asleep, abnormal breathing during sleep (sleep apnea), excessive sleepiness and sleep attacks at inappropriate times (narcolepsy)
• Psychiatric Symptoms: Depression, anxiety, difficulty concentrating, irritability

Question 7

Traumatic Brain Injury (TBI)

Answer 7

• Cause: Brain injury caused by direct impact or secondary indirect injuries
• Medical Symptoms: Cognitive impairments, dizziness, headaches, difficulty sleeping, vomiting, numbness, loss of consciousness
• Psychiatric Symptoms: Irritability, depression, anger, rage, behavioral problems (e.g., impulsivity, aggression, hyperactivity, and cognitive deficits)

Question 8

Parkinson Disease

Answer 8

• Cause: Degeneration of brain neurons
• Medical Symptoms: Movement abnormalities (e.g., tremors [often resting tremor in hands], rigidity, akinesia [muscle rigidity], and bradykinesia [slowness of motion])
• Psychiatric Symptoms: Cognitive changes, depression, impaired memory and concentration, slowed psychomotor activity, anxiety (e.g., social phobia and panic disorder), restricted affect,
  fatigue; Hallucinations and delusions can also arise either spontaneously or in association w/ mood disturbances, although it usually only develops later in disease process

Question 9

Lyme Disease

Answer 9

• Cause: Bacterial infection, often from a deer tick bite
• Medical Symptoms: Joint pain, flu-like symptoms, neurological problems, large rash
• Psychiatric Symptoms: Depression, mania, delirium, dementia, psychosis, obsessions and compulsions, panic attacks, and personality change

Question 10

Multiple Sclerosis

Answer 10

• Cause: unknown; may be combo of genetic, immunologic and environmental factors, considered an immune mediated disease in which the
  immune system attacks its own tissues and eats away at protective covering of nerves,
  resulting nerve damage disrupts communication b/w brain and body.
• Medical Symptoms: fatigue, difficulty swallowing, vision issues (blurriness and/or pain), changes in gait, loss of balance or coordination, loss of bladder and/or bowel control, speech difficulties, muscle stiffness, weakness and spasms, numbness and tingling
• Psychiatric Symptoms: Anxiety, mood swings, and depression (some studies report a lifetime prevalence of depression of around 50%); erectile dysfunction or sexual dysfunction; issues around thinking, learning and planning