mental disorders and physical health Flashcards

1
Q

what is adjustment disorder

A

-Recent psychosocial stressors (illness and move into care)
-Mood changes and focusing on stressors

-Typically resolves after 6 months
-Psychotic symptoms typically not seen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is Psychotic depression

A

-Recent psychosocial stressors
-Older age and chronic medical conditions are risk factors

-No other core features of depression (anergia, anhedonia) or biological symptoms reported
-Paranoid psychosis rare. Typically a mood congruent psychosis is seen (delusions of nihlism, guilt, Cotard’s syndrome)
-Visual hallucinations uncommon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is Behavioural and psychological symptoms of dementia (BPSD)

A

-recent stoke
-Delusions and hallucinations
-Ongoing vascular risk factors and advancing age (main risk factor for dementia)

-Normal score on MoCA
-No cognitive concerns raised by carers
-BPSD typically a feature of more advanced disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is post stroke psychosis- where it occurs, typical symptoms and management

A

-commonly after right MCA lesion affecting frontal and temporal regions
-delusion
-auditory hallucinations (followed by visual)

managemnt:
-some response to antipsychotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

antipsychotic use in those with dementia increases the risk of what?

A

stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

common type of delusion in post stroke psychosis

A

persecutory or jealous type (Othello’s syndrome)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

physical illness causing mental illness -addison’s disease

A

depression, poor concentration, irritability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

physical illness causing mental illness -hyperglycaemia

A

depression, anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

physical illness causing mental illness -hyperthyroidism ✯

A

anxiety, mania

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

physical illness causing mental illness -hypothyroidism✯

A

depression, cognitive impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

physical illness causing mental illness - cushing’s syndrome✯

A

depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

physical illness causing mental illness -HIV

A

psychosis, dementia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

physical illness causing mental illness -SLE

A

depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

physical illness causing mental illness - cancer

A

depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

physical illness causing mental illness -parkinson’s disease✯

A

depression , anxiety, dementia, psychosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

physical illness causing mental illness -phaeochromocytoma✯

17
Q

physical illness causing mental illness -dementia✯

A

psychosis, aggression/violence, depression, anxiety

18
Q

physical illness causing mental illness - Huntington’s disease✯

A

psychosis, aggression/violence, cognitive impairment, depression, anxiety

19
Q

medication adverse effects- dopamine agonist✯

20
Q

medication adverse effects-L-dopa

A

psychosis, delirium, anxiety, depression

21
Q

medication adverse effects- steroids (prednisolone) ✯

A

depression, mania, psychosis, anxiety

22
Q

medication adverse effects-isoniazid (Tb ab)

A

mania, psychosis

23
Q

medication adverse effects-anticholinergics✯

A

delirium, anxiety, psychosis

24
Q

medication adverse effects-isotretinoin (roaccutane)

A

depression

25
medication adverse effects-digoxin
depression, psychosis
26
medication adverse effects- Interferon alpha
depression, mania, psychosis
27
what is the mortality gap
people with chronic mental illness are at greater risk of all cause mortality
28
cause of mortality gap/impact on physical health with those with mental illness
-med adverse effects (ie. weight gain, sedation) -increase smoking, alcohol rate -poor diet and exercise -chaotic life style and low socioeconomic status
29
management of mortality gap/impact on physical health with those with mental illness
-choose medication that minimise impact on physical health -monitor cardiometabolic factors (ie MBI/HbA1c) -smoking cessation -dietary advice -drugs and alcohol support service
30
what is delirium
acute confusion state and neuropsychiatric manifestation of physical illness/injury/intervention can be considered as 'acute brain failure' compared to 'chronic brain failure' - dementia
31
3 types of delirium
hyperactive- agitation, hallucination, inappropriate behaviour hypoactive-lethargy, reduced concentration, reduced alertness, reduced oral intake mixed-combo of above
32
risk factor of delirium
older people frail poor nutrition cognitive impairment etc
33
common cause of delirium
Physical illness or injury (e.g. infection, constipation, urinary retention, electrolyte disturbance, pain, acute vascular events, dehydration
34
pathological cause of delirium
poorly understood and likely multi-factorial Delirium involves various brain processes like inflammation, vascular dysfunction, altered metabolism, neurotransmitter imbalance, and impaired connectivity
35
delirium management
1. address modifiable risk factors 2.optimise co-morbidities treatment 3.treat underlying cause 4.re-orientation strategy 5.normalise sleep-wake cycle 6. maintain safe mobility to avoid falls
36
what to do in challenging behaviours in delirium
-verbal and non-verbal de-escalation technique -in extremis- short term pharmacological interventions (ie. low dose Haloperidol [0.5mg] for<7days)
37
what affects diagnosis of physical disorders in people with mental illness
-illness behaviour (ie. poor insight/mistrust in others, chaotic lifestyle) -diagnostic overshadowing (misattribution of physical symptoms to psychiatric symptoms) -lack of resources/access to service (low socio-economic status=RF for mental disorder development)