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Mental Health Flashcards

1
Q

What are the features of dental anxiety?

A

Normal state
- Managed with communication and trust
- Can develop into panic disorder
- Extremely difficult with mental health issues superimposed on top of this

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2
Q

What % experience a mental disorder in their life time?

A

50%

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3
Q

What are some of the comorbidities of mental health disorders?

A

Obesity

Asthma

COPD

Hypertension

Life expectency- can be reduced by 10-20 years (schizophrenia, schizoaffective, bipolar)

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4
Q

What are the dental impacts of mental health disorders?

A

More susceptible to oral disease:
poor OH
poor diet
dental phobia
difficulty registering
costs
difficulty in access
adverse orofacial side effects caused by antipsychotics and antidepressants- xerostomia

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5
Q

What is the issue with mental health training for dentists?

A

No current training on dealing with mental health emergencies

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6
Q

What are the general impacts of good mental health?

A
  • Improved educational attainment- better job
  • Greater productivity
  • Less sickness absence
  • Better physical health
  • Reduced mortality
  • Reduced risk of suicide
  • Increased social interaction
  • Reduced risk taking behaviour- smoking, drugs, alcohol
  • Increased resilience
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7
Q

What are some examples of protective factors against mental health issues?

A
  • Genetics
  • Family background (loving safe environment)
  • Personality
  • Age
  • Gender
  • Marital status
  • Social support
  • Socioeconomic factors- access to resources
  • Reduced inequality
  • Employment- purposeful activity
  • Community factors- participation
  • Self esteem
  • Autonomy
  • Altruism
  • Emotional and social literacy
  • Physical health
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8
Q

What are some of the causes in children of poorer mental health?

A
  • Parental use of alcohol, tobacco and drugs during pregnancy
  • Maternal stress during pregnancy
  • Parental poor mental health
  • Low birth weight
  • Impaired cognitive function and language development as a child
  • Unemployed parents
  • Child abuse
  • Use of cannabis (at young age)
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9
Q

What are some of the causes of poorer mental health in adulthood?

A
  • Lower income
  • Debt
  • Violence
  • Stressful life events- bereavement
  • Unstable housing
  • Fuel poverty
  • Unemployment
  • Suicide
  • Personality traits
  • Abuse experience
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10
Q

What are the features of generalised anxiety disorder?

A
  • Regular uncontrollable worries about things in every day life
  • Individual to each person
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11
Q

What are the features of panic disorder?

A
  • Frequent panic attacks without clear cause or trigger
  • Constant fear of having another panic attack (can be a trigger)
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12
Q

What is a phobia?

A

Extreme fear or anxiety triggered by particular situation or object

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13
Q

What is a social anxiety disorder?

A

Fear or anxiety triggered by social situations
- Parties, workplaces, talking to others

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14
Q

What are the features of PTSD?

A

Development anxiety problems after going through traumatic experience
- Flashbacks
- Nightmares
- Reliving fear and anxiety of traumatic event

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15
Q

What is OCD?

A

Occurs when anxiety causes repetitive thoughts, behaviours, urges, obsessions

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16
Q

What is health anxiety?

A

Obsessions and compulsions related to illness
 Researching symptoms and thinking they have them

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17
Q

What is body dysmorphia disorder?

A

obsession and compulsions relating to physical appearance

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18
Q

When does perinatal anxiety occur?

A

During pregnancy or first year after giving birth

19
Q

What are the symptoms of depression?

A
  • Low mood
  • Diminished interest in activities
  • Weight gain or loss
  • Psychomotor agitation or retardation
  • Fatigue
  • Inappropriate guilt
  • Difficulty concentrating
  • Recurrent thoughts of death
  • Sleep issues
20
Q

What are the causes of depression?

A
  • Stressful events- bereavement, relationship breakdown
  • Personality traits- low self-esteem, overly self-critical
  • Genetics
  • Life experience
  • Family history
  • Giving birth
  • Loneliness
  • Alcohol and drugs
  • Illness
21
Q

What are the dental impactions of depression

A
  • Less likely to seek treatment
  • Chronic facial pain
  • TMD
  • Burning mouth- oral dyaesthesia
  • Somatoform issues- spots/lumps, dry mouth, excess salivation, halitosis, disturbed taste
22
Q

What is a tardive dyskinesia?

A

Involuntary movements of tongue, lips, face, trunk, extremities
 Associated with antipsychotics (atypical), neuroleptics
 Mild- patient may be unaware
 Does not respond to removal of medication

23
Q

What is psychosis?

A

Loss of contact with reality
 Auditory/visual/gustatory/olfactory hallucination
 Delusions- believing things that are not true (belief not shared by others- conspiracy to harm patient)

24
Q

What are some of the causes of psychosis?

A
  • Schizophrenia
  • Bipolar- mood disorder, episodes of low mood or elation
  • Severe depression
  • Trauma
  • Stress
  • Drug/alcohol misuse
  • Side effects of prescribed medicine
  • Brain tumours
25
What is bipolar?
Severe mood swings (out with cyclothymic mood changes) - Lasts weeks or months
26
What are the different phases of bipolar?
Low mood/depressive phase- intensely low feeling, depressed, despairing High/mania- elation, overactivity, grandiose delusions, spending issues Hypomanic- mood is high but not as extreme Manic- mixture of depression and mania (restless)
27
How common is bipolar?
Affects 1 in 50 -> Usually starts between age 15-25 (rarely after 50)
28
What are the dental implications of bipolar?
Depression phase- decline in OH, increased caries/periodontal disease Mania- NCTSL due to overzealous OH
29
What is schizophrenia?
Disorder of mind affecting how patient thinks, feels, behaves -> Fundamental distortions of thought and perception
30
What are the epidemiological features of schizophrenia?
 Affects 1 in 100 people  M=F  Usually occurs between 15-35 (rare before age 15)
31
What are the symptoms of schizophrenia?
* Hallucination- hearing voices (rude, critical, abusive, irritating), discomfort in body, feeling of being touched or hit * Delusion- unrealistic thoughts and beliefs that patient is completely sure of (can be inexplicable- not related to culture, background or religion) * Paranoia- person feels persecuted or harassed (spied on by government, partner being unfaithful) * Ideas of reference- patient sees special meaning in ordinary day to day events (connection to radio or TV- feeling someone is telling them to do things) * Thought disorder- difficulty concentrating (issues finishing tasks, working, studying) * Issues with memory * Feeling of being controlled- thoughts suddenly disappear, thoughts are not their own, body is being taken over * Loss of motivation/energy * Loss of interest in life * Isolation * Stop taking care of themselves- washing, tidying * Issues with social interaction
32
How is schizophrenia treated?
- Medication- tablet form, capsules, syrup, depot injection - CBT - Counselling - Supportive psychotherapy
33
What are the dental implcations of schizophrenia?
- Haloperidol/phenothiazines can cause orthostatic hypotension (raise slowly from supine position in chair) - Xerostomia- long term use of neuroleptics (candidiasis, caries, parotitis) - Oral pigmentation - Extrapyramidal symptoms- facial dyskinesia, issues swallowing, issues speaking, uncontrollable grimacing (dystonia) - Haloperidol and clozapine- hypersalivation
34
What is schizoaffective disorder?
affects thoughts, emotions and actions - Combination of psychoses and Bipolar - Clear symptoms present for most of the time for more than 2 weeks
35
What are the types of schizoaffective disorder?
SD manic type- psychotic and manic symptoms in one episode SD depressive type- psychotic and depressive symptoms Mixed- both manic ad depressive symptoms, psychotic symptoms are independent
36
What are the signs/symptoms of annorexia nervosa?
- Worrying about weight - Calorie counting- eating less, excluding certain food groups - Excess exercise - Being below safe weight - Smoking or chewing gum to keep weight down - Checking weight/appearance in mirrors obsessively - Withdrawal from social situations that involve eating - Wearing baggy clothes - Water loading before being weighed - Avoiding mealtimes - Loss of interest in sex - OCD symptoms- sticking to rigid routines and times, difficulty in spending money, need to study or work all the time
37
How common is AN in 15 year olds?
Girls- 1/150 Boys- 1/1000
38
What are the features of bulimia nervosa?
* worry more and more about their weight * binge eat * make themselves vomit and/or use laxatives or other ways to get rid of calories * have irregular menstrual periods * feel tired * feel guilty * stay a normal weight, in spite of their efforts to diet
39
What is ARIF?
avoidant/restrictive food intake disorder (not caused by worry about weight and body image)
40
What are the psychological signs and symptoms of eating disorders?
* Psychological- poor sleep * issues concentrating, depression * loss of interest in others * obsession about food and eating (and cleaning/washing etc)
41
What are the physical signs and symptoms of eating disorders?
- finding it harder to eat (stomach shrunk) - Feeling tired, weak, cold (metabolism slows) - Constipation - Changes in hair- falls out - Dry skin - Not growing to full height/loss of height - Brittle bones- OP - Unable to ger pregnant - Damage to liver - Death
42
What are the implications of vomiting seen in eating disorders?
- Erosive tooth wear - Sialosis - Palpitations- disturbed salt balance in blood - Feeling weak and tired - Weight swings - Damaged kidneys - Epileptic fits - Issues with getting pregnant
43
What are some of the effects of laxatives used by patient with eating disorders?
- Persistent stomach pain - Swollen fingers - Issues going to toilet without using laxatives (damage caused by medication to bowel muscles) - Weight swings- loss of fluid on purging
44
What are the dental implications of eating disorders?
NCTSL -> Loss of vertical dimension -> Dento-alveolar compensation -> affects quality of dentine for bonding -> Use of resin-based materials Xerostomia Sensitivity

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