Mental Health Flashcards
3 types of stress?
A stressor is a perceived threat
Eustress
- good stress
Neustress
- neutral
Distress
- bad, threatening
- acute vs chronicCa
Categories of Stressors
- Psychological (thoughts, beliefs, perceptions)
- Physiological
- Social
- Bioecological
What are Adverse Childhood Experiences
ACEs
Potentially traumatic events in childhood (0-17 yrs)
6/10 adults
Examples of ACEs
- abuse or neglect
- violence (experience / witness)
- family member suicide
- household substance use, MH, instability (parental separation)
Body’s mechanism to survive a perceived threat?
- HPA (hypothalamic-pituitary)
- Nor / epinephrine
- Cortisol
Sympathetic response > Parasympathetic response …in
Chronic stress
How to manage pathologic stress response ?
- Breathing tools
- Movement
- Meditation
- Connect with nature
- Self-expression
- Community
- Reading self-help
- Massage
- Listen to music
10.Light therapy
What is a mental disorder?
(WHO)
Clinically significant disturbance in
- cognition
- emotional regulation
- behaviour
+
Distress
Impairment in function
Causes of MDD / Anxiety
Non modifiable
- genetics, perinatal, social, cultural
Modifiable
- stress, nutrition, financial, sedentary, addictions
Bidirectional association between MDD and T2DM? T/F
True
Insulin mediated mechanism for tryptophan and tyrosine –> serotonin, NA, Dop
Diabetes-related risk factors for suicidal ideation?
- use of insulin
- duration of diabetes > 5yrs
- HbA1c > 6.5 (poor control)
Ppl with depression have higher risk of CAD, through?
- > abnormal platelet adherence
- endothelial dysfunction
- lower HR variability
- Poor adherence to lifestyle changes
MDD and heart disease
Independent risk factor for cardiac events!
Primary RF for IHD
Secondary RF for worse prognosis
15-20% higher cardiac risk
Doubles cardiac events
Modifiable; preceded by a few years
Screening for stress
Perceived Stress Scale (PSS)
10 - item questionnaire
Scale of 0 to 4
Higher score = More stress
(13, 26)
Longer work hours increase heart disease risk?
Yes
Work stress increases T2DM incidence?
Yes
Plus
- smoking
- physical inactivity
- heavy alcohol
(not BP or chol)
Screening for Depression?
What method
PHQ- 2
Over the past 2 weeks, have you felt:
1. down, depressed, hopeless?
2. little interest/pleasure
Rated 0-3
PHQ-2 Positive
Score?
What next?
> = 3
(72% sensitive)
Needs further assessment with
1. PHQ-9
2. HAM-D (Hamilton) (Beck)
3. BDI-II
to check severity
Diagnosis of MDD
Criteria
> = 5 symptoms
Nearly every day for 2 weeks
Change from prior levels of fn
At least one of:
1. Depressed mood most of day
2. Loss of interest or pleasure
4 or more of:
- weight change
- sleep disturbance
- irritability
- fatigue
- feeling worthless / guilt
- diff concentrating / decisions
- suicidal ideation
Screening for Anxiety
No recommendations
fear, worry, excessive apprehension
Brief anxiety screening
GAD-2
In the last 2 weeks, how often
- Nervous, anxious, on-edge
- Not been able to stop or control worrying
Positive if score >= 3
If GAD-2 positive?
Follow up with
- Hamilton Rating Scalen (HAM-A)
- GAD-7
- BAI (Beck Anxiety Inventory)
Diagnosis of anxiety
Crieteria
More than half the days in 6 months:
1. Excessive anxiety
2. Worry difficult to control
At least 3 other:
- restlessness
- easily fatigued
- difficulty concentrating
- irritability
- muscle tension
- sleep disturbance
Significant impairment
Not due to substance use
Not from another cause
Brief screening fro Depression AND Anxiety?
PHQ-4
Over past 2 weeks, how often:
1. nervous, anxious, on edge
2. cannot control worry
3. down, depression, hopeless
4. little interest / pleasure
