Mental health Flashcards
Safety plan - for suicide risk
- Identifying triggers/warning signs
- Creating a safe environment (get rid off lethal means)
- Identify reasons to live
- Internal coping strategies
- Family and friend support - being with them
- Professional contacts/access line
CHILDREN- Eating disorders
Indicators for Admission
- Temp< 35.5
- QTC: >450
- HR <50
- BP <80/50
- Hypokalaemia/neutropenia
- Postural drop >20mm
ADULTS- Eating disorders
Indicators for Admission
(note mental health admission cut offs less severe than medical admission)
- BMI <14
- SPB <90
- postural drop >10
- temp <35.5
- Na <130
- K <3
- Neutrophils <1.5
- Suicidal/ self harm/ high distress
Differentials (mental health diagnoses) for psychotic symptoms
- Schizophrenia
- Schizophreniform disorder
- First episode psychosis
- Drug induced psychosis
- Schizoaffective disorder
- Bipolar 1
Clozapine monitoring bloods & ECG
–Troponin
weekly first 6 we
eks then 3monthly
–FBC (agranulocytosis)
weekly for first 18 weeks then monthly
–Fasting BGL and lipids
3 months then 6 monthly
–ECG
Weekly to 4 weeks then at 3 months
– Annual Echo
- clozapine levels
Risk factors for suicide
- Access to means
- Previous attempts
- Family history of suicide
- Drug or etoH abuse
- Writing letter, giving away possessions
Psychological principles of first aid
- Promoting calm (acknowldge normalcy of symptoms)
- Promoting sense of safety (that was then, youre safe now)
- Promoting the sense of self efficacy (what has helped in the past when you’ve been overwhelmed to help overcome this)
- Promoting connectedness (is there someone you can spend some time with)
- Instill hope (Im confident you will get through this)
Acute stress disorder time frame
- 3 days to 1 month
Symptoms for stress disorder (main categories)
- Arousal symptoms
- Avoidance symptoms
- Dissociative symptoms
- Negative mood
- Intrusion symptoms
Trauma informed care based answer
- Safety (prioritise, are you safe at home)
- Foster capacity to soothe arousal
- Validate
- Colllaborate and empower
- Connect and stay involved
SSRI or SNRI for first line treatment of OCD?
SSRI
Difference between BPD and histrionic personality disorder
BPD has more
- Self destructive behaviour
- Angry disruptions
- Feelings of emptiness
Anti-depressant medications with higher chance of discontinuation symptoms:
Paroxtine
Venlafaxine
Desvenlafaxine
Duloxetine
Anti-depressant medication with least discontinuation symptoms
Fluoxetine
Depression in the elderly (what time of day are symptoms worse)
Morning
(diurnal too)
