Mental Health Flashcards
Which scales are often used for the diagnosis of mental health conditions?
DSM-V
ICD-10
PHQ-9
What are the characteristic symptoms of schizophrenia that help with diagnosis?
- Delusions
- Hallucinations
- Disorganised speec
- Grossly disorganised behaviour
- Negative symptoms
- Social or occupation dysfunction
- Signficant duration (more than 6 months)
What is the ‘dopamine hypothesis ‘in schizophrenia?
Drugs which increase dopamine in the CNS (such as amphetamine) produce psychotic like symptoms in some instances
Dopamine blockade seems to be linked to acute antipsychotic effect (at least in some individuals)
Glutamate and serotonin also play a role
What are the main positive symptoms of schizophrenia?
Hallucinations
- Hearing voices
- May also include smell, taste and touch
Delusions
- Paranoid
- Grandiose
- Idease of reference
Thought disorder
Passivity phenomena
What are the main negative symptoms of schizophrenia?
Slowed down through and movement
Indifferent to social contact
Lack of interest in previously pleasurable things
What are the long term treatment goals of schizophrenia?
Symptom control
Prevent relapse and re-admission
Ensure tolerability / safety
Improve quality of life
Improve social functioning
Reduce cost
What are the main symptoms of depression?
Low mood
Other symptoms include:
- Sleep disturbances
- Weight gain or loss
- Suicidal thoughts
- Feelings of guilt
- Restlessness
- Reduced concentration
- Reduced self-esteem
- Pessimistic views
If someone has lost someone close to them recently, can you still treat them for depression?
Yes
The ‘bereavement exclusion’ has been eliminated
What are the main possible causes of depression?
Psychological such as adverse life events
Genetic factors
Biochemical
Drug causes
Concurrent chronic illness
What is the ‘monoamine hypothesis’ in depression?
A depletion in the levels of serotonin, noradrenaline and/or dopamine in the CNS leads to depression
Appears to be supported by efficacy of classical antidepressants
- Forms the basis of most current pharmacological approaches
Only part of the story
What treatment options are available for depression?
Watchful waiting
Social interventions
Sleep and anxiety management
Exercise
Psychological Treatments
- CBT
- Problem solving
- Guided self-help
- Interpersonal therapy
Medication
ECT
PHQ-9 Score interpretation
0-4 = None 5-9 = Mild 10-14 = Moderate 15-19 = Moderate-Severe 20-27 = Severe
What are the main challenges with clinical trials in psychiatry?
Recruitment challenges
- Informed consent?
What are appropriate outcome measures?
Length of time required for meaningful follow-up
Conditions which fluctuate in their natural course
What are the main considerations when choosing an antidepressant?
Safety
- Previous antidepressant history
Effectiveness
- Previous antidepressant history
Tolerability
- Previous antidepressant history
Cost
What do patients need to know when prescribed antidepressants?
Antidepressants are one tool to combat depression, they cannot fix all problems
Treatment should be continued for at least 6 months after recovery
Depression often reoccurs
The chances of staying well are improved by antidepressants
Some people need treatment for several years
Antidepressants are not addictive
Antidepressants should not usually be stopped or changed suddenly – discontinuation effects may occur (if been taking for more than 4 weeks)
