Mental Health Flashcards
Cultural variables relating to mental illness
- The way that we perceive mental health and illness as a culture will influence our definition.
- Depression might be thought of as mental illness in some cultures, and a normal mood state in others.
- Our collective moral and religious beliefs might influence our interpretation of symptoms and therefore diagnosis.
What is the WHO definition of mental health?
“a state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively ad fruitfully, and is able to make a contribution to her or his community.”
What are the two standardised sets of diagnostic criteria for Mental Illness in Australia?
DSM-V: The Diagnostic and - Statistical Manual of Mental Disorders (Currently volume 5). The DSM-V is currently the benchmark manual used in Australia for the clinical diagnosis of mental illness.
- ICD-10: The International Classification of Diseases, (Section 10: Classification of Mental and Behavioral Disorders). The ICD 10 is used in Australia to report and categorise diseases internationally. The ICD 10 is often referred to by clinicians but the diagnostic codes are not recorded in clinical practice
Methods for diagnosing mental illness
- Mental State Assessment (MSA)
- Significant medical history
- Social circumstances
- Circumstances of presentation
- Risk assessment
- Assessment is fluid and can change rapidly
Two broad categories of severe and enduring mental illness
1 - psychotic illness - schizophrenia - bi-polar affective disorder - drug-enduced psychosis - psychotic depression 2 - acute disorders that move between moderate and severe, e.g. depression with suicidal intent
Characteristics of schizophrenia
- the presence of psychosis a state in which a persons reasoning and thinking are distorted, leading to a loss of contact with reality
- hearing voices (auditory hallucinations), which are sometimes quite commanding
Pathophysiology of schizophrenia
- strong genetic influence in schizophrenia
- Multiple, interacting genes may be likely in the development of schizophrenia
- Schizophrenia is likely to be caused by a combination of genetic, environmental and neurodevelopmental factors
positive symptoms (exaggeration or distortion of normal function) of schizophrenia
- Hallucinations; commonly auditory. Most people with schizophrenia hear voices or noises in their head. Many also have visual, olfactory and tactile hallucinations.
- Thought disorders such as delusion (illogical or incoherent thinking)
- Disorganised speech and behaviour.
negative symptoms (reduction in normal functioning) of schizophrenia
- Apathy
- Lack of motivation
- Reduction in energy
- Low mood and depression
- Social inactivity
- Isolation
- Loss of pleasure
phases of schizophrenia
There are three distinct stages, often referred to as “phases” that traditionally informed our understanding and diagnosis of schizophrenia.
- Prodromal
- Acute
- Chronic
Not all people move through these phases and they’re not often used in contemporary services, but still useful to identify.
What is the prodromal phase of schizophrenia
- Commonly starts in adolescence.
- Characterised by loss of function
- Social functioning
- Organisation
- Intellectual
- Performing physical activity
Many parents interpret these as normal stages of adolescence, and schizophrenia is rarely diagnosed at this stage without the emergence of acute symptoms.
What is the acute phase of schizophrenia
Characterized by distortion of perception and further loss of functioning.
- Hallucinations
- Delusions
- Decreased self-care
- Isolation
- Acute distress and anxiety
What is the chronic phase of schizophrenia
Characterized by the “burnout” of positive symptoms and increase in negative symptoms:
- Social Isolation
- “Poverty of ideas”
- “Poverty of speech”
The chronic phase might also be a feature of the long term use of older style anti-psychotic medication and major tranquilizers reducing dopamine activity in the frontal cortex of the brain.
Treatment for schizophrenia
Pharmacological therapy Occupational Therapy - Physiotherapy - Cognitive Behavioural Therapy - Social and Welfare needs - Educational and career support - Ongoing support with physical health
pharmacotherapy for schizophrenia
- Anti-psychotic medication
- Typical anti-psychotics include:
- Chlorpromazine
- Haloperidol
- atypical anti-psychotic (2nd generation
- clozapine
- Olanzapine
- Risperidone
- Quetiapine
