Mental illness Flashcards
Presentation of serious depression?
Anhedonia (loss of interest or pleasure) along with >4 of the following nearly everyday for at least 2 weeks: Suicide plan or ideas of self harm Unexplained guilt or worthlessness Inability to function Concentration impaired Impaired appetite Decreased sleep/early waking Energy low/unaccountable fatigue
Management of depression involves?
Psychological treatment
Anti-depressants
Lithium/valproate prophylaxis
When is physical treatment required in depression?
If delusions or hallucinations are present
What reasons for hospital admittance are there in depression?
Social circumstances (children involved)
High suicide drive
Isolation
What is the first line treatment for depression in middle age?
SSRI (Citalopraom, fluoxetine, paroxetine, sertraline)
Risk factors for depression?
Female
Past history
Significant physical illness causing disability or pain
Other mental health problems
Name a common tricyclic antidepressant
Amitryptiline
What is neurosis?
Maladaptive psychological symptoms not due to organic causes and usually precipitated by stress
Symptoms of anxiety?
Tension Agitation Feelings of impending doom Trembling a sense of collapse insomnia poor concentration hyperventilation headaches sweating palpitations poor appetite nausea 'lump in the throat' excessive concern about self and bodily functions
Causes of anxiety?
Genetic predisposition
Stress
Events (losing/gaining a spouse, moving house)
What are the treatment options for anxiety?
Symptom control Regular (non obsessive) exercise Meditation CBT Behavioural therapy Drugs Progressive relaxation training Hypnosis
What are the drug options for anxiety
Benzodiazepines (diazepam) SSRIs (paroxetine) Azapirones (buspirone) Antihistamines Beta blockers
Causes of delirium?
Infection Drugs Raised or lowered U&Es Hypoglycaemia Hypoxia Increased PaC02 Epilepsy Alcohol withdrawal Trauma Surgery
If agitation is distressing a delirious patient and non drug methods have not worked what medication should be considered?
Haloperidol (antipsychotic)
What is the MMM approach to agitation?
Music
Muscle relaxation
Massage
