Mental Illness Flashcards
What is Dysthymia?
Persistent depressive disorder is characterized by depressive symptoms that last for at least TWO YEARS, with depressed mood present for most of the day, and for more days than not. Dysthymic disorder, a chronic form of MDD, is seen more commonly in the older adult and is associated with symptoms of MDD but lasts for more than 2 years.
Dysthymia is characterized by two of the following factors…?
- Decreased or increased appetite
- Insomnia or hypersomnia
- Low energy
- Poor self-esteem
- Poor concentration
- Hopelessness
Major depressive disorder manifests with 5 or more of the follow s/s…
- Depressed mood**
- Loss of interest or pleasure in most or all activities**
- Insomnia or hypersomnia
- Change in appetite or weight
- Psychomotor retardation or agitation
- Low energy
- Poor concentration
- Thoughts of worthlessness or guilt
- Recurrent thoughts about death or suicide
What are the clinical RED FLAGS for depression?
- Insomnia
- Fatigue
- Chronic pain
- Recent life changes or stressors
- Fair or poor self-rated health
- Unexplained physical symptoms
What enzyme tends to be elevated in people with depression?
Cortisol
What are somatic symptoms
Depression accompanied by (headache, abdominal or pelvic pain, back pain, or other physical complaints)
What population typically has somatic symptoms with depression
pregnant women, older adults, incarcerated individuals, some cultural ethnicities, patients with low incomes, and patients with co-existing medical conditions.
For treatment what age should SSRI’s be avoided and why?
18-29: Avoid SSRI’s because of suicidal risk
> 65: Avoid SSRIs because of Upper GI risk
Difference between anxiety disorder and normal anxiety?
Anxiety disorder effects a person’s functioning and anxiety is present without anxiety producing issue.
What are S/S of a panic attack?
Symptoms may resemble an acute cardiac event with sweating, palpitations, shortness of breath, choking sensation, chest pain, nausea, and lightheadedness.
How is a panic attack characterized?
characterized by recurrent, unexpected panic attacks followed by at least 1 month of persistent concern about having another.
What is a phobia?
A persistent, irrational fear of a particular object, place, or situation referred to as a phobic stimulus. Exposure therapy is usually effective.
Are patient’s aware of OCD?
Although aware of the irrational nature of the thoughts and behaviors, people with OCD feel helpless to interrupt the cycle.
How is OCD manifested?
Patients may experience either obsessions, compulsions, or both. The thoughts or obsessions cause anxiety, which is partly relieved by the compulsive, ritualistic behavior.
The patient may spend great amounts of time carrying out rituals or may go to great lengths to avoid situations associated with the obsessions.
What is social phobia or social anxiety disorder?
Refers to a fear of social or performance situations (such as public speaking) in which embarrassment may occur, resulting in an immediate anxiety response. The fear relates to being judged or humiliated. It can be distinguished from shyness based on the degree of discomfort and social/work impairment that results.
Social phobias are self-reinforcing in that the anxiety about performing interferes with performance—leading to embarrassment—which further reinforces the fear of performing.
How does PTSD Manifest itself?
Follows a traumatic event. The event does not have to be personally experienced or witnessed to have a traumatic effect. Sometimes the patient develops anxiety related to an event that was experienced by someone else and then made known to them.
S/S of PTSD
depression, anxiety, sleep disturbances, sexual dysfunction, or even psychosis.
Intense re-experiencing through traumatic memories is most common and can involve flashbacks or hallucinations.
What are the time frames for PTSD and ASD?
In PTSD, symptoms appear more than 1 month after exposure. If the symptoms appear within 1 month after the traumatic event, a diagnosis of acute stress disorder (ASD) may apply. If unresolved, ASD can progress to PTSD.
Criteria for GAD
Uncontrollable anxiety over a period of at least 6 months.
What has been linked to GAD?
GAD has been linked to heart disease, GI disturbances, and pain disorders. EARLY CHILDHOOD TRAUMA IS A SIGNIFICANT ENVIRONMENTAL FACTOR IN THE DEVELOPMENT OF ANXIETY DISORDERS
s/s of GAD
- Symptoms include restlessness
- Fatigue
- Difficulty concentrating
- Irritability
- Difficulty sleeping
- Muscle tension
- Primary care setting pt may present with unexplained physical symptoms
What are the diagnostic tests for GAD?
New onset of anxiety includes a physical exam, a mental status exam, a medical and psychiatric history, family history of anxiety or mood disorders, and a basic lab profile.
complete blood cell count chemistry profile thyroid function tests urinalysis urine drug screen
Anxiety symptoms can be related to the physiologic effects of caffeine, abusive drugs, and TOC medications. ALL PATIENTS SHOULD BE ASSESSED FOR DEPRESSION, SUICIDAL, AND HOMICIDAL IDEATION.
What is Schizophrenia?
Mental disorder often characterized by abnormal social behavior and failure to realize what is real. These individuals experience auditory and visual hallucinations, disorganized speech, flat affect, impairment in cognition including attention.