mental wellbeing and psychiatric illness Flashcards
childhood risks for poor mental health
7
- parental use of alcohol, tobacco and drugs during preganancy
- maternal stress during pregnancy
- low birth weight with impaired cognitive and language development
- poor parental mental health
- parental unemployment
- child abuse and adverse experiences
- use of cannabis
adulthood risks of poor mental health
9
- lower income and debt
- violence
- stressful life events
- houseing
- fuel poverty
- unemployment
- suicide is assoc with mental illness, physical illness, alchohol and drug missuse
- certain personality traits
- experience of abuse
common anxiety disroders
9
- generalised anxiety disorder
- panic disorder
- phobias
- social anxiety disorder
- post-traumatic stress disorder
- obsessive compulsive disorder
- health anxiety
- body dysmorphic disorder
- perinatal anxiety or perinatal OCD
generalised anxiety disroder
means having regular or uncontrollable worries about many different things in your everyday life. Because there are lots of possible symptoms of anxiety this can be quite a broad diagnosis, meaning that the problems you experience with GAD might be quite different from another person’s experiences.
* Excessive – more than someone else
* Persistent – doesn’t go away
* Unreasonable – shouldn’t be worried
panic disorder
- means having regular or frequent panic attacks without a clear cause or trigger. Experiencing panic disorder can mean that you feel constantly afraid of having another panic attack, to the point that this fear itself can trigger your panic attacks.
phobia
extreme fear or anxiety triggered by a particular situation (such as going outside) or a particular object (such as spiders).
social anxiety disorder
experience extreme fear or anxiety triggered by social situations (such as parties, workplaces, or everyday situations where you have to talk to another person). It is also known as social phobia.
PTSD
develop anxiety problems after going through something you found traumatic. PTSD can involve experiencing flashbacks or nightmares which can feel like you’re re-living all the fear and anxiety you experienced at the time of the traumatic events.
OCD
anxiety problems involve having repetitive thoughts, behaviours or urges.
depression definition
dental relevance
characterized by depressed or sad mood, diminished interest in activities that used to be pleasurable, weight gain or loss, psychomotor agitation or retardation, fatigue, inappropriate guilt and difficulties concentrating, as well as recurrent thoughts of death.
raise idea of depression if pt has change in behaviours, withdrawal, low mood. Be patient with them and empathetic
defer tx until depression is under control but prevention is key
* Careful with drugs – interactions
* Dry mouth – oral candidiasis, inc caries risk, reduced OH
* Have inc sugar due to xerostomia
main neurotransmitters focussed on by anti-depressant drugs
Serotonin, norepinephrine, dopamine
dental implications/complaints related to depression
- Chronic facial pain
- Burning mouth or sore tongue (oral dysaesthesia)
- Temporomandibular dysfunction syndrome
- discharges (of fluid, slime or powder coming into the mouth)
- dry mouth or sialorrhea despite normal salivary flow
- spots or lumps
- halitosis
- disturbed taste sensation.
tardive dyskinesia
Involuntary movements of the tongue, lips, face, trunk, and extremities
It affects about 15–20% of patients who have been receiving antipsychotics including neuroleptics and atypical antipsychotics for many years, but sometimes only for short periods.
The symptoms of TD are usually mild so that the patient may be unaware of the movements. TD does not respond to withdrawal of the causative drug or to any other medication.
psychosis
lose some contact with reality.
might involve seeing or hearing things that other people cannot see or hear (hallucinations) and believing things that are not actually true (delusions).
hallucinations
Where a person hears, sees and, in some cases, feels, smells or tastes things that do not exist outside their mind but can feel very real to the person affected by them; a common hallucination is hearing voices.
delusions
where a person has strong beliefs that are not shared by others; a common delusion is someone believing there’s a conspiracy to harm them.
posssible causes of psychoses
Schizophrenia– a condition that causes a range of psychological symptoms, including hallucinations and delusions
Bipolar Disorder – a mental health condition that affects mood; a person with bipolar disorder can have episodes of low mood and highs or elated mood.
severe depression – some people with depression also have symptoms of psychosis when they’re very depressed
possible triggers:
* a traumatic experience
* stress
* drug or alcohol misuse
* side effects of prescribed medicine
* a physical condition, such as a brain tumou
bipolar disorder
patient would have severe mood swings. These usually last several weeks or months and are far beyond the emotional ups and downs that most of us experience
types
* low/depressive
* high/manic
* hypomanic
* manic (mix highs and lows)
1 in every 50 adults will have bipolar disorder at some point in their life. It usually starts between the ages of 15 to 25 - and rarely after the age of 50
mania
bipolar disorder
During a manic phase of bipolar disorder, they may feel very happy and have lots of energy, ambitious plans and ideas.
They may spend large amounts of money on things they can’t afford and wouldn’t normally want.
depression
bipolar disorder
Feel very sad, down, empty, or hopeless
Have very little energy and have decreased activity levels
Have trouble sleeping, they may sleep too little or too much
Feel like they can’t enjoy anything and feel worried and empty
Have trouble concentrating, forget things a lot
Eat too much or too little
Feel tired or “slowed down”
Think about death or suicide
depression bipolar disorder impact on oral health
decline in OH
inc caries
inc perio
mania bipolar disorder impact on oral health
overzealous use of OH aids resulting in NCTSL (abrasion)
schizophrenia
disorder of the mind that affects how you think, feel and behave.
“Fundamental and characteristic distortions of thinking and perception.”
affects around 1 in every 100 people over the course of their life.
* men and women equally and seems to be more common in city areas and in some ethnic minority groups.
* rare before the age of 15, but can start at any time after this, most often between the ages of 15 to 35.
* For every 5 people, 1 get better in first 5 year of symptoms, 3 will get better but will have times when they will get worse again and 1 have troublesome symptoms for long period of time
Mild – go unrecognisable – flatness of mood, loss of social conduct/inappropriate social behaviour, attempts of communication met by irrelevant remarks, delusions in oral symptoms
symptoms of schizophrenia
hallucinations
delusions
‘paranoid’ delusions
ideas of reference
muddled thinking
feelings of being controlled
withdrawla or lack of function
tx for schizophrenia
medications
CBT
psychotherapy
dental implications of schizophrenia
Haloperidol and phenothiazines may cause orthostatic hypotension. Patients should be raised slowly and carefully assisted from the dental chair.
The long-term use of neuroleptics can lead to xerostomia (with susceptibility to candidiasis and caries, and, occasionally, ascending parotitis), oral pigmentation and severe extrapyramidal symptoms.
facial dyskinesia’s: frequently involving the bulbar or neck muscles, with subsequent difficulties in speech or swallowing. Alternatively, there may be uncontrollable facial grimacing (orofacial dystonia)
Haloperidol and clozapine can cause hypersalivation.
eating disorders
examples
anorexia nervosa
bulima nervosa
binge eating disorder
ARIF - avoidant/restrictive food intake disorder
denta implications of eating disorders
- Erosive toothwear
- loss of OVD
- poor quality dentine bonding
- sensitivity
- xerostomia
- Sialosis
- Palpitations (vomiting disturbs the balance of salts in your blood)
- feel weak
- feel tired all the time
- experience huge weight swings
- damage kidneys
- have epileptic fits
xerostomia
effects
management
chewing, swallowing (dysphagia), speech (dysarthria), taste (dysgeusia), and QoL
higher risk of caries, perio, candida, sialdenitis, pros difficulties
oral gel or lubricants - coat and protect lips and soft tissues
pilocarpine HCl - enhance salivary secretions in pt who have some oral functional salivary glands
stimulation by sugar free chewing gum
saliva repalcement - sips of water, Oral Balance Gel, saliva orthana
