MH and Psych Flashcards
Diagnostic criteria for depression
5+ symptoms (including 1 & 2) in a 2 week period:
1. depressed mood or anhedonia
2. loss of interest in daily activities
3. change in weight/appetite
4. insomnia/hypersomnia
5. psychomotor agitation or retardation
6. loss of energy/ fatigue
7. inappropriate guild or sense of worthlessness
8. impaired concentration or indecisiveness
9. suicidal thoughts, ideation, or attempt
Symptoms cause significant distress or impairment
Episode is not attributable to substance or medical condition
Episode is not better explained by psychotic disorder
Patient has not had previous manic or hypomanic episodes
Risk factors of depression
Increased risk of situational depression
- living alone
- lack of social support
Living in LT care
Diseases and medications
- parkinson’s
- alzheimer’s
- CVA
Medical management of depression
Serotonin reuptake inhibitors (SSRIs)
- Cymbalta
- Zoloft
> Side effects of nausea, dizziness
Electroconvulsive therapy
Bipolar Disorder
Much less common
Manic –depressive disorder
Bipolar I-typical
Bipolar II-not as manic
Cyclothymic-both milder
Substance related
Disease related
Symptoms of bipolar disorder
Distractibility
Impulsivity
Grandiosity
Flight of ideas
Activity increase
Sleep deficit
Talkativeness
Medical management for bipolar disorder
Mood Stabillizers
- Lithium
Antipsychotics
- Abilify
- Risperdal
Occupational Deficit
- Left over from adulthood
- Added issue of falls, safety with adgitation
Generalized anxiety disorder
Feelings of excessive worry about events, activities, and situation
Obsessive-compulsive disorder
Unwanted recurring thoughts and compulsive, repetitive behaviors
Post-traumatic stress disorder
Extreme anxiety and distress symptoms due to being exposed to a traumatic event
Panic disorder
Intense and recurring panic attacks that occur unexpectedly
Social anxiety disorder
Feelings of extreme anxiety in social situations
Specific phobias that may cause issues for the elderly
Agoraphobia: afraid to leave environments they know or consider to be safe
Sociophobia: fear of social gatherings, fear of embarrassment in social situations that is extremely intrusive and can have debilitating effects on relationships.
Trypanophobia: overwhelming, extreme fear of medical procedures that involve needles
Late onset schizophrenia
Hallucinations often auditory
Off the wall delusions
Impaired executive function
Criteria:
- Onset after 60
- Presence of fantastic (new ruler of Russia), persecutory (being tracked) (, referential (t swift is bff), or grandiose (i’m the smartest person in the room) delusions, with or without hallucinations
- Absence of primary dementia
- Absence of primary affective disorder
- No clouding of consciousness
- No history of neurological illness/alcohol or substance abuse
- Normal hematological/biochemical screen
Psychosis with dementia
Often occurs with Alzheimer’s disease, Parkinson’s or others.
Hallucinations tend to be visual
Delusions of:
- Harm
- Theft
- “Normal things” that aren’t true
What is delirium?
Begins suddenly and develops quickly
Defined starting point
Temporary and reversible
Difficulty paying attention
Caused slowed and slurred speech
What is dementia?
Begins gradually and progresses
Uncertain starting point
Permanent and worsens
Difficulty remembering
Causes forgetfulness of words
Causes of delirium
(P)ain
(I)nfection
(N)utrition
(C)onstipation
(H)ydration
(M)edication
(E)lectrolytes
Clusters of personality disorders
Cluster A:
- paranoid
- schizoid
- schitotypal
Cluster B:
- antisocial
- borderline
- histrionic
- narcissistic
Cluster C:
- dependent
- avoidant
- obsessive-compulsive
Paranoid personality disorder
Excessive distrust and suspiciousness of others; pathologically jealous; interprets actions as demeaning, malevolent, threatening, or exploitative; ideas of reference (believes coincidences or innocuous events have strong personal significance)
Schizoid personality disorder
detachment from social interactions without a desire for close interpersonal relationships; restricted affect
Schizotypal personality disorder
Eccentric beliefs without frank delusions; cognitive and perceptual disturbances; impaired social interactions
Antisocial personality disorder
Lack of empathy, with disregard for rights of others; deceitfulness, impulsivity, irresponsibility
Borderline personality disorders
Unstable self-image; chronic feelings of emptiness; instability of interpersonal relationships; affective instability; self-harm behavior; hypersensitivity to rejection and fear of abandonment
Histrionic personality disorder
Excessive attention seeking behavior and emotionality; often excessively impressionistic and shallow
Narcissistic personality disorder
Need for admiration; grandiosity in speech and behavior; lack of empathy for others, interpersonally exploitative; arrogant and haughty
Dependent personality disorder
Inability of extreme difficulty making own decisions; overly reliant on others; submissiveness; feelings of inadequacy; avoidance of confrontation
Avoidant personality disorder
Feelings of inadequacy; hypersensitivity to rejection; social inhibition despite a desire to form close interpersonal relationships
Obsessive-compulsive personality disorder
Preoccupation with details and rules; excessive organization; perfectionism, orderliness, miserliness; rigidity and stubbornness
Types of elder abuse
Physical abuse
Emotional abuse
Sexual abuse
Financial exploitation
NEglect
Abandonment
What is self neglect
When an elderly person becomes incapable of taking care of themselves, and even fails to take care of their basic daily needs, and refuses to tell anyone or hire anyone to take care of them and their needs.
Role of OT in MH and psych
Mandated Reporter
Interventions based on Occupational Profile and current Occupational Performance
- Screens
Improve Occupational opportunity
Prevention, Health and Wellness
Adaptations
Self Care
