MH disorders Flashcards
Neurocognitive Disorders
Includes delirium, dementia, and amnesia etc; clinically relavent changes in thinking and memory in contrast to previous thinking and memory abilities that may affect functioning in all areas of daily functioning
Cog domains:
1. complex attention
2. executive function
3. learning memory
4. language
5. perceptual-motor
6. social cognition
Intervention for Neurocognitive Disorders
- environmental adaptation for SAFETY
- caregiver education
- behavioral intervention to manage fatigue and sleep-wake cycles
Substance-Related &
Addictive Disorders
- Can affect cognitive, behavioral, and physiological symptoms that lead to addiction and compulsive actions to obtain desired substances and maintain ongoing use
- Impact in all areas of occupational functioning, routines/roles, substance abuse heavlity in daily life
Intervention for Subtance-Related/Addictive Disorders
- psychosocial therapies, including coping, stress management, and social skills training
- cognitive-based intervention geared toward increasing client’s motivation control of life
- OT helps identify realistic expectations and discharge plan; reasons for why using (important to address during eval.)
- support group refferals
Schizophrenia
A-C
S&S:
Criterion A
1. delusions
2. hallucinations
3. disorganized thinking (speech)
4. grossly disorganized or abnormal motor behavior (including catatonia)
5. Negative symptoms
Criterion B: disturbence in one or more areas of function such as work, interpersonal relations, or self-care
Criterion C: ongoing signs of the illness for** 6months** includung** at least 1 symptom of criterion A**
Schizophrenia
D-F
Criterion D: other related disorders, inclulding schizoaffective disorder or depressive/bipolar disorder with psychotic features, have been ruled out as diagnoses
Criterion E: the disturbances is not being caused by another medical condition or substance use
Criterion F: if an already existing neurodevelopmental or childhood communication disorder is diagnosed, schizophrenia is only diagnosed if req. symptoms plus prominent delusions/hallucinations are present for at least one month without treatment
Psychotic DIsorders
Criterion A: presence of 1 or more sensory behavioral, cognitive, or psychomotor symptoms, including delusions, hallucinations, disorganization of speech or behavior, and’or catatonia
Criterion B: symptoms range from one day to one month in duration, followed by complete resolution of symptoms and return to prior level of functioning
Schizoaffective disorder
uninterrupted period of illness during which, at some point, there is a** major depressive, manic, or mixed episode concurrent **with positive or negative symptoms associated with schizophrenia; symptoms of bipolar and schizophrenia; mental ill ness that can affect your thoughts, mood, and behavior.
no psychosis
Schizophreniform disorder
**meets criteria for schizophrenia; however, the episode lasts for more than 1 month, but less than 6 months **required for a diagnosis of schizophrenia
Delusional disorder
presence of 1 or more delusions for the duration of 1 month or longer and the criteria for schizphrenia has not been met
Bipolar I
- One or more manic episodes
- May be combined with hypomanic or major depressive episodes
CBT, interpersonal therapy, illness management
Cyclothymic- milder form of bipolar
Bipolar II Disorder
- One or more major depressive episodes
- Must be atleast 1 hypomanic episode
- NO history of manic episode
Cyclothymic Disorder
Characterized by several periods of hypomanic and depressive symptoms, which do not meet the criteria for a manic, hypomanic, or major depressive episode, lasting for** at least 2 years**.
Manic Episode
- at least 3 symptoms must persist for the period of at least 1 week
- mood disturbances/psychotic features (required hospitalization to prevent harm to self/others
- Behavoirs associated: resistence to treatment (fail to recognize illness)
- suggestive/flamboyant dress
- gambling, promiscuity, excessive spending, or giving things away
- irritable, assaultive, or suicidal behavior
Manic Symptoms
- irritable, consistently moody
- inc. targeted, goal-directed behavoir or restless, purposeless behaviors (psychomotor agitation)
- inflated self-esteem/grandiose/impulsive behaviors
- dec. need for sleep
- pressured or quick speech, potentially related to feelings of rushed/racing thoughts
- increased engagement in subjectively pleasureable activities that may be high risk painful, harmful, or have adverse consequences
Meds for Manic Episodes
- antipsychotics
- mood-stabilizers
OT considerations for Manic Episodes
- limit-setting to set and improve boundaries, reduce the individual’s fear of losing control, increase participation in the intervention process, and promote safety
- Engagement in activity that provide structure and the opportunity for release of excess energy in a positive and therapeutic manner
- Periods beween episodes should be used to educate the individual,, the family, and sign. other on symptom management
Major Depressive Episode
- Five or more diagnostic symptoms must be present for at least 2 weeks.
- Fluctuations in weight/appetite changes
- insomnia/hypersomnia
- slowed thinking/motor speed/restlessness, purposeless movement patterns
- Fatigue/loss of energy
- changes in mood/self-perception
- dec. concentration
- Recurrent suicidal thoughts
- Behavior: irribility, anxiety, phobias, obessive thinking; difficulty in social relationships, self-destructive, comatic complaints, increased use of medical services
causes impairment in daily functioning
dysthymic-persistent depression (milder form)
Meds for Major depressive episodes
- antidepressants
- tricyclics
- SNRIs
- Atypical antidepressants
- Monoamine oxidase inhibitors (MAOIs
Treatment for Major Depressive Episodes
- Most effective: antidepressant with psychotherapy
- CBT for ppl who are self-aware, intact cog skills, and ability to actively particpate in the intervention process
- Electroconvulsive therapy (ECT) for ppl unresponsive to trails on meds/other interventions (may casue memory loss/confusion for period surrounding treatment.)
- OT: provides safe enviroment/management of behaviors that threaten safety and well-being
Must monitor closely to prevent suicide/self-destruction
Hypomanic Episode
Symptoms are the same as for a manic episode; however, not severe enough **(last 4 days rather than 1 week) **to cause marked impairment in social or occupational function or to require hospitalization
Major Depressive Disorders
The presence of one or more major depressive episodes.
Depressive disorders
Problem solving training and CBT,
Persistent Depressive Disorder
(dysthymia)
- Characterized by at least two years of a depressed mood, most days, with depressive symptoms
- Criteria for a major depressive disorder may be continuously present for 2 years.
Depressive disorders
Disruptive mood dysregulation disorder
Temper:
1. severe/recurrent verbal or behavioral episodes
2. Uncharacteristic for expectations consistent with developmental level
3. The outbursts are considered an overreaction (either in intensity or duration of response) based on the stimuli
Diagnosis: around 6-18 yrs based on observation from parents/teachers/peers
Depressive disorders
Premenstrual dysphoric disorder
Symptoms include marked affective lability, irritability or anger, increased interpersonal conflixts, depressive symptoms, depressed mood, and/or marked anxiety
Depressive disorders
Anxiety
Associated with fear; excessive worry that interfere with daily life
Treatment for Anxiety Disorders
- Anxiolytic medication
- anti depressants, hypnotic medications in some cases
OT:
1. Skills training and CBT to reduce anxiety/avoidant behav.
2. Relaxation, stress management- breathing/meditation/visualization, and progressive muscle relaxation
3. Graded activities/exposure therapy/expressive writing
Treatment for OCD
and related disorders
- Psychotherapy: to explore psychodynamic issues
- CBT: skill development for managing symptoms
- Meds (anxiolytic, anti depressants, anti-obsessional meds, hypnotic meds)
OT:
1. Skills trianing, CB approach: reduce intrucive thoughts and complusive behaviors
2. Relaxation, stress management to dec incidence/severity of symptoms
3. provide graded activities to promote self-efficacy (inc. confidence, motivation, and participation
Trichotiomania
- complusive, irresistable desire to pull out one’s hair
- Hair-pulling often results in bald or patchy spots, potentially impacting social and occupational functioning
Excoriation disorder
Repeated picking at one’s own skin, resulting in skin lesion and causing signficant disruption in daily occupations
Reactive Attachment Disorder (RAD)
of Infancy or Early Childhood
- social neglect or instability/inconsistency of primary caregivers, leading to insufficient or frequently changing care that alters the nature of interactions with caregivers
RAD (inhibited type)
- persistent failure to initiate or respond in a developmentally appropriate fasion to most social interactions
- Interactions are excessively inhibited, hypervigilant, or highly ambivalent and contradictory in nature
RAD (disinhbited type)
- indiscriminate socialibilty with insability to exhibit appropriate selective attachments
- demo by excessive familiarity with relative strangers or lack of selectivity
Functional impact of
RAD
- high need to be in control
- freq. lying
- affectionate and overly related with strangers
- frequent episodes of horading or gorgin on food w/o physical need
- denial of responsibility
- projecting blame for their actions on others
OT considerations for
RAD
- close and ongoing collaboration
- Actively involve parents or caregivers in treatment
- Assist children to form a more secure sense of self
- limit child’s exposure to muiltiple caregivers
5. provide high levels of structure and consistency - goals need to be specifi, realistic, and attainable
Other trauma/stress disorders
- PTSD- symptoms lasting over 1 month
- Acute distress disorder- symptoms do not last more than 1 month
- Adjustment disorders- clearly identifyable stressor causes onset of emotional and/or behavioral symptoms within 3 months of experiencing the stressor (symptoms resolve and disappear within 6 months of stressor or its cn=onsequences being removed)
Anorexia Nervosa
- fears gaining weight; altered self-perception of body weight or shape depsite being at normal weight
- self worth is tied to physical body
- either food restrive or binge eating/purging type
- obsessive/compulsive behavior, depression, anxiety, ridigity, perfectionism, and poor sexual adjustment
Bulimia Nervosa
- Ongoing binge eating of much larger portions than would be expected and feeling the inability to control consumption to avoid gaining weight
- Attempts are made to avoid gaining weight through vomiting, using laxatives, fasting, and engaging in extreme amounts of exercise
- Personal self-concept defined by body proportions/size
- Obsession with appearance/attractiveness to others
- individuals maintain normal weight
Higher risk of suicide ideation/attempts with adolescents than anorexia
Binge-Eating Disorder
- inability to control recurrent periods of consuming exorbitant amount food in discrete
- Feelings of guilt/depression after; eating when not hungry; embarrassement over behavior/eats in solitary
Oppositional defiant disorder (ODD)
- Negativistic, hostile, and defiant behaviors that reulst in functional impairment; vindicitive
- Precursor for conduct disorder if aggression is prominent
Conduct disorder
- Assaultive behavior and parental criminality correlate highly with future incarceration
