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Mental Health > MH Week 1 > Flashcards

MH Week 1 Flashcards

1
Q

Mental Health Act 2000: Treatment Authority; Treatment Criteria

A
  1. The person has a mental illness, and
  2. The person does not have capacity to consent for treatment of the illness, and
  3. The absence of treatment is likely to result in imminent serious harm to the person or others or result in the person suffering serious mental or physical deterioration.
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2
Q

DSM IV Domains for Alcohol Use Disorder

A
  1. Impaired control
  2. Social dysfunction and physical risk
  3. Physiological dependence
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3
Q

Approved medications for Alcohol Use Disorder.

A
  1. Naltrexone
  2. Acamprosate
  3. Disulfiram
  4. Nalmefene
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4
Q

Naltrexone MOA:

A
  1. u-opioid antagonist
  2. Bocks endogenous opioid reward centre
  3. Reduces alcohol cue-conditioned reinforcement signals
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5
Q

Acute sedation (oral) : 1st Line for medication naive or elderly patients.

A
  1. Oral Lorazepam: 0.5 - 1mg (4mg Max in 24 hours)
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6
Q

Acute sedation (oral) : 1st Line for Adults

A
  1. Oral Lorazepam 1 - 4 mg (8 mg total - 12 mg with consultant approval)
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7
Q

Acute sedation (oral) : 2nd Line for medication naive or elderly patients (if lorazepam fails)

A
  1. Oral Olanzapine 2.5 mg (10 mg Max dose)
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8
Q

Acute sedation (oral): 2nd Line for Adults (if lorazepam fails)

A
  1. Olanzapine wafers 5 - 10 mg (20 mg Max, 30 mg with consultant approval)
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9
Q

Acute sedation (oral) : 3rd Line

A
  1. Combine oral lorazepam 1 - 2 mg with oral antipsychotic
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10
Q

DSM IV Criteria for Schizophrenia

A
  1. Two or more of the following symptoms are present:
    a) delusions
    b) hallucinations
    c) disorganised speech
    d) disorganised/ catatonic behaviour
    e) presence of negative symptoms
  2. Symptoms occur for a period of at least 1 month, and are associated with at least 6 months of functional decline
  3. Symptoms do not occur with substance use or with mood disorder.
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11
Q

Negative symptoms of Schizophrenia.

A
  1. Asocial behaviour
  2. Affective blunting
  3. Anhedonia
  4. Alogia (decreased qualitative and quantitative speech)
  5. Avolition (inability to sustain goal directed behaviour)
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12
Q

Positive symptoms of Schizophrenia.

A
  1. Hallucinations.
  2. Delusions.
  3. Bizarre or disorganised behaviour.
  4. Incongruent affect.
  5. Pressured speech.
  6. Distractible speech.
  7. Tangentiality.
  8. Circumstantiality.
  9. Perservation.
  10. Word salad.
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13
Q

DSM IV - Major Depressive EPISODE (MSIGECAPS)

A
  1. > 5 of the following symptoms present for the same 2 week period.
  2. At least 1 symptom of depressed mood or anhedonia.
  3. Mood: depressed
  4. Sleep: increased/ decreased
  5. Interest: decreased
  6. Guilt
  7. Energy: decreased
  8. Concentration: decreased
  9. Appetite: increased/ decreased
  10. Psychomotor: agitation/ retardation
    11: Suicidal ideation
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14
Q

DSM IV - Major Depressive Disorder

A
  1. Presence of MDE
  2. MDE not better accounted for by other Axis I condition
  3. There has been no manic or hypomanic episode
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15
Q

DSM IV - Manic Episode (GST PAID)

A
  1. Distinct period of mood abnormally and persistently elevated > 1 week, present most of the day.
  2. > 3 of the following symptoms.
  3. Grandiosity
  4. Sleep (decreased need)
  5. Talkative
  6. Pleasurable activities, with painful consequences
  7. Activity (increased)
  8. Ideas (flight of)
  9. Distractible
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16
Q

DSM IV - Panic Disorder (STUDENTS FEAR the 3 C’s)

A
  1. Recurrent panic attacks with 4 or more of the following symptoms.
  2. Sweating
  3. Trembling
  4. Unsteadiness
  5. Depersonalisation
  6. Excessive heart rate
  7. Nausea
  8. Tingling
  9. SOB
  10. Fear of dying, losing control, or going crazy
  11. Chest pains, chills, choking
17
Q
  1. Recurrent panic attacks with 4 or more of the following symptoms.
  2. Sweating
  3. Trembling
  4. Unsteadiness
  5. Depersonalisation
  6. Excessive heart rate
  7. Nausea
  8. Tingling
  9. SOB
  10. Fear of dying, losing control, or going crazy
  11. Chest pains, chills, choking
A
  1. DSM IV - Panic Disorder (STUDENTS FEAR the 3 C’s)
18
Q
  1. Distinct period of mood abnormally and persistently elevated > 1 week, present most of the day.
  2. > 3 of the following symptoms.
  3. Grandiosity
  4. Sleep (decreased need)
  5. Talkative
  6. Pleasurable activities, with painful consequences
  7. Activity (increased)
  8. Ideas (flight of)
  9. Distractible
A
  1. DSM IV - Manic Episode (GST PAID)
19
Q
  1. > 5 of the following symptoms present for the same 2 week period.
  2. At least 1 symptom of depressed mood or anhedonia.
  3. Mood: depressed
  4. Sleep: increased/ decreased
  5. Interest: decreased
  6. Guilt
  7. Energy: decreased
  8. Concentration: decreased
  9. Appetite: increased/ decreased
  10. Psychomotor: agitation/ retardation
    11: Suicidal ideation
A
  1. DSM IV - Major Depressive EPISODE (MSIGECAPS)
20
Q
  1. Two or more of the following symptoms are present:
    a) delusions
    b) hallucinations
    c) disorganised speech
    d) disorganised/ catatonic behaviour
    e) presence of negative symptoms
  2. Symptoms occur for a period of at least 1 month, and are associated with at least 6 months of functional decline
  3. Symptoms do not occur with substance use or with mood disorder.
A
  1. Positive symptoms of Schizophrenia.
21
Q

DSM IV - Generalised Anxiety Disorder (C-FIRST)

A
  1. Excessive anxiety and worry for more days than not for at least 6 months - about a number of activities
  2. 3 or more of the following symptoms.
  3. Concentration issues.
  4. Fatigue.
  5. Irritability.
  6. Restlessness.
  7. Sleep disturbance.
  8. Tension (muscles)
22
Q
  1. Excessive anxiety and worry for more days than not for at least 6 months - about a number of activities
  2. 3 or more of the following symptoms.
  3. Concentration issues.
  4. Fatigue.
  5. Irritability.
  6. Restlessness.
  7. Sleep disturbance.
  8. Tension (muscles)
A
  1. DSM IV - Generalised Anxiety Disorder (C-FIRST)
23
Q

Mood stabilisers for Bipolar.

A
  1. Lithium 600 - 900 mg/ day

2. Valproate 750 mg per day

24
Q

Antipsychotics for Bipolar.

A
  1. Risperidone 1 mg per day

2. Olanzapine 5 mg per day

25
Q

Indications for ECT: Treatment resistant mood disorders

A
  1. Severe Major depression (all subtypes)
  2. Psychotic Depression
  3. Catatonic states
  4. Severe Mania
26
Q

Indications for ECT: treatment resistant psychotic disorders

A
  1. Acute severe psychosis

2. Schizophrenia (as augmentation therapy is highly unwell patient)

27
Q

Precautions for ECT

A
  1. Heart disease
  2. Hypertension (meds should be given the morning of)
  3. Pulmonary disease
  4. Neurological disease
  5. Psychotropic medications
    a) have pro-convulsive effects
    b) Lithium increase risk of post-ECT delirium
    c) anti-convulsants raise the seizure threshold
28
Q

Complications of ECT

A
  1. Memory dysfunction
  2. Post-ECT delirium
  3. Headaches and myalgia
  4. Prolonged seizures > 2 minutes
  5. Manic switching
29
Q

When is grief abnormal?

A
  1. Acute grief lasting longer than 6 months.
  2. Inability to return to work after 2 weeks.
  3. Suicide attempt.
  4. Social isolation.
  5. Denial of reality of death.
  6. Hostility towards those associated with the death.
  7. Anxiety/ hypochondriasis.
  8. Absence of grief is pathological.
30
Q

Risk factors for poor bereavement outcome.

A
  1. Poor social supports.
  2. Unanticipated death or lack preparation.
  3. Highly dependant relationship with the deceased.
  4. High initial distress.
  5. Other concurrent stressors or losses.
  6. Death of a child.
  7. Pre-existing psychiatric disorder.
31
Q
  1. Poor social supports.
  2. Unanticipated death or lack preparation.
  3. Highly dependant relationship with the deceased.
  4. High initial distress.
  5. Other concurrent stressors or losses.
  6. Death of a child.
  7. Pre-existing psychiatric disorder.
A
  1. Risk factors for poor bereavement outcome.
32
Q

Confusion Assessment Method (CAM) for Diagnosis of Delirium.

A
  1. Part 1: An assessment instrument to measure overall cognitive impairment.
  2. Part 2: Must include 4 features to distinguish delirium form other cognitive disorders.
    a) Acute Onset or Fluctuating Course
    b) Inattention
    c) Disorganised Thinking
    d) Altered Level of Consciousness

Mental Health (4 decks)

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