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Psych > Obsessions, Personality / Eating / Psychosexual Disorders > Flashcards

Obsessions, Personality / Eating / Psychosexual Disorders Flashcards

1
Q

Types of obsessions

A

Thoughts - sex / violence / numbers / contamination
Images - vivid, morbid or violent scenes
Impulses - Eg fear of jumping in front of train
Ruminations - continuous pondering

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2
Q

What do you need to distinguish obsesssions from? What are they ? How are they different from obsessions ?

A

Volitional fantasies - pleasurable thoughts

Obsessions - unwelcome, instructive senseless and uncomfortable for the individual

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3
Q

What are compulsions?

A

Repetitive, purposeful physical/mental behaviours

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4
Q

Example of compulsions

A

Hand washing, counting, hoarding, tidiness, rearranging for symmetry

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5
Q

Usual age of onset for OCD?

A

Adolescence

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6
Q

Example of a linked obsessions and compulsion

A

Hand washing as concerned with contamination

Obsessions without compulsive acts Eg. Hoarding and difficulty discarding items that may appear worthless to others

Checking compulsions in responses to obsessive thoughts about potential harm Eg. Keep checking gas

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7
Q

How long do people with OCD spend on their O/C ?

A

> 1HR

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8
Q

Aetiology of OCD

A

Genetics (Fx of OCD, tics, Tourette’s)

  • > Parental over protection
  • > may occur post strep infection in children (PANDA subtype)
  • > *Decreased serotonin, abnormalities in cortico-striato-thalamic circuit, operant conditioning
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9
Q

What is operant conditioning

A

Type of learning where the strength of the behaviour is modified by the consequences

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10
Q

Complications of OCD

A

Depression
Abuse of alcohol / anxiolytics
Severe -> functional impairment / psychotic illness

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11
Q

What is body dysmorphic disorder?

A

Obsessional preoccupation with imagined / mild physical defects

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12
Q

Management of OCD ? Eg? Pharmacological?

A

CBT - exposure followed by response prevention Eg wipe toilet seat and not wash hands
Drugs - SSRIs / clomipramine (tricyclic)
ECT

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13
Q

What is anakastic personality disorder ? Common feature?

A

Concern with order ness, perfectionism, excessive attention to details
Emotional coldness

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14
Q

Aetiology of eating disorders

A

Genetics

  • > troubled family relationships
  • > media
  • > sexual / physical abuse
  • > altered serotonin function
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15
Q

What does PANDAS stand for / what is it?

A

Paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections

Children develop ocd shortly after infection with group A b-haemolytic streptococcal infection

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16
Q

What is anorexia? What BMI?

A

Distorted body image & FEAR OF FATNESS
Deliberate weight loss Eg restricted eating / excessive exercise
BMI <17.5

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17
Q

Signs of anorexia

A

Amenorrhea
Dry/yellow skin, bradycardia, hypotension, anaemia, lanugo hair
Vomiting - > hypokalaemia, alkalosis, pitted teeth, Russell’s sign

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18
Q

What is lanugo hair

A

Growing of fine hair all over (usually arms and chest)

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19
Q

What is Russles sign

A

Calluses on the knuckles or back of hand due to repeated self induced vomiting

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20
Q

DDs of anorexia

A

Diabetes, depression, psychotic disorders with delusions about food

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21
Q

Long term complication of anorexia

A

Osteoporosis

DEATH - has the highest death rate of ant psychiatric disorder

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22
Q

Management of anorexia in adolescents? Adults?

What can you do in emergencies?

A

Adolescents - family intervention
Adults -CBT , IPT (interpersonal psychotherapy)

May need NG feeding without consent under MCA

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23
Q

What is bulimia ?

A

Intense cravings, secretly over eat
Prevent weight gain Eg vomiting / laxatives
Fear of fatness - fluctuating weight

24
Q

Signs of bulimia

A

Amerhhorea - >50%
Hypokalamia
Signs of vomiting - Eg acute oesophageal tears

25
DDs of bulimia
Anorexia, Kleine-levin / kluver-Bucy syndromes
26
What is kluver-bucy syndrome?
Bilateral lesions of temporal lobe including amydyla -> over eating, hypersexuality, insertion of objects into mouth, impairment of recognising visual objects, and docility
27
What is klein-levin syndrome? Also known as ?
Sleeping beauty syndrome Persistent episodic hypersomnia and cognitive / mood changes Excessive appetite and hypersexuality
28
Management of bulimia
Medical stabilisation CBT, IPT Drugs - antidepressants (fluoxetine)
29
Aetiology of personality disorders
Genetics Peri-post natal factors -> abnormal cerebral maturation Poor parenting, sexual abuse -> poor coping strategies
30
Patients often fill the criteria of more than 1 personality disorder... what should you do?
Assess them more than once
31
General management of personality disorders
Structure, consistency and clear boundaries
32
People with personality disorders often struggle to cope with the everyday, what should you do?
Help / refer for help with housing / social matters
33
Features of borderline personality disorder
Unstable and intense relationships Self damaging and impulsivity - sex, drugs, money, gambling Suicidal / self harm
34
Management of borderline personality disorder ? Risks ?
CBT Dialectical behaviour therapy + mentalisation based treatment Ending / changes to treatment may -> strong emotion
35
What is mentalisation? | based treatment? Used for?
Mentalisation - ability to reflect upon and understand ones state of mind Mentalisation enables us to understand our own contributions to problems and conflicts with others; 2) Mentalisation helps us to change our behaviours and calm down when we are upset; 3) Mentalisation allows us to relate to ourselves and other people with empathy and compassion; and 4) Mentalisation promotes our ability to effectively cope with conflict. Helps by 1) helping participants to identify what it is they are feeling, and learning to verbalise those feelings 2) examining what brought about these feelings, or what happened right before the feelings emerged, and 3) carefully considering the consequences of their behaviours. Borderline personality disorder
36
What is antisocial personality disorder? Common features?
Disregard for rights / safety of others Irresponsible Unable to maintain relationships Frustration, aggressive, impulsive
37
How to prevent antisocial personality disorder?
Target children with a conduct disorder -> parent training
38
What is paranoid personality disorder? Common features?
Distrust and suspiciousness of friends / spouse bearing grudges Unable to confide Interprets remarks negatively & grandiose sense of personal rights
39
What is schitzoid personality disorder? Features?
``` Social withdrawal & restricted emotional range Restricted pleasure (including sex) Lacks confidents + indifferent to praise / criticism Insensitivity to social norms ```
40
Egs of sexual function disorders
Low interest, failure of erection / ejaculation
41
Aetiology of sexual disorders
Abuse, poor general relationships
42
Causes of sexual disorders
Conditions - diabetes, hypothyroid, pelvic surgery, neurological (eg MS) Psych - depression, alcohol dependence, anxiety Drugs - b-blockers, diuretics, benzodiazepines, antidepressants, opiates
43
Pharmacological Management of erectile dysfunction
Phosphodiesterase inhibitors | Eg - sidenafil
44
General management of erection problems
Limit cycling / alcohol | Lose weight, stop smoking, diet, exercise, reduce stress
45
Erectile dysfunction caused by Narrowing of penis blood vessels, high blood pressure, high cholesterol Hormone problems Side effects of prescribed medication
medicine to lower blood pressure, statins hormone replacement – for example, testosterone Consider changing medication
46
Physical / psychological causes of premature ejaculation
Phys - prostate problems, thyroid problems, recreational drugs Psych - performance anxiety, relationship problems, stress
47
Self management of premature ejaculation
Masturbate an hour or 2 before sex Use a thick condom Take breaks during sex - stop/go technique
48
Medical management of premature ejaculation
Low dose SSRIs Eg sertraline / fluoxetine CBT Education and sex/couples therapy
49
What is paedophilia, fetishism, beasiality, and necrophilia
Variations of object (psychosexual disorder)
50
Management of variations of object ?
Behaviour therapy | Anti androgens -> reduce sexual desire
51
What is exhibionism ? Management ?
Indecent exposure Behavioural Anti androgen
52
What is transsexualty
Cross dressing
53
What is dependent personality disorder? Sx ?
Excessive need to be taken care of -> submissive / clingy behaviour Fear of being alone Needs excessive advice to make decisions Struggles to disagree -> fear of loss / support Compliance of others wishes + doesn’t make demands of others
54
What is avoidant personality disorder
Persistent feelings of tension and inadequacy Social inhibitions Can become involved with people unless they are certain they are liked Restricted lifestyle to maintain physical security
55
What is a histrionic personality disorder?
``` Shallow emotionally Attention seeking Seductive and flirtatious Narcissistic, granulose and exploitative Suggestibility ```

Psych (14 decks)

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