Overdose Flashcards
What are some examples of primitive defences?
- Acting out
- Regression
- Splitting
- Denial
What are some examples of less primitive defences?
- Undoing
- Rationalisation
- Intellectualisation
What are some examples of mature defences?
- Sublimation
- Compensation
What must be done on first seeing a patient who has tried to overdose?
- Full psychiatric assessment
- Full history if needed
- Risk assessment
- Mental state exam
What aspects of the history should be explored when speaking to a patient who has tried to overdose?
- Exploration of events leading to overdose
- Exploration of signs and symptoms
- Exploration of substance abuse/dependency
What would constitute a moderate risk to self?
Moderate:
- History of self-harm
- Presenting after an episode of self-harm
- Regrets incident
- No active plans to harm again
- Hopeful for the future
What constitutes harmful use of a substance?
Harmful:
- No signs of dependence
- Substance being used in a harmful way
- Exacerbates problems with mental state
What is a pseudohallucination?
Pseudohallucination:
- Voices etc heard inside the head
- Common in patients with personality disorders
- Does not feel voices are from a true separate perception
What is the criteria for dependence syndrome?
3 of the following together within a period of 12 months:
- Craving of substance
- Increasing tolerance to the substance
- Using the substance in preference of other things in life
- Reinstatement after a period of abstinence despite knowing substance is harmful
- Narrowed repertoire of substances used
- Loss of control
- Withdrawal symptoms
What is splitting?
Splitting: An element of Object-Relations Theory:
- Individuals with weak egos engage in a defence mechanism by which they evaluate people/events or things in a black or white way
- They often judge people as either good/bad with no shades of grey.
What is projection?
A defence mechanism that blames others
What is the idea of epigenetics?
Epigenetics:
- The way one is raised affect their personalities as adults
- Poor relationships with parents results in poor attachment as adults
- Attachment styles such as anxious or avoidant styles are seen
- We tend to carry our parents’ habits and parenting styles forward, even if there isn’t a genetic link
- Changes in upbringing can alter gene expression
What is seen in borderline personality disorders?
Deeply ingrained patterns of behaviour and attitude
This results in distress as adults
Frequently self-medicating using alcohol/substances that is harmful, worsening impulsive behaviours
What are factors that predispose a patient to suffer mental health conditions?
Biological:
- Genetic factors given the family history
- Illicit drug use
Psychological:
- Loss of parent/difficult relationship
- Sexual abuse
- Bullying at school
Social:
- Impact of trauma or sexual abuse
- Impact of child poverty
- Social isolation and school refusal
- Social impact of court cases/publicity
What factors precipitate deterioration in mental health?
Biological:
- Alcohol consumption
- Illicit drugs
Psychological:
- Loss of partner/loved one
- Illness of a close friend or relative
- Anniversary of significant negative events
- Emotional blackmail
- Loss of input from mental health team
Social:
- Social isolation
- Reduced input from social worker
