Psych Flashcards
Baby Blues
60-70% of women
Typically seen 3-7 days following birth, more common in first time mothers
Sx: anxious, tearful, irritable
Mx: reassurance and support, health visitor has a key role
Post Natal Depression
Affects 10% of women
Most cases start within a month and peak at 3 months
Features similar to depression
Mx: reassurance and support, CBT, SSRIs (sertraline and paroxetine) used if symptoms are severe (can continue to breastfeed)
Puerperal Psychosis
Affects approximately 0.2% of women
Onset within first 2-3 weeks post partum
Sx: severe mood swings (similar to BPD), disordered perception (auditory hallucinations)
Mx: admission to hospital required
20% risk of recurrence following future pregnancies
Schizophrenia
1st rank Sx:
- auditory hallucinations
- thought disorders
- passivity phenomena
- delusional perceptions
Other features:
- impaired insight
- incongruity/blunting of affect (inappropriate emotion for circumstances)
- decreased speech
- neologisms: made up words
- catatonia
- negative symptoms: anhedonia (inability to derive pleasure), alogia (poverty of speech), avolition (poor motivation)
Mania
Lasts for at least 7 days - causes severe functional impairment in social and work setting
May require hospitalisation due to risk of harm to self or to others
May present with psychotic symptoms
Hypomania
A lesser version of mania
Lasts for <7 days, typically 3-4 days. Can be functioning and does not impair functional capacity in social or work setting
Unlikely to require hospitalisation
Does not exhibit any psychotic symptoms
Common Sx of Mania/Hypomania
Mood:
- predominantly elevated
- irritable
Speech and thought:
- pressured
- flight of ideas: characterised by rapid speech with frequent changes in topic based on associations, distractions or word play
- poor attention
Behaviour:
- insomnia
- loss of inhibitions: sexual promiscuity, overspending, risk-taking
- increased appetite
Generalised Anxiety Disorder (GAD)
Step 1: education about GAD and active monitoring
Step 2: low intensity psychological interventions (individual non-facilitated self-help or individual guided self-help or psychoeducational groups)
Step 3: high intensity psychological interventions (cognitive behavioural therapy or applied relaxation) or drug treatment
Step 4: highly specialist input e.g. multi agency teams
NICE suggests sertraline should be considered the first line SSRI
Panic Disorder
Step 1: recognition and diagnosis
Step 2: treatment in primary care - CBT or drug treatment (SSRIs are first line, if no response in 12 weeks or contraindicated, offer imipramine/clomipramine)
Step 3: review and consideration of alternative treatments
Step 4: review and referral to specialist mental health services
Step 5: care in specialist mental health services
Antisocial Personality
- failure to conform to social norms with respect to lawful behaviours as indicated by acts that are grounds for arrest
- more common in men
- deception, as indicated by repeatedly lying, use of aliases, or conning others for personal profit or pleasure
- impulsiveness or failure to plan ahead
- irritability and aggressiveness, as indicated by repeated physical fights or assaults
- reckless disregard for safety of self or others
- consistent irresponsibility, as indicated by failure to sustain consistent work behaviour or honour financial obligations
- lack of remorse, as indicated by being indifferent to or rationalising having hurt, mistreated or stolen from another
Avoidant Personality Disorder
- avoidance of occupational activities which involve significant interpersonal contact due to fears of criticism or rejection
- unwillingness to be involved unless certain of being liked
- preoccupied with ideas that they are being criticised or rejected in social situations
- restraint in intimate relationships due to the fear of being ridiculed
- reluctance to take personal risks due to fears of embarrassment
- views self as inept and inferior to others
- social isolation accompanied by a craving for social contact
Borderline Personality Disorder
- efforts to avoid real or imagined abandonment
- unstable interpersonal relationships which alternate between idealisation and devaluation
- unstable self-image
- impulsivity in potentially self-damaging area (e..g. spending, sex, substance abuse)
- recurrent suicidal behaviour
- affective instability
- chronic feelings of emptiness
- difficulty controlling temper
- quasi psychotic thoughts
Dependent Personality Disorders
- difficulty making everyday decisions without excessive reassurance from others
- need for others to assume responsibility for major areas of their life
- difficulty in expressing disagreement with others due to fears of losing support
- lack of initiative
- unrealistic fears of being left to care for themselves
- urgent search for another relationship as a source of care and support when a close relationship ends
- extensive efforts to obtain support from others
- unrealistic feelings that they cannot care for themselves
Histrionic Personality Disorder
- inappropriate sexual seductiveness
- need to be the centre of attention
- rapidly shifting and shallow expression of emotions
- suggestibility
- physical appearance used for attention seeking purposes
- impressionistic speech lacking detail
- self-dramatisation
- relationships considered to be more intimate than they are
Narcissistic Personality Disorder
- grandiose sense of self-importance
- preoccupation with fantasies of unlimited success, power or beauty
- sense of entitlement
- taking advantage of others to achieve own needs
- lack of empathy
- excessive need for admiration
- chronic envy
- arrogant and haughty attitute
