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
Obsessive Compulsive Disorder
- occupied with details, rules, lists, order, organisation or agenda to the point that the key part of the activity is gone
- demonstrates perfectionism that hampers with completing tasks
- is extremely dedicated to work and efficiency to the elimination of spare time activities
- meticulous, scrupulous and rigid about etiquettes of morality, ethics or values
- not capable of disposing worn out or insignificant things even when they have no sentimental meaning
- is unwilling to pass on tasks or work with others except if they surrender to exactly their way of doing things
- takes on a stingy spending stye towards self and others; and shows stiffness and stubbornness
Paranoid Personality Disorders
- hypersensitivity and an unforgiving attitude when insulted
- unwarranted tendency to question the loyalty of friends
- reluctance to confide in others
- preoccupation with conspirational beliefs and hidden meaning
- unwarranted tendency to perceive attacks on their character
Schizoid Personality Disorders
- indifference to praise and criticism
- preference for solitary activities
- lack of interest in sexual interactions
- lack of desire for companionship
- emotional coldness
- few interests
- few friends or confidants other than family
Schizotypal Personality Disorder
- ideas of reference (differ from delusions in that some insight is retained)
- odd beliefs and magical thinking
- unusual perceptual disturbances
- paranoid ideation and suspiciousness
- odd, eccentric behaviour
- lack of close friends other than family members
- inappropriate affect
- odd speech without being incoherent
Circumstantiality
Inability to answer a question without giving excessive, unnecessary detail
Tangentiality
Wandering from a topic without returning to it
Neologisms
New word formations, which might include the combining of two words
Clang Associations
Ideas are related to each other only by the fact that they sound similar or rhyme
Word Salad
Completely incoherent speech where real words are strung together into nonsense sentences
