Psych Flashcards
Somatization Disorder
multiple physical complaints. Symptoms not intentionally produced
Conversion disorder
mono-symptomatic
Factitious Disorders
Consciously and voluntarily produces physical symptoms of illness ie self harm
Motivation is to assume the sick role
Malingering
External incentive for behaviour (eg economic gain)
Cluster A
odd, eccentric, emotionally distant. Paranoid, schizoid, schizotypal
Cluster B
impulsive, excessively emotional, erratic: antisocial, borderline, histrionic, narcissistic
Cluster C
anxiety and fear: avoidant, dependent, obsessive-compulsive
Generalised Anxiety Disorder
persistent, excessive and/or unrealistic worry with impaired concentration, autonomic arousal, insomnia… Onset usually before age 20
Anxiety D/O - Mx
CBT
Antidepressants
Anxiolytics - benzos
Schizo Symptoms + Subtypes
Positive symptoms: hallucinations, delusions
Negative symptoms: social withdrawal, impoverished speech, lack of motivation
Cognitive symptoms: poor executive function
Subtypes:
Catatonic: profound changes in motor activity
Paranoid: prominent preoccupation with a specific delusional system
Disorganised: disorganised speech and behaviour
Residual: residual negative symptoms without delusions, hallucinations or motor disturbance
Comorbidities in Schizoprenia
T2DM Hyperlipid Higher rate of preventable RF - smoking, EOTH etc Hep C, Hep B OP IHD, arrhymias H pylori! OR 3.0 Sx of increased prolactin
Depression
- sx
- sleep pattern
SX - SEIGECAPS
disordered REM sleep, and sometimes, reduced stage 4 delta slow wave sleep
Depression Mx
CBT - effective
Meds - 40-65% will have response
SSRI, TCA, MOAi, SNRI, Lithium
TCA - MOA, S/E
Amitryptiline etc Inhibit reuptake if 5-HT Narrow therapeutic index- toxicity can cause arrhythmia and seizures Give sodium bicarb for cardiac toxicity Can have anticholinergic effects A/E - Hyponatremia, seizures, NMS
SSRI MOA, S/E
Inhibits reuptake of serotonin, less sedating, better in older and diabetics
A/E - GI, tremor, headaches, restlessness, ED, SIADH
Citalopram first line
SNRI MOA, S/E
Venlafaxine
Serotonin and noradrenaline reuptake inhibitor
SE - GI, sexual dysfunction, HTN, agitation
good for coexisting pain
Lithium
Pharmaco, Tox
Renal excreted. risk of Tox with dehydration (causing increased Na and water resorption in kidney and thus increased Li absorption)
Tox- tremor, ataxia, nystagmus, AKI, seizures
Can cause Lithium Nephrotoxicity - Nephrogenic diabetes insidious, interstitial nephritis. Can give amiloride
Clozapine AE
Agranulocytosis, neutropenia Eosinophilia Tachycardia Myocarditis, cardiomyopathy Constipation --> ileus, obs etc - common Seizures Weight gain -->metabolic syndrome
