Psych across the lifecourse Flashcards
What sort of approach do you take when assessing child mental health?
Systemic - focus on relationships, social context of school and family. NO drugs to assess psychological activity
What factors may lead to an impact on child mental health?
Predisposing Factors (genes) - risk
Precipitating Factors (stress) - triggers
Perpetuating Factors (bullying) - problem fuel
Protective Factors (coping and resilience teaching) - reduce likelihood
What is the staging tool for assessing child psychological development?
Erikson’s Stages of Psychological Development - shows the main problems associated with each age group (eg trust for an infant)
Shows that psychological development continues into late adulthood
How can adolescence lead to a period of neural imbalance?
Early maturation of subcortical brain areas whereas maturation of prefrontal control areas are delayed - associated with sensory and motor tasks
What is somatisation?
Psychological distress manifesting as physical symptoms
Body Distress Disorder (pain) - recurrent pain with no physical cause
Ego-dystonic thoughts
Unpleasant thoughts, conflicting with self image
Ego-syntonic thoughts
enjoyable thoughts, compatible with core values
Anorexia vs Bulimia
B - normal, slightly overweight patients
A - 15% underweight
both involve a cycle of binging and purging
What is the diagnostic criteria used for ADHD diagnosis?
DSM-5 Criteria
What are some of the features mentioned in the DSM-5 Criteria for ADHD?
Persistent pattern of inattention and hyperactivity-impulsivity for at least 6 months,
impacting their function or development in multiple environmental settings
symptoms start before age 12
What is the evidence for the genetic risk factors for ADHD?
First degree relatives have a higher ADHD diagnostic probability (4-5x)
Boys:Girls 2-3:1
What are some of the environmental risk factors for ADHD development?
Premature birth, Low birth weight, Prenatal smoking exposure
How many cases of ADHD last into adulthood
50 % of cases persist into adulthood
Dementia
Chronic brain failure due to irreversible and progressive changes
post mortem diagnosis, usually of mixed pathology
What are some reversible causes of dementia?
Normal Pressure Hydrocephalus, Subdural Haematoma, Depression, Delirium, hypothyroidism, deficiency
Wha are some of the clinical features of a normal pressure hydrocephalus?
Hakim-Adams Triad -
cognitive impairment,
urinary incontinence,
gait disturbance (magnetic gait - cannot lift feet off floor)
Normal pressure hydrocephalus CT scan features
Abnormally large ventricles due to being filled with CSF. Draining the fluid can reverse symptoms and improve the condition.
Atrophy at the edges of the cerebrum
What are some complications from dementia leading to death?
Falls
Decreased eating/drinking
loss of basic drive
aspiration pneumonia due to decrease in swallow mechanism
What are the clinical features of mild dementia?
Can live independently with support
Problem Solving and Planning impaired
No social judgement impairment
What are the clinical features of moderate dementia?
Simple household tasks possible
Memory loss and problem solving impairment
Social judgement impairment
Difficult communication
What are the clinical features of severe dementia?
Behavioural and psychological complications
Fully dependent
Severe memory impairment and disorientation
Urinary and faecal incontinence
What is BPSD, with examples?
Behavioural and Psychological Symptoms in Dementia - apathy, mood disturbances, hallucinations, agitation
Anterograde amnesia
Short term memory loss
due to degeneration starting in the hippocampus which is responsible for converting short term memory to long term
Assessment of dementia
Bloods, MSE, cognitive assessment, neuroimaging
What values for the MMSE show signs of concern?
Mini-Mental State Examination: <25 cause of concern // 10-20 need urgent support
