Psych Cards

Question 1

What is the structure of a psych Hx?

Answer 1

PC:
- Like normal, SOCRATES it: what is it, how long for, describe it, anything improve/worsen etc

PsychHx:
- Prev admissions? Formal treatment/diagnoses? inpt vs outpt, MH Act before?

PMHx:
Psych Pts usually have poor health
- More likely to smoke, substance use,
- Poor ADLs, Access to primary care, oral health

FHx:
- Eg schizophrenia FHx - strong genetic association and associated with ASD

Personal Hx:
- Trauma? Antenatal issues, developmental delay, adverse childhood experiences
- Job, financial situation, benefits?, living arrangements

SHx:
- smoke? affects medications, drug use, prescription meds, alcohol

Forensice Hx:
- criminal record, custodial sentences

Question 2

What are some potential adverse childhood experiences which may predispose a person to psych illness?

Answer 2

Living with someone with a MH problem
Domestic violence at home
Parent in prison
Suicide within family
Poverty
Substance use within family

Question 3

Give an example of a psych medication affected by smoking.

Answer 3

Clozapine - because why wouldn’t it…
Clozapine is metabolised by CYP1A2, smoking induces CYP1A2 so increases metabolism which lowers serum levels.
If a patient chooses to stop smoking whilst on clozapine, dose should be lowered by about 30% to reduce likelihood of toxicity.

Question 4

What is a delusion/delusional belief?

Answer 4

A fixed false belief that is outside of the patients cultural norm.

Question 5

What is an over-valued idea?

Answer 5

A belief but with less conviction that it is true than a delusion.
The patient will believe it but may admit there is a possibility it may not be true.