Psych - Disorders through life Flashcards
What are Erikson’s stages of development?
What causes the neural imbalance in adolescence?
- prefrontal cortex matures later than the cortical areas associated with sensory and motor tasks
- neural imbalance caused by early maturation of subcortical brain areas and delayed maturation of prefrontal control areas
What is the peak age of onset for depression?
19.5
What is the peak age of onset for anxiety?
5.5
What is the peak age of onset for ADHD?
9.5
What is the peak age of onset for eating disorders?
15.5
What is the peak age of onset for autism spectrum disorders?
5.5
What is the peak age of onset for OCD?
14.5
What is the peak age of onset for substance misuse?
19.5
10 year old girl, doesn’t want to sleep in the room alone, gets raised heart rate, sweating and difficulty breathing in crowded places and does not like doing presentations in class.
What condition might they have?
anxiety
10 year old boy, several attendances to GP and Emergency Department with recurrent abdominal pain, no physical cause found so far.
What condition might they have?
somatisation disorder
15 year old young woman with tiredness, sleeping 12 hours/day, irritability and reduced enjoyment from her hobbies.
What condition might they have?
depression
4 year old boy, language is behind peers in class, doesn’t interact much with others, prefers watching buses/trains to playing in the playground.
What condition might they have?
autism spectrum disorder
8 year old boy who has been fidgeting in lessons, speaking out of turn and struggling to stay focused on homework tasks.
What condition might they have?
attention deficit and hyperactvity disorder
9 year old boy, has been using increasing amounts of alcohol hand gel, wearing rubber gloves when going outdoors, and lining up the toys in his room before going to sleep.
What condition might they have?
OCD
10 year old boy with involuntary movements in the face, neck and arms as well as making sounds which are not context-appropriate.
What condition might they have?
tic disorder, tourette syndrome
15 year old young man with conduct disorder has been truanting from school and stealing mother’s credit cards; he was found smelling of cannabis, and more recently has been smoking it in his bedroom.
What condition might they have?
substance misuse
16 year old young woman who has been cutting herself with a razor when feeling distressed, and recently has bought several packets of paracetamol.
What condition might they have?
self-harm and suicide
14 year old girl who has been spending a lot of time thinking about food, has cut out carbohydrates from her diet, has been skipping breakfast and using grandfather’s laxatives to lose weight.
What condition might they have?
eating disorder
What are the core features of ADHD?
- Persistent pattern of inattention and/or hyperactivity -impulsivity
- Present for at least 6 months
- Inappropriate for their developmental level
- Interferes with functioning or development
- Several symptoms present-before age 12
- Several symptoms present in two or more settings
- The symptoms are not better explained by another mental disorder
What are the genetic risk factors for ADHD?
- No isolated gene for ADHD, there may be several genes contributing to the vulnerability for developing it
- Twin studies have shown a significant heritability for ADHD - as high as 76%
- First degree relatives of children with ADHD have an ADHD diagnostic probability 4-5 times higher than the general population
- Boys are more vulnerable than girls
What are the environmental risk factors for ADHD?
- Premature birth
- Low birth weight
- Prenatal tobacco exposure
How many of those you have ADHD as children, continue to have ADHD as teenagers, and then adults?
70% of children who have ADHD, have it as teenagers
40-60% will continue to have it as adults
What is dementia?
Degenerative disease of the brain with:
- cognitive and behavioural impairment
- sufficiently severe to interfere significantly with social and occupational function
What is the epidemiology of dementia?
Worldwide, 47.5 million people have dementia. Expected to reach 75.5 million by 2030 and 135.5 million by 2050.
UK, dementia is leading cause of death in women and is second to heart disease for men.
Most common cause of dementia is Alzheimer’s disease (AD), 70% of cases.
Risk of AD increases with age:
1% at age 60yrs;
doubles every 5yrs;
40% of those aged 85yrs.
What are the early features of dementia?
Early symptoms
Absent-mindedness
Difficulty recalling names and words
Difficulty learning new information
Disorientation in unfamiliar surroundings
Reduced social engagement
What are the progressive features of dementia?
Marked memory impairment
Reduced vocabulary
Loss of less complex speech patterns.
Mood swings and/or apathy
Decline in ADL’s & social skills
Emergence of psychotic phenomena.
What are the advanced features of dementia?
Monosyllabic speech
Psychotic symptoms
Behavioural disturbance
Loss of bladder and bowel control
Reduced mobility
What are the psychiatric symptoms in dementia?
Delusions (15%)—usually of a paranoid nature.
Auditory and/or visual hallucinations (10–15%)—which may be simple misidentification, and indicate rapid cognitive decline.
Depression is common, requiring treatment in up to 20% of patients.
What behavioural disturbances can be present in dementia?
aggression
wandering
explosive temper
sexual disinhibition
incontinence
excessive eating
searching behaviour.
What personality changes can occur in dementia?
often reflects an exaggeration of premorbid traits with coarsening of affect and egocentricity.
What can be used to assess a patient’s mental state / cognition?
MMSE
(mini mental state examination)
According to the NICE guidelines, what do different scores in the MMSE suggest?
cognitive impairment
