Psych in Primary Care Flashcards
what is the first thing to do treatment wise if a patient is having a bipolar manic episode?
put them on a mood stabilizer (therapy will then follow after)
our mental state impacts __________ disorders, our physical state impacts __________ disorders
physical; mental
“actual” leading causes of death (9)- according to hadley
tobacco, diet, alcohol, microbial agents, toxic agents, motor vehicles, firearms, sexual behaviors, illicit drug use
The “BIG 5” causes of death
tobacco, diet, alcohol, exercise outlet
what three things make up the “triangle”? how likely is a person to have one or more of these things?
depression, alcohol dependence/substance abuse, anxiety (social or simple phobia); 20% of people
7 problems with treating mental health problems
1) . recognition
2) . treatment
3) . burden to system
4) . burden on relationships
5) . economic costs
6) . children
7) . suffering that occurs with chronic illness
out of the 20% of people who have one or more of the triangle parts, its estimated that only ____% recognize these parts
10%
what percent of people are given formal treatment out of the 10% who recognize their mental health concerns?
only 5% (only a few % have successful tx)
what are the two components to burden to system?
disproportionate utilization of resources and stigma to care
____% of American children and adolescents suffer from mental illness severe enough to cause some level of impairment; what fraction of these kids receive treatment?
10%; fewer than 1/3
lifetime prevalence with depression? what fraction of those people are treated? ____% are treated on sub-therapeutic doses or inadequate duration of tx
1 in 5; 1/4 of those are treated; 40% on inaccurate dose
what drug class is first line for OCD and panic attacks?
SSRIs
what are the two most important screening questions for depression?
Over the past 2 weeks, have you felt down, depressed, or hopeless?”
“Over the past 2 weeks, have you felt little interest or pleasure in doing things?”
____% of depressed patients have at least one comorbidity
68%
half of those with depression have an ________ disorder as well
anxiety
____% lifetime incidence for social phobia. ___% never access the medical system
13%; 75% (diagnosis is only made 1-2% of the time for people who do access the medical system)
symptoms for social phobia?
blushing, trembling, SOB, sweating, tachycardia, abdominal distress, extensive embarrassment, maladaptive thoughts about social situations (onset at young age, less than 25)
4 morbidities with social phobia
educational, occupational, relational, financial (limits which jobs a person can work in, usually settle for less paying jobs)
lifetime incidence of panic attacks? what are some symptoms?
10-35%; disabling symptoms of SOB, sweating, feelings of doom, maybe hallucination
how long can physical symptoms of a panic attack last?
10 minutes to a few days (3), attacks can progress to social isolation
lifetime incidence of alcohol dependence?
15%
stages of change
precontemplation- deny contemplation- delay preparation- declare action- do maintenance- keep doing (can relapse after the action stage)
what is the “pressure system” or push-me-pull-you model?
certain things are motivating and influence you to progress; certain things cause resistance and lead you to regress
always pressure on status quo
___% of adults suffer from a diagnosable mental disorder each year
25%
mental illness is the _________ leading cause of disability in the US for ages 15-44
first
___% of primary care appointments have a mental health reason
20%
what are the three components to deviance?
1) . cognitions- what the person is thinking
2) . behavior
3) . affect- facial expression of emotion and mood
what is the psychodynamic model of mental health?
disorders in adults are viewed as a result of (unconscious) childhood trauma or anxiety
what is the behavioral model of mental health?
maladaptive behaviors are learned (classical and operant conditioning)
what is the cognitive model of mental health?
conscious thought mediates or modifies, an individual’s emotional state/behavior in response to a stimulus (ABC model of events, thoughts, feelings)
what is the most accepted model of mental health?
biopsychosocial model
what three conditions must every psych diagnosis meet?
1) . not caused by a drug
2) . not caused by a medical condition
3) . impairment in functioning
