psych revision lecture Flashcards
good structure for management
BIOPSYCHOSOCIAL
what perceptions can manifest in psych conditions?
illusion - misperception of real stimuli (often low stim situations)
hallucination (perception in the absence of an external stimulus (2nd person - depression) (3rd - schizophrenia - he she it)
Visual hallucination - THINK lewy body
Overvalued idea - belief sustained beyond logic / reason (not to the extent of a delusion)
Delusion
Delusional perception - resulting from a real perception - eg. red light = polic coming to get me (another schied 1st rank Sx of Schizo_)
Schneiderian 1st rank Sx of Schizophrenia
aud halluc
3rd person arguing / conversing / commenting on actions
Passivity experiences
made actions / feelings / delusions of control
thought alienation
insertion / withdrawal
delusion
symptoms of expression
loosening of association
circumstantiality
perseveration wernickes / organic or frontal lobe disorder / B1 def)
tangential - does not return to the topic
confabulation
symptoms of expression
loosening of association
circumstantiality
perseveration wernickes / organic or frontal lobe disorder / B1 def)
tangential - does not return to the topic
confabulation
symptoms of passivity
somatic passsivity (sn1strankSxofSchizo)
made acts / feelings / drives
psychomotor retardation - major depressive disorder..
stupor - loss of activity with no response to stimuli
catatonia - significantly inhibited / increased and chaotic movement
mood symptoms
flight of ideas
neologisms (MANIC PATIENTS - made up words)
pressure of speech
anhedonia
flattening of affect - reduced range of emotional expression
incongruity of affect - mania / psychosis / schizophrenia
obsession - unwanted recurrent intrusive thought
compulsion - an irresistible urge to behave in a certain way
misc symptoms in psych
depersonalisation - thoughts and feelings do not seem to belong to someone - (DISSOCIATION / ANXIETY)
derealisation - feeling as if you’re looking at yourself from the outside (DISSOCIATION / ANXIETY / TRAUMA / PD)
symptoms indicating psychosis?
loads
delusional beliefs / thought disorders / thought insertion / withdrawal / broadcast / echo / block / made acts
describing hallucinations
- medium (auditory etc.)
2. 2nd /3rd person
capgras syndrome - what is it?
imposter Sx
look at core problems in 3a handbook
transgender etc
Anxiety
self harm and risk - coping strategies for self harm and the sort of things you’d advise
describe the symptoms of psychosis:
positive:
delusions / halluc
meds help
negative
flat / blunted affect /
meds don’t help much
what are the types of schizophrenia
paranoid - grandiose delusions / delusions of persecution
catatonic - exitement and stupor phases
hebephrenic / disorganised - bizarre behavior
residual schizophrenia - chronic negative symptoms
Psychosis - other types
persistent delusional disorder - elderly / smells / sensory problems
acute and transient psychosis - on w/in 2wks recover in 3/12 - no Tx needed
schzoaffective
puerperal psychosis
organic psychosis
treatment of psychosis?
LEARN THIS AS GENERAL STRUCTURE…
bio - antipsychs (+clozapine for tx resistant - need to be registered with drug company to prescribe, need to check WCCs - learn SEs - toxic megacolon / neutropenia)
Psych - family therapy / cbt
Socio - family intervention / carer support / employment activie education / support with engagement and benefits
mood disorders - mania (bipolar 1)
presentation + symptomatology..?
at least 2 episodes in which patients mood and activity levels are significantly disturbed
disturbance up on some, down on some
**finish with
hypomania - bipolar 2
it’s a change
lesser degree of mania - doesn’t affect functioning to same degree
management of Bipolar
bio - mood stabilisers
psych - talking treatment eg. CBT / relapse prevention / psychoeducation
Socio - family or carer support / employment / activity / engagement / support / benefits
driving in bipolar?
yes you can - as long as well according to doctor and inform the DVLA and med levels not
depression:
1. symptoms
2. mild / mod / severe
- DEAD SWAMP
2. learn icd 10 again
mx of depression
bio:
antidepressants (ssri / tca , both)
ect
psycho:
talking tx : CBT / CAT
group work / self help
psychoeducation
socio:
as before..
SPECIFIC:
mild:
ww
IAPT
mod:
SSRI:+ IAPT
ref to psych??
Severe
consider admission to psych ward
?ECT
psychopharmacology of hypnotics…
bdzs (-pams… / chlordiazepoxide for)
types of antidepressants:
SSRIs
fluoxetine
SE: abdo / suicidality / sex dysf / safe in OD
TCAs
ampitryp
SE: sedation / Anti-Chol
SNRIs
Tetracyclic - Mirtazapine
MAOi
cheese and red wine HTNive crisis
