Psychiatric Conditions Flashcards
almost __-__% of individuals would meet the criteria for a mental illness at some point in their lives (probably not this high though)
–> depends on?
30-50
- how we define mental illness (too broad?)
what is the most common disorder as a group?
anxiety disorders
what are the most common disorders as individuals ?
- major depressive (#1) (2x higher in women)
- alcohol abuse (2x higher in men)
what is the median age of onset of first symptoms of mental illness?
(lots of people cant remember if their symptoms started in their teens or childhood)
16
75% of the population surveyed experienced their first symptoms by age 24
____% of people who had an active disorder had sought treatment
19%
about ____% of individuals with psychiatric illness had 2 concurrent disorders
60
what are the 8 sections of the mental status exam?
- general appearance, accessibility rapport, behaviour
- mood and affect
- speech
- thought process
- thought content
- perceptions
- cognition
- insight and judgement
what is the difference between mood and affect?
affect: the emotional foreground, refers to the visible manifestations of the emotional state, and reflects moment to moment changes in emotional expression
Mood: internal feeling state; it is subjective, and described by the patient
(mood = general season, and affect = weather)
in the mental status exam, what are the several components of affect that are evaluated?
- quality (happy, sad, angry, afraid)
- range (expanded–> normal–> narrow or restricted)
- intensity (flattened –> normal –> exaggerated)
- stability (fixed, labile)
- Appropriateness
in the mental status exam mood is described with what components (3)?
- quality ( dysthymic, euthymic, euphoric, irritable)
- stability (does mood change from one day to the next)
- reactivity (how responsive is mood to extrinsic factors)
the quality of speech can reveal what?
an idea of the underlying pathology
what aspects of speech are observed? (3)
- Amount : terse short responses vs over inclusive
- rate and pressure: is the speech “pressured” or can the patient be interrupted
- prosody: does the speech have a normal range of emotional tone
describes the way in
which ideas are produced and organized – the degree of
connection between ideas and the flow of thoughts are
evaluated
thought process
normal thought process is described as?
goal directed
what does a circumstantial thought process look like?
going into excessive, unnecessary detail
but eventually returning to the original point
what does a tangential thought process look like?
wandering from topic to topic and never returning to the original point
what does derailment thought process look like?
ideas slip from one topic to another that is unrelated: patient unaware of these changes
what does a incoherent thought process look like?
word salad- speech in unintelligible; although the individual words are real words, they are strung together incoherently
when are hallucinations considered non- psychotic?
when the patient recognizes that they are products of their own mind
perceptual experiences that occur in the absence of an external stimuli
hallucinations
2 types of hallucinations
- true hallucinations: experienced as originating outside the body
- pseudohallucinations: occurring within the head
The \_\_\_\_ was published in 1952, and was the first official manual of mental disorders focusing on clinical utility
DSM - diagnostic statistical manual
a __________ ________ is a syndrome characterized by clinically
significant disturbance in cognition, emotion regulation, or
behavior that reflects a dysfunction in the psychological,
biological, or developmental processes underlying mental
functioning.
mental disorder (DSM-5)
what are mental disorders usually associated with?
significant distress or disability in social, occupational, or other important activities
is socially deviant behaviour a mental disorder?
no
the DSM-5 states that neurodevelopmental disorders manifest when?
- early in development, typically before school
These may range from specific learning
disorders to global impairments in intelligence, and include
disorders such as attention-deficit hyperactivity disorder
and autism spectrum disorders
neurodevelopmental disorders (ex, ADHD, ASD)
Schizophrenia spectrum and other psychotic disorders are
defined by the presence of ______, which is defined by abnormalities in one or more of 5 domains:
- psychosis
1. delusions
2. hallucinations
3. disorganized thinking
4. disorganized behaviour
5. negative symptoms
hallucinations, delusions and disorganization are ____ symptoms
positive
fixed beliefs that persist despite conflicting
evidence
delusions
_______are held with an
absolute conviction, and cannot be corrected despite
compelling proof that they are false
delusions
what is the difference between bizarre delusions and non-bizarre delusions
bizarre: clearly implausible (ex, an external force has removed your organs and replaced them with someone else’s) - not feasible
non bizarre: feasible but not true (ex, your under surveillance by the police)
what are the 5 types of delusions
- persecutory
- referential
- grandiose
- erotomanic
- somatic
type of delusion characterized by the belief that
particular gestures or comments are directed at oneself,
and are also common
referential delusion (ex, you were sending me a signal when you scratched your nose)
delusions typically referred to as “paranoid”
delusions, are the most common. These delusions involve
the belief that one is going to be harmed
persecutory delusions (ex, fear that hospital staff are going to kill you)
delusions that involve the belief that one has
exceptional abilities, wealth, or fame
grandiose delusions (ex, believe you are reincarnation of a religious figure or control a large corporation)
delusion (also called de Clerambault’s
syndrome) are characterized by the belief that someone
(usually a famous stranger) is in love with the person;
denial by the individual is dismissed
erotomanic delusions
delusion reflect a preoccupation with health and organ function
somatic delusions (ex, belief that your body is infested with parasites)
delusions and hallucinations are a core feature of ________ but you will also see them with ______
- schiz
- bipolar
auditory hallucinations are typically experienced as voices coming from _____ the head
outside
for disorganized thought to be included, it must be sever enough to?
impair effective communication
disorganized behaviour can include various degrees of problems in ?
goal directed behaviour
- leading to problems in performing activities of daily living
catatonic behaviour is a severe form of ? and is characterized by?
disorganized behaviour
- decreased reactivity to the environment
4 types of disorganized behaviour
- negativism: resistance to instructions
- catatonic posturing: maintaining a rigid, bizarre posture
- mutism or stupor: a complete lack of verbal or motor responses
- catatonic excitement: purposeless, excessive motor activity without obvious cause
5 types of negative symptoms
- diminished emotional expression
- avolition
- alogia
- anhedonia
- asociality
diminished capacity for pleasure
anhedonia
lack os interest in social interactions
asociality
decrease in self directed purpose activity, may involve sitting for long periods of time
avolition
diminished speech output
alogia
reductions in prosody, and physical expression of emotions in the face
diminished emotional expression
when is the peak onset for schizophrenia
- early to mid 20’s for men ad late 20’s for women
what is rapid cycling bi polar disorder characterized by
4 episodes a year of mania or depression
It is
associated with elevated energy despite decreased sleep
(sleeping only a few hours a night), as well as rapid and
pressured speech, distractibility, and impulsive activities
with negative consequences (spending sprees, sexual
indiscretions, foolish investments)
a manic episode
persistent
irritability and extreme behavioral dyscontrol in children
disruptive mood dysregulation
discrete episodes of clear-cut
changes in behavior, thoughts, and feelings
major depressive disorder
chronic form of
depression that continues for two years or longer
persistent depressive disorder
specific form of
depression that begins after ovulation and remits within a
few days of menses
premenstrual dysphoric disorder
Depression is a syndrome of a discrete \_\_\_\_ week period of feeling sad most of the day every day, associated with a number of other symptoms:(7)
2
- no interest in activities
- change in appetite
- change in sleep
- feelings of worthlessness
- fatigue
- difficulty thinking
- thoughts of death
main treatments for depression?
cognitive behaviour therapy and anti depressant meds
what are the 3 distinct groups of anxiety disorders
- anxiety disorders
- obsessive compulsive disorders
- trauma and stressor related disorders
main treatment for anxiety disorders?
cognitive behaviour therapy
an excessive fear of judgment in
social situations leading to avoidance and social
isolation
social anxiety
recurrent panic attacks leading to a change in behavior to try to avoid the attacks (avoiding
malls, bridges) (happen randomly without a trigger)
panic disorder
excessive worry that is
difficult to control and manage, is associated with
tension, and causes impairment – reassurance seeking
and avoidance of uncertainty is common
generalized anxiety disorder
generalized anxiety often turns into _____ if not treated
depression
patients have recurrent
unwanted thoughts that are neutralized by repeatedly
performing specific rituals
OCD
patients are preoccupied
with perceived defects in their physical appearance
body dysmorphic disorder
symptoms in obsessive compulsive disorders typically fall into one of a number of dimensions: (4)
- contamination (cleaning)
- harm (checking)
- symmetry (repeating,
counting, ordering,
arranging) - taboo thoughts
(aggressive, sexual,
and religious thoughts
children subject to neglect
who demonstrate emotionally withdrawn behavior
reactive attachment disorder
children
subject to neglect who demonstrate disinhibition in their social interaction with others
disinhibited social engagement disorder
a cluster of symptoms
arising from an inability to adequately process a severe
traumatic event
PTSD
symptoms in the immediate
aftermath of a traumatic event
acute stress disorder
how is PTSD treated?
exposure therapy
multiple physical symptoms
(such as pain and fatigue) that cause significant suffering
and are associated with excessive anxiety
somatic symptom disorder
preoccupation with having or
acquiring a serious illness, in the absence of significant
symptoms
illness anxiety disorder
altered motor or sensory function
that is not explained by an underlying neurological
condition
conversion disorder
falsification of signs or symptoms to
present as ill, in the absence of external rewards
factitious disorder
compensatory behaviours after binge eating
bulimia nervosa
binge eating with no compensatory behaviours
binge eating disorder
Anorexia can present as either restricting or binge-eating /
purging. Unlike patients with binge-eating and purging in
the context of bulimia, patients with anorexia fail to?
maintain a healthy weight
anorexia is ___x more common in women
10
typically binges are associated with
eating more rapidly than normal
• eating until feeling uncomfortably full
• eating large amounts of food when not physically hungry
• eating alone because of embarrassment
• feeling guilty or disgusted with yourself afterwards
Insomnia affects approximately ___% of the population. For
about ___% of the population, insomnia becomes a chronic
problem
33%, 20%
most cases of insomnia can be treated by?
CBT
how long are episodes of apnea/hypoapnea ?
10-30 seconds but can be longer
apnea is much more common in ?
men
what are the risk factors for sleep apnea ?
- small jaw
- large neck
- smoking
- alcohol use
- obesity
untreated sleep apnea presents a risk for ?
- hypertension
- depression
- motor vehicle crashes
- poor job performance
- work related accidents
a pattern of distrust and suspicion; others tend
to be interpreted as malevolent
paranoid personality disorder
detachment from social relationships (neither
desires or enjoys close relationships, prefers to be along,
lacks close friends and seems indifferent to praise or
criticism)
schizoid personality disorder
eccentric behaviors, discomfort in close
relationships, and cognitive or perceptual distortions
schizotypal personality disorder
disregard for and violation of the rights of others
(deceitfulness, lack of remorse; consonant with
psychopathy or sociopathy)
antisocial personality disorder
impulsivity and unstable relationships, self-
image, and emotions (fears of abandonment, recurrent
self-harm, chronic feelings of emptiness, difficulty with
anger)
borderline personality disorder
excessive emotionality and attention seeking
(needing to be the center of attention; seductive,
inappropriate behavior, dramatic and exaggerated
emotions)
histrionic personaility disorder
grandiosity, a need for admiration and a lack
of empathy
narcissistic personality disorder
feelings of inadequacy, hypersensitivity to
rejection, and social inhibition (avoids social situations,
sees self as socially inept
avoidant personality disorder
submissive and clinging behavior, needing to
be taken care of (needs excessive advice and support
from others)
dependent personality disorder
preoccupation with orderliness,
perfectionism, and control (perfectionistic, excessively
devoted to work, rigid and stubborn, overly conscientious,
preoccupied with rules and order)
obsessive compulsive disorder
what is the treatment for borderline personality disorder
dialectical behavioural therapy
