Psychiatric Conditions Flashcards

1
Q

What Act is there for people with psychiatric disorders/diseases?

A

The Mental Health Act (Scotland) 2003

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2
Q

What is the Mental Health Act Scotland 2003 concerned with and what does it allow?

A
  • Is concerned purely with management & treatment of psychiatric disorders
  • Can detain people for compulsary treatment
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3
Q

What can’t the Mental Health Scotland Act 2003 detain someone for?

A

Compulsary treatment of physical problems

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4
Q

If there is a detained patient under the mental health act, do they need to stay there all the time?

A

No - can be in the community on ‘leave of absence’ but must have treatment

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5
Q

What are the different ways/reasons someone can be detained under the mental health act and how long for?

A
  • Emergency Detention – 72hrs
  • Short term Detention – 28 days
  • Compulsory Treatment Order – 6 months
  • Removal to a place of safety – Police
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6
Q

What needs to be done before deciding if someone is detained for 72 hours? (emergency detention)

A

Within 2 hours of detention have been assessed by a doctor who can then decicde if the 72 hour detention should be enforced

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7
Q

In order to detain someone under the mental health act, what criteria must be met?

A
  • That the person has a mental disorder.
  • Medical treatment is available which could stop their condition getting worse, or help treat some of their symptoms
  • If that medical treatment was not provided, there would be a significant risk to the person or to others.
  • Because of the person’s mental disorder, his/her ability to make decisions about medical treatment is significantly impaired (can’t be lucid when detaining)
  • That the use of compulsory powers is necessary.
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8
Q
A
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9
Q

Why can’t you detain somone with a personality disorder?

A

There is no treatment for it

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10
Q

What is the main difference between neurosis and psychosis?

A

Neurosis - contact with reality retained

Psychosis - contact lost with reality

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11
Q
A
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12
Q

What are some examples of differetn psychiatric conditions you might come accross?

A
  • neurosis (anxiety states, phobias)
  • Psychoses
  • Eating disorders
  • Personality disorders
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13
Q

How is the ‘normal’ patient in the dentist? (how do they act/feel)

A
  • Is anxious
  • may not behave rationally (from the dentists perspectibe but may be based on previous experience)
  • Dosent have a psychiatric diagnosis
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14
Q

How would you desribe someone who is neurotic to do with their emotions?

A

They are more unstable with their emotions

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15
Q

What are different examples of neuroses?

A
  • anxiety
  • phobic
  • obssetional
  • hyp0chondrial
  • depressive
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16
Q

What is different between the anxious patient and someone with anxiety neuosis?

A

The anxious patient had a reasonable anxiety about dental treatment

Anxiety neurosis - perosn is concerned about everything.

It often moves from topic to topic as circumstances change

Can also be worried about the fact they arent worried about something as they havent yet identitfied what to be anxious about

Can be debilitating

17
Q

What are the 3 types of anxiety disorders?

A
  • generalised anxiety disorder
  • phobic anxiety
  • panic disorder
18
Q

What is a basci description of generalised anxiety disorder?

A

Free-floating anxiety in many/all situations

19
Q

What is a basic description of phobic anxiety?

A

-intense anxiety/panic in specific situations

20
Q

What is a basic description of a panic disorder?

A

-unpredictable extreme anxiety

21
Q

What are somatoform disorders?

A
  • “repeated presentation of physical symptoms and persistent requests for medical investigations, in spite of negative findings and reassurance that the symptoms have no physical basis”
  • there may or may not be clear psychological / psychiatric symptomatology e.g. of depression
22
Q

What are some management strategies patients use for neurosis conditions?

A
  • Psychological Treatment
    • ‘psycho-education’
    • Anxiety Management strategies
    • Cognitive Behavioural Therapy
  • Drug treatment
    • Self medication (alcohol)
    • Prescribed medication
      • Anti-depressants etc but dont get to the root of the problem
23
Q

What are some examples of anxiolytic drugs? (groups of drugs)

Anxiolytic = treat anxiety

A
  • Alcohol
  • Benzodiazepines
  • antidepressants with anxiolytic features
24
Q

What are some benzodiapzepines used to treat anxiety?

A
  • diazepam
  • midazolam
  • temazepam
  • lorazepam
25
Q

What are some antidepressants that can be used to treat anxiety?

A
  • mirtazepine
  • Tricyclic drugs
  • SSRI (selective serotonin reuptake inhibitors)
26
Q

Anxiety neurosis is seen in many patients. What clinical signs might you see?

A
  • TMJ parafunction
  • oral dysaethesias (dry mouth, burning) and facial pain
  • denture intolerance
  • major aetiological factor in oral somatisaiton

NEED TO treat the AN as well as symptoms

27
Q

How can phobias be described?

A

fear out of proportion to threat

28
Q

What other phobias (not medical) can prevent dental treatment?

A
  • agorphobia (fear of going out/leaving house/crowded places)
  • claustrophobia
29
Q

Describe the cycle of OCD.

A

They have rituals developed that contain anxiety

30
Q

Why can OCD lead to depression?

A

The patient has an insight into the OCD and it is very difficult to break the cycle which can lead to depression

31
Q

How can OCD relate to dental work/dentistry?

A
  • fear of infection
  • fear of ‘dirty’ oral environment
32
Q

What are the differences between percectionism and OCD?

A
  • Perfectionism
    • a personality trait
    • may have habits or rituals that they follow rigidly
    • not doing it out of anxiety avoidance (being done because they like things a certain way)
  • OCD
    • •a mental health disorder
    • involves repeated, unwanted thoughts or urges that cause a person anxiety
    • the individual performs a compulsive action or ritual to prevent the development of the anxiety
    • Ritual may not be related to the anxiety itself
33
Q

What are asjustment disorders ? (is a neurosis)

A
  • “maladaptive responses to severe past or continuing stress / trauma”
  • occur during adaptation to new circumstances
  • e.g. bereavement, separation, loss

PTSD is a type of adjustment disorder

34
Q

What is needed for an adjustment disorder to be classes as PTSD?

A

requires stress of “exceptionally threatening or catastrophic nature”

35
Q

How are adjustment disorders managed?

A
  • Managed by psychological intervention
  • Mood disorders usually accompany Adjustment Disorders – treat with medication