Psychiatric Conditions Flashcards
What Act is there for people with psychiatric disorders/diseases?
The Mental Health Act (Scotland) 2003
What is the Mental Health Act Scotland 2003 concerned with and what does it allow?
- Is concerned purely with management & treatment of psychiatric disorders
- Can detain people for compulsary treatment
What can’t the Mental Health Scotland Act 2003 detain someone for?
Compulsary treatment of physical problems
If there is a detained patient under the mental health act, do they need to stay there all the time?
No - can be in the community on ‘leave of absence’ but must have treatment
What are the different ways/reasons someone can be detained under the mental health act and how long for?
- Emergency Detention – 72hrs
- Short term Detention – 28 days
- Compulsory Treatment Order – 6 months
- Removal to a place of safety – Police
What needs to be done before deciding if someone is detained for 72 hours? (emergency detention)
Within 2 hours of detention have been assessed by a doctor who can then decicde if the 72 hour detention should be enforced
In order to detain someone under the mental health act, what criteria must be met?
- 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.
Why can’t you detain somone with a personality disorder?
There is no treatment for it
What is the main difference between neurosis and psychosis?
Neurosis - contact with reality retained
Psychosis - contact lost with reality
What are some examples of differetn psychiatric conditions you might come accross?
- neurosis (anxiety states, phobias)
- Psychoses
- Eating disorders
- Personality disorders
How is the ‘normal’ patient in the dentist? (how do they act/feel)
- Is anxious
- may not behave rationally (from the dentists perspectibe but may be based on previous experience)
- Dosent have a psychiatric diagnosis
How would you desribe someone who is neurotic to do with their emotions?
They are more unstable with their emotions
What are different examples of neuroses?
- anxiety
- phobic
- obssetional
- hyp0chondrial
- depressive
What is different between the anxious patient and someone with anxiety neuosis?
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
What are the 3 types of anxiety disorders?
- generalised anxiety disorder
- phobic anxiety
- panic disorder
What is a basci description of generalised anxiety disorder?
Free-floating anxiety in many/all situations
What is a basic description of phobic anxiety?
-intense anxiety/panic in specific situations
What is a basic description of a panic disorder?
-unpredictable extreme anxiety
What are somatoform disorders?
- “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
What are some management strategies patients use for neurosis conditions?
- 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
What are some examples of anxiolytic drugs? (groups of drugs)
Anxiolytic = treat anxiety
- Alcohol
- Benzodiazepines
- antidepressants with anxiolytic features
What are some benzodiapzepines used to treat anxiety?
- diazepam
- midazolam
- temazepam
- lorazepam
What are some antidepressants that can be used to treat anxiety?
- mirtazepine
- Tricyclic drugs
- SSRI (selective serotonin reuptake inhibitors)
Anxiety neurosis is seen in many patients. What clinical signs might you see?
- 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
How can phobias be described?
fear out of proportion to threat
What other phobias (not medical) can prevent dental treatment?
- agorphobia (fear of going out/leaving house/crowded places)
- claustrophobia
Describe the cycle of OCD.
They have rituals developed that contain anxiety
Why can OCD lead to depression?
The patient has an insight into the OCD and it is very difficult to break the cycle which can lead to depression
How can OCD relate to dental work/dentistry?
- fear of infection
- fear of ‘dirty’ oral environment
What are the differences between percectionism and OCD?
- 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
What are asjustment disorders ? (is a neurosis)
- “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
What is needed for an adjustment disorder to be classes as PTSD?
requires stress of “exceptionally threatening or catastrophic nature”
How are adjustment disorders managed?
- Managed by psychological intervention
- Mood disorders usually accompany Adjustment Disorders – treat with medication
