Psychiatric Lectures Flashcards
List 4 advantages of classifying conditions. (4)
1) research
2) education of current and future practitioners
3) education of patients and their families
4) organisation of disorders for standardised treatment options
List 4 disadvantages of classifying conditions. (4)
1) over-generalisation
2) confirmation bias
3) stigma
4) medicalise variations in human behaviour
By what age are 50% of mental health conditions established?
14 years old.
By what age are 75% of mental health conditions established?
24 years old.
What percentage of under 18s get appropriate treatment for their mental health before becoming adults?
30%.
List 2 things that childhood physical abuse is associated with. (2)
1) 15% increase in medical diagnoses (e.g. heart disease, COPD, cancer)
2) 16% increase in medical symptoms
Define the most important tenet of attachment theory.
“An infant needs to develop a relationship with at least one primary caregiver for the child’s successful social and emotional development, and in particular for learning how to effectively regulate their feelings.”
What is the attachment timeline for the first 24 months of a child’s life? (4)
1) 0-3 months —> indiscriminate attachment
2) 3-6 months —> preference for main caregiver
3) 6-12 months —> only main caregiver
4) 12-24 months —> increasingly able to separate from main caregiver
List 3 criteria that must be met for a personality disorder diagnosis. (3)
1) the way the patient thinks, feels or behaves causes patient or others significant problems in daily life
2) the way the patient thinks, feels or behaves causes significant problems across different aspects of life
3) problems have continued for a long time
What can distinguish a personality disorder from conditions such as depression, bipolar disorder or schizophrenia?
Fixed, long term difficulties for the patient, no relapsing-remitting pattern with periods of good function in between.
List the main personality disorders listed in ICD-10. (8)
1) emotionally unstable (impulsive or borderline)
2) anakastic
3) anxious
4) dependant
5) dissocial
6) histrionic
7) paranoid
8) schizoid
What is the origin of the term borderline in borderline personality disorder?
Old Freudian classification, borderline between neurotic and psychotic.
List 3 causes of mental health conditions in the old age population. (3)
1) cognitive changes
2) physical changes
3) social changes
List 5 reasons why old age psychiatric services are separated. (5)
1) differences in presentation
2) difference in needs (mental and physical)
3) increasing population
4) impacts on physical health
5) impacts on mental health
List 6 considerations for pharmacological treatment of an old age patient. (6)
1) decreased body fat
2) decreased body water content
3) decreased albumin
4) decreased renal blood flow
5) decreased intestinal blood flow and motility
6) increased gastric pH
List the 3 big conditions of old age psychiatry.
1) depression
2) delirium
3) dementia
Define dementia.
an acquired global impairment of intellect, memory and personality without impairment of consciousness, it is usually progressive and irreversible
List the 3 most common types of dementia.
1) Alzheimer’s disease (~66%)
2) vascular (~20%)
3) Lewy body (~15%)
List 6 ‘other’ types of dementia.
1) mixed
2) frontotemporal
3) Parkinson’s disease associated
4) progressive cortical atrophy
5) primary progressive aphasia
6) alcohol related dementia
What is the gold standard assessment of cognition in dementia?
ACE-III (Addenbrooke Cognitive Examination)
What is the gold standard imaging in dementia?
MRI
What imaging is used to diagnose Lewy body dementia?
DaT scan
What imaging is used to diagnose frontotemporal dementia?
SPECT scan
List the 5 domains of an ACE-III assessment.
1) attention
2) memory
3) fluency
4) language
5) visuospatial
What is a ‘normal’ ACE-III score?
> 82/100
What ACE-III domain is lower in Alzheimer’s disease? (1)
memory
What ACE-III domains are lower in frontotemporal dementia? (2)
fluency and language
What is the difference between Lewy body dementia and Parkinson’s disease associated dementia?
1) LBD - memory problems first
2) PDD - movement problems first
Define mild cognitive impairment.
cognitive impairment but no functional impairment
What is the prognosis of mild cognitive impairment? (3)
1) 1/3 improve
2) 1/3 remain stable
3) 1/3 progress to dementia
Define pseudodementia.
cognitive impairment secondary to a mental illness (depression most common cause)
Define delirium.
transient acute syndrome characterised by disturbance of consciousness, perception, sleep wake cycle, emotion and cognition
List 5 disturbances in delirium.
1) consciousness
2) perception
3) sleep wake cycle
4) emotion
5) cognition
List 3 types of delirium.
1) hyperactive
2) hypoactive
3) mixed
List 7 causes of delirium.
PINCH ME
1) pain
2) infection
3) nutrition
4) constipation
5) hydration
6) medicines
7) environment
