Psychiatric problems in the general hospital Flashcards
Mental health in general hospital patients
more common than general population
not always recognised
can affect management of physical condition
staff may feel ill equipped
Why mental health problems in general hospital patients may go unrecognised
disguised as physical disorder
focus on physical disorder
reaction considered to be normal
3 reasons for increased prevalence
challenges of physical illness
increased physical morbidity
somatoform disorders
Challenges of physical illness
psychological
effect of physical illness on brain function
treatment of illness eg medication
Somatoform disorders
functional disorders with medically unexplained symptoms
Common mental health problems in general hospital
affective disorder eg depression + anxiety self-harm delirium substance misuse somatoform personality dementia eating disorder
Less common mental health problems in general hospital patients
schizophrenia
bipolar
severe depression
Who is depression more common in within the hospital?
general patients 2x general population
chronic illness
neurological disease
PMH
hyperactive/hypoactive delirium
increased/decreased motor activity
How is disorganised thinking in delirium indicated?
rambling
irrelevant
incoherent speech
Is self harm more common in males or females?
females
Commonest drug taken in overdose
paracetamol
How may substance misuse present?
physical complication intoxication withdrawal eg delirium trauma/accident drug-induced psychosis
Importance of recognising psychiatric disorders in general hospital patients
appropriate treatment shorten length of treatment in hospital avoid unnecessary investigations enhance recovery rehab improve QOL
Commonest reason for admission in females <65
self harm
