Psychiatry Flashcards
Risk factors (static) for completed suicide?
male sex (hazard ratio (HR) approximately 2.0)
history of deliberate self-harm (HR 1.7)
alcohol or drug misuse (HR 1.6)
history of mental illness
depression
schizophrenia: NICE estimates that 10% of people with schizophrenia will complete suicide
history of chronic disease
advancing age
unemployment or social isolation/living alone
being unmarried, divorced or widowed
Risk factors for future completion of suicide after an attempt?
efforts to avoid discovery planning leaving a written note final acts such as sorting out finances violent method
How to remember biological features of anorexia?
most things low
G’s and C’s raised: growth hormone, glucose, salivary glands, cortisol, cholesterol, carotinaemia
Difference in conversion disorder, somatisation disorder, malingering and factitious disorder (munchausen’s)?
Conversion
- typically involves loss of motor or sensory function
- the patient doesn’t consciously feign the symptoms (factitious disorder) or seek material gain (malingering)
Somatisation
- Multiple physical SYMPTOMS present for at least 2 years
- Patient refuses to accept reassurance or negative test results
Factitious
- The intentional production of physical or psychological symptoms
Malingering
- Fraudulent simulation or exaggeration of symptoms with the intention of financial or other gain
Management of PTSD?
following a traumatic event single-session interventions (often referred to as debriefing) are not recommended
watchful waiting may be used for mild symptoms lasting less than 4 weeks
military personnel have access to treatment provided by the armed forces
trauma-focused cognitive behavioural therapy (CBT) or eye movement desensitisation and reprocessing (EMDR) therapy may be used in more severe cases
drug treatments for PTSD should not be used as a routine first-line treatment for adults. If drug treatment is used then venlafaxine or a selective serotonin reuptake inhibitor (SSRI), such as sertraline should be tried. In severe cases, NICE recommends that risperidone may be used
Most common cause of drug induced hyponatraemia?
Most commonly implicated drugs include diuretics (especially thiazides), selective serotonin reuptake inhibitors (SSRIs), antipsychotics such as haloperidol, nonsteroidal anti-inflammatories and carbamazepine.
What is Cotard syndrome?
Cotard syndrome is characterised by a person believing they are dead or non-existent
What is Othello syndrome?
Othello syndrome is a delusional belief that a patients partner is committing infidelity despite no evidence of this
What is de clerambault syndrome?
De Clerambault syndrome (otherwise known as erotomania), is where a patient believes that a person of a higher social or professional standing is in love with them. Often this presents with people who believe celebrities are in love with them.
What is Ekbom syndrome?
Ekbom syndrome is also known as delusional parasitosis and is the belief that they are infected with parasites or have ‘bugs’ under their skin.
What is capgras syndrome?
Capgras delusion is the belief that friends or family members have been replaced by an identical looking imposter.
In thought disorder what is Circumstantiality?
Circumstantiality is similar to tangentiality but the patient, after giving excessive details, eventually returns to the topic.
In thought disorder what is Tangentiality?
Tangentiality is where the patient veers off topic and never answers the initial question.
Common SEs of TCAs?
drowsiness dry mouth blurred vision constipation urinary retention
lengthening of QT interval
Warfarin/heparin and SSRIs interaction?
Prolonged bleeding, should not be co-prescribed
