Psychiatry Flashcards
What is mental illness?
Subjectively distressing experiences to a person.
Can involve abnormal perceptions, beliefs and behaviour
Much of this is on a continuum and involves a degree of subjective clinical/professional judgement.
Women and black ppl have higher incidence of a common mental disorder (CMD)
Service user is the preferred term and not patient
Mental health assessment involves…
Symptoms, experiences, feelings, thoughts and actions
Physical health
Housing and finances, work/education
Social relationships, culture and ethnicity
Gender and sexuality
Use of drugs/alcohol
Past experiences, risks to self or others
Carer responsibility
Strengths, coping strategies, hopes and aspiration
Why are diagnoses useful?
Help to frame difficulties and gives an explanation for a person’s experiences
Helps signpost to assessment and treatment using the best available evidence
Provides prognosis
Creates communication w colleagues via shared language and approaches
What are the disadvantages of diagnoses?
Can be reductionist Stigma and pejorative labelling Attribution of blame Some ppl may not have a clear diagnosis Some ppl may have several diagnoses
Give the criteria which can be used to classify mental health conditions
Phenomenology – direct experience(s) Symptoms/Syndrome (group of consistent symptoms occurring juntos) Aetiology (cause) Duration Diagnostic criteria
What are the 2 main diagnostic manuals?
1: ICD-10 by the WHO uses numbers from F0-F99 to classify the different types of mental disorders into different diagnoses
2: DSM-V which doesn’t have a numbering system but also classifies the different mental disorders
Give some of the most common mental disorders in clinical practice
Substance misuse
Schizophrenia, schizotypal and delusional disorders
Mood disorders (hypomania, bi-polar, depression)
Anxiety and behavioural disorders (panic disorders, phobias)
Personality disorders, Dementias, Eating disorders
Reactions to severe stress (PTSD, adjustment/ dissociative disorders)
Self-harm/suicide
Describe dementia
Dementia is the umbrella term for a range of progressive brain conditions:
Alzheimer’s disease, vascular dementia, dementia with Lewy Bodies, Fronto-temporal dementia, Mixed dementia
Dementia
Patients can struggle w: new info, cognitive abilities, processing info, making decisions, concentration and communication.
Describe Schizophrenia and Psychosis
Prevalence= ~1% in the UK, typically affecting young adult males and 25-35yr old females
Often needs anti-psychotic medication, can involve CBT/psychological interventions. Early intervention is key, relapse is possible
Symptoms: hallucinations, delusions, thought disorder, negative symptoms
E.g. Bipolar affective disorder, schizophrenia, post partum psychosis
Describe the main mood disorders
Bipolar affective disorder: episodes of elevated mood and irritability. Can inc psychosis, depressed mood. Often co-morbid w anxiety, substance misuse, personality disorders and ADHD. Peak onset is 15-19
Depression: V broad diagnosis which depends on the number/severity of symptoms. Depressed mood, functional impairment, loss of pleasure in most activities.
Describe anxiety disorders
Agoraphobia (fear of being in situations where escape might be difficult), social phobia or other specific phobia.
Panic disorder, OCD, PTSD
Anxiety disorder:
Excessive worry, hyperarousal, counterproductive and debilitating fear
Describe personality disorders
Personality disorders: maladaptive patterns of relating to self, others and the world. It relates to the characteristics and traits developed from child to adulthood
Associated w other mental health co-morbidities, suicide, homelessness, unemployment, crime, substance abuse. Stress worsens symptoms.
Difficulties w social, family relationships, their own distress, avoiding trouble/crime, controlling feelings or impulses. Treatable
What are the symptom clusters?
What risk factors are associated with suicide?
Risk factors associated with suicide can include:
Societal- difficulties access or receiving care, stigma
Community- poverty, trauma or abuse
Individual factors- previous attempts, self-harm, drugs/alcohol, physical and financial problems, family history of suicide
Relationships- isolation, lack of support, loss or conflict within a relationship
Describe self harm
Self-harm: intentional act of self poisoning or self injury regardless of motivation. Can be a way to communicate intolerable distress, inability to cope, stress.
Can be suicidal or non-suicidal, but can be a strong predictor.
Girls self harm more than boys
Causes: past abuse, depression, insecurity, relationship or work problems. V common in people w borderline personality disorder.
What is the The Diathesis-Stress Model
The diathesis-stress model recognises that genetics (nature) and developmental experiences (nurture) contribute to a person’s lifetime risk of developing mental health problems.
What are the 4 Ps?
Factors which influence the course of mental illness.
•Predisposing (genetics, early developmental experience)
•Precipitating (psychosocial stress, significant life event, spliff)
•Perpetuating (sick role, learned helplessness)
•Protective (the good stuff – family, meaningful work, religion)