Psychiatry Flashcards
define ANXIETY
a state consisting of psychological and physical symptoms brought about by a sense of apprehension at a perceived threat
Characteristic features of Generalised Anxiety disorders
long standing, free floating anxiety, that may fluctuate, but is neither situational nor episodic
Characteristic features of Panic Disorder
repeated, sudden attacks of overwhelming anxiety, accompanied by severe physical symptoms
There is fear of the implications and consequences of a panic attack - e.g. having a heart attack; this fear in itself triggers further panic attacks.
What is a phobia?
intense fear/anxiety is triggered by a stimulus, or group of stimuli, that are predictable and normally cause no particular concern to others
- leads to avoidance behaviour
- pt knows fear is irrational but can’t help it
What is an Obsession?
intrusive thoughts that can cause anxiety
What is a Compulsion?
repetitive behaviours/rituals that neutralise anxiety
Psychological Therapy for OCD
CBT focussing on exposure and response prevention
Bipolar Disorder Type 1
At least 1 manic or mixed episode
Bipolar Disorder Type 2
Never had a full manic episode; at least 1 hypomanic episode and at least 1 major depressive episode
For what duration must symptoms be present for a dx of Mania to be made
> 1 week
For what duration must symptoms be present for a dx of Hypomania to be made
at least 4 days
What are the core symptoms of depression?
low mood
Anhedonia
Fatiguability
ICD-10 definition of Depressive Disorder
presence of at least twocore symptomsplusat least two others symptoms, for at least 2weeks.
each symptom should be present at sufficient severity for most of every day.
Mild Depression
2 core symptoms + 2 associated symptoms
Moderate Depression
2 core symptoms + 3+ associated symptoms
Severe Depression
3 core symptoms + 4+ associated symptoms
Define Illusion
False interpretation of a real perception
Define Hallucination
False sensory perception in the absence of a real external stimulus
perceived as being located in objective space (i.e. outside head)
What is a Nilhilistic Delusion?
delusional belief of being dead, decomposed or annihilated, having lost one’s own internal organs or even not existing entirely as a human being
What is a psuedohallucination?
A form of imagery arising in the subjective inner space of the mind and lacking the substantiality of normal perceptions
perceived as from inside mind
What is a Delusion
false fixed belief that is not amenable to change in light of conflicting evidence
What is Catatonia?
A state of increased muscle tone affecting extension and flexion and abolished by voluntary movement.
What are the negative features of Schizophrenia?
Affective flattening Apathy Avolition (lack of motivation) Anergy Anhedonia Alogia (poverty of words and thoughts) Asociality Attentional impairment"
What are the disorganised symptoms of schizophrenia?
When are these symptoms present?
disorganised thinking/speech
Disorganised behaviour
inappropriate affect
often detectable in the prodromal phase before the onset of positive symptoms
Describe factors associated with poor prognosis in Psychosis/Schizophrenia
fam hx Personal hx of any psychiatric disorder Eccentric shy personality Poor social and psychosexual adjustment Single civil status Unstable work record Young age insidious onset Blunted affect Prolonged episode
What is Acute Dystonia?
spastic contraction which is often painful of certain muscle (groups) most commonly affecting the head and neck
What is Akathisia?
motor restlessness
What is Tardive dyskinesia
involuntary, repetitive, purposeless movements of the tongue, lips, face and extremities
What are the features of Neuroleptic Malignant Syndrome?
pyrexia
muscle rigidity
autonomic lability: typical features include hypertension, tachycardia and tachypnoea
agitated delirium with confusion
occurs within hours to days of starting an antipsychotic
A raised creatine kinase is present in most cases.
Acute kidney injury (secondary to rhabdomyolysis) may develop in severe cases.
leukocytosis may also be seen
Section 2
admission for up to 28 days for assessment ± treatment
Section 3
treatment for up to 6 months for treatment
Section 4
72 hour assessment order
used as an emergency, when a section 2 would involve an unacceptable delay
Section 5(2)
a patient who is a voluntary patient in hospital (for physical or mental health problem) can be legally detained by a doctor for 72 hours
Section 5(4)
voluntary patients can be detained by a nurse for up to 6 hours
Section 17a
Supervised Community Treatment (Community Treatment Order)
can be used to recall a patient to hospital for treatment if they do not comply with conditions of the order in the community, such as complying with medication
Section 135
Used if there is belief that the person has a mental disorder and is at risk of harm.
Requires warrant, authorising a police officer (+ Dr and AMHP) to enter premises and take to/keep at place of safety
Section 136
someone found in a public place who appears to have a mental disorder can be taken by the police to a Place of Safety
can only be used for up to 24 hours, whilst a Mental Health Act assessment is arranged
Which 3 professionals are required for undertaking MHA assessments?
- approved mental health practicioner (mental health professionals who have been approved by a local social services authority to carry out duties under the Mental Health Act, such as social workers)
- Registered medical practicioner
- Section 12 Dr - doctor trained and qualified in the use of the Mental Health Act, usually a psychiatrist
