Psychiatry Flashcards
Mental health act (2003) Scotland
concerned with the management and treatment of psychiatric disorders
gives provision for detainment of compulsory treatment of psychological problems but NOT detainment for treatment of medical problems
name 3 types of detention allowed under the Mental health 2003 act scotland
emergency detention - 72 hours
short term detention - 28 days
detention for assessment by a doctor - 2 hours
compulsory treatment order - 6 months
what must be present for the Mental Health Act 2003 to be applied
- person must have a mental disorder
- there is medical treatment available which could stop their condition worsening or treat some of their symptoms
- if said medical treatment wasn’t provided there would be a significant risk to the person or others
- because of the persons mental disorder, their ability to make decisions about medical treatment is impaired
- the use of compulsory powers is necessary
what are the two broad groups of psychiatric illnesses
Neurosis - contact is retained with reality, aware of and able to function and process surroundings
Psychosis - contact is loss with reality , aware of surroundings but not able to process them
somatoform disorders
psychological manifestation of a physical problem that does not exist medically or pathologically
phobias
fear out of proportion to the threat
OCD
type of neurosis
driven by anxiety and classed as a mental disorder
adjustment disorders
maladaptive responses to severe past or continuing stress/ trauma
occur during adaptation to new circumstances e.g due to bereavment, separation etc
mood disorders
spectrum of disorders
in extremes a change in perception of reality is possible (psychoses)
moods can change due to internal influences or the environment
cyclothymic temperament
slightly exaggerated ups and downs in mood
cyclothymic disorder
very exaggerated ups and downs in moods
bipolar type I vs bipolar type II
type I : changing periods of severe depression then mania
type II: severe depression followed by reasonably happy states (never reaches mania)
name 5 common symptoms of depression
low mood
lethargy and tiredness
sleep disturbance
apetite disturbance
poor concentration
loss of confidence and self esteem
reduced interest and motivation
monopolar mania
mood ranges from normal to mania
name 3 symptoms of mania and hypomania
increased productivity and feeling of wellbeing
reduced need for sleep
increase in reckless behaviour
gradual reduction in social and occupational functioning
what might a person experiencing dysphoria present like
irritable, agitated, restless, excessively angry
name 2 types of antidepressant medications that might cause dry mouth
Tricyclic andidepressants (TCS’s) - e.g amitriptyline
SSRIs (selective serotonin reuptake inhibitors) - e.g sertraine
what are some possible side effects of antidepressants that are relative to dentistry
dry mouth
may require caution with sedation
facial dyskinesias - uncontrollable facial twitches
schizophrenia
mental disorder seeing distortions to thinking and perception resulting in a variety of delusions that can be auditory or visual
their reality can be very different from real life so their behaviour can be very irrational
what makes people more susceptible to schizophrenia
genetic susceptibility but also environmental risks
Drug use can be a trigger
why might patients with schizophrenia have low self esteem
auditory hallucinations often threatening and derogatory
why might schizophrenia patients taking medication see side effects similar to parkinsons
one drug treatment is dopamine antagonists which block dopamine in area of concern and also elsewhere in the brain
Results in extra pyramidal side effects - cant sit still, involuntary muscle contractions, involuntary facial movement
what extra pyramidal side effect might persist even after treatment has stopped
tardive dyskinesia - uncontrollable facial movements e.g lip smacking, sticking tongue out, chewing
how can the extra pyramidal side effects of dopamine antagonist drugs be combatted
using an atypical antipsychotic instead
anticholinergics
beta adrenergic blockers
(when dopamine blocked acetylcholine is most prominent neurotrasnmitter so aiming to reduce it)