Psychiatry

Question 1

Mental health act (2003) Scotland

Answer 1

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

Question 2

name 3 types of detention allowed under the Mental health 2003 act scotland

Answer 2

emergency detention - 72 hours
short term detention - 28 days
detention for assessment by a doctor - 2 hours
compulsory treatment order - 6 months

Question 3

what must be present for the Mental Health Act 2003 to be applied

Answer 3

• 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

Question 4

what are the two broad groups of psychiatric illnesses

Answer 4

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

Question 5

somatoform disorders

Answer 5

psychological manifestation of a physical problem that does not exist medically or pathologically

Question 6

phobias

Answer 6

fear out of proportion to the threat

Question 7

OCD

Answer 7

type of neurosis
driven by anxiety and classed as a mental disorder

Question 8

adjustment disorders

Answer 8

maladaptive responses to severe past or continuing stress/ trauma
occur during adaptation to new circumstances e.g due to bereavment, separation etc

Question 9

mood disorders

Answer 9

spectrum of disorders
in extremes a change in perception of reality is possible (psychoses)
moods can change due to internal influences or the environment

Question 10

cyclothymic temperament

Answer 10

slightly exaggerated ups and downs in mood

Question 11

cyclothymic disorder

Answer 11

very exaggerated ups and downs in moods

Question 12

bipolar type I vs bipolar type II

Answer 12

type I : changing periods of severe depression then mania
type II: severe depression followed by reasonably happy states (never reaches mania)

Question 13

name 5 common symptoms of depression

Answer 13

low mood
lethargy and tiredness
sleep disturbance
apetite disturbance
poor concentration
loss of confidence and self esteem
reduced interest and motivation

Question 14

monopolar mania

Answer 14

mood ranges from normal to mania

Question 15

name 3 symptoms of mania and hypomania

Answer 15

increased productivity and feeling of wellbeing
reduced need for sleep
increase in reckless behaviour
gradual reduction in social and occupational functioning

Question 16

what might a person experiencing dysphoria present like

Answer 16

irritable, agitated, restless, excessively angry

Question 17

name 2 types of antidepressant medications that might cause dry mouth

Answer 17

Tricyclic andidepressants (TCS’s) - e.g amitriptyline
SSRIs (selective serotonin reuptake inhibitors) - e.g sertraine

Question 18

what are some possible side effects of antidepressants that are relative to dentistry

Answer 18

dry mouth
may require caution with sedation
facial dyskinesias - uncontrollable facial twitches

Question 19

schizophrenia

Answer 19

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

Question 20

what makes people more susceptible to schizophrenia

Answer 20

genetic susceptibility but also environmental risks
Drug use can be a trigger

Question 21

why might patients with schizophrenia have low self esteem

Answer 21

auditory hallucinations often threatening and derogatory

Question 22

why might schizophrenia patients taking medication see side effects similar to parkinsons

Answer 22

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

Question 23

what extra pyramidal side effect might persist even after treatment has stopped

Answer 23

tardive dyskinesia - uncontrollable facial movements e.g lip smacking, sticking tongue out, chewing

Question 24

how can the extra pyramidal side effects of dopamine antagonist drugs be combatted

Answer 24

using an atypical antipsychotic instead
anticholinergics
beta adrenergic blockers
(when dopamine blocked acetylcholine is most prominent neurotrasnmitter so aiming to reduce it)

Question 25

anorexia nervosa

Answer 25

altered perception of body image leading to patients not eating

Question 26

oral implications of anorexia

Answer 26

ulcers
dry mouth
increased infection risk
increased bleeding risk

Question 27

bulimia

Answer 27

normal weight but binge then vomit

Question 28

dental effects of bulimia

Answer 28

dental erosion
ulcers - nutritional deficiencies
burns in mouth from purging

Question 29

borderline personality disorder

Answer 29

instability of interpersonal relationship and self image, marked impulsivity

Question 30

name 3 symptoms of borderline personality disorder

Answer 30

unstable relationships
impulsive behaviour
changes in self image
deep fear of abandonment
suicidal threats stemming from fear of abandonment
excessive mood swings