Psychiatry Flashcards
Define depression:
Mood (affective) disorder characterised by low mood, low energy and loss of enjoyment
Causes/risk factors of depression:
Genetics, other mental health history
Hypothyroidism, chronic illness
Negative thoughts, low self-esteem, previous trauma
Life events - birth, job loss, divorce, illness, grief, stress
What are the core symptoms of depression?
Low mood
Low energy (anergia)
Loss of enjoyment (anhedonia)
What is the DSM-IV Criteria for depression?
DEADSWAMP
Depressed mood most of day
Energy low
Anhedonia
Death thoughts (suicidal)
Sleep disturbances –> insomnia, hypersomnia
Worthlessness, guilt, hopelessness
Appetite/weight change
Mentation decreased –> lack of concentration
Psychomotor agitation/retardation
What is the most common endocrine disorder caused by chronic lithium toxicity?
Hypothyroidism
What is Cotard syndrome?
Rare mental disorder where the affected patient that they (or part of their body) is dead or non-existent
What are the cluster A personality disorders?
Paranoid
Schizoid
Schizotypal
What are the cluster B personality disorders?
Antisocial
Emotionally unstable (borderline)
Histrionic
Narcissistic
What are the cluster C personality disorders?
Obsessive-compulsive
Avoidant
Dependent
Description of cluster A personality disorders:
‘Odd or eccentric’
Description of cluster B personality disorders:
‘Dramatic, emotional or erratic’
Description of cluster C personality disorders:
‘Anxious and fearful’
What symptoms are common in first 6-12 hours of alcohol withdrawal?
Tremor
Sweating
Tachycardia
Anxiety
When is the peak incidence of seizures in alcohol withdrawal?
36 hours
When is the peak incidence of delirium tremens in alcohol withdrawal?
48-72 hours
What are the symptoms of delirium tremens?
Coarse tremor
Confusion
Delusions
Auditory and visual hallucinations
Fever
Tachycardia
How do you manage an oculogyric crisis from antipsychotics?
Procyclidine
How long should SRRIs be continued for for depression when patient is feeling better?
6 months
Reduces risk of relapse
What is akathisia?
A sense of inner restlessness and inability to keep still
What is the SSRI of choice in children and adolescents?
Fluoxetine
What is circumstantiality?
The inability to answer a question without giving excessive, unnecessary detail
What is tangentiality?
Wandering from a topic without returning to it
What is a neologism?
A new word formation, which might include the combining of two words
What are clang associations?
When ideas are related to each other only by the fact they sound similar or rhyme
What is word salad?
Completely incoherent speech where real words are strung together into nonsense sentences
What is knight’s move?
A severe type of loosening of associations, where there are unexpected and illogical leaps from one idea to another
What is flight of ideas?
A thought disorder where there are leaps from one topic to another but with discernible links between them
What is perseveration?
The repetition of ideas or words despite an attempt to change the topic
What is echolalia?
The repetition of someone else’s speech, including the question that was asked
How long after an event can PTSD be diagnoses?
4 weeks
What is somatisation disorder?
- no organic cause can be found
- multiple physical symptoms present for at least 2 years
- patient refuses to accept reassurance or negative test result
What is illness anxiety disorder/hypochondriasis?
- persistent belief in the presence of an underlying serious disease
- patient refuses to accept reassurance or negative test results
What is conversion disorder?
Typically involves loss or motor or sensory function with no underlying neurological cause
What is dissociative disorder?
- patient ‘separates off’ certain memories form normal consciousness
- involves psychiatric symptoms eg. amnesia, fugue, stupor
What is factitious disorder?
- Also known as Munchausen’s syndrome
- Intentional production of physical or psychological symptoms
What is malingering?
Fraudulent simulation or exaggeration of symptoms with the intention of financial or other gain
1st and 2nd line pharmacological treatments for ADHD:
- Methlyphenidate
- Lisdexamfetamine
What is the pharmacological management of PTSD?
Venlafaxine
SSRI
Risperidone - in severe cases