Psychiatry Flashcards
MDD - Criteria
At least 5 criterias for min 2 weeks
Main :
* Depressed Mood
* Anhedonia
Others
* Weight Change /Appetite disturbance
* Sleep disturbance
* Fatigue/Tiredness
* Feeling worthless/guilty
* Difficulty concentrating
* Suicidal ideas
* Psychomotor agitation or retardation
MSIGECAPS
Mood
Sleep
Intrest
Guilt
Energy
Concentration
Appetit
Psychomotor
Suicid
MDD Management
- Pharma
- Non Pharma (CBT)
- Support groups (Beyond blue)
- relaxation techniques
- LSM ( Exercise, healthy diet)
- Sleephygiene
- Crisis plan ( red flags)
Red Flags
- TX in Hospital
- significant risk of harm
- Significant risk of suicide/homocide
- inaddaequate social support
- MDD with psychosis
- complicated MDD /treatment resistance
CBT
CBT is a talking therapy that focuses on the connection between your thoughts, feelings, and behaviors. It helps you identify unhelpful patterns in these areas and work on strategies to change them
Dystemia
MDD for 2 Years
Adjustment disorder
- emotional and behavioral Symptoms developed in response to an stressor
- onset within 3 month
- sympt do not persist longer than 6 month
- out of proportion stressed
- significant impaired ( social occupation ..)
- Does not meet criteria for other mental health disorders
Schiziphrenia
min 2 of the following sym:
* delusion
* hallucination
* disorganised speech
* disorganised or catatonic behavior
* negative symptoms( decreased emotion , anhedonia, poverty of speech, loss of interest)
< 1 month brief psychotic disorder
1-6 schizophreniphorm
pharmacology MDD principal
eCitalopram
Initiate is 10 mg orally
Response within 2 to 4 weeks (follow-up )
increase the daily dose by 5 mg no more often than every two weeks and follow up until Max dose of 20 mg
Continue same for 6 to 12 months
**sertraline **
50 mg orally
Increased by 25
Max 200 mg
SSRI Sideeffects
weight gain
sexual difficulties
CNS Effect
Anticholinergic effect ( dry mouth, tremor)
gastrointest disstress
anorexia nervosa important
- Are you afraid of gaining weight?
- Have you ever restricted your diet to lose weight?
- How do you prevent putting on weight like excessive exercising laxative or induced vomiting?
- How do you feel about your body weights?
- What are others think about your bodyweight?
- how do you see yourself in the mirror?
Bulimia nervosa
- Do you have any episodes of binge eating when you eat a lot in a short period of time?
- Have you lost control over your eating?
- Have you ever tried to vomit use laxatives or exercise after eating?
- Is your self-esteem linked to the way you feel about your weight and your body shape?
SCOFF Questions:
S: Do you make yourself Sick (induce vomiting) because you feel uncomfortably full?
C: Do you worry you have lost Control over how much you eat?
O: Have you recently lost more than 6kg in a 3-month period?
F: Do you believe yourself to be Fat when others say you are too thin?
F: Would you say that Food dominates your life?
Brandnames Psychopharma
Prozac Floxetin
Zoloft Sertralin
Aropax Paroxetin
Lexapro Ecitalopram
reason for non-responding Pharma treatment
- Diagnosis correct?
- Possible medical causes?
- alcohol or drugs?
- Adequate dose and duration
- Adherent to therapy ( take regular, adverse affect)
Serotonin Syndrom Cause
to much medication( switching starting)
Interaction ( Tramal, St.John Worth)
Serotonin SX Symptoms
Everything is HIGH
Hyperreflexia
Hypertonia
Hyerthermia
Aggitation
Tachykardia
Mydriasis
Flushing
Anxiety/confusion
bt
