Psychiatry Flashcards
What are the key diagnostic criteria for GAD?
Excessive and disproportionate worry lasting >6 months with a negative impact on quality of life.
What are the common physical and cognitive symptoms of GAD?
Physical: Muscle tension, palpitations, sweating, tremor, GI upset, dry mouth, sleep disturbance.
Cognitive: Excessive worry, restlessness, impaired concentration, inability to relax, fatigue.
How is GAD diagnosed?
Clinically, with exclusion of medical and psychiatric conditions (e.g., hyperthyroidism, drug misuse).
What lifestyle modifications help manage GAD?
Stress management, sleep hygiene, exercise, reducing alcohol and caffeine intake.
What psychological and pharmacological treatments are used for GAD?
Psychological: Cognitive Behavioural Therapy (CBT).
Pharmacological: Propranolol (for physical symptoms), SSRIs/SNRIs (for cognitive symptoms).
How does anxiety affect dental health and behaviour?
Higher rates of dental avoidance.
Increased DMFT (Decayed, Missing, Filled Teeth).
Bruxism leading to tooth surface loss.
Dry mouth due to medication.
How does dental anxiety differ from a dental phobia?
Dental anxiety: General uneasiness around dental visits.
Dental phobia: Intense, irrational fear leading to avoidance.
What is the difference between “depression” and “major depressive disorder” (MDD)?
Depression refers to low mood, whereas MDD is a clinical condition with significant functional impairment.
What are the key factors in the pathogenesis of depression?
Genetics
Neurotransmitter activity (serotonin, dopamine, noradrenaline)
Stressful life events
Substance misuse
HPA axis dysregulation
Systemic inflammation
Gut microbiota changes
Neuroanatomical differences
What are the core symptoms of depression?
Low mood
Anhedonia (lack of pleasure in activities)
Fatigue
What are the emotional, cognitive, and physical symptoms of depression?
Emotional: Anxiety, irritability, guilt, hopelessness, low self-esteem.
Cognitive: Poor concentration, poor memory, slowing of thoughts.
Physical: Fatigue, sleep disturbances, poor appetite, slowed movements.
How is depression diagnosed?
Clinically, using DSM-5 or ICD-11 criteria.
What are the treatment options for depression?
Lifestyle: Stress management, sleep hygiene, exercise, reduced alcohol use.
Therapy: CBT, counselling, psychotherapy, group mindfulness.
Medication: SSRIs (first-line treatment).
Severe cases: Urgent specialist input, hospital admission, Electroconvulsive Therapy (ECT).
How does depression impact dental health?
Self-neglect leading to poor oral hygiene and missed appointments.
Dry mouth due to medication.
What are the main types of eating disorders?
Anorexia Nervosa (AN)
Bulimia Nervosa (BN)
Other Specified Feeding or Eating Disorder (OSFED)
What are the diagnostic criteria for anorexia nervosa?
Low body weight (BMI < 18.5, significant caloric restriction).
Intense fear of gaining weight (despite being underweight).
Body image disturbance (fixation on appearance, repeated measurements).
What are the major complications of AN?
Medical: Electrolyte disturbances, cardiac arrhythmias, amenorrhoea, hypotension, osteoporosis.
Psychiatric: Highest mortality rate of any psychiatric disorder, increased suicide risk.
What are the key features of bulimia nervosa (BN)?
Recurrent binge eating episodes.
Loss of control over eating.
Compensatory behaviours: vomiting, laxative abuse, excessive exercise, fasting.
Weight fluctuations (often normal weight).
What are the dental signs of eating disorders?
Erosion: From self-induced vomiting.
Sialosis: Bilateral, painless salivary gland swelling.
Russell’s sign: Calluses on knuckles from inducing vomiting.
Anorexia-specific signs: Obsessional personality traits, immaculate oral hygiene, dissatisfaction with dental appearance.
What are the key characteristics of bipolar disorder?
Depression: Low mood, anhedonia, sleep disturbances, fatigue.
Mania: Elevated mood, decreased need for sleep, grandiosity, racing thoughts, risky behaviour, delusions.
How is bipolar disorder managed?
Acute: Antipsychotics (olanzapine, quetiapine, risperidone).
Long-term: Mood stabilizers (e.g., lithium) + psychotherapy.
What is a key dental implication of lithium use?
Dry mouth.
What are the core features of schizophrenia?
Psychosis: difficulty distinguishing reality from thoughts.
Positive symptoms: Hallucinations (auditory), delusions, thought insertion, thought broadcasting.
Negative symptoms: Social withdrawal, poverty of speech, lack of emotional reactivity.
What are common dental implications of schizophrenia?
Bruxism.
Impaired engagement with dental care.
Dental-specific delusions (e.g., phantom bite syndrome).
What is management of schizophrenia?
- Acute phase: may require compulsory treatment, sedation
- Long-term: oral antipsychotic or depot injection.
- Psychological: CBT, Family therapy
What are common oral side effects of psychiatric drugs?
Dry mouth (91%)
Increased salivation (49%)
Tardive dyskinesia (49%)
Dysguesia (46%)
Dysphagia (37%)
Oral stomatitis (25%)
Which psychiatric medications can cause dry mouth?
Tricyclic antidepressants (TCAs), lithium, and some antipsychotics.
