PSYCHIATRY 2 Flashcards
On the mood disorder spectrum what does Bipolar affective disorder incl?
- Mania w/ Psychosis
- Mania
- Hypomania
- Elation
- Normal Mood
- Dysthymia
- Mild depression
- Moderate Depression
- Sev Depression
- Sev Depression w/ Psychosis
On the Mood disorder spectrum, what does Cyclothymia include and what is it?
- Normal mood swing
- Elation - Normal mood - dysthymia
What are the ratios for Mood disorders?
- Female: Male 2-3:1
- Unipolar - 6% point prevalence
- Bipolar 1.2% prevalence
What are common Depressive Mood disorders?
- Major depressive disorder
- Persistent Depressive Disorder
- Bipolar Depression
- Postpartum Depression
- Premenstrual Dysphoric Disorder
- Seasonal affective disorder
- Atypical Depression
List 5 (of many) common symptoms of depression
- Low mood
- Reduced interest & motivation
- Lethargy & tiredness
- Sleep disturbance
- Appetite disturbance
- Poor Conc
- Loss of confidence & Self-esteem
- Recurrent thoughts of death & suicide
- Unreasonable Self-reproach & guilt
- Any form of anxiety - can be associated w/ depression
What are the 2 types of Bipolar on the spectrum
- Bipolar 1 - Normal - Mania are interchangeable
- Bipolar 2 - Leads to mania w/ psychosis
What are some associated symptoms with Mania and Hypomania?
- Increased Prod & feeling of wellbeing
- Reduced need for sleep
- Gradual reduction in social functioning
and occupational func - Increase in reckless behaviour (dont realise that there are downsides associated with them)
- Followed by period of depression
What are the 2 types of elevated mood disorders?
- Euphoric
- Dysphoric
What are the common factors of Elevated mood disorders?
- Rapid speech
- Restlessness
- Reckless Behaviour
- Excessive energy
- Decreased sleep
What are symptoms of Euphoric Elevated mood disorders?
Upbeat
More talkative
Inflated self-esteem
felt everything was possible
What are symptoms of Dysphoric elevated mood disorders?
Irritable
Agitated
Aggressive energy
Restlessness
Rage
What are the different kinds of treatment for Mood disorders?
- Psychological (cognotive therapy or interpersonal psychotherapies)
- Drug Tx (antidpressants/mood staibalising tx) - Req for 2 yrs
- Physical (Excersize/phototherapy/ECT)
What Tx is best for S.A.D?
Phototherapy
What is ECT therapy? And what is it good for?
electric convulsive therapy
good for helping with a low mood
Good for post-natal depression
List the 4 main types of Acute phase Antidepressive drugs
- Selective Serotiin Reuptake Inhibitor - SSRI - diff types available
- Venalfaxine/Mitrazepine (2nd line)
- tricyclic antidepressants (TCA)
Monoamine Oxidase Inhibitor (MAOI) - not used due to side effects
List the 4 Mood stabilising Drugs
Lithium
Carbamazepine
Valproate
Lamotrigine
What are uses of depressants?
- Treating depression
- Treating anxiety disorders - incl OCD & panic attacks
- Pain relief
Help Psychological Tx’s
List TCAs and their side effects?
Original - amitriptyline, nortiptyline, dosulepin
New - Imipramine, doxepin
Side effects - Drymouth, Sedation, Weight gain
What should TCAs be used in caution with?
Glaucoma & Prostatism
What are the MAOI interactions
- Indirect sympathomimetic amines
-Enhanced vasoconstrictor effect - Cold and cough remedies
- W/ food - tyramine containing, alcohol, marmite,cheese, herring and beans - if Px eats this cannot give MAOI
SSRI side effects?
- GI upset
- Acute anxiety disorders
- Sedation & dry mouth
What are other drugs used as antidepressants that psychiatrist involvement usually occurs?
- Venlafaxine (mixed SRI/RI)
-Mirtazapine
-Nefazodone (SSRI)
-Reboxetine
What drugs are used to treat bipolar disorder?
- Lithium (but avoid NSAIDs)
- Carbamazepine/Lamotrigine/Valproate - mood stabiliser
What are the antispychotic medicines used in treating episodes of mania?
- Aripiprazole
- Olanzapine
- Quetiapine
- Risperidone
What are Drug effects on Dent w/ antidepressants
- Drymouth
- Sedation
- Facial dyskinesia (uncontrollable facial twitches)
- Drug interactions w/ metabolism and LA
What are diff types of psychoses?
- Perceptual abnormalities
- Manic dpression
Schizophrenia
Koraskoffs Psychosis - Alcohol induced brain degeneration
What is Schizophrenia?
- A thought disorder with relapsing and remitting periods of acute psychosis
- Freq delusions and auditory hallucinations
- Fundamental and characteristic distortions of thinking and perception
1-2% prevalent
What is management of schizophrenia
- Psychological therapy - CBT/Cognaive remediation/family intervention
- Drug therapy -
What is the drug therapy for Schizophrenia?
oral/IM injection
Dopamine antagonist drugs- blocking the effects of dopamine receptors w/in brain - also cause side effects such as dry mouth and sedation
Atypical Antipsychotics - less likely to cause side effects above
What are the new atypical antipsychotics?
Clozapine/Sulpiride/olanzapine
What are some (Extrapyramidal) side effects of antipsychotics?
- Akathisia - Restless - unable to sit sill
- Dystonia - involuntary muscle movements
- Parkisonism - slower thought process
- Tardive dyskinesia -uncontrollable facial movements
How to treat side effects from antiosychotics?
- Use beta-adrenergic blockers
- Use Anticholinergics
Or use an atypical antipsychotic instead
What behaviours are associated w/ borderline personality disorder?
- Bipolar Disorder
- Depression
- Higher rate of self-harm/ suicide
- Anxiety disorders
- Substance use
- Eating disorders
What are SYMPTOMS of Borderline personality disorder?
- Deep fear
- Unstable relationships
- Changes in self image
- Stress Paranoia
- Impulsive behaviour
- Suicidal threats
- Excessive mood swings
- Feelings of solitude
List Eating Disorders
- Anorexia nervosa - Altered body image - Don’t eat therefore - oral effects of malnutrition
- Bulimia - Binge/vomit - Comfort eating - leads to dental erosion & oesophageal stricture
-Comfort eating - Eating disorder used as a coping strategy
