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3A REVISION > PSYCHIATRY 3 > Flashcards

PSYCHIATRY 3 Flashcards

1
Q

What is affect?

A

Observed external manifestation of emotion

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2
Q

What is psychosis?

A

Severe mental disturbance characterised by a loss of contact with external reality - often with delusions, hallucinations, disorganised thinking

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3
Q

What is neurosis?

A

Relatively mild mental illness not caused by organic disease, involving symptoms of stress (depression, anxiety, obsessive behaviour, hypochondria) but not a radical loss of touch with reality

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4
Q

What is illusion?

A

Abnormal perception caused by misinterpretation of an actual stimulus, can be precipitated by a strong emotion e.g. fear provoking thoughts of people in the shadows

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5
Q

What is a hallucination?

A

Abnormal perception in the absence of an external stimulus, has the qualities of normal perception and is experienced as real, usually externally

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6
Q

What are the types of hallucination?

A

Auditory, visual, somatic, gustatory, olfactory

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7
Q

What is a pseudo-hallucination?

A

Perception in the absence of external stimulus experienced INTERNALLY with preserved insight

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8
Q

What is an over-valued idea?

A

Acceptable, comprehensible idea pursued by the patient beyond the bounds of reason and to an extent that can cause distress

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9
Q

What is a delusion?

A

Fixed, false, firmly held belief out of keeping with the person’s social and cultural background, unaltered by evidence to the contrary

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10
Q

What is a delusion of grandiosity?

A

Delusional belief that a person has special abilities, power, or is very important

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11
Q

What is a delusion of guilt?

A

Delusional belief that the person has committed a terrible act or crime, may occur in psychotic depression

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12
Q

What is a delusion of nihilism?

A

Delusional belief that the person has lost everything, or that they are dying or their body is rotting

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13
Q

What is a delusion of persecution?

A

Delusional belief that an organisation, person or other force is trying to harm the patient

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14
Q

What is a delusion of reference?

A

Delusional belief that events have a particular meaning to the patient e.g. cars parked in the street are there to tell them something, held with more intensity than ideas of reference

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15
Q

What is delusional perception?

A

Delusion that arises in response to a normal perception e.g. the traffic light turned red so I knew my dog was about to die

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16
Q

What is thought alienation?

A

Patient believes their thoughts are no longer in their control

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17
Q

What is thought insertion?

A

Patient experiences thoughts as being not their own and has a delusional belief that they have been put in their mind by an external source

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18
Q

What is thought withdrawal?

A

Delusional belief that the patient’s thoughts are removed from their head by an external force

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19
Q

What is thought broadcast?

A

Delusional belief that the patient’s thoughts are available to others, either to everyone or specific people

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20
Q

What is thought echo?

A

Auditory hallucination in which the patient hears their own thoughts spoken out loud

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21
Q

What is thought block?

A

Subjective experience that a person’s thoughts suddenly disappear

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22
Q

What is word salad?

A

Severe thought disorder, speaking in seemingly random words

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23
Q

What is concrete thinking?

A

Thinking becomes more logical and coherent so the patient is able to order, sort and classify things but cannot yet produce abstract ideas or generalise

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24
Q

What is flight of ideas?

A

Speech in where there is an abnormal connection between statements e.g. linked with rhymes/puns

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25
Q

What is pressure of speech?

A

Speech in which rate and volume are increased and interruption is difficult

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26
Q

What is circumstantiality?

A

Speech that is discursive and takes a long time to get to the point, but they do answer the question eventually

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27
Q

What is perseveration?

A

Describes an inappropriate repetition of some behaviour, thought or speech e.g. echolalia or talking exclusively on one subject

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28
Q

What is confabulation?

A

A falsified memory - patients with memory loss often confabulate as they cannot really remember what happened

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29
Q

What is somatic passivity?

A

Delusion that an outside force is able to control your body

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30
Q

What are made acts/feelings/drives?

A

Patient feels they are being forced to do something by someone else who controls them

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31
Q

What are compulsions?

A

Repetitive, purposeful physical or mental behaviours performed with reluctance in response to an obsession, carried out according to certain rules in a stereotyped fashion to neutralise or prevent discomfort

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32
Q

What is clouding of consciousness?

A

Abnormality in the regulation of the overall level of consciousness that is mild and less severe than a delirium, characterised by decreased perception and comprehension of the environment

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33
Q

What is catatonia/stupor?

A

Extreme disorder of motor function that occurs in catatonic schizophrenia, patients may sit still for hours or there are periods of extreme activity

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34
Q

What is psychomotor retardation?

A

A decrease in overall motor activity, a sign of more severe depression

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35
Q

What is formal thought disorder?

A

Patient’s speech indicates the links between consecutive thoughts are not meaningful, includes loosening of association

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36
Q

What is anhedonia?

A

Inability to experience enjoyment when taking part in previously enjoyable activities

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37
Q

What is incongruity of affect?

A

Emotion expressed by a patient differs markedly from that which might be expected in their situation

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38
Q

What is blunting of affect?

A

Patient’s emotional response is very limited in range, the normal range of emotions is not encountered

39
Q

What is Belle indifference?

A

Naive, inappropriate lack of emotion or concerns for the perception by others of one’s disability or the implications of their physical symptoms

40
Q

What is depersonalisation?

A

The unpleasant experience of subjective change, feeling detached, unreal, empty within, unable to feel emotion, watching oneself from the outside - feels like cut off by a pane of glass

41
Q

What is conversion/dissociation?

A

The process by which psychological distress is experienced as physical, usually in the form of neurological symptoms

42
Q

What is a mannerism?

A

Goal directed, understandable movement e.g. a salute

43
Q

What is stereotyped behaviour?

A

Repetitive, purposeless movements e.g. flapping hands in people with autism

44
Q

What is an obsession?

A

Recurrent thoughts, feelings, images or impulses that are intrusive, persistent, senseless and unwelcome but are recognised as the patients own

45
Q

What are extrapyramidal symptoms?

A

Side effects of antipsychotic medications, including Parkinsonian symptoms such as tremor, bradykinesia, akathisia, tardive dyskinesia

46
Q

What is akathisia?

A

Unpleasant subjective feeling of restlessness resulting in inability to sit still or a need to pace

47
Q

What is agnosia?

A

Loss of ability to recognise objects, people, sounds, smells or other stimuli that is not due to sensory loss

48
Q

What is dysphasia?

A

Difficulty understanding or verbally communicating

49
Q

What is dyspraxia?

A

Difficulty coordinating or performing movements and gestures in the absence of motor or sensory impairment

50
Q

What is echolalia?

A

Repeating words said by another person

51
Q

What is echopraxia?

A

Repeating actions done by the other person

52
Q

What is amnesia?

A

Partial or complete loss of memory

53
Q

What is anterograde amnesia?

A

Loss of memory subsequent to the cause or event

54
Q

What is retrograde amnesia?

A

Loss of memory for a period of time prior to the cause or event

55
Q

What is aphasia?

A

Partial or total loss of language skills

56
Q

What is mania?

A

An affective disorder characterised by intense euphoria, overactivity and loss of insight, with possible psychotic symptoms

57
Q

What is hypomania?

A

Less severe form of mania, no psychosis

58
Q

What is a community treatment order?

A

Used for patients who have been detained under a section 3 so they can be treated in the community as long as they can be recalled to hospital
Conditions are set, is supervised

59
Q

What is a section 135?

A

Warrant to search for and remove patients - police can enter the home and remove to a place of safety someone suspected of being dangerously mentally ill

60
Q

What is a place of safety?

A

Usually 136 suite at a mental hospital, can be police station, A and E

61
Q

What is a section 136?

A

Allows police to remove to a place of safety someone they find in a public place who appears to be suffering from a mental disorder and in immediate need of care/control

62
Q

How long can you be kept on a 135 or 136? Can you be forced to have treatment?

A

72 hours

No

63
Q

What is a section 2?

A

ADMISSION FOR ASSESSMENT
Person must appear to suffer from a mental disorder
Must cause risk to themself or others which cannot be managed without being in hospital, and they are refusing

64
Q

Who applies for a section 2?

A

Approved mental health professional (AMHP)

or Nearest relative

65
Q

How must assess/approve section 2?

A

2 doctors, one section 12 approved

Other previous knowledge of patient

66
Q

Length of a section 2?

A

28 days

can’t be renewed, can be converted to section 3

67
Q

Can a person be forced to have treatment under section 2?

A

Yes but not ECT

68
Q

Can you appeal section 2?

A

Yes in first 14 days, can speak to an IMCA (independent mental capacity advocate)

69
Q

Who discharges patients from section 2? (4)

A

Responsible clinician
MHA managers
Nearest relative (can be overruled by responsible clinician)
Tribunal

70
Q

What is a section 3?

A

ADMISSION FOR TREATMENT
Person must suffer from a mental health condition, must cause some risk to either the person or others which cannot be managed outside of hospital
Appropriate treatment must be available!

71
Q

Difference between patient in section 2 and section 3?

A

Section 2 often newly presenting, not been assessed

Section 3 known to services, following section 2 admission

72
Q

Who applies for section 3?

A

Approved mental health professional

or nearest relative

73
Q

Who must approve a section 3?

A

2 doctors, one section 12 approved
one with knowledge of patient

nearest relative must not object

74
Q

Length of a section 3?

A

6 months, can be renewed after 6 months then annually

75
Q

Can you appeal section 3?

A

Once in the first 6 months
Then once per renewal
can speak to IMCA at any time

76
Q

Can you refuse treatment in section 3?

A

no - but can’t give ECT

If refusing treatment for over 3 months a second opinion dr is needed

77
Q

Who can discharge from a section 3?

A

Responsible clinicial
MHA managers
nearest relative - can be overruled by clinician
Tribunal

78
Q

What is section 117 aftercare?

A

Specific aftercare, free, after section 3 discharge

79
Q

What is a section 4?

A

EMERGENCY ASSESSMENT
Person must appear to suffer from mental disorder, causing risk to self or others which cannot be managed without being in hospital
refusing admission
treatment must be available
section 2 would take too long, this is used

80
Q

Who applies for a section 4?

A

Approved mental health professional (AMHP)

or nearest relative

81
Q

Who must approve section 4?

A

ONE doctor, doesnt have to be section 12 approved

82
Q

Length of a section 4?

A

72 hrs - can be converted to section 2

83
Q

Can you refuse treatment under section 4?

A

Yes

unless lacks capacity and it is emergency treatment

84
Q

Can you appeal section 4?

A

no

85
Q

Who can discharge from section 4?

A

Responsible clinician only

86
Q

What is section 5?

A

Section for a patient already in hospital
must appear to suffer from mental disorder, causing risk to self or others, wants to leave hospital
not possible to use 2/3/4

87
Q

What is section 5(2)?

A

Doctors holding power - may only be used by the dr in charge of the patient or a nominated deputy

88
Q

What is a section 5(3)?

A

nurses holding power - only a mental health or disability nurse

89
Q

Length of a 5(2)?

A

72 hours - non renewable, must have MHA assessment ASAP

90
Q

Length of a 5(3)?

A

6 hours - ends as soon as dr arrives and it is then a 5(2)

91
Q

Can patient refuse treatment under section 5?

A

Yes unless lacks capacity and is in best interest in emergency

92
Q

Do patients have right to appeal section 5?

A

No

93
Q

Who discharges from section 5?

A

Automatic when time ends unless changed to a section 2 or 3

94
Q

What must be fulfilled in any cause before detention under the MHA

A

Must be correct NATURE - suffering/appear to suffer from a mental disorder
Must be to a severe DEGREE - risk of harm to self or other

3A REVISION (17 decks)

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