Psychiatry Flashcards
when is typical onset of psychiatric disorders?
adolescence or early adulthood
what are the two most common outcomes of a psychiatric disorder?
- chronic
- relapsing/remitting
what % of psychiatric disorders are dealt with in primary care?
> 90%
what are two factors that contribute to psychiatric disorder
- polygenic (genetic)
- environmental
name 2 organic disorders?
- dementia
- delirium
what are of the brain is affected by dementia?
global issue
what are 4 characteristics of dementia?
- poor memory
- disorientation
- poor ability to judge and plan
- difficulty learning new things
what the outcome for dementia? ie is it curable?
it is progressive and persistent
what can slow down the progression of dementia?
medication
what should be considered when treating a patient who has dementia?
- capacity to give informed consent? - do they require a certificate of incapacity?
- may forget to brush teeth etc
what are the 3 stages of alcohol and drug misuse?
- intoxication
- harmful use (physical harm to self or others)
- dependence (limits life)
what is the definition of schizophrenia?
fundamental and characteristic distortions of thinking and perception
what are 5 symptoms of schizophrenia?
- delusions (sometimes bizarre)
- auditory hallucinations (usually threatening/derogatory)
- thought and feeling disorder
- deficits in motivation
- poor social skills
what is the prevalence of schizophrenia?
1% (1 in 100)
the typical onset of schizophrenia…?
early adulthood
what is the treatment of schizophrenia?
anti-psychotic drugs + psychosocial/supportive measures
what is the 4 dentally relevant points with schizophrenia?
- psychotic beliefs (ie teeth causing voices in head - take them out!)
- reduced motivation = poorer oral hygiene & diet
- increased smoking rates
- antipsychotic drugs have anti-cholingeric effect = hyposalivation
what % of the population are affected by depression?
10%
what are the typical symptoms of depression?
- low mood
- lack in motivation
- tiredness/lethargy (unresposiveness)
- sleep disturbance
- appetite disturbance
- poor concentration
- regular suicidal thoughts
- loss of self esteem/confidence
- unreasonable approach to ones self
- any form of anxiety
depression happens at …. age?
any
is depression more common in men or women?
2/3 x more common in women
what is the treatment for depression?
- antidepressants
2. psychosocial treatment (eg CBT)
dental relevance of depression?
- poorer OH
- poorer diet
- missed appointments due to
1. forgetfulness
2. low motivation
3. poor concentration
4. agoraphobic avoidance (irrational fear of open places)
what are the symptoms of mania?
- elevated mood
- distractible
- irritable
- disinhibited (unable to relax)
- increased energy
- decreased sleep
- loss of judgement
- delusions/halucinations
- lack of insight
- expansive plans/ideas
- pressure of speech
what is bipolar affective disorder?
recurrent episodes of depression and/or mania
what is the prevalence of bipolar affective disorder in %?
1-3%
what are the 3 anxiety disorders?
- generalised anxiety disorder
- panic disorder
- phobic anxiety
what is generalised anxiety disorder?
free floating anxiety surrounding many or all situations
what is panic disorder?
where a patient experiences extreme UNPREDICABLE anxiety
what is phobic disorder?
where someone experiences intense anxiety/panic in a specific situation. (ie dentist)
what are the physical symptoms of anxiety?
- increased heart rate/palpitations
- sweating
- trembling
- chills/hot flushes
- choking feeling
- chest pain/discomfort
- nausea/abdominal pain
- dizzy/light-headed/faint
- parasthesia (numbness/tingling)
- dry mouth
what is Obsessive Compulsive Disorder?
Recurrent obsessive thoughts and compulsive behaviour that is recognised by the patient as irrational but cannot be resisted and is usually stressful to the patient.
what is stomatoform disorders (stomatisation)?
repeated presentation of PHYSICAL symptoms and PERSISTENT REQUESTS by the patient for MEDICAL INVESTIGATIONS in spite of previous negative findings and reassurance that symptoms have no physical basis.
4 ways that you may recognise a patient who has stomatoform disorder?
- frequent dental surgery attendance
- inexplicable dental symptoms
- high treatment use
- unreasonable requests with respect to treatment
what is the psychopathology behind eating disorders?
- morbid fear of being fat
- self perception of fatness
eating disorders are most common in..
young females
6 orofacial complications of self-induced vomiting are?
- dental caries
- acid erosion
- submandibular lymphadenopathy
- enlargement of the parotid gland
- reddening of palate
- angular cheilitis
what is a definition of personality disorders?
- deep engrained patterns of behaviour that are maladaptive and harmful to self or others
can personality disorders be treated?
not really, they are lifelong and not easily amendable to treatment
what are 4 examples of personality disorders?
- dissocial
- emotionally unstable
- histrionic
- anankastic
what is histrionic behaviour?
attention seeking
what is anankastic behaviour?
obsessional
what is munchausen’s syndrome?
where individuals will exaggerate symptoms and present with these to gain access to healthcare, drugs, treatment , attention care etc
what is the difference between munchausens syndrome and feightened symptoms?
there is usually no clear gain to the patient with munchausens syndrome and it is unknown if they are consciously doing it of not.
what is the mental health care and treatment act 2000 (scotland) concerned with?
purely management and treatment of psychiatric disorders so unusual to meet in the dental setting
what are 3 types of patient will require a certificate of incapacity?
- learning difficulties
- communication difficulties
- mental disorders
what does this certificate of incapacity enable?
treatment can be carried out for the patients best interest even though they may be incapable to give informed consent.
even though a patient has a certificate of incapacity what can you not do?
carry out treatment against their will
