Psychiatry Flashcards
Psychiatry: What is psychiatry?
Psychiatry is the medical specialty concerned with the recognition and treatment of disorders of the mind
Psychiatry: When does anxiety become pathological?
when it becomes too intense, frequent or persistent, and as a consequence interferes with the functioning of the individual
Psychiatry: What is anxiety?
Anxiety is a normal experience to a perceived threat or danger
It serves to mobilise energy reserves for action and enhances performance by increasing arousal
Psychiatry: What are the symptoms of anxiety?
Psychological: Sense of dread Irritability Fear of loss of control Avoidance Panic
Physical: Palpitations Shortness of breath Chest pain ‘Butterflies’ Sweating Dry mouth Nausea
Psychiatry: What is generalised anxiety disorder?
The anxiety experienced is not confined to a specific situation but is pervasive
Anxiety is experienced more days than not
Understandably, whilst frequently anxious, anxiety levels typically rise in stressful situations
May result in panic attacks
Psychiatry: What are phobic disorders? and what are the types?
In common these are situational, predictable, with anticipatory anxiety and avoidance
Types: Simple phobias specific animal phobias Social phobia Agoraphobia
Common in general population but only 2% considered “severely disabling
Psychiatry: What are possible presentations of odontophobia?
Delayed presentation
Looking anxious
Cancel appointments at short notice / fail to attend
Psychiatry: What are possible reasons for odontophobia?
Specific phobia (e.g. drills, needles, sounds, smells)
Anxiety about somatic reactions (gagging, injection)
Generalized anxiety disorder
Social phobia.
Psychiatry: How can you manage dental anxiety?
Prevention: Dental health education Calm, sympathetic paced approach Honest and tactful explanation of procedures Relaxed, welcoming atmosphere Confident and professional manner
Treatment:
Education regarding anxiety
Relaxation techniques
Desensitisation (graded exposure)
Short term pharmacological anxiolytics (e.g. diazepam)
Long term pharmacological antidepressants
Psychiatry: What is body dysmorphic disorder?
The affected person is excessively concerned about a perceived defect in his or her physical features
may present to the dentist
Psychiatry: What is hypochondriasis?
Abnormal preoccupation about the presence of an underlying serious physical disease
Patients can place an abnormal interpretation upon a normal sensation (e.g. transient dry mouth is proof of oral cancer).
It is often very difficult to persuade patients that their symptoms might have a largely psychological component.
Psychiatry: What is somatoform pain? What are the key characteristics?
The cause is psychological rather than organic/physical
Absence of organic pathology
Evidence of a psychological cause
Inconsistent with anatomical landmarks
May be continuous and bilateral
May prevent sleep but does not wake patient
Repeated negative investigations
Analgesia ineffective
Associated with emotional factors and may have symbolic meaning.
Psychiatry: What are affective disorders?
Extremes of mood, if accompanied by associated symptoms and impaired function can be delineated into ‘illnesses’
Mood can go up as well as down
Unipolar affective disorder
Bipolar affective disorder
Psychiatry: how is depression diagnosed?
Depressed mood
2 weeks or more Lack of energy Loss of enjoyment Poor appetite/ Weight loss Sleep disturbance Loss of libido Psychomotor retardation Poor concentration Guilt and worthlessness Hopelessness / Suicidal ideation Delusions / hallucinations
Psychiatry: What is bipolar affective disorder?
Elevated mood may be a normal experience
Most patients with mania also experience depression
Bipolar disorder is a very disruptive condition
Men and women are at equal risk
1% of the population
