Psychiatry (HD 23/24)

Question 1

What is psychiatry?

Answer 1

Medical speciality concerned with the recognition and treatment of disorders of the mind

Question 2

Are disorders confirmed by pathological diagnosis?

Answer 2

No

Question 3

What are the vast majority of psychiatric diagnoses?

Answer 3

Syndromal

Question 4

What conditions can be diagnosed on clinical grounds?

Answer 4

IBS

Schizophrenia

Question 5

What does syndromal diagnosis focus on?

Answer 5

Reliability and reproducibility, before establishing validity

Question 6

What is the difference between organic and functional disorders?

Answer 6

Organic disorders are when the symptoms relate to the disease e.g. depression in Parkinson’s disease is labelled as organic as the part of the brain responsible for it is affected. I

If the symptoms don’t relate to the disease, they are functional (unknown cause of psychiatry diagnosis)

Question 7

What are the majority of psychiatric diagnoses?

Answer 7

Syndromal

Occasionally, an underlying physical cause if found and the condition relabelled organic

Question 8

What is included in the International Classification of Disease (version 10)?

Answer 8

1. Organic mental disorders e.g. dementia
2. Psychoactive substance use
3. Schizoprenia and delusional disorders
4. Mood disorders
5. Neurotic, stress-related and somatoform disorders
6. Behavioural syndromes with physiological disturbance
7. Personality disorders
8. Learning disability
9. Disorders of psychological development
10. Childhood behavioural disorders

Question 9

What is anxiety?

Answer 9

A normal experience to a perceived threat or danger

Question 10

What does anxiety do?

Answer 10

Serves to mobilise energy reserved for action and enhances performance by increasing arousal

Question 11

When is anxiety said to be pathological?

Answer 11

Only when it becomes too intense, frequent or persistent, and as a consequence interferes with the functioning of the individual

Question 12

What are the psychological symptoms of anxiety?

Answer 12

1. Sense of dread
2. Irritability
3. Fear of loss of control
4. Avoidance
5. Panic

Question 13

What are the physical symptoms of anxiety?

Answer 13

1. Palpitations
2. Shortness of breath
3. Chest pain
4. Butterflies
5. Sweating
6. Dry mouth
7. Nausea

Question 14

What is Generalised Anxiety Disorder?

Answer 14

The anxiety experience is not confined to a specific situation but is pervasive

Fear in the background (ongoing always)

Brain predicts worst possible outcome for everything

Question 15

When is anxiety experienced in Generalised Anxiety Disorder?

Answer 15

More days than not

Question 16

What are people with Generalised Anxiety Dirsorder generally said to have?

Answer 16

Trait anxiety

- having always been prone to worrying

Question 17

What may Generalised Anxiety Disorder result in?

Answer 17

Panic attacks

Question 18

What are panic attacks?

Answer 18

Episodes when anxiety can be extremely intense and result in an overwhelming feeling of panic

Question 19

What are panic attacks strongly associated with?

Answer 19

Avoidance e.g. avoid going shopping, travelling on public transport etc

Result in efforts to avoid the stimulus or situations in which the stimulus is likely to be encountered

Question 20

What is a phobia?

Answer 20

A fear out of proportion to the stimulus which is irrational and cannot be reasoned away

Question 21

What is phobia linked to?

Answer 21

A specific stimulus which is used to designate the type of phobia

Question 22

When are phobias usually present from?

Answer 22

Childhood

Question 23

What is the medical word for dental phobia?

Answer 23

Ondontophobia

Question 24

What is the central feature of anxiety disorders?

Answer 24

Avoidance

Question 25

What does avoidance do in anxiety?

Answer 25

Results in a reduction of anxiety

- relief experienced serves to reinforce this pattern of avoidance

Question 26

What does avoidance/ relief as a result of anxiety increase the likelihood of?

Answer 26

Anxiety being experienced in similar situations long term and further avoidance behaviour

Question 27

What determines the likelihood of attendance?

Answer 27

The degree of anticipatory anxiety

Question 28

What sort of response can anxiety be though of as?

Answer 28

Conditioned response

Question 29

What is a conditioned response?

Answer 29

An automatic response established by training to an ordinarily neutral stimulus

Question 30

What treatments can be used to manage dental anxiety?

Answer 30

Education

Relaxation techniques

Desensitisation (graded exposure to stimulus)

Short term pharmacological anxiolytics such as diazepam

Long term pharmacological anti-depressants

Question 31

What does OCD stand for?

Answer 31

Obsessive Compulsive Disorder

Question 32

What is OCD?

Answer 32

Patient experiences compulsions and obsessions

Recurrent, intrusive and distressing thoughts, impulses or images

Question 33

People experiencing OCD get egodystonic thoughts. What are these?

Answer 33

Thoughts that are intrusive and disliked which the pt wants to get rid of

• often these thoughts may be of contamination e.g. thinking hands are dirty all the time
• this causes anxiety, causing them to wash their hands
• the anxiety goes away temporarily but it comes back very quickly, causing them to wash their hands again

Question 34

What are compulsions?

Answer 34

The motor response to obsessions, typically in the form a ritualised pattern of behaviour

Question 35

Are compulsions in OCD resisted?

Answer 35

Yes, the behaviour is resisted but resistance increases the anxiety until it is unbearable

Question 36

What happens when compulsions are carried out?

Answer 36

Anxiety is reduced and the behaviour effectively reinforced

Question 37

Where does OCD typically require treatment within?

Answer 37

Secondary psychiatric services

Question 38

What is hypochondriasis?

Answer 38

Abnormal preoccupation with the state of health or bodily functions