Psychiatry (HD 23/24) Flashcards
What is psychiatry?
Medical speciality concerned with the recognition and treatment of disorders of the mind
Are disorders confirmed by pathological diagnosis?
No
What are the vast majority of psychiatric diagnoses?
Syndromal
What conditions can be diagnosed on clinical grounds?
IBS
Schizophrenia
What does syndromal diagnosis focus on?
Reliability and reproducibility, before establishing validity
What is the difference between organic and functional disorders?
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)
What are the majority of psychiatric diagnoses?
Syndromal
Occasionally, an underlying physical cause if found and the condition relabelled organic
What is included in the International Classification of Disease (version 10)?
- Organic mental disorders e.g. dementia
- Psychoactive substance use
- Schizoprenia and delusional disorders
- Mood disorders
- Neurotic, stress-related and somatoform disorders
- Behavioural syndromes with physiological disturbance
- Personality disorders
- Learning disability
- Disorders of psychological development
- Childhood behavioural disorders
What is anxiety?
A normal experience to a perceived threat or danger
What does anxiety do?
Serves to mobilise energy reserved for action and enhances performance by increasing arousal
When is anxiety said to be pathological?
Only when it becomes too intense, frequent or persistent, and as a consequence interferes with the functioning of the individual
What are the psychological symptoms of anxiety?
- Sense of dread
- Irritability
- Fear of loss of control
- Avoidance
- Panic
What are the physical symptoms of anxiety?
- Palpitations
- Shortness of breath
- Chest pain
- Butterflies
- Sweating
- Dry mouth
- Nausea
What is Generalised Anxiety Disorder?
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
When is anxiety experienced in Generalised Anxiety Disorder?
More days than not
What are people with Generalised Anxiety Dirsorder generally said to have?
Trait anxiety
- having always been prone to worrying
What may Generalised Anxiety Disorder result in?
Panic attacks
What are panic attacks?
Episodes when anxiety can be extremely intense and result in an overwhelming feeling of panic
What are panic attacks strongly associated with?
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
What is a phobia?
A fear out of proportion to the stimulus which is irrational and cannot be reasoned away
What is phobia linked to?
A specific stimulus which is used to designate the type of phobia
When are phobias usually present from?
Childhood
What is the medical word for dental phobia?
Ondontophobia
What is the central feature of anxiety disorders?
Avoidance
What does avoidance do in anxiety?
Results in a reduction of anxiety
- relief experienced serves to reinforce this pattern of avoidance
What does avoidance/ relief as a result of anxiety increase the likelihood of?
Anxiety being experienced in similar situations long term and further avoidance behaviour
What determines the likelihood of attendance?
The degree of anticipatory anxiety
What sort of response can anxiety be though of as?
Conditioned response
What is a conditioned response?
An automatic response established by training to an ordinarily neutral stimulus
What treatments can be used to manage dental anxiety?
Education
Relaxation techniques
Desensitisation (graded exposure to stimulus)
Short term pharmacological anxiolytics such as diazepam
Long term pharmacological anti-depressants
What does OCD stand for?
Obsessive Compulsive Disorder
What is OCD?
Patient experiences compulsions and obsessions
Recurrent, intrusive and distressing thoughts, impulses or images
People experiencing OCD get egodystonic thoughts. What are these?
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
What are compulsions?
The motor response to obsessions, typically in the form a ritualised pattern of behaviour
Are compulsions in OCD resisted?
Yes, the behaviour is resisted but resistance increases the anxiety until it is unbearable
What happens when compulsions are carried out?
Anxiety is reduced and the behaviour effectively reinforced
Where does OCD typically require treatment within?
Secondary psychiatric services
What is hypochondriasis?
Abnormal preoccupation with the state of health or bodily functions
