Psychiatry I

Question 1

What is the prevalence of mental illness?

Answer 1

1/3 in lifetime
—> 1/3 GP consultations

Question 2

How much NHS funding goes to mental health?

Answer 2

10%
—> cuts in funding

Question 3

What are the 3 treatment approaches for mental illnesses?

Answer 3

1. Psychotherapies
2. Social therapies
3. Medication

Question 4

Why are mental health disorders difficult to diagnose?

Answer 4

1. No scientific basis to diagnose —> use symptom
   cluster —> uncertainty
2. Stigmatisation —> patients don’t seek/want
   diagnosis

Question 5

What is an anxiety disorder?

Answer 5

Excessive feelings of fear and dread
- most common cause of mental disorder —> 14-33%
- 2:1 to females
- median onset 11

Question 6

What are the 8 physical symptoms of anxiety?

Answer 6

1. Palpitations
2. Sweating
3. Dry mouth
4. Splanchnic vasoconstriction (butterflies)
5. Tremor
6. Paraesthesia (pins and needles)
7. Depersonalisation
8. Syncope (fainting)

Question 7

What are the 7 types of anxiety disorders?

Answer 7

1. GAD (generalised)
2. Panic disorder
3. Agoraphobia (social)
4. Simple phobia
5. Social phobia
6. OCD
7. PTSD

Question 8

What is OCD and how does it manifest?

Answer 8

Obsessive Compulsive Disorder

1. Obsessions = ego-dystonic thoughts, repetitive
   ruminations, delusional
   
   • still maintain insight —> know they sound bizarre
   • resistance —> anxiety
2. Compulsions = motor response to obsessions
   
   • eg. hand-washing, counting, arranging, checking
     locks
   • repeat from start if disturbed/not perfect

Question 9

What are the 7 psychological symptoms of depression?

Answer 9

1. Poor concentration
2. Guilt
3. Hopelessness
4. Low self-esteem
5. Indecisive
6. Suicidal ideation
7. Delusions

Question 9

How are anxiety disorders treated?

Answer 9

1. Psychotherapies —> CBT
2. Medication —> clomipramine

Question 10

What is depression?

Answer 10

Long-lasting low mood, anergia (no energy) and anhedonia (no enjoyment)
- 10% lifetime risk

Question 11

What are the 7 physical symptoms of depression?

Answer 11

1. Lose appetite
2. Weight loss
3. Diurnal mood swings
4. Poor sleep
5. Low/no libido
6. Constipation
7. Psychomotor slowing/agitation

Question 12

What is the prevalence of suicide in the UK?

Answer 12

Over 6000/year
- 3:1 to males —> commonest cause of death in young
men —> rates rising
- commonest method —> hanging
- associated with drug addiction, alcohol addiction,
depression

Question 12

What are the 9 symptoms of mania?

Answer 12

1. Elated mood
2. Irritability
3. Over-energised
4. Grandiose —> overly ambitious
5. Poor concentration
6. Poor judgement
7. Over-spending
8. Rapid speech
9. Little sleep need

Question 13

How is depression treated?

Answer 13

1. Psychotherapies —> 12 session CBT
2. Social therapies —> exercise
   —> company
3. Medication —> respond in 2-3 weeks
   - eg. venlafaxine
   - 90% patients fully recover

Question 14

What is schizophrenia?

Answer 14

Abnormal interpretation of reality
- Delusions
- Disorganised speech —> neologisms, FTD
- Hallucinations —> 2nd or 3rd person
- Apathy, social withdrawal, poor self care

Question 15

What are the 5 symptoms of schizophrenia?

Answer 15

1. Hallucinations —> hear, see, feel
2. Delusions —> passivity (no questioning), thought
   alienation (can’t control)
3. Abnormal behaviour —> wandering, mumbling,
   laughing, self-neglect
4. Disorganised speech —> neologisms, FTD (formal
   thought disorder)
5. Abnormal emotions —> apathy, emotion doesn’t
   match face/body

Question 16

How is schizophrenia treated?

Answer 16

1. Psychotherapies
2. Social therapies —> family therapy
   —> arts therapy
3. Medications —> antipsychotics