Psychiatry intro

Question 1

what is an adjustment reaction?

Answer 1

states of subjective distress and emotional disturbance, interfering with social functioning/performance arising in a period of adaptation to a significant life change or stressful life event

Question 2

what is an organic delusional disorder?

Answer 2

a disorder in which persistent or recurrent delusions dominate. there may be hallucinations, thought disorders too

Question 3

what is the prevalence of post stroke psychosis?

Answer 3

delusions 4.7%
hallucinations 5.1%
more common in right hemisphere strokes (5:1)

Question 4

what is post stroke psychosis?

Answer 4

psychosis following a stroke

common delusional themes: persecutory, jealousy, environmental

Question 5

what is the point prevalence of mental illness in england?

Answer 5

20%

Question 6

what is a significant risk factor for mental illness?

Answer 6

having a long term physical condition

Question 7

what is the morbidity rate of mental illness?

Answer 7

takes 20 years off life expectancy

Question 8

Which long term medical conditions are associated with increased risk of mental illness? (4)

Answer 8

• CVD → 3x risk of depression and anxiety
• Diabetes → 2x risk of depression
• COPD → 10x risk of panic disorder
• MSK disorder → 2x risk of depression

Question 9

What are endogenous vs exogenous steroid excess linked more with in terms of mental illness?

Answer 9

Endo: depression
exo: mania

Question 10

what are the types of delirium?

Answer 10

hypoactive - depressed, withdrawn and subdued

hyperactive - aggressive, loud presentation

Question 11

what is delirium?

Answer 11

psychiatric manifestation of physical illness

Question 12

what is the range of delirium causes?

Answer 12

very large - change in environment, surgery, medications, constipation, hypoxia etc
- Liver/renal impairment- important
- Hyponatraemia- important
- Constipation- common cofactor in leading to delirium in elderly
- Alcohol withdrawal- you get hallucinations and strong tremors
- infection (urine, pneumonia, cellulitis, wound etc)

Question 13

what are the predisposing factors to delirium?

Answer 13

advanced age, dementia, impaired AoDL, immobility, sensory impairment, urinary catheterisation, malnutrition, alcohol, depression

Question 14

how does one manage delirium?

Answer 14

anticipate, modify risk factors & early diagnosis

treat the cause, good nursing, medication (often not helpful), wait it out

Question 15

what is mental health stigma?

Answer 15

challenges faced by mentally ill people related to: poor understanding, negative attitudes towards mental illness, social exclusion

Question 16

what is intrapersonal stigma?s

Answer 16

internalised discrimination compounded by the direct effects of the illness

Question 17

what is interpersonal stigma?

Answer 17

stigma from friends, family, colleagues which may cause social isolation

Question 18

what is structural stigma?

Answer 18

poor resources/funding and access to physical health care compounding social stigma

Question 19

give examples of illnesses causing mental deficits

Answer 19

thyrotoxicosis - mania, anxiety
hypothyroid - depression, dementia
cushings - depression
infections - depression
cancer - depression
parkinsons - depression, anxiety, dementia