Psychosis

Question 1

Five criteria for involuntary treatment under the MHA Vic

Answer 1

1. Appears to have mental illness
2. Imminent risk to self and others
3. Treatment available in gazetted facility
4. Incapable of making informed consent
5. Least Restrictive method

Question 2

What are the stems in involuntary treatment?

Answer 2

1. Request made (> 18)
2. Recommendation by medical practitioner + completion of ITO
3. Statutory review

Question 3

What is neuroeplieptic malignant syndrome?

Answer 3

Development of severe muscle rigidity and elevated temperature associated with use of neuroepileptic medication

Question 4

Signs and symptoms of NMS?

Answer 4

> =2 of;

1. Dysphagia, diaphoresis
2. Tremor, tachycardia
3. Conciousness (confusio nto coma)
4. Leukocytosis, mutism
5. Lab findings = elevated CK

Question 5

Management of NMS

Answer 5

1. Stop antipsychotics
2. Full exam
3. Exclude other organic (Sepsis, ST syndrome, Dystonia, Stroke, Encephalistis)
4. Transfer to ICU (Sup measure
5. Call for help (registrars)
6. Benzodiazepines for agitation
7. Wait 5 days before challenge

Question 6

What are the causes of non-compliance?

Answer 6

(Patient)

1. Lack of insight
2. Lack of understanding re dosage, times
3. Side effects
4. Stigma/ denial of illness
5. Unrealistic expectations - belief that they are cured

(Doctor)

1. Poor therapeutic alliance
2. Inadequate educaation
3. Wrong diagnosis or treatment

(System)

1. Cost
2. Delivery methods
3. Others interfering