Quiz 2- Psychiatric Disorders Flashcards
What is bipolar spectrum disorder?
- Symptoms are episodic with intervals of depression and mania, interspersed with periods of remission when clients may be symptom free
- Occurs 1-2% of population
- higher morbidity and mortality rate than depression
When does bipolar usually onset?
young adulthood
first episode 15-19 y.o
What are the typical S/S of bipolar in children and adolescents?
- irritability
- explosive anger
- agitation
- antisocial activity
- extreme risk-taking behaviors
- S/S more typically chronic than episodic in the age group
Describe the mania episode.
Can be manic or hypomanic
1) Mania: elevated or extremely high mood that is beyond happy and often accompanied by an irritable mood and irrational thoughts
- elevated mood must last 1 week or be sever to warrant hospitalization
- more than just extremely happy, progresses to state of expansive and chaotic thinking and poor judgement
- considered “out of control”
2) Hypomania: not as severe as true mania, enjoy the “high” and can be very productive to to creativity and high energy
- productive state does not last
- can escalate to full manic = judgement and cognitive ability deteriorate
What are the cognitive S/S for mania?
- inflated feelings of importance or grandiosity with delusions
- invulnerability
- decreased ability to assess risks- physical, social, financial
What are the physiological S/S for mania?
- Decreased need for sleep
- Extremely high energy levels
- loss of perceived need to eat or drink
What are the mood/emotion S/S for mania?
- elevated, expansive mood, excited
- Feeling “high” - I can accomplish anything
- Agitated, irritable, angry
What are the behavioral S/S for mania?
- May be hostile, aggressive, or belligerent
- Rapid, incessant talking (pressured speech)
- Creative, flight of ideas
- Engages in dangerous behaviors, without regard to safety
- Hypersexualtiy
- “out of control:
What are the appraisal problems with mania?
- unrealistic appraisals of capacities and limitations
- Lacks safety awareness- frequently engages in extremely high-risk behaviors
What are the anxiety disorders?
1) Generalized anxiety disorders
2) Social and other Phobias
3) Panic Disorders
4) PTSD
5) Conversion Disorder
What is Generalized anxiety disorder (GAD)?
- Can be present all the time or episodic
- Persistently high level of tension, with pervasive feelings of anxiety and apprehension, loss of appetite, difficulty concentrating, restlessness, sleep disturbances, and feelings of overarousal
- aka “the worried well”
- difficult to diagnose because pt recall is inaccurate
- may cling to the provider emotionally, may be rigid or manipulaitve
- fear losing control
Describe social and other phobias
- Usually specific phobias trigger anxiety symptoms to appear or worsen
- Fear occurs when triggering event present, it is intense and not under voluntary control
- Extreme cases can cause severe morbidity that is significant as that which occurs with Serious and Persistent Mental Illness (SPMI)
What is a panic disorder?
A sudden, uncued, and intense feeling of anxiety
- SNS cascade causes sudden and intense “fight or flight” response
- Symptoms: palpitations, hyperventilation, SOB
- feelings of going insane or will die
- can be brief in duration (not usually longer than 10 min)
What is the criteria for diagnosing a panic disorder?
At least 4 of the following during the episode:
- pounding heart
- sweating
- trembling
- choking or other smothering sensations
- chest pain
- nausea
- dizziness
- denationalization
- fear of losing control
- fear of dying
- numbness or tingling
- hot and cold flashes
What can panic disorder be associated with?
- anicipaotry anxiety caused by fear of having a panic attack
- other specific phobias such as where the panic attack occured
- can lead to agoraphobia- perceives environment to be unsafe
What is PTSD?
- only occurs after clients experience a traumatic event that is perceived by the clients to put themselves or loved one at risk of death or serious injury
- occurs when catastrophic stress overwhelms individuals’ adaptive biological and coping responses
How is a PTSD diagnosis made?
Adults must have presence of three clusters of symptoms:
-Reexperiencing the traumatic event
-hyperarousal and hypervigilant behaviors
-avoidance of stimuli that trigger memories of the event
Children may express agitation or disorganization behaviors
-Exposure alone to an event is not sufficient to trigger PTSD
-Must observe or experience traumatic event
-Individual responds with feelings of extreme fear and helplessness
-Symptoms must last at least 1 month
What type of events can trigger PTSD?
- medical procedures
- prolonged illness and disability
- sudden onset of medical crisis
- rape
- domestic violence
- war experiences
- surviving a natural disaster
- traumatic medical event
What are the cognitive S/S of PTSD?
- Painful reexperiencing of traumatic events
- flashbacks
- intrusive thoughts or memories
- may have amnesia of the event
What are the physiological S/S of PTSD?
- hyper vigilance
- hyperresponsiveness to stimuli
- Increased levels of SNS arousal
- Increased startle reactions
- Insomnia
What are the Mood/emotion S/S of PTSD?
- Emotional numbing
- Flat affect
- Feeling disconnected from reality–dissociation
What are the Behavioral S/S of PTSD?
- Persistent avoidance of emotionally charted people, places, and events
- Persistent avoidance of triggers for memories of traumatic events
- irritability
- self-injurious behaviors
- poor impulse control
What are the appraisal problems with PTSD?
- Faulty judgment of current environment for safety, based on memories of past traumatic events
- Hypersensitivity to danger cues
What is conversion disorders?
- clients develop symptoms of physical illness that have no obvious physiological cause
- it’s a somatoform disorder- type of psychiatric disorder where clients manifest symptoms that cannot be otherwise explained
- client believes symptoms and illness are real
- symptoms do not match any known physical condition
- “convert” psychological distress, conflict, or need into “pseudo-neurological” symptoms, presumably unconciously
What is an important feature of conversion disorder?
la belle indifference- client does not seemed concerned about the symptoms
How prevalent is conversion disorder?
about 3% of clients seen in outpatient mental health clinics
What type of behaviors should raise a red flag in HCP’s thoughts?
- impaired judgement
- slovenly appearance
- risky behavior
- off-putting comments
- general social incompetence
In general, what type of symptoms do clients with psychiatric disorders present with?
Neurovegitative symptoms:
- eating or sleeping pattern changes
- altered states of arousal
- hyperventilation
- cardiovascular changes
- changes in muscle tone
