Self-test questions Flashcards
What are the chapters included in the ICD10?
Chapter 5 – mental and behavioural disorders
• F00-F09 Organic, including symptomatic, mental disorders
• F10-F19 Mental and behavioural disorders due to psychoactive substance use
• F20-F29 Schizophrenia, schizotypal and delusional disorders
• F30-F39 Mood [affective] disorders
• F40-F48 Neurotic, stress-related and somatoform disorders
• F50-F59 Behavioural syndromes associated with physiological disturbances and physical factors
• F60-F69 Disorders of adult personality and behaviour
• F70-F79 Mental retardation
• F80-F89 Disorders of psychological development
• F90-F98 Behavioural and emotional disorders with onset usually occurring in childhood and adolescence
• F99-F99 Unspecified mental disorder
Described the interactions between mental health and physical health
Physical illness can precede mental illness – grief, loss, chronic pain, change in role/work. People with any chronic physical disease tend to feel more psychological distress than do healthy people. Poor physical health brings an increased risk of depression, as do the social and relationship problems that are very common among chronically ill patients.
Mental illness can precede physical illness – poor/maladaptive coping, self-harm, drug misuse. Depression linked to coronary heart disease, stroke, colorectal cancer, back pain, irritable bowel syndrome, multiple sclerosis, and possibly type 2 diabetes.
What is dysthymia?
A mood disorder consisting of the same cognitive and physical problems as in depression, with less severe but longer-lasting symptoms
Why might depression be more common in women?
Bio – Genetic predisposition, fluctuating hormone levels (think childbirth and menopause)
Psych – women ruminate more, men more likely to be stoic, angry or abuse substances. Women more invested in relationships.
Sociocultural – Women under more stress than men, women live lon ger – bereavement, loneliness, poor physical health. Women more likely to seek out a diagnosis of depression
What social factors make people vulnerable to depression?
- Death of a loved one
- Divorce or marital problems such as infidelity
- Loss of a job, financial problems, or poverty leading to homelessness
- A chaotic, unsafe, and dangerous home life such as violence in the family
- Abusive relationships that undermine self-confidence
- Social failures such as friendships
- Moving to another city
- Experiences that cause learned helplessness in which one believes that they have no control in life
- Serious trauma such as abuse, neglect, rape, etc.
- Social isolation
What are the indications for ECT?
It should only be used if other treatment options have failed or the condition is potentially life-threatening (eg, personal distress, social impairment or high suicide risk).
• Severe depressive illness or refractory depression.
• Catatonia.
• A prolonged or severe episode of mania
Action TCAs
TCAs raise serotonin and norepinephrine
What are the advantages and disadvantages of SSRIs compared to tricyclic antidepressants?
- SSRIs and TCAs have similar efficacy for the treatment of depression
- SSRIs have fewer anticholinergic and cardiovascular side effects
- TCA have fewer sexual and gastrointestinal side effects
- SSRIs are better tolerated by patients
- TCAs are associated with more frequent treatment discontinuations (i.e. more people dropping out tricyclics than SSRIs)
- SSRIs are safer in overdose than TCAs
What is “thought broadcast”?
Belief that others can hear or are aware of an individual’s thoughts
What are core symptoms of schizophrenia according to the ICD10 classification?
Positive symptoms - Hallucinations, delusions, disordered thinking & speech
(Negative symptoms - or little emotion, poverty of speech, inability to experience pleasure, lack of desire to form relationships, and lack of motivation)
What is a delusion and how can it be distinguished from normal experience?
A delusion is a belief, out of keeping with the individual’s cultural origins, that is held with strong conviction despite superior evidence to the contrary.
As a pathology, it is distinct from a belief based on false or incomplete information, confabulation, dogma, illusion, or other effects of perception
What is the difference between second person and third person auditory hallucinations?
Second order hallucinations are auditory hallucinations in which a voice appears to address the patient in the second person. For example the voice may be talking directly to the patient - “You are going to die” - or the voice may be telling the patient to do some action - “kill him”. These types of auditory hallucinations are not diagnostic in the same way as third person auditory hallucinations, but the content of the hallucination, and the patient’s reaction to it, may help in diagnosis
Third person hallucinations are auditory hallucinations in which patients hear voices talking about themselves, referring to them in the third person, for example “he is an evil person”.
Which forms of hallucinations are characteristic of a) schizophrenia? b) organic disorders?
a) Third person auditory hallucinations
b) Visual and tactile hallucinations
What are the components of insight? (How should it be recorded?)
Can be said to have three components:
- recognition that one has a mental illness
- compliance with treatment
- he ability to re-label unusual mental events (such as delusions and hallucinations) as pathological
(the clinician should not describe it as simply present or absent, but should report the patient’s explanatory account descriptively)
Why is an assessment of insight important?
Impaired insight is characteristic of psychosis and dementia, and is an important consideration in treatment planning and in assessing the capacity to consent to treatment.
What is a “word salad”?
Confused or unintelligible mixture of seemingly random words and phrases
What is a hallucination?
Perception in the absence of external stimulus that has qualities of real perception
In what conditions can hallucinations occur?
Infectious disorders e.g. encephalitis, herpes simplex
Neoplasms e.g. temporal lobe tumor
Mental/psychiatric e.g. psychosis, schizophrenia, mania
Poisoning e.g. amphetamine, delirium tremens, alcohol halluinosis
Progressive disorders e.g. parkinsons and lewy body dementia
Charles bonnet syndrome
Focal epilsepsy
What is the definition of a neurotic disorder?
Class of functional mental disorders involving distress but neither delusions nor hallucinations.
What disorders are included under “neurosis”?
Anxiety disorders
Phobias
Obsessive compulsive disorder
What are patients with dependent personalities at risk of developing depression?
Inability to make decisions without advice (poor self-efficacy & locus of control)
Intense helplessness when relationships end
Over-sensitivity to criticism
Pessimism and lack of self-confidence
Poor assertiveness skills (self-sacraficing)
More willing to tolerate mistreatment and abuse from others
What are simple phobias?
Specific or simple phobias centre around a particular object, animal, situation or activity. They often develop during childhood or adolescence and may become less severe as you get older.
Common examples of simple phobias include:
•animal phobias – such as dogs, spiders, snakes or rodents
•environmental phobias – such as heights, deep water and germs
•situational phobias – such as visiting the dentist or flying
•bodily phobias – such as blood, vomit or having injections
•sexual phobias – such as performance anxiety or the fear of getting a sexually transmitted infection
What defines someone’s personality?
A collection of characteristics or traits that we have developed as we have grown up and which make each of us an individual.
These include the ways that we:
think
feel
behave
