Psychiatric Disorders throughout the life course Flashcards
Define Adjustment reaction
States of subjective distress and emotional disturbance, usually interfering with social functioning and performance, arising in the period of adaptation to a significant life change or a stressful life event.…. The manifestations vary and include depressed mood, anxiety or worry (or mixture of these), a feeling of inability to cope, plan ahead, or continue in the present situation, as well as some degree of disability in the performance of daily routine.
Define Organic delusional disorder
A disorder in which persistent or recurrent delusions dominate the clinical picture. The delusions may be accompanied by hallucinations. Some features suggestive of schizophrenia, such as bizarre hallucinations or thought disorder, may be present.
What Happens in Post Stroke Psychosis
Prevalence
Delusions 4.67% (95% CI 2.30% to 7.79%)
Hallucinations 5.05% (95% CI 1.84% to 9.65%).
More in right hemisphere strokes (5:1)
Common delusional themes:
Persecutory
Jealousy
Environment
Treatment response unknown
What is the relationship between physical illness and mental health symptoms?
Many long term medical conditions are associated with increased risk of mental illness:
Cardiovascular diseases 3x risk of depression and anxiety
Diabetes 2x risk of depression
Chronic obstructive pulmonary disease 10x risk of panic disorder
Muscloskeletal disorders 2x risk of depression
What are some examples of physical illness causing discrete mental illness?
Thyrotoxicosis - anxiety, mania
Thyroid Deficiency - depression, dementia
Cushing’s disease - depression
Infections (syphilis,HIV) - psychosis
Cancer - depression
Parkinson’s disease - depression, anxiety, dementia
What is the relationship between chronic mental illness & physical illness?
People with chronic mental illness are at greater risk of developing physical illness;
Diet & Excercise
Smoking, Alcohol & Drugs
Medication
What is the life expectancy of people with Chronic mental illness?
Die 20 years younger than the general population
Define Delirium
organic cerebral syndrome characterized by concurrent disturbances of consciousness and attention, perception, thinking, memory, psychomotor behaviour, emotion, and the sleep-wake schedule. The duration is variable and the degree of severity ranges from mild to very severe
What is the Prevalence of Delirium?
Prevalence
20% acute hospital patients >65 on admission
20% more develop delirium after admission
Overall prevalence 30% on wards, 80% in intensive care
50% undetected
50% “hypoactive”
What are the possible causes of Delirium?
Infection (Urine, pneumonia, cellulitis, wound etc)
Change in environment (ITU, HDU, ward)
Medication (opiates, anticholinergics, steroids)
Alcohol withdrawal
Surgery
Pain
What are some physiological causes of Delerium?
Liver/renal impairment
Hypoxia
Hyponatraemia
Stroke
Encephalitis
Constipation
Urine retention
Dehydration
What are the predisposing factors for Delerium?
Advanced age
Dementia (often undetected)
Impaired activities of daily living
Immobility
Sensory impairment
Urinary catheterization
Malnutrition
Alcohol
Depression
What is the Management for Delirium?
Anticipate
Modify risk factors if possible
Early diagnosis
Treat the causes
Good nursing
Single room, well lit, familiar staff/family (in an ideal world)
Medication
Wait!
What is stigma?
Stigma refers to challenges faced by people with mental illness related to knowledge, attitudes, and behaviour of people they meet
Poor understanding of mental health
Negative attitude
Social exclusion
What is the relationship between stigma and discrimination?
Stigma leads to discrimination
Increases the disability caused by mental illness
Creates disadvantage with personal relationships, education, and work
Pervasive and widespread
75% people with mental illness experience stigma
