Psychiatry throughout the life course Flashcards
What is the burden of Adolescent Mental Health?
Mental health conditions account for 16% of the global burden of disease and injury in people aged 10-19 years
Half of all mental health conditions start by 14 years of age but most cases are undetected and untreated
What is happening in the adolescent brain?
The prefrontal cortex matures later than the cortical areas associated with sensory and motor tasks.
Adolescence is a period of neural imbalance caused by early maturation of subcortical brain areas and delayed maturation of prefrontal control areas.
What is the peak age of onset for different illnesses?
Depression 19.5 Anxiety 5.5 Attention Deficit Hyperactivity Disorder 9.5 Autism Spectrum Disorder 5.5 Obsessive Compulsive Disorder 14.5 Eating Disorders 15.5 Substance misuse 19.5
What is the proportion with a median age of onset of mental disorders before the age of 18?
48.4%
What are the core features of ADHD?
Persistent pattern ofinattentionand/orhyperactivity–impulsivity
Present for at least 6 months
Inappropriate for their developmental level
Interferes with functioning or development
Several symptoms present before age 12
Several symptoms present in two or more settings
The symptoms are not better explained by another mental disorder
What are the risk factors for ADHD?
Risk Factors: Genetic
No isolated gene for ADHD, there may be several genes contributing to the vulnerability for developing it
Twin studies have shown a significant heritability for ADHD - as high as 76%
First degree relatives of children with ADHD have an ADHD diagnostic probability 4-5 times higher than the general population
Boys are more vulnerable than girls
Risk Factors: Environmental
Premature birth
Low birth weight
Prenatal tobacco exposure
What is the prognosis like for ADHD?
Prognosis: 70% of children who have this disorder will have the disorder as teenagers, and about 40%-60% will still have it as adults
Describe Dementia?
Degenerative disease of the brain with:
cognitive and behavioural impairment
sufficiently severe to interfere significantly with social and occupational function
What is the epidemiology of dementia?
Worldwide, 47.5 million people have dementia. Expected to reach 75.5 million by 2030 and 135.5 million by 2050.
UK, dementia is leading cause of death in women and is second to heart disease for men.
Most common cause of dementia is Alzheimer’s disease (AD), 70% of cases.
Risk of AD increases with age:
1% at age 60yrs;
doubles every 5yrs;
40% of those aged 85yrs.
What are the early symptoms of dementia?
Absent-mindedness Difficulty recalling names and words Difficulty learning new information Disorientation in unfamiliar surroundings Reduced social engagement
What are the late features of dementia?
Marked memory impairment Reduced vocabulary Loss of less complex speech patterns. Mood swings and/or apathy Decline in ADL’s & social skills Emergence of psychotic phenomena.
What are the features of advanced Dementia?
Monosyllabic speech Psychotic symptoms Behavioural disturbance Loss of bladder and bowel control Reduced mobility
What is the scoring criteria for the mental health exam?
Scores of 25-30 out of 30 are considered normal; the National Institute for Health and Care Excellence (NICE) classifies 21-24 as mild, 10-20 as moderate and <10 as severe impairment.
