Psych - 10th Nov Flashcards
3 major and name a few of the 7 minor sx of depression
Low mood, anhedonia, fatigue / low energy
Disturbed sleep, appetite change, poor concentration, low self esteem, guilt, suicidal thoughts, bleak and pessimistic thought of future
Diagnosis of depression?
> 1major sx present most of every day
Mild - 4 sx but still mostly functioning
Moderate - 5/6 and impact on normal functioning
Severe - 7 or more sx and severe impact on social functioning
Psychotic - severe + psychotic sx
Management of mild, moderate, and severe depression?
ALWAYS assess suicide risk
Mild - low intensity psychological Eg CBT self help, active monitoring
Moderate- medication, psychosocial interventions
Severe - medication, inpatient care, ECT if catatonic
Some sx of mania
Elated mood and increased energy Feeling of mental and psychical well-being Reduced need for sleep Loss of social inhibition Over-spending Increased sexual energy Pressure of speech Increased self esteem, grandiosity Insight is usually lost
Diagnosis of mania
Sx for >1wk
Impact on normal functioning
Social rejection due to bizarre behaviour
Usual time of episodes of bipolar? How long do manic / depressive episodes usually last?
Following stressful life events
Manic - 4 months
Depressive - 6 months
Management of manic? Depressive? Maintenance of bipolar?
Manic - don’t make important decisions until better
- antipsychotics
- mood stabilisers can be used 2nd line acutely
Depressive - fluoxetine + antipsychotic
Maintenance - lithium / sodium valproate
3 clusters of personality disorders
Cluster A ‘Odd or eccentric’ (MAD) Schizoid Schizotypal Paranoid Cluster B ‘Dramatic, emotional or erratic’ (BAD) Antisocial/Dissocial Emotionally unstable/Borderline Histrionic Narcissistic Cluster C ‘anxious or fearful’ (SAD) Anankastic Anxious/Avoidant Dependant
Talk about schitzoid ? Eg of who ?
emotionally ‘cold’
don’t like contact with other people, often uninterested in sexual contact
have a rich fantasy world
day dream a lot
Sheldon Big Bang theory
Schitzotypal features ? Eg of who?
eccentric behaviour
odd ideas
difficulties with thinking
lack of emotion, or inappropriate emotional reactions
see or hear strange things
You wonder if they are psychotic
sometimes related to schizophrenia, the mental illness
David tennant in doctor who
Paranoid personality disorder features? Eg?
suspicious
feel that other people are being nasty to you (even when evidence shows this isn’t true)
feel easily rejected
tend to hold grudges
The husband who always thinks his wife in cheating on him
Antisocial personality disorder features? EG?
don’t care much about the feelings of others
easily get frustrated
tend to be aggressive
commit crimes
find it difficult to makeclose relationships
impulsive - do things on the spur of the moment without thinking about them
don’t feel guilty about things you’ve done
The joker from batman
Features of borderline / emotionally unstable? Eg?
find it hard to control your emotions feel bad about yourself often self-harm, and use it as a threat make relationships quickly, but easily lose them can feel paranoid or depressed clingy, falls in love easily
A certain person post break up
Features of histrionic ? Eg?
over-dramatise events
self-centered, attention seeking behaviour
have strong emotions which change quickly and don’t last long
can be suggestible
worry a lot about your appearance
crave new things and excitement
can be seductive, sexually promiscuous
Reality TV stars
Features of narcissistic? Eg?
Sense of self importance
Dream of unlimited success, power and intellectual brilliance
Crave attention, but show few warm feelings in return
Asks for favours but doesn’t like doing them
Kanye west
Features of Anankastic (obsessive compulsive) Eg?
Worry and doubt Perfectionist Cautious - pre occupied with detail Worry about doing the wrong thing Find it hard to adapt to new situations High moral standards Judgemental Sensitive to criticism Obsessional thoughts
Eg behrouz
Features of avoidant ? Eg?
Anxious and tense Worry a lot Insecure and inferior Have to be liked and accepted Sensitive to criticism Avoid people due to feeling
Eg
Features of dependant
Passive Rely on other to make your decisions Do what other people want you to Find it hard to cope with daily chores Hopeless and incompetent feeling Feel easily abandoned
Define hallucination / delusion
Delusion
a belief that is held with strong conviction despite superior evidence to the contrary
Hallucination
an experience involving the apparent perception of something not present
Parts of the mental state examination? Mnemonic
ASEPTIC Appearance and behaviour Speech Emotion Perceptions Thoughts Insights Cognition
Diagnosis of schitzophrenia
ICD 10
1 clear 1st rank symptom
Or at least 2 other symptoms
For > 1 month
1st rank symptoms Thought echo, insertion, withdrawal or broadcasting Delusions of control 3rd Person auditory hallucinations Delusions of perception
Other symptoms Persistent delusions in other modalities Breaks in train of thought Catatonic behaviour -ve symptoms
Features of paranoid schitz
Most common form
(a) delusions of persecution, reference, exalted birth, special mission, bodily change, or jealousy;
(b) hallucinatory voices that threaten the patient or give commands, or auditory hallucinations without verbal form, such as whistling, humming, or laughing;
(c) hallucinations of smell or taste, or of sexual or other bodily sensations; visual hallucinations may occur but are rarely predominant.
Features of Hebephrenic schitz
Affective changes prominent
Hallucinations fleeting
Behaviour is irresponsible and unpredictable
