Chapter 7- Mental Health

Question 1

What’s the four headings on the mental health continuum model

Answer 1

Healthy
Reacting
Injured
ill

Question 2

What model can be used to demonstrate stress ins and outs and acute crisis

Answer 2

Bucket model of stress-vulnerability

Question 3

Clinically significant distress relies on what?

Answer 3

Perspective of the treatment provider

Question 4

Diagnosis of mental health conditions is based on what

Answer 4

DSM-V

ICD-10

Question 5

What are the characteristic symptoms of schizophrenia

Answer 5

Delusions 
Hallucinations 
Disorganised speech 
Grossly disorganised behaviour 
Negative symptoms 
Social/occupational dysfunction
Signs for at least 6months

Question 6

List positive symptoms of schizophrenia

Answer 6

Hallucinations
Delusions
Thought disorder
Passivity phenomena (chip in brain)

Question 7

What can delusions entail in schizophrenia

Answer 7

Paranoia
Grandiose
Ideas of reference (bus top numbers)

Question 8

List negative symptoms of schizophrenia

Answer 8

Slowed down thought and movement
Indifferent to social contact
Lack of interest in previously pleasurable things

Question 9

What’s more difficult to treat in schizophrenia.. positive or negative symptoms?

Answer 9

Negative

Question 10

What are the long term treatment goals of schizophrenia

Answer 10

Symptom control 
Prevent relapse/re-admission 
Ensure tolerability/safety 
Improve quality of life 
Improve social functioning 
Reduce cost

Question 11

What are the three key symptoms of depression

Answer 11

Lowered mood
Anergia (lethargy)
Anhedonia (no pleasure from activities)

Question 12

The new DSM-V criteria has taken out what and what problem could this cause

Answer 12

Bereavement exclusion

–> medicalising normal life

Question 13

What’s a big problem with SSRIs

Answer 13

Vomiting/nausea

Question 14

True/false: SSRIs are safer in overdose than TCAs

Answer 14

Yeh

Question 15

Three side effects of SSRIs

Answer 15

Nausea/vom
GI
Sexual dysfunction

Question 16

Side effects of TCA

Answer 16

Postural hypotension
Sedation
Anticholinergic effects

Question 17

TCAs are more toxic in overdose what two things can occur

Answer 17

Cardiac toxicity

Seizures

Question 18

Why is mirtazapine often used in combination with other antidepressants?

Answer 18

Different mechanisms of action

Question 19

After recovery how long should antidepressants be continued for

Answer 19

6months

Question 20

Why is alternate day dosing not a good idea with e.g venlafaxine

Answer 20

Short half life

Question 21

List the antidepressant discontinuation symptoms

Answer 21

Flu like symptoms 
Insomnia 
Nausea 
Imbalance 
Sensory disturbances 
Anxiety/ agitation

Question 22

Which type of antipsychotic is more targeted?

Answer 22

Atypical

Question 23

What do you need to consider when choosing antipsychotic medication

Answer 23

Metabolic
Extrapyramidal
Cardiovascular
Hormonal

Question 24

Risk of clozapine

Answer 24

Serious blood disorders

Question 25

Trial of antipsychotic medication should continue for how many weeks

Answer 25

4-6 weeks

Question 26

Half life of fluoxetine

Answer 26

Approx 1 week

Question 27

Why caution from switching to a TCA from fluoxetine/paroxetine

Answer 27

They inhibit metabolism of TCA start lower dose of TCA

Question 28

3 ways of switching medication

Answer 28

1) taper down drug and simultaneously start low and increase new drug(cross-tapering) 2) taper down and stop one then start another after gap 3) stop one and start another

Question 29

Symptoms of severe serotonin syndrome

Answer 29

Fever Seizures Irregular heartbeat Unconscious

Question 30

Side effects of typical antipsychotics

Answer 30

Hypotension EPSE abticholinergic effects

Question 31

3 examples of typical antipsychotics

Answer 31

Chlorpromazine Haloperidol Perphenazine

Question 32

Side effects of atypical antipsychotics

Answer 32

Diabetes Sexual dysfunction Weight gain

Question 33

Examples of atypical antipsychotics

Answer 33

Olanazpine Quetiapine Clozapine Risperidone

Question 34

What score on the PHQ-9 indicates moderate-severe depression

Answer 34

>10

Question 35

True false: PHQ-2 questionnaire can be an enhanced service and you have to be trained whereas PHQ-9 isn't

Answer 35

False it's the other way round

Question 36

PHQ-2 questionnaire asks about the past how many weeks?

Answer 36

2 weeks

Question 37

PHQ-2 score ranges from what

Answer 37

0-6

Question 38

PHQ-2 asks what 2 questions

Answer 38

1) little interest/pleasure in doing things | 2) feeling down, depressed or hopeless

Question 39

What's HADS

Answer 39

Hospital anxiety and depression score used in hospitals

Question 40

GADS7

Answer 40

Generalised anxiety and depression score 7