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Clinical Conditions > Exam 14: Psychiatric Disorders (Part 1) > Flashcards

Exam 14: Psychiatric Disorders (Part 1) Flashcards

1
Q

mental health definition

A

a state of being, relative rather than absolute; ability to cope with the stresses of life; work productively, contribute to community

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2
Q

mental health deficits definition

A
  • difficulty controlling feelings, thoughts, and behaviors
  • difficulty doing everyday activities/ tasks
  • disordered patterns of relating to others
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3
Q

mental health disorder definition

A
  • behavioral or psychological syndrome that causes significant stress
  • impairs function
  • increases the risk of death, pain, or loss of freedom
  • can be caused by a medical condition (undiagnosed)
  • manifestation of behavioral, psychological, or biological dysfunction
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4
Q

diagnosis definition

A
  • ongoing process
  • the process of determining, through examination and analysis, the nature of a patient’s illness
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5
Q

impact of mental health disorders

A
  • can cause physical, emotional, interpersonal discomfort
  • poor emotional regulation
  • impairment in ability to function/ work
  • increases risk of self harm and imprisonment
  • creates difficulty in relationships
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6
Q

least stigma to most stigma

A
  • physical
  • cognitive
  • mental health
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7
Q

DSM definition

A

diagnostic and statistical manual of mental disorders

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8
Q

ICD definition

A

international classification of disease

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9
Q

symptom definition

A

subjective indicator of disease

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10
Q

sign definition

A

objective indicator of disease (lab values, X-ray/ MRI)

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11
Q

syndrome definition

A

a cluster of commonly co-occurring symptoms

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12
Q

sub-syndromal definition

A
  • does not rise to threshold of diagnosis
  • could also be called “sub-clinical)
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13
Q

co-morbidity definition

A

two or more disorders that occur together
- “dual-diagnoses

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14
Q

differential diagnosis definition

A

the process of determination between similar diagnoses

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15
Q

unspecified definition

A

symptom clusters may vary from typical descriptions

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16
Q

depressive mood disorders definition

A
  • disturbance of mood that is not because of any other physical or mental disorder
  • prolonged
  • affects all aspects of daily living
  • depression
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17
Q

major depression symptoms (5+ present over 2 week period)

A
  • depressed mood
  • anhedonia (lack of pleasure in things you typically would)
  • anorexia (absence of appetite/ eating)
  • appetite/ weight change
  • psychomotor retardation/ agitation
  • insomnia/ hypersomnia
  • worthlessness/ guilt
  • recurrent thoughts of death/ suicide
  • indecisiveness; inability to think/ concentrate
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18
Q

functional deficits in major depression

A
  • social, work, leisure roles
  • possible ADL and IADL deficits
  • habits, roles, routines deteriorate during episode
  • motor, process, and communication slowing
  • changes in cognitive function
    • all deficits improve between episodes
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19
Q

etiology of mood disorders

A
  • biological
  • genetic
  • environmental
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20
Q

biological cause of mood disorders

A
  • changes in brain chemistry
  • imbalance in neurotransmitters/ hormones
    (serotonin, norepinephrine, acetylcholine, and melatonin)
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21
Q

genetic cause of mood disorders

A
  • family link
  • connected through twins
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22
Q

environmental cause of mood disorders

A
  • stress as a contributing factor
    • traumatic events increase risk
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23
Q

facts about major depressive disorder

A
  • onset may be gradual
  • often unrecognized and untreated
  • may be irritable
  • less social, withdrawn
  • disinterest
  • tired; not yourself
  • affect
  • sadness
  • hopelessness
  • guilt
  • cognitive impairments
    • (poor concentration; difficulty making decisions)
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24
Q

major depressive disorder symptoms

A
  • psychomotor agitation
    • unintentional and purposeless motions
    • wandering
    • wringing hands
  • psychomotor retardation
    • slow physical movements
    • difficulty carrying out automatic tasks
    • difficulty performing tasks that require little thought
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25
Q

what is electro convulsive therapy? (ECT)

A
  • important treatment for persistent or treatment resistant depression or anxiety
  • can be done on outpatient basis
  • initially 6-12 treatments
  • maintenance ECT weekly and then monthly
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26
Q

side effects of ECT

A
  • headache, nausea, flu-like symptoms
  • short term memory loss
  • decrease in inhibitions
  • disorganization or ADHD like symptoms
    • must have 24 hr supervision following an ECT treatment
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27
Q

what is dysthymic disorder

A
  • milder, chronic depressive disorder
  • at least 2 years
  • Eeyore
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28
Q

seasonal affective disorder

A
  • SAD
  • fall/ winter short days and long nights may trigger feelings of depression, lethargy, and fatigue
  • light therapy, melatonin
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29
Q

OT intervention for depression

A
  • TUS
  • don’t make decisions for client
  • reality orientation (done with adequate rapport)
    “what could be some other reasons” never talk a person out of their feeling though; always validate them
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30
Q

risks for suicide

A
  • high stress
  • mental illness
  • chemical abuse
  • history of impulsive behavior
  • chronic physical illness or sudden onset disability
  • age: adolescents & elderly
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31
Q

types of self harm

A
  • cutting, burning, eating disorders, chemical abuse +
    • can be cause of accidental death
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32
Q

all about panic disorder

A
  • panic attacks can become a panic disorder if recurrent/ severe
  • sympathetic nervous system
  • neuroplasticity to break the cycle
  • symptoms:
    • apprehension, dyspnea, dizziness, nausea, chest pain, hot flashes, numbness, feeling of doom
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33
Q

agoraphobia

A

fear of leaving a familiar environment
- can also begin to occur with early dementia

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34
Q

obsessive-compulsive disorder (OCD)

A
  • obsessions = intrusive thoughts
  • compulsions = required behaviors
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35
Q

post traumatic stress disorder (PTSD)

A
  • common following traumatic incident
  • genetic component
  • impairments in sleep, can become hyper-alert, can dissociate, nightmares, anxiety, agitation, volatile temper
36
Q

conversion disorder (PTSD)

A

neurologic symptoms that are real, but no diagnosable physical condition; can present as seizures, paralysis, blindness, weakness, sensory loss

37
Q

reactive attachment disorder (RAD)

A
  • disorder consistent pattern of inhibited, emotionally withdrawn behaviors toward adult caregiver
  • persistent social and emotional disturbance
  • experienced a pattern of extremes in lack of care
  • stems from lack of consistent caregiving
  • fear, sadness, irritability
  • 9 months +
  • foster care, addicted/ abusive parents, institutionalized care
38
Q

etiology of dissociative disorders

A

believed to be related to extreme psychosocial stress, shock, or trauma

39
Q

etiology of dissociative identity disorder (DID)

A

believed to be related to the above or physical, emotional, or sexual abuse occurring early in childhood

40
Q

depersonalization disorder

A

feeling of detachment or estrangement from one’s self, body or mind

41
Q

personality disorders

A
  • when personality traits become maladaptive and cause significant functional impairment
  • cluster A, B, & C
42
Q

paranoid personality disorder

A
  • pattern of pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent
  • not related to other disorders
43
Q

antisocial personality disorder

A
  • occurs with onset or before 15, but is at least 18
  • pervasive pattern of disregard for and violation of the rights of others
  • not exclusively with other disorders
44
Q

histrionic personality disorder

A

pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts

45
Q

dependent personality disorder

A

pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts
- lots of symptoms

46
Q

borderline personality disorder

A
  • identity disturbance
  • self-damaging actions
  • impulsive
  • self-mutilating behavior
  • affect/ demeanor
  • extrinsic vs. intrinsic locus of control
47
Q

specific skill sets to address with personality disorders

A
  • ability to accurately identify emotions
  • ability to accurately identify and verbalize needs
  • improvement in self-awareness: think MOHO
48
Q

eating disorders definition

A

characterized by severe disturbances in eating or eating related behavior that results in the altered consumption or absorption of foods and that significantly impacts physical health

49
Q

common comorbidities with eating disorders + treatment

A
  • depression
  • anxiety
  • personality disorder
  • substance abuse
  • internal > external locus of control
50
Q

etiology for eating disorders

A
  • unknown
  • possible role in genes/ serotonin
  • possible OCD, perfectionism, low self-esteem, PTSD
  • possible standards
51
Q

anorexia nervosa signs & symptoms

A
  • refuses to maintain minimum body weight
  • afraid to gain weight
  • body dysmorphia
  • inconsistent periods (amenorrhea)
52
Q

anorexia nervosa subtypes

A
  • restricting type
  • binge-eating/ purging type
53
Q

anorexia nervosa course and prognosis

A
  • day-to-day fight recovery
  • treatment can last years to lifetime
  • increased mortality rate due to complications
54
Q

bulimia nervosa

A
  • recurrent episodes of binge eating
  • recurrent inappropriate compensatory behavior to prevent weight gain
55
Q

bulimia nervosa subtypes

A
  • purging: vomiting
  • nonpurging: vomiting, exercise
56
Q

self-medicating examples, goal, diagnoses

A
  • chemical use/ abuse
  • physical self-harm
  • eating disorders
  • destructive relationships
  • risky behavior
  • goal: temporary emotional regulation
  • diagnoses: bipolar, BPD, history of chemical abuse
57
Q

consequences of negative coping strategies

A
  • higher risk of injury and death
  • accidental death due to self harm
  • decreased impulse control
  • higher risk of assault
  • diminishes support system
  • increases deficits in self-esteem
  • becomes part of the person’s identity
  • offers no long term solutions
  • delays recovery
58
Q

chemical abuse/ dependency risks

A
  • imitate neurotransmitters
  • flood the brain with dopamine
  • slow down or block the neurons from communicating
59
Q

stimulants (sympathetic)

A
  • caffeine
  • nicotine
  • cocaine
  • ecstasy
  • ADHD drugs
60
Q

depressants (parasympathetic)

A
  • marijuana
  • alcohol
  • pain pills
  • anti-anxiety pills
61
Q

psychological withdrawal symptoms

A
  • anxiety
  • restlessness
  • agitation
  • looks like mania or ADHD (off stimulants)
  • depression
  • fatigue
  • paranoia
62
Q

physical withdrawal symptoms

A
  • tremor
  • high or low bp
  • headaches
  • nausea/ vomiting
  • hallucinations
  • chest pain
  • sweating
  • cravings for drug
63
Q

bipolar disorder symptoms/ prognosis

A
  • one or more episodes of mania, hypomania, or mixed mood states
  • onset around 18 years
  • high risk of suicide
  • BPD I & BPD II
  • prodromal period: time before full onset
  • at first the elevated periods are very productive
  • persistently elevated, expansive or irritable mood lasting at least 1 week
64
Q

BPD I

A

manic then hypomanic then major depressive

65
Q

BPD II

A

hypomanic then major depressive
- no mania

66
Q

what is a manic episode

A

period of abnormally and persistently elevated, or irritable mood lasting at least 1 week
- 3-4 symptoms

67
Q

manic episode symptoms

A
  • inflated self-esteem or grandiosity
  • decreased need for sleep (3 hrs)
  • excessively talkative
  • racing thoughts
  • flight of ideas
  • distractibility
  • excessive in goal directed activity or psychomotor agitation
  • impulsive; self-destructive activities
68
Q

cyclothymic disorder

A
  • milder, chronic manic/ depressive disorder
  • at least 2 years with symptom-free intervals of no more than 2 months
69
Q

what you might see with mania

A
  • person talks really fast and switches topics quickly
  • content may not make sense
  • often become religiously preoccupied
  • can be delusional or hallucinate
  • may be impatient with others around them
  • makeup might be excessive or grooming and clothing generally odd
  • psychomotor agitation
70
Q

challenges with psychosis

A
  • do not stay on their meds (insight is poor or effects are upsetting)
  • patients become preoccupied with their internal stimuli
  • numerous functional deficits
  • can be difficult to redirect
  • difficulty discriminating between psychosis and reality
71
Q

what is psychosis

A

can be a comorbidity with other conditions
- major depression
- postpartum depression
- mania
- chemical use
- schizophrenia
- dementia (lewy body & alzheimer’s)
- acquired brain injury

72
Q

psychotic symptoms

A
  • hallucinations
  • delusions
  • paranoia
  • disorganization
73
Q

secondary cognitive issues when psychotic

A
  • disorganized
  • variable moods
  • difficulty communicating
  • difficulty with attention and concentration
74
Q

types of schizophrenic disorders

A
  • schizophrenia
  • schizoaffective disorder
  • delusional disorder
  • brief psychotic disorder
75
Q

definition of schizophrenia

A
  • delusions, hallucinations, disorganized thinking (speech, grossly disorganized or abnormal motor behavior and negative symptoms
  • progressive, chronic, treated > cured
  • affects brain (insight, impulse control, judgment, affect, social skills)
76
Q

signs & symptoms premorbid or pre illness

A
  • learning problems in school
  • change in activity level
  • hypo/hyperactive
  • changes in mood
  • euphoric or depressed
  • complaints about the body
  • obsessiveness
  • guilt
  • unpredictable or odd behavior
  • anxiety, fearfulness
77
Q

positive schiz symptoms

A

excess of behavior
- hallucinations
- delusions
- disorganized speech
- disorganized or lack of motor
- catatonia

78
Q

negative schiz symptoms

A

absence of function
- anhedonia (lack of pleasure in typical things that would be)
- avolition (no motivation)
- flat or blunted affect
- alogia (no speech flow/ logic)

79
Q

cognitive schiz symptoms

A
  • reduced ability to process information
  • lack insight or awareness of disorder
80
Q

affective (affect) schiz symptoms

A
  • inappropriate emotional response
  • mood disturbances
    • dysphoria
81
Q

echolalia definition

A

the repetition of vocalizations made by another person

82
Q

echopraxia

A

involuntary repetition or imitation of the observed movements of another

83
Q

schizoaffective disorder

A

uninterrupted period of illness during which, at some time, there is either a major mood (depressive) episode, a manic episode, or a mixed episode concurrent with 6 that meet for criteria for schizophrenia

84
Q

etiology of schizophrenia disorders

A
  • unknown
  • genetic
  • environmental
  • structural changes
85
Q

neurological theories

A

many have a higher sensitivity to sensory input, difficulty tuning things out, functional deficits
- peripheral vision
- reticular activating system
- neuroplasticity and schizophrenia

86
Q

brief psychotic disorder

A

1 or more of:
- delusions
- hallucinations
- disorganized speech
- grossly disorganized or catatonic behavior
1 day - 1 month, person returns back to normal level of function

87
Q

delusional disorder

A
  • non bizarre delusions of at least 1 month
  • may be tactile and olfactory hallucinations related to the delusional theme
  • functioning is not markedly impaired

Clinical Conditions (16 decks)

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