Exam 14: Psychiatric Disorders (Part 1) Flashcards
(87 cards)
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
2
Q
mental health deficits definition
A
- difficulty controlling feelings, thoughts, and behaviors
- difficulty doing everyday activities/ tasks
- disordered patterns of relating to others
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
4
Q
diagnosis definition
A
- ongoing process
- the process of determining, through examination and analysis, the nature of a patient’s illness
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
6
Q
least stigma to most stigma
A
- physical
- cognitive
- mental health
7
Q
DSM definition
A
diagnostic and statistical manual of mental disorders
8
Q
ICD definition
A
international classification of disease
9
Q
symptom definition
A
subjective indicator of disease
10
Q
sign definition
A
objective indicator of disease (lab values, X-ray/ MRI)
11
Q
syndrome definition
A
a cluster of commonly co-occurring symptoms
12
Q
sub-syndromal definition
A
- does not rise to threshold of diagnosis
- could also be called “sub-clinical)
13
Q
co-morbidity definition
A
two or more disorders that occur together
- “dual-diagnoses
14
Q
differential diagnosis definition
A
the process of determination between similar diagnoses
15
Q
unspecified definition
A
symptom clusters may vary from typical descriptions
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
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
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
19
Q
etiology of mood disorders
A
- biological
- genetic
- environmental
20
Q
biological cause of mood disorders
A
- changes in brain chemistry
- imbalance in neurotransmitters/ hormones
(serotonin, norepinephrine, acetylcholine, and melatonin)
21
Q
genetic cause of mood disorders
A
- family link
- connected through twins
22
Q
environmental cause of mood disorders
A
- stress as a contributing factor
- traumatic events increase risk
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)
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
25
what is electro convulsive therapy? (ECT)
- 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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side effects of ECT
- 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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what is dysthymic disorder
- milder, chronic depressive disorder
- at least 2 years
- Eeyore
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seasonal affective disorder
- SAD
- fall/ winter short days and long nights may trigger feelings of depression, lethargy, and fatigue
- light therapy, melatonin
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OT intervention for depression
- 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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risks for suicide
- high stress
- mental illness
- chemical abuse
- history of impulsive behavior
- chronic physical illness or sudden onset disability
- age: adolescents & elderly
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types of self harm
- cutting, burning, eating disorders, chemical abuse +
- can be cause of accidental death
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all about panic disorder
- 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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agoraphobia
fear of leaving a familiar environment
- can also begin to occur with early dementia
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obsessive-compulsive disorder (OCD)
- obsessions = intrusive thoughts
- compulsions = required behaviors
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post traumatic stress disorder (PTSD)
- common following traumatic incident
- genetic component
- impairments in sleep, can become hyper-alert, can dissociate, nightmares, anxiety, agitation, volatile temper
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conversion disorder (PTSD)
neurologic symptoms that are real, but no diagnosable physical condition; can present as seizures, paralysis, blindness, weakness, sensory loss
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reactive attachment disorder (RAD)
- 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
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etiology of dissociative disorders
believed to be related to extreme psychosocial stress, shock, or trauma
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etiology of dissociative identity disorder (DID)
believed to be related to the above or physical, emotional, or sexual abuse occurring early in childhood
40
depersonalization disorder
feeling of detachment or estrangement from one's self, body or mind
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personality disorders
- when personality traits become maladaptive and cause significant functional impairment
- cluster A, B, & C
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paranoid personality disorder
- pattern of pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent
- not related to other disorders
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antisocial personality disorder
- 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
histrionic personality disorder
pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts
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dependent personality disorder
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
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borderline personality disorder
- identity disturbance
- self-damaging actions
- impulsive
- self-mutilating behavior
- affect/ demeanor
- extrinsic vs. intrinsic locus of control
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specific skill sets to address with personality disorders
- ability to accurately identify emotions
- ability to accurately identify and verbalize needs
- improvement in self-awareness: think MOHO
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eating disorders definition
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
common comorbidities with eating disorders + treatment
- depression
- anxiety
- personality disorder
- substance abuse
- internal > external locus of control
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etiology for eating disorders
- unknown
- possible role in genes/ serotonin
- possible OCD, perfectionism, low self-esteem, PTSD
- possible standards
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anorexia nervosa signs & symptoms
- refuses to maintain minimum body weight
- afraid to gain weight
- body dysmorphia
- inconsistent periods (amenorrhea)
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anorexia nervosa subtypes
- restricting type
- binge-eating/ purging type
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anorexia nervosa course and prognosis
- day-to-day fight recovery
- treatment can last years to lifetime
- increased mortality rate due to complications
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bulimia nervosa
- recurrent episodes of binge eating
- recurrent inappropriate compensatory behavior to prevent weight gain
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bulimia nervosa subtypes
- purging: vomiting
- nonpurging: vomiting, exercise
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self-medicating examples, goal, diagnoses
- chemical use/ abuse
- physical self-harm
- eating disorders
- destructive relationships
- risky behavior
- goal: temporary emotional regulation
- diagnoses: bipolar, BPD, history of chemical abuse
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consequences of negative coping strategies
- 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
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chemical abuse/ dependency risks
- imitate neurotransmitters
- flood the brain with dopamine
- slow down or block the neurons from communicating
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stimulants (sympathetic)
- caffeine
- nicotine
- cocaine
- ecstasy
- ADHD drugs
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depressants (parasympathetic)
- marijuana
- alcohol
- pain pills
- anti-anxiety pills
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psychological withdrawal symptoms
- anxiety
- restlessness
- agitation
- looks like mania or ADHD (off stimulants)
- depression
- fatigue
- paranoia
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physical withdrawal symptoms
- tremor
- high or low bp
- headaches
- nausea/ vomiting
- hallucinations
- chest pain
- sweating
- cravings for drug
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bipolar disorder symptoms/ prognosis
- 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
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BPD I
manic then hypomanic then major depressive
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BPD II
hypomanic then major depressive
- no mania
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what is a manic episode
period of abnormally and persistently elevated, or irritable mood lasting at least 1 week
- 3-4 symptoms
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manic episode symptoms
- 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
cyclothymic disorder
- milder, chronic manic/ depressive disorder
- at least 2 years with symptom-free intervals of no more than 2 months
69
what you might see with mania
- 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
challenges with psychosis
- 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
what is psychosis
can be a comorbidity with other conditions
- major depression
- postpartum depression
- mania
- chemical use
- schizophrenia
- dementia (lewy body & alzheimer's)
- acquired brain injury
72
psychotic symptoms
- hallucinations
- delusions
- paranoia
- disorganization
73
secondary cognitive issues when psychotic
- disorganized
- variable moods
- difficulty communicating
- difficulty with attention and concentration
74
types of schizophrenic disorders
- schizophrenia
- schizoaffective disorder
- delusional disorder
- brief psychotic disorder
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definition of schizophrenia
- 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)
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signs & symptoms premorbid or pre illness
- 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
positive schiz symptoms
excess of behavior
- hallucinations
- delusions
- disorganized speech
- disorganized or lack of motor
- catatonia
78
negative schiz symptoms
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
cognitive schiz symptoms
- reduced ability to process information
- lack insight or awareness of disorder
80
affective (affect) schiz symptoms
- inappropriate emotional response
- mood disturbances
- dysphoria
81
echolalia definition
the repetition of vocalizations made by another person
82
echopraxia
involuntary repetition or imitation of the observed movements of another
83
schizoaffective disorder
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
etiology of schizophrenia disorders
- unknown
- genetic
- environmental
- structural changes
85
neurological theories
many have a higher sensitivity to sensory input, difficulty tuning things out, functional deficits
- peripheral vision
- reticular activating system
- neuroplasticity and schizophrenia
86
brief psychotic disorder
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
delusional disorder
- non bizarre delusions of at least 1 month
- may be tactile and olfactory hallucinations related to the delusional theme
- functioning is not markedly impaired
