General hospital psychiatry Flashcards
1
Q
Liaison psychiatry
A
- Subspeciality of psychiatry working with patients in the general hospitals
- Work with medical and surgical colleagues in management of their patients
- Specialist care to patients in a general hospital setting with a wide range of mental disorders
- Education to general hospital clinicians on basic management of mental health problems in the general hospital
2
Q
Liaison psychiatry
A
- Subspeciality of psychiatry working with patients in the general hospitals
3
Q
Common mental disorders in the general hospital
A
- Self-harm
- Affective and adjustment disorders (anxiety and depression)
- Organic brain syndromes (delirium, dementia, amnesic syndromes)
- Personality disorders
- Psychiatric disorders associated with substance misuse
- Eating disorders
- Functional disorders
3
Q
Common mental disorders in the general hospital
A
- Self-harm
- Affective and adjustment disorders (anxiety and depression)
- Organic brain syndromes (delirium, dementia, amnesic syndromes)
- Personality disorders
- Psychiatric disorders associated with substance misuse
- Eating disorders
- Functional disorders
4
Q
Less common mental health disorders in the general hospital
A
- Schizophrenia
- Bipolar affective disorder
- Melancholia (severe depression)
5
Q
Aetiology of mental health disorders in general hospital settings
A
- Challenges of physical illness
- Psychological
- Effects of physical illness on brain functioning
- Treatment of physical disorder (medication)
- Increased physical morbidity in those with mental health disorders
- Functional disorders (somatoform, dissociative)
6
Q
Self harm
A
- Commonest cause of admission in females <65 years
- Recent increase in self-harm rates in young males
- All self harm patients should have routine psychosocial assessment
- Paracetamol → commonest drug taken in overdose
- Associated with significant personality disorder/ mental health disorder (not often one itself)
- Substance misuse common (alcohol and drugs)
7
Q
Self-harm assessment
A
- Environment → patient feels listened, experience relief and able to identify the issues
- Identify risk factors of further self-harm → suicide
- Identify mental disorder and need for further psych treatment
- Identify psychosocial stressions and patients way of coping
- Identify appropriate help, even in absence of mental disorder
8
Q
Delirium tremens
A
- Better explained in Organic Mental Disorder lecture
- Lasts less than 72 hours
- Rarely recurrent over long period of tine
- Mortality due to cardiovascular collapse, infection, hyperthermia or self-injury
9
Q
Managed of Acute Confusional State in general hospital
A
- Environmental and supportive measures
- Education
- Safe environment
- Optimise stimulation
- Orientation
- Correct factors contributing to delirium
- Avoid sedatives and antipsychotics
10
Q
Substance misuse/ dependance
A
- 20% admissions directly related to ill effects of alcohol
- Physical complications
- Intoxication
- Withdrawal (including delirium)
- Alcohol-related brain disease
- Trauma/ accident
- Drug-induced psychosis
- Feigned illness to obtain drugs (opiates)
11
Q
Functional neurological disorders
A
- Medically unexplained symptoms
- Dissociative disorders
- Somatoform disorders
- One third of neurology outpatients
- Present to all specialties
- Subject to inappropriate investigations and treatments
- Significant disability
- Often associated with underlying or co-morbid psychiatric disorder
12
Q
Presentation of functional neurological disorders
A
- Neuro
- Function neurological disorder
- Non-epileptic attack disorder
- Persistent postural-perceptual dizziness
- GI
- Irritable bowel syndrome
- Cyclical vomiting syndrome
- Functional dyspepsia
- Rheumatology
- Fibromyalgia
- Benign hyper mobility disorder
- General med → chronic fatigue syndrome
- ENT/ dentistry
- TMJ joint dysfunction
- Atypical facial pain
- Gynaecology
- Loin pain haematuria syndrome
- Chronic pelvic pain
- Cardiology → atypical chest pain
- Respiratory → chronic hyperventilation
13
Q
History in function neurological disorder
A
- More common psychological symptoms
- ⅔ have past history of mental health problems
- History of adverse childhood experiences/ trauma
