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KC2017 Behavioral Health > Intro > Flashcards

Intro Flashcards

1
Q

Mental Disorder (definition)

A

Illness with psychological or behavioral manifestations associated with significant distress and impaired functioning

Caused by biological, social, psychological, genetic, physical or chemical disturbance

Measured in terms of deviation from some normative concept

Ea. Illness has characteristics signs and symptoms

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2
Q

Official classification system used by mental health professionals to diagnose psychiatric illness

A

Diagnostic and Statistical Manual of Mental Disorders *DSM) 5th ed. (2013)

Has diagnostic criteria for 22 major categories of mental disorders (727 discrete illnesses)

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3
Q

Major Categories of Psychiatric Illnesses (9 in class)

A
  1. Schizophrenia Spectrum +
  2. Bipolar and related
  3. Depressive
  4. Anxiety
  5. Obsessive-compulsive +
  6. Trauma and stressor related
  7. Feeding and eating
  8. Substance related and addictive
  9. Personality disorders
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4
Q

Schizophrenia Spectrum and other Psychotic disorders

Defined by abnormalities in which domains:

A
  1. Delusions
  2. Hallucinations
  3. Disorganized thinking/speech
  4. Grossly disorganized or abnormal behavior
  5. Negative/positive symptoms
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5
Q

Bipolar and related disorders

A

defined by “manic episodes” and “depressive episodes”

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6
Q

Depressive disorders

A

Defined by presence of sad, or empty, or irritable mood

Accompanied by somatic and cognitive changes

Affects individuals capacity to function

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7
Q

Anxiety disorders

A

Excessive fear, anxiety and behavioral disturbances

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8
Q

Fear

A

Emotional response to real or perceived imminent threat

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9
Q

Anxiety

A

Anticipation of a FUTURE threat

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10
Q

Obsessive compulsive and related disorders

A

Presence of obsession and/or compulsion

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11
Q

Obsessions

A

Recurrent and persistent thoughts, urges, or images that experienced as intrusive and unwanted

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12
Q

Compulsions

A

Respective behaviors or mental acts that an individual feels driven to perform in response to an obsession

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13
Q

Trauma and stressor related disorders

A

Requisite exposure to trauma or stressful event

Variable symptoms (anxiety, anhedonia, dysphoria, externalized anger, aggressiveness, dissociativeness)

May have more than one

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14
Q

Somatic symptom and related

A

Prominence of somatic symptoms associated with significant stress and impairment

Abnormal thoughts, feelings, and behaviors in response to the symptoms

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15
Q

Feeding and eating disorders

A

Characterized by a persistent disturbance of eating and or eating-related behavior that results in the consumption or absorption of food that significantly impairs physical health or psychosocial functioning

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16
Q

10 classes of drugs – substance related and addictive disorders

A
  1. Alcohol
  2. Caffeine
  3. Cannabis
  4. Hallucinogens
  5. Inhalants
  6. Opioids
  7. Sedative, hypnotics, anxiolytics
  8. Stimulants
  9. Tobacco
  10. Other/unknown
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17
Q

Personality disorders

A

Enduring pattern of inner experience and behavior that deviates markedly from expectations of culture

Pervasive and inflexible

Onset in adolescence or early adulthood

Stable over time

Leads to distress or impairment

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18
Q

Psychotic

A

Loss of reality testing with delusions and hallucinations

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19
Q

Neurotic

A

No loss of reality testing

Based mainly on intrapsychic conflicts or life events that cause anxiety

Symptoms include obsessions , phobia, and compulsion

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20
Q

Functional

A

No known structural damage or clear cut biological cause to account for impairment

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21
Q

Organic

A

Illness caused by specific agent producing structural changes in the brain

Associated with cognitive impairment, delirium or dementia

NOT used in DSM

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22
Q

Primary

A

No known cause

Aka idiopathic

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23
Q

Secondary

A

Known to be a symptomatic manifestation of systemic, medical, or cerebral disorder (i.e. Delirium from fever)

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24
Q

Tangentially

A

Oblique, digressive, or even irrelevant manner of speech in which central idea is never communicated

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25
Circumstantiality
Disturbance in associative thought and speech process in which a patient digresses into unnecessary details and inappropriate thought before communicated in the central idea Seen in schizophrenia, obsessional disturbances, and certain cases of dementia
26
Thought blocking
Abrupt interruption in training of thinking before a thought or idea is finished After a brief pause, the patient indicates no recall of what is being said or was going to be said Often indicates presence of mental illness such as schizophrenia
27
Loosening of associations
Thinking or speech disturbance involving a disorder in logical progression of thoughts, manifested as a failure to communicate verbally adequately Unrelated and unconnected ideas shift from one subject to another
28
Flight of ideas
Rapid succession of fragmentary thoughts or speech in which content changes abruptly and speech may be incoherent Seen in mania
29
Word salad
Incoherent, essentially incomprehensible, mixture of words and phrases commonly seen in far-advanced cases of schizophrenia
30
Hallucinations
False sensory perception occurring in the absence of any relevant external stimulation of the sensory modality involved
31
Delusions
A false belief, based on incorrect inference about external reality Held firmly despite objective and obvious contradictory proof or evidence and despite the fact that other members of the culture do not share the belief
32
Orientation
State of awareness of onself and one's surroundings in terms of person, place, time and situation (Ox4)
33
Insight
Conscious recognition of one's own condition In psychiatry refers to conscious awareness and understanding of one's own psycho dynamics and symptoms of maladaptive behavior Highly important in effecting changes in the personality and behavior of the person
34
Judgement
Mental act of evaluating or comparing choices within the framework of a given set of values for the purpose of electing a course of action If the course of action is consonant with reality or with mature adult standards of behavior, judgment is said to be intact or normal Judgment is impaired if course is maladaptive, results from impulsive decisions based on need for immediate gratification, or is otherwise not consistent with reality as measured by mature adult standards
35
Two sections of the psychiatric exam
1. Complete medical history, pertinent PE | 2. Psychiatric history
36
Screening lab tests used in psych exams
Can't determine specific psychiatric disorders CBC Renal and liver panel (creatinine/BUN/LFTs) TSH Lyres, blood sugar, RPR (syphilis), vitamin B12, UA, tox screen
37
Thyroid function test
Depression with hypothyroidism Lithium therapy can cause hypothyroidism Subclinical hypothyroidism can cause depression (order TRH)
38
Dexamethasone-suppression test
Used to confirm major depressive disorder 1mg p.o. At 11PM, blood level measured at 8a, 4p, 11p) (Level >5mg/dl= + result or non-suppression (abnormal)) Not perfect --- many false -/false +
39
Catecholamines
5-HIAA elevated w/carcinoid tumors (urine) +/- when on phenothiazines (urine) In CSF: low in suicidal depressed patients Decreased in all violent behaviors but increased in PTSD
40
Renal function tests
Need to monitor in patient taking lithium Creatinine/BUN
41
LFTs
Need to monitor on patients taking phenothizine, tricyclic antidepressants, phenobarbital/carbamezpine (Tegretol) and valproate (Depakene)
42
Lab tests related to medications
Plasma levels - lithium Clozapine (clozaril) -- WBC (risk of agranulocytosis) Tricyclics/tetracycl drugs -- EGC (conduction delays), blood levels for therapeutic range
43
Drugs that you order plasma levels for
Imipramine/Tofranil Nortriptyline/Pamelor Desipramine/Norpramin
44
Lithium lab tests
Thyroid function Lytes WBC Renal function ECG
45
Sodium lactate
Can precipitate panic attack with sodium lactate IV Can be used to confirm dx
46
Types of psychotherapy
1. Psychoanalysis 2. Group therapy 3. Family therapy 4. Marital therapy 5. Biofeedback 6. Cognitive therapy
47
Cognitive therapy
Patient's problem is based on perception of their environment Individual therapy sessions aimed at changing these perceptions
48
Cognitive therapy is used in patients with which disorders
Depression Panic disorder OCD Personality disorders Somatoform disorders
49
Cognitive triad of depression
Negative self perception View world in negative manner Expects world will not change
50
8 main topics of mental status exam
1. Appearance and behavior 2. Speech 3. Mood 4. Thoughts 5. Perception 6. Cognition 7. Insight 8. Judgment
51
Biofeedback
Brings autonomic nervous system under voluntary control Patients then learn relaxation techniques EMG often used
52
Martial therapy goal
Alleviate emotional distress and disability Promote levels of well being of both partners together and of ea. As an individual
53
Martial therapy
Conflicts between married people involving social, emotional, sexual, or economic problems Can be individual, couples, groups CI if one person involved has psychosis Doesn't always result in couples remaining together
54
Family therapy
Focused on improving relationships within family structure Therapist trained for family therapy Uses interview technique, sessions held weekly (1-2 hrs/session)
55
Group therapy
8-10 patients with mental health disorders (can be a variety of disease, heterogeneous situations work best) Meet weekly with a therapist present to change behavior Can be inpatient or out patient Contraindicated if social anxiety
56
Psychoanalysis
Used by psychiatrists Based on sigmund Freud Patient lies on couch
57
Psychoanalysis Goals
Bring suppressed memories into present personality Main emphasis on conflict between unconscious drives and moral judgments patient makes regarding their behavior
58
Psychoanalysis Indication
Psychoneuroses (anxiety disorders, compulsive behavior, conversion disorder, sexual dysfunction, personality disorders)
59
Patient indications Psychoanalysis
Genuine desire to gain self understanding of behavior Able to handle emotions that emerge with psychoanalysis Must be honest with analysis
60
Psychoanalysis Fundamental principle (second principle)
Free association Second principle - analyst must remain neutral

KC2017 Behavioral Health (11 decks)

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