Introduction to Psychiatry I

Question 1

How many people will have a mental health disorder in their lifetime?

Answer 1

1 in 3

Question 2

How many GP consultations have a mental health component?

Answer 2

1 in 3

Question 3

Do most people fully recover?

Answer 3

Yes

Question 4

How is the engagement with patients?

Answer 4

Poor engagement with patients sometimes

Question 5

How many people feel stigmatised?

Answer 5

3 in 4
Many people are scared to discuss illness

Question 6

How much of the NHS funding funds mental health?

Answer 6

10%

Question 7

How can you treat mental illness?

Answer 7

Psychotherapies
Social therapies
Medication

(excellent evidence based)

Question 8

What is the difference between mental and physical illness?

Answer 8

No scientific basis to diagnosis
Similar to 18th century medicine
Diagnose by symptom cluster- not aetiology or pathology
Uncertainty about diagnosis
Dispute about existence of mental illness
Perceived lack of treatment
Agents of social control

Question 9

What are symptoms of anxiety? (9)

Answer 9

Psychic:
- Feeling fear or dread

Physical symptoms:
- Palpitations
- Sweating
- Dry mouth
- Splanchnic vasoconstriction (butterflies)
- Tremor
- Paraesthesia (pins and needles)
- Depersonalisation
- Syncope

Question 10

What are symptoms of obsessive compulsive disorder- obsessions? (6)

Answer 10

Ego-dystonic thoughts
Repetitive, circular ruminations
May be bizarre and sound delusional
Insight maintained
Unbidden and resisted
Resistance leads to anxiety

Question 11

What are symptoms of obsessive compulsive disorder- compulsions? (3)

Answer 11

Motor response to obsessional thoughts
Often ritualistic, stereotyped, precise

E.g.,:
- Handwashing
- Counting
- Arranging and symmetry
- Checking door locks

Start again if interrupted or doubt

Question 12

How can anxiety be classified? (7)

Answer 12

Generalised anxiety disorder
Panic Disorder
Agoraphobia
Simple phobia
Social phobia

Obsessive compulsive disorder
Post traumatic stress disorder

Question 13

What is anxiety’s epidemiology?

Answer 13

Anxiety is normal and useful.
Anxiety is only a disorder if it is excessive, impacts on life or out of context.

Question 14

What are 4 facts about anxiety?

Answer 14

Most common cause of mental disorder
Estimates of lifetime prevalence between 14 and 33%
More common in females (2:1)
Median onset age is 11

Question 15

What can you do to treat anxiety?

Answer 15

Course of cognitive behaviour therapy (CBT)
Clomipramine
(medication and psychological therapies)

Question 16

What is the most common cause of mental illness?

Answer 16

Anxiety

Question 17

What are the core features of depression?

Answer 17

Pervasive low mood/ sadness
Loss of energy (anergia)
Loss of enjoyment (anhedonia)

Question 18

What are the physical symptoms of depression?

Answer 18

Loss of appetite
weight loss
Diurnal variation of mood
Poor sleep
Loss of libido
Constipation
Psychomotor slowing or agitation

Question 19

What are the psychological symptoms of depression?

Answer 19

Poor concentration
Feelings of guilt
Feelings of hopelessness
Low self-esteem
Indecisive
Suicidal ideation
Delusions

Question 20

How many suicides in the UK anually?

Answer 20

over 6000

Question 21

What is the most common cause of death in young men?

Answer 21

Suicide

Question 22

What is the male to female ratio of suicide?

Answer 22

3:1

Question 23

Rates of suicide are rising in which group of people?

Answer 23

young and middle aged men

Question 24

What is the most common method of suicide?

Answer 24

Hanging

Question 25

What is suicide most commonly associated with

Answer 25

Drug and alcohol use disorders and depression

Question 26

What is the treatment for depression?

Answer 26

Medication: antidepressants (response after 2-3 weeks) Psychological therapies: (12 session of cognitive behavioural therapy) Social prescribing: Exercise, company (90% of patients make a full recovery)

Question 27

What are the symptoms of mania?

Answer 27

Elated mood Irritability Over-energized Grandiose Little need for sleep Poor concentration Poor judgement Over-spending Rapid speech

Question 28

What are the symptoms of schizophrenia?

Answer 28

Hallucinations Delusion Abnormal Behaviour Disorganised Speech Disturbances of emotions Passivity Thought alienation

Question 29

What are hallucinations?

Answer 29

Hearing, seeing or feeling things that are not there

Question 30

What are delusions?

Answer 30

Fixed false beliefs not shared by others in the person's culture and that are firmly held even when there is evidence to the contrary.

Question 31

What is meant by abnormal behaviour?

Answer 31

Disorganised behaviour such as wandering aimlessly, mumbling or laughing to self, strange appearance, self-neglect or appearing unkempt

Question 32

What is meant by disorganised speech?

Answer 32

Incoherent or irrelevant speech

Question 33

what is meant by disturbances of emotions?

Answer 33

Marked apathy or disconnect between reported emotion and what is observed such as facial expression or body language

Question 34

What is formal thought disorder (linked to schizophrenia)?

Answer 34

Failing to follow the semantic and syntactic rules of language

Question 35

What are treatments for schizophrenia?

Answer 35

Antipsychotics Psychological therapies Family therapy Arts therapies

Question 36

What are the 4 key features of schizophrenia?

Answer 36

Delusions Disorganised speech Hallucinations Negative symptoms

Question 37

Key features of schizophrenia: delusions

Answer 37

Fixed false beliefs Persecutory Bizarre Thought possession and passivity

Question 38

Key features of schizophrenia: Disorganised speech

Answer 38

Neologisms Formal thought disorder

Question 39

What are the 4 key features of schizophrenia?

Answer 39

Delusions Disorganised speech Hallucinations Negative symptoms

Question 40

Key features of schizophrenia: Hallucinations

Answer 40

Second person Third person Tactile

Question 41

Key features of schizophrenia: Negative symptoms

Answer 41

Apathy Social withdrawal Poor self care

Question 42

What is the state of mind of depression?

Answer 42

horrible, corrosive state of mind

Question 43

What is the lifetime risk of depression?

Answer 43

10% lifetime risk

Question 44

Do most people make a full recovery with depression?

Answer 44

Yes

Question 45

How many patients with schizophrenia develop chronic symptoms?

Answer 45

1 in 3

Question 46

What is the lifetime risk of schizophrenia?

Answer 46

1%