L3 Introduction to Pyschiatry

Question 1

what is psychiatry

Answer 1

“the branch of medicine which is concerned with the understanding, assessment, diagnosis and treatment of the mind”

Question 2

what may psychiatric disorders involve

Answer 2

emotions, behaviour, perceptions and cognition

Question 3

what can psychiatric disorders affect

Answer 3

social life, work, and relationships

Question 4

historical context in psychiatry

Answer 4

• Patients institutionalised in separate facilities → in order to keep them separate from other people.
• Now integrated with general hospitals and primary care.

Question 5

Examples of co-morbidities between mental and physical illnesses

Answer 5

• Depression and cardiovascular disease (e.g., post-stroke depression).
• Diabetes and schizophrenia.

Question 6

Hippocrates contributions to psychiatry

Answer 6

• (460–379 BC):
• Humorism (Four humours)
  
  • Black bile - depression
  • Yellow bile - mania
  • Blood
  • Phlegm

Question 7

Plato’s contributions to psychiatry

Answer 7

(387 BC): Brain is the “seat of mental processes”

Question 8

historical aspect of psychiatry in ireland

Answer 8

• Pre-1600s:
  
  • Spiritual/religious approaches, Brehon Law altruism.
  • Monasteries offered limited care; most lived in destitution or imprisonment.
  • Sites like Gleann na nGealt said to offer relief.
• Post-1600s: Reports of people “wandering the roads” because the didn’t have anywhere else to go.

Question 9

1708

development

Answer 9

St. James’ Gate Workhouse had six cells for the “lunatic poor”

Question 10

1746

development

Answer 10

Jonathan Swift’s bequest led to St Patrick’s Hospital (first psychiatric hospital) (built in 1757)

Question 11

1814

development

Answer 11

Richmond Asylum opened with “moral management” principles

Question 12

1817

development

Answer 12

Robert Peel “Select Committee on the Lunatic Poor in Ireland”

Question 13

result of Select Committee assessnebt

Answer 13

• Legislation that resulted in building of asylums:
  
  • 1820s: Asylums in Armagh, Belfast, Derry and Limerick
  • 1835: Asylums in Ballinasloe, Carlow, Waterford, Maryborough (Portlaoise)
  • 1840s and 1850s: Central Mental Hospital (Dublin), Eglinton (Cork), Mullingar, Letterkenny, Castlebar.

Question 14

how many people were in asylums in 1900

Answer 14

21,000

Question 15

what problems existed in asylums

Answer 15

overcrowding and infection

Question 16

examples of early psychiatric treatments

from the 1900s

Answer 16

• insulin therapy (1938)
• convulsive therapy (1939)
• psychosurgery (1946)
• chlorpromazine (1952)

Question 17

why was there a decline in asylum numbers between the 1900s and 2000s

Answer 17

• challenges and changes made to mental health legislation
• developments in human rights, psychological medicine, and outpatient treatment led to changes in how people were treated

Question 18

what first psychiatric medications were created in the 1950s

Answer 18

• chlorpromazine - antipsychotic
• imipramine - antidepressant

Question 19

when were SSRIs introduced

Answer 19

the 1980s

Question 20

what does SSRI stand for

Answer 20

selective serotonin reuptake inhibitor

Question 21

examples of SSRIs

Answer 21

• fluoxetine
• sertraline
• escitalopram

Question 22

what development in mental health policy occured in 1966

Answer 22

Commission of Enquiry on Mental Illness

Question 23

Commission of Enquiry on Mental Illness

changes to policy

Answer 23

• promoted “radical and widespread changes”
• shift towards community care and family support
• recommended inclusion of the patients’ general practioner

Question 24

what development to mental health policy occured in 1984

Answer 24

planning for the future

Question 25

what did planning to the future describe

Answer 25

- admission to hospital was determined a final treatment resource - community care was underfunded - day hospitals and child guidance teams were recommended - highlighted concerns over premature discharges leading to encounters with the criminal justice system

Question 26

what development in mental health policy occured in 2006

Answer 26

A vision for change

Question 27

What was a vision for change

Answer 27

- Policy pertaining to mental health assessment, care and treatment - called for accessible, community-based services - Closure of all mental hospitals was emphasised - specifics regarding community mental health teams, per population

Question 28

What development in mental health policy occured in 2020

Answer 28

"sharing the vision"

Question 29

what were the general aims of "sharing the vision"

Answer 29

- mental health promotion - prevention and early intervention - acute, community and specialist services - enhanced capacity for primary care services to treat mental health

Question 30

when was the mental health act enacted

Answer 30

2001

Question 31

what did the mental health act 2001 say

Answer 31

- governs involuntary detention of people with mental illness to approved centres for inpatient treatment. - defines the role of he mental health commission as the regulation and promotion of development of service delivery both in approved centres and the community

Question 32

what percentage of adults with experience mental illness in their lifetime

Answer 32

25%

Question 32

what is the bio-psycho-social model

Answer 32

- Interdependency between biological, psychological, and social processes. - Biological processes underlie psycho-social function, and psychological and social processes impact biological function.

Question 33

what type of care follows the bio-pscho-social framework

Answer 33

multidisciplinary involvement to provide holistic, individualised care

Question 34

what is mental illness

Answer 34

a series of syndromes consisting of characteristic clusters of symptoms and signs of disordered mental functioning (ie. emotions, thoughts, perceptions and behaviours) resulting in substantial suffering and psychological, social or occupational dysfunction

Question 35

two examples of standard classification manuals used to classify psychiatric disorders

Answer 35

- Diagnositci and Statistic Manual of Mental Disorders (DSM-V) (2013) - International Classification of Diseases (ICD-11)

Question 36

which standard classification manual is used in the US and Canada

Answer 36

DSM-V

Question 37

which standard classification manual is used in Ireland and europe

Answer 37

ICD-11

Question 38

two stages of psychiatric assessment

Answer 38

1. Elicit psychopathology diagnosis (according to ICD-11/DSM-V) 2. Understand the individual patient holistically, identifying their vulnreabilities and protective factors

Question 39

mental health service provision in hospitals

Answer 39

- in-patient treament - safe environment - groups - 1:1 → psychology, OT, social work, nursing, medicine - medication

Question 40

mental health service provision in the community

Answer 40

- GP - day hospital/services - community OT, nursing, social work - community groups - supported accommodation

Question 41

MDT members

Answer 41

- consultant psychiatrist - SHO/registrar - community psychiatric nurse - social worker - OT - psychologist - addiction counseller - dietitican - pharmacist - SLT

Question 42

other disciples involved outside of the MDT

Answer 42

- private psychology - music/art/drana therapist - family-based supports - TUSLA - addiction services (inpatient rehab & community-based) - specialist communities (As I Am, Belong To, SHINE) - service user representatives

Question 43

stigma

Answer 43

negative stereotypes leading to discrimingation

Question 44

stereotypes

Answer 44

generalised beliefs about something

Question 45

prejudice

Answer 45

negative judegements based on stereotypes

Question 46

discrimination

Answer 46

actions based on these prejudiced judegments and beliefs

Question 47

public stigma

Answer 47

stigma faced externally from a system, group or individual

Question 48

impacts of public stigma

Answer 48

life areas such as employment, housing, healthcare and education