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Flashcards in Mental Health Deck (34):
1

Who did 1970s psychiatric hospital study?

Rosenhan

2

Describe Rosenhan's study

1970s
8 normal people at 12 psychiatric hospitals in USA - hearing voices (empty, hollow, thud)
All admitted with schizophrenia / mania depression.
Patients thought they were CQC/journalist
7-52 days to be discharged - all given mediation and 'Sx/Mania in remission'

3

what illness are included under mental health?

depression, stress, anxiety, eating disorders, drug dependence, mania, schizophrenia, OCD, bipolar

4

Define psychiatrist

Medical doctor specialising in psychiatry
Can prescribe drugs

5

Define psychologist

Psychological / mental management / treatment of patients. Not medical

6

Define psychiatric nurses

Work with patients and families in the community

7

Define psychiatric social workers

Welfare rights
community facilities
powers under Mental Health Act (2005)

8

Rosenhan's second study

Psychiatric hospital told about
- first study
- in next 3 months pseudo patients will arrive
- rate each new arrival 0-10 (0=pseudo, 10=def has mental illness)
Results:
- 193 patients admitted
- 83 may have been pseudo (41 - confident they were pseudo)
- Rosenhan didn't send any pseudo, all were 'real'

9

What are affective disorders?

depression
anxiety

10

What ratio suffer from a mental disorder in the UK?

1:7
NB diagnosed (clinical iceberg)

11

What % of people with mental disorders are female in the UK?

55%

12

Out of 1000 in general pop, how may have POOR mental HEALTH?

300
NB these people have same problems and are entitled to same OH care, but have:
- increased disease / needs (medications, poor OH, reduced ability to look after themselves)
- increased barriers to dental care
- increased risk of dental anxiety/phobia

13

What is DSM-V?

Diagnostic and Statistical Manual of Mental Disorders - Version 5
- used in the UK
- ICD-10 (International Classification of Disease, Version 10) used in USA
Categories:
- neurodevelopmental disorders, schizophrenia, bipolar, depression, anxiety, OCD, post traumatic stress disorder, dissociative disorder (memory, awareness, identity, or perception affected), medically unexplained symptoms (eg IBS), eating disorders, elimination disorders (not going to toilet properly), sleep-wake disorders, dysmorphia, substance/addiction disorders, personality disorders, medication induced disorders

14

What are 5 models of psychiatric disorders?

1. Historical
- witchcraft, demons
2. Biomedical Model
- 1950/60s, physiological issues, fix with medicine
3. Extreme forms of normal behaviour
4. Psychological Models
- thoughts, attitudes, beliefs, experiences and associated responses
5. Biopsychosocial Model
- all of above
- most recent model
- biology, chemistry, psychological, social
- NB what is social acceptable? African tribe - witch doctor on hallocinating drugs is ok

15

Define Historical Model of Mental illness

witchcraft, demons

16

Define Biomedical Model of Mental illness

1950/60s
physiological issues, fix with medicine

17

Define Psychological Model of Mental illness

thoughts, attitudes, beliefs, experiences and associated responses

18

Define Biopsychosocial Model of Mental illness

most recent model
- biology, chemistry, psychological, social
- NB what is social acceptable? African tribe - witch doctor on hallocinating drugs is ok

19

Prevalence of alcohol addiction in men and women

Men - 6%
Women - 1%

20

Prevalence of illicit drug addiction

36% (9%)

21

Prevalence of depression (lifetime)

10-20%

22

Prevalence of anxiety (1 year)

4%

23

Prevalence of schizophrenia (1 year)

0.4%

24

Prevalence of eating disorders (lifetime)

0.5 - 1% (probably higher)

25

Study of 508 new dental patients - how many reported 1 / 2 / 3 / 4 mental illnesses?

1 = 20%
2 = 6%
3 = 0.8%
4 = 0.6%
Over or under reporting?
Likely under reporting - stigma, denial

26

What is the relationship between:
- mental health and GP visits?
- mental health and GDP visits?

Inverse relationship
- increase mental illness = increase GP visits
- increase mental illness = decrease GDP visits (anxious / different priorities - hard to get out of bed)

27

Inpatients with mental illness have what types of worse oral health?

- more missing teeth
- increased caries
- increased perio
- poorer oral hygiene
- fewer dental visits

28

Outpatients with mental illness have what types of worse oral health?

- more missing teeth
- fewer dental visits
- better OH cf inpatients

29

Who has better OH - inpatients or outpatients with mental illnesses?

Outpatients

30

What barriers to professionals / dentists have towards mentally ill patients?

- lack of knowledge
- attitudes towards mental illness
- low tolerance of ppl crying / angry / hard to treat
- poor communication

31

Can diagnosis vary globally?

Yes
Cooper et al 1972 - psychiatrist taped patients
- UK = more depression / mania diagnosed
- USA = more schizophrenia diagnosed

32

Symptoms of depression

- Temporal differences - morning / evening (diff for diff ppl)
- anxious
- irritable
- can't concentrate / relax
- adverse reaction to stress
- lack of interest / apathy / lethargy
- sleep disturbances (too much / little)
- loss of appetite / weight
- amplification of pain / lower pain threshold
- lack of insight (don't realise what they're doing is detrimental)

33

How does DSM-V diagnose / catergorise depression?

Must have 2 of the following:
- fatigue / low mood / anhedonia (lack pleasure) / irritable
Then needs minor symptoms
- eg sleep / eating
- 4 minor symptoms = mild depression
- 5-6 = moderate
- 7+ = severe
NB symptoms must be persistent / impact daily life

34

What are oral manifestations of depression?

- Chronic facial pain
- 18 mo study at Eastman (take pt others don't want)
- 813 new referrals
- mean pain duration 4.2yrs
- 70% responded to appropriate MH / SH and medication

- Oral ulcers
- obtain SH and ulcer diary
- reduce with tricyclic antidepressants
- NB factitious ulcers - chewing lips / cheeks, cause harm to seek treatment

NB protect patients with depression from unneeded investigations, eg biopsy - increase stress levels