psychiatric disorders across the lifespan Flashcards
what is dementia
Degenerative disease of the brain with:
cognitive and behavioural impairment
must be severe enough to impact social and occupational functon
pathophysiology of Alzheimers
Amyloid plaques
Neurofibrillary tangles (NFTs)
loss of neurons and synapses in the cortex and hippocampus
example of an acetylcholinesterase inhibitor
Donepezil
example of a NMDA receptor antagonist
Memantine
early symptoms of Alzheimers
Absent-mindedness Difficulty recalling names and words Difficulty learning new information Disorientation in unfamiliar surroundings Reduced social engagement
features of progressive alzheimers
Marked memory impairment Reduced vocabulary Loss of less complex speech patterns. Mood swings and/or apathy Decline in ADL’s & social skills Emergence of psychotic phenomena
advanced alzheimers symptoms
Monosyllabic speech Psychotic symptoms Behavioural disturbance Loss of bladder and bowel control Reduced mobility
psychiatry involved in alzheimers
delusions - paranoid
auditory/visual hallucinations
depression
catastrophic reactions in alzheimers
the patient becomes very frustrated and angry with their inability to understand and lash out
tool used to assess alzheimers
MMSE
delirium vs dementia vs depression
delirium - acute, fluctuating, hours/weeks, altered consciousness, impaired attention, psychomotor agitation/depression, reversible
dementia - insidious, progressive, months/years, irreversible
depression - acute or insidious, chronic, months/years, psychomotor depression, reversible
importance of adolescent brain
vulnerable to influence by peers
reward system develops faster than [refrontal cortex )risky behaviours therefore)
diagnosis of ADHD
at least 6 months of persistent pattern of inattention/hyperactivity inappropriate to developmental level interferes with functioning seveal symptoms before 12 symptoms in two or more settings not explained by another disorder
risk factors of ADHD
boys 1st degree relatives premature birth low birth weight prenatal tobacco
prognosis of ADHD
70% still have it as teenager
40-60% as adults
stages of psychosocial development
infant - hope 18mth-3yr - will 3-5 - purpose 6-13 - competency 14-21 - fidelity 22-39 - love 40-65 - care 65+ - wisdom
somatisation disorder
symptoms/pain with no physical cause found
autism spectrum disorder
not interacting with others, behind peers in class, prefers to sit back and observe
OCD
compulsions and obsessive thoughts manifesting as repeated actions + perfectionism
tourettes syndrome
involuntary movements of body, not context-appropriate sounds/actions
What is the epidemiology of dementia?
UK, dementia is leading cause of death in women and is second to heart disease for men.
Most common cause of dementia is Alzheimer’s disease (AD), 70% of cases.
Risk of AD increases with age:
1% at age 60yrs;
doubles every 5yrs;
40% of those aged 85yrs.
What are behavioral disturbances associated with dementia?
aggression, wandering, explosive temper, sexual disinhibition, incontinence, excessive eating, and searching behaviour.
What are features of personality disorders in dementia?
often reflects an exaggeration of premorbid traits with coarsening of affect and egocentricity.
What are the 4 P’s regarding factors which impact mental disorders?
Predisposing, precipitating, perpetuating and protective factors
