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BDS3 BAMS > Psychiatry 1 - Overview and Anxiety > Flashcards

Psychiatry 1 - Overview and Anxiety Flashcards

1
Q

What is included in the Mental Health Act (Scotland) 2003?

A
  • Concerned purely with management and treatment of psychiatric disorders
  • No provision for compulsory treatment of physical problems ie if patient has fractured leg and schizophrenia they can only be detained for the schizophrenia and can still decide not to have leg sorted in another hospital after there mental health stay
  • Can have detained patients in community on ‘Leave of Absence’
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2
Q

How long is emergency detention under the Mental health Act (Scotland) 2003?

A
  • 72hrs
  • Need to be assessed by Dr for this to be placed and the wait for assessment can take 2 hrs
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3
Q

How long is short term detention under the Mental health Act (Scotland) 2003?

A
  • 28 days
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4
Q

How long is Compulsory treatment order under the Mental health Act (Scotland) 2003?

A
  • 6 months
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5
Q

Can the police remove a person?

A
  • Can remove to place of safety under the Act and need to be seen by Dr within 2 hrs
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6
Q

What constituents are required for Mental Health Act 2003 to be applicable?

A
  • Person has medical disorder
  • Medical treatment is available that could stop condition getting worse or help treat some of their symptoms
  • If medical treatment was not provided there would be significant risk to person or others
  • Because of their mental disorder their ability to make decisions about medical treatment is significantly impaired
  • Use of compulsory power is necessary
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7
Q

What are the two broad types of psychiatric conditions?

A
  • Neurosis
  • Psychoses
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8
Q

What is Neurosis?

A
  • Group of uncertain functional neuro-psychical disorders that exhibit themselves in specific clinical phenomena in absence of psychical phenomena
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9
Q

What is Psychosis?

A
  • Critical mental illness
  • Occur due to loss of contact with reality and deep disturbance of relationships with other people, causing social acceptance
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10
Q

What are the Psychiatric conditions that impinge on dentistry?

A
  • Neuroses like phobias and anxiety states
  • Psychoses
  • Eating disorders
  • Personality disorders
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11
Q

Is anxiety a pyshciatric diagnosis?

A
  • No
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12
Q

What are the categories in the spectrum of neuroses?

A
  • Anxiety
  • Phobic
  • Obsessional
  • Hypochondriacal
  • Depressive
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13
Q

What is the difference between the anxious patient and anxiety neurosis?

A
  • Anxious patient concerned about dental treatment
  • Anxiety neurosis is concerned about everything (do you worry about worrying about something that hasn’t happened yet)
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14
Q

What are the 3 anxiety disorders?

A
  • Generalised anxiety disorder (free floating anxiety in many/all situations)
  • Phobic anxiety (Intense anxiety/ panic in specific situations)
  • Panic disorder (unpredictable extreme anxiety)
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15
Q

What is a Somatoform disorder?

A
  • Repeated presentation of physical symptoms and persistent requests for medical investigations
  • In spite of negative findings and reassurance that symptoms have no physical basis
  • May not be clear e.g. depression
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16
Q

What are some management of somatoform disorders?

A

Psychological treatment (more successful)
- ‘Psycho-education’
- Anxiety management strategies
- Cognitive behavioural therapy

Drug treatment
- Self medication
- Prescribed medication

17
Q

What are some anxiolytic drugs?

A
  • Alcohol
  • Benzodiazepines (diazepam, midazolam, temazepam, lorazepam)
  • Antidepressant with anxiolytic features (Tricylic, mirtazepine, SSRI)
18
Q

How can anxiety neurosis present in dental patients?

A
  • TMD and parafunctional clenching
  • Oral dysesthesias (dry, burning) and facial pain
  • Denture intolerance
  • Treat AN then treat symptoms (CBT/ Benzodiazepine and tricyclics)
19
Q

What are phobias?

A
  • Fear out of proportion to the threat
  • Based on experience
  • Remember other phobias may prevent dental treatment (agoraphobia/claustrophobia)
20
Q

What is obsessive-compulsive disorder?

A
  • Type of neuroses
  • Born out of fear of anxiety for something
  • Rituals developed to contain anxiety
  • Difficult o break cycle and can lead to depression
21
Q

What is the difference between perfectionism and OCD?

A

Perfectionism
- Personality trait
- May have habits or rituals but they are not doing out of anxiety

OCD
- Mental health disorder
- Repeated, unwanted thoughts or urges that cause anxiety
- Performs compulsive action or ritual to prevent development of anxiety
- Ritual itself may not be related to anxiety itself

22
Q

What are adjustment disorders?

A
  • Maladaptive responses to severe past or continuing stress/trauma
  • Occur during adaptation to new circumstance e.g. bereavement, loss, separation
  • PTSD is a type and requires stress of exceptionally threatening or catastrophic nature
23
Q

How are adjustment disorders managed?

A
  • Psychological intervention
  • If mood disorder accompanies this then treat this with medication

BDS3 BAMS (15 decks)

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