Psychoderm Flashcards
Define delusions of parasitosis
- Fixed unshakeable belief that infested by things
- Outside of what would be considered normal cultural beliefs
- monosymptomatic (this is the only delusion)
- Functional (maintaining job etc)
- may or may not be underlying psychiatric disorder but doesn’t meet criteria for schizophrenia
- not attributable to other condition
How does Morgellon’s differ from delusions of parasitosis
Associated arthralgia, myalgia, fatigue, poor concentration as well as the belief/sensation of fibres under the skin
Mx approach
ASSESS FOR SUICIDE RISK/ SELF HARM
Treat any itch/irritation - general measures, menthol
Pre-antipsychotic Ix - lipids, BSL, HbA1c, weight, bp
Risperidone 0.5mg
Olanzapine 2.5mg
Quetiapine 25mg
Newer antipsychotics vs older
Older - more significant AEs - extrapyramidal, QT prolongation
Newer - sedation, weight gain, anticholinergic, metabolic syndrome
Define body dysmorphic disorder
preoccupation with real (out of proportion) /imagined defect in physical appearance
Can be associated w mood disorders, OCD, social phobia, SI, substance abuse, eating disorders, prior sexual abuse
Mx of prurigo nodularis
general measures menthol TCS, ILCS Occlusion Phototherapy SSRIs, mood stabilisers immunosuppressants thalidomide 100mg/day N-acetylcysteine
Definition trichotillomania
recurrent hair pulling causing hair loss
Strong desire to pull hair
Tension increasing just prior to pulling hair
pleasure when hair pulled
Epidemiology of trichotillomania
bimodal - habit tic in young children, psychological in older adolescents/ young adults
How to assess depression
SADFACES
= sleep disturbance, appetite change, depressed mood, fatigue, anhedonia, poor concentration, esteem reduced, SI
how to assess suicide
SADPERSONS
= sex male, age <20 or >45, depressed, prior attempt, excess drugs/alcohol, rationality lost, social supports lacking, organised plan, no spouse, sick
