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Somatic & Addiction Disorders Flashcards

(53 cards)

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1
Q

What is somatization ?

A

expression of psychological stress through physical manifestions
- the physical manifestations can’t be explained through diagnostics test, labs, or underlying pathology
- S&S expressed in place of anxiety, depression or irritability

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2
Q

What is somatic symptom disorder ?

A

excessive thoughts, anxiety, and behaviors around symptoms or health concerns
- without significant physical and medical diagnosis
- suffering is authentic
- high level of functional impairment
- one or more distressing symptoms >6 months
- often resistant to seeking psychiatric assistance

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3
Q

What is illness anxiety disorder (hypochondriac) ?

A

misinterpretation of physical manifestations as evidence of a serious disease process/condition
- for at least 6 months
- high anxiety about health
- may be care-seeking or care-avoidant
- still won’t feel reassured despite negative diagnostic tests and reassurance from provider

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4
Q

What is conversion disorder ?

A

neurological symptoms in the absence of a neurological diagnosis
- unconscious awareness
- converting a feeling/emotion into physical form
- can’t find anything in labs/diagnostics but the pt is still feeling the S&S

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5
Q

What is factitious disorder ?

A

psychiatric disorders in which people consciously pretend to be ill to get emotional needs met and attain the status of “patient”
- artificially, and dramatically fabricate symptoms
- imposed on self or others
- malingering

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6
Q

What is malingering ?

A

conscious fabrication of illness or exaggerating symptoms for secondary gain (to gain something other then emotional)
- like insurance fraud, prescription medication, avoidance of prison or military service

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7
Q

What is factitious disorder by proxy ?

A

rare condition where a person intentionally causes or perpetuates the illness of a loved one (like contaminating IVF with fecal matter)
- common parent to child
- malingering can also occur here

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8
Q

What are some interventions for factitious disorder by proxy ?

A
  • keep careful, detailed records of visitation and events
  • interact with patient frequently during visiting hours
  • sitter in the room may be required
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9
Q

What is the psychoanalytic theory on these disorders ?

A

psychogenic complaints of pain, illness, or loss of physical function is a cover up for conflicted feelings and/or unwelcome experiences

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10
Q

What are behavioral theories on these disorders ?

A
  • communication of helpfulness
  • attention seeking
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11
Q

What are cognitive theories on these disorders ?

A
  • negative, distorted, catastrophic thoughts
  • focus on body sensations and misinterpret their meaning, responding with excessive alarm
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12
Q

What are some assessments we will conduct ?

A
  • assess for nature, location, onset, S&S, duration
  • past history of ACEs
  • identify symptoms of anxiety, depression, or past trauma that could be contributing
  • determine current quality of life, social support, and/or coping skills
  • identify any secondary gain
  • explore pt’s way of communicating feelings/emotions
  • assess current psychosocial and biological needs
  • screen for misuse of prescribed meds and substance use
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13
Q

How does cognitive reframing help ?

A

questions the pt to determine other potential causes of feared disease

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14
Q

What are the 6 key elements for effective treatment of these disorders ?

A
  • provide continuity of care
  • avoid unnecessary procedures
  • provide frequent, brief, and regular visits
  • always conduct a physical exam
  • avoid disparaging comments
  • set reasonable therapeutic goals
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15
Q

What is addiction ?

A

inability to consistently abstain from a substance or activity

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16
Q

What is intoxication ?

A

under the influence, varying levels

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17
Q

What are intoxication symptoms of caffeine ?

A
  • restlessness
  • nervousness
  • flushing feeling
  • GI upset
  • tachycardia
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18
Q

What are withdrawal symptoms and tx for caffeine ?

A
  • HA
  • drowsiness
  • irritability
  • poor concentration
    Tx: abstinence (resolves within a week)
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19
Q

What are intoxication symptoms of cannabis ?

A
  • heightened senses
  • depersonalization
  • derealization
  • delirium
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20
Q

What are withdrawal symptoms and tx for cannabis ?

A
  • irritability/anger
  • restlessness/anxiety
  • depression
  • GI upset/fever/chills/HA
    Tx: abstinence (support therapy & SSRIs)
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21
Q

What are some intoxication symptoms of hallucinogens ?

A
  • paranoia
  • impaired judgement
  • derealization
  • pupil dilation
  • tachycardia/tremors
  • can cause medical emergency (PCP)
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22
Q

What are some withdrawal symptoms and tx for hallucinogens ?

Study These Flashcards
A
  • reexperiencing symptoms of use that can be distressing
  • can less weeks, months, and years
    Tx: reassurance of safety, benzo’s, and restraints
23
Q

What are some intoxication symptoms of inhalants ?

Study These Flashcards
A
  • disinhibition
  • euphoria
  • illusions/hallucinations
  • nystagmus
  • N/V
  • decreased reflexes
24
Q

What are some withdrawal symptoms and tx for inhalants ?

Study These Flashcards
A

no symptoms considered under DSM5
- abstinence
- resolves quickly

25
What are some intoxication symptoms for opioids ?
- constricted (pinpoint) pupils - respiratory arrest - drowsiness/slurred speech - impaired memory and attention - psychomotor retardation
26
What are some withdrawal symptoms for opioids ?
- mood dysphoria/anxiety - N/V/D - diaphoresis - hyperreflexia
27
What are some treatments for opioids ?
- methadone program - medications (MAT): buprenorphine, naltrexone - psychotherapies - Naloxone (Narcan) for overdoses
28
What are some intoxication symptoms for stimulants ?
- elated, euphoric - hypervigilant/anxious - dilated pupils (short-term) - weight loss/confusion - seizures - chest pain/arrhythmias
29
What are some withdrawal symptoms for stimulants ?
- tiredness/insomnia - vivid nightmares - depression/suicidal - paranoia/irritability
30
What are some treatments for stimulants ?
- inpatient (amphetamines) - outpatient (cocaine) - antipsychotics - diazepam (valium)
31
What are some examples of opioids ?
morphine, hydromorphone, oxycodone, heroin
32
What are some intoxication symptoms for sedatives, hypnotics, antianxiety meds ?
- slurred speech - impaired thinking - incoordination - nystagmus - coma
33
What is nystagmus ?
where your eyes make rapid, repetitive, and uncontrolled movements
34
What are some withdrawal symptoms and treatment for sedatives, hypnotics, and antianxiety meds ?
- rebound hyperactivity - tremors/insomnia - anxiety/seizures Tx: - gradual reduction - Overdose: gastric lavage, activated charcoal
35
What are some withdrawal symptoms for tobacco ?
- irritability - anxiety - depression - difficulty concentrating - restlessness - insomnia
36
What are some treatments for tobacco ?
- behavioral therapy - bupropion: decreases cravings & withdrawal S&S - clonidine: helps relieves S&S of diarrhea, nausea or vomiting - varenicline (can cause vivid dreams/nightmares): reduces cravings & severity of withdrawal S&S
37
What is MAT ?
medication assisted treatment - medications can be used to treat specific substance use disorders to sustain recovery when used in addition to a treatment program
38
What is Buprenorphine used for ?
the first opioid use disorder medication that could be prescribed in a doctor's office - decreases feelings of cravings and effective in maintaining compliance - the injections are better because they are more effective and it lasts for 28 days
39
What is methadone used for ?
long-acting full opioid agonist - helps achieve and sustain recovery - schedule 2 controlled medication
40
What are some characteristics of methadone drug use ?
can only be given in a methadone clinic - taken daily for a minimum of 12 months - must be medically monitored daily to receive dose - low dose is the only MAT that can safely be used during pregnancy - can be used to treat pain management as well as opioid use disorder - can also be addictive (often sold as drug of abuse)
41
What is naltrexone used for ?
first line treatment for opioid use disorder and alcohol use disorder - binds to the endorphin receptors and blocks effects of opioids - suppresses cravings & effects of alcohol (also used for opioid withdrawal) - can be given in a doctor's office
42
What are some characteristics for Naltrexone use ?
- treatment should last 3-4 months - OUD: reduces tolerance for opioids - taking the same or even a lower dose of opioids used in the past can cause OD - AUD: must be fully withdrawn from alcohol before use - reduces cravings and amount of alcohol consumed - must maintain sobriety - IM: vivitrol q 28 days - must wait at least 7 days from last opioid use for short-acting and 10-14 after long acting
43
What is Disulfiram/Antabuse used for ?
only for AUD - used in adjunct for treatment for chronic alcoholism - blocks the enzymes involved in processing alcohol which creates severe discomfort and is a deterrent to drinking
44
What are some characteristics of Disulfiram/Antabuse ?
- SE: SEVERE N/V, chest pain, tachycardia, flushing, dizziness - never use with any alcohol containing products such as mouthwash, deodorant, hand sanitizer, perfume, etc - carefully check labels of all liquid medications - avoid breathing fumes of paints, stains, and stripping compounds
45
What are some ways for tobacco cessation ?
- patches - lozenges - gum - hypnosis - medications; bupropion (zyban, wellbutrin) an NDRI antidepressant and it decreases cravings, varenicline also reduces cravings
46
What levels of alcohol is needed to be considered intoxication ?
80-100 mg/dL
47
What are some systemic effects of alcohol ?
- peripheral neuropathy - alcoholic myopathy and cardiomyopathy - esophagitis, gastritis, and pancreatitis - alcoholic hepatitis - cirrhosis of liver - leukopenia - thrombocytopenia - cancer (head and neck)
48
What are some minor withdrawal symptoms of alcohol ?
(6-8 hrs after) - N/V - shaky - jitters - HA - mild perceptual changes
49
What are some moderate withdrawal symptoms of alcohol ?
(8-10 hrs after) - psychotic and/or perceptual symptoms begin (hallucinations) - can lead to seizures, delirium, or unconsciousness - Tx: ativan, librium
50
What are some severe withdrawal symptoms of alcohol?
(12-24 hrs after) - seizures: generalized and tonic-clonic - Tx: diazepam (valium)
51
What is alcohol withdrawal delirium (delirium tremens) ?
- medical emergency - causes physiologic problems - delusions and hallucinations - patients are danger to self - monitor VS carefully - notify provider with changes
52
What are the transtheoretical stages of change theory ?
where they are in the process of wanting to change - precontemplation: not think about making change - contemplation: thinking about change in the next 6 months - preparation: has taken steps towards change or intends to make change in next month - action: has changed behavior for 6 months - maintenance: has changed behavior for more than 6 months
53
What are some S&S of conversion disorder ?
- paralysis - blindness - movement and gait disorders - numbness - paresthesia - loss of vision or hearing - episodes resembling epilepsy

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