Block 33 Week 1 Flashcards

Question

Graded exposure needs to be:

Answer 1

* clearly planned - SMART targets * prolonged * repeated freq * graded e.g. ladder or steps * w/o dissociation

Answer 2

* Done in CBT session, then as homework * Self-directed, or accompanied by therapist, friend or relative * In reality or imagination (eg PTSD/trauma)

Answer 3

one-off prolonged (‘flooding’)

Answer 4

graded exposure plus relaxation

Answer 5

* behavioural: anx management

Answer 6

* cognitive: tackle worry about worry * Test out unhelpful beliefs about worry eg ‘worry helps me solve problems’

Answer 7

* Mindfulness: awareness plus acceptance

Answer 8

* Purposeful and non-judgemental attentiveness to one’s own experience, thoughts and feelings * letting it be * focusing on present moment > distressing thoughts * notice

Answer 9

* Education: anxiety is normal, fight or flight * Draw a vicious circle (diagram with arrows) * Exposure to own body sensation * Experiments: test out fears to disprove them

Answer 10

* The trigger can be external (eg crowds) or internal (eg heartbeat) – ‘selective attention’/ ‘hypervigilence’ * The person misinterprets normal body sensations as meaning that a physical or mental disaster is imminent – ‘catastrophic misinterpretation’ * The ‘fight or flight’ survival response produces more symptoms - which fuel the ‘vicious cycle’ of panic * attempts by the person to manage panic bring short term relief but make it worse in the long term (avoidance + safety behaviours)

Answer 11

* situation * worst symptoms * worst dears * safety behaviours * alt explanation * behavioural experiment - nexttime it occurs * predictons * outcome

Answer 12

* excessive anxiety - exaggeration of the normal anxiety response * out of proportion to stimulus * anxiety is prolonged after stimulus removed and does not assist in dealing w the situation

Answer 13

* GAD * Panic disorder * Phobic anxiety disorders: social phobia, simple phobia, agoraphobia

Answer 14

* anx symptoms persistent but may fluctuate in intensity, not situation specific

Answer 15

* sleep disturbance * worrying * feeling on edge * irritability * poor conc * autonomic symptoms - palpations, sweating, dry mouth * inc muscular tension giving rise to head, neck and backaches

Answer 16

* 1 year prev - 3% * F >M

Answer 17

* Genetic * biological mechanisms - breakdown of the mechanisms * personality traits - neuroticism * childhood adversity - especially when lack of secure attachments * stressful life events

Answer 18

* panic attacks often occur w other disorders e.g. GAD, agarophobia, depressive disorders * the anxiety is unrelated to any paticular circumstances so is unpredictable

Answer 19

* characterised by sudden onset of symptoms, reaching a peak within 10 mins

Answer 20

* depersonalisation = patient feels detached from their surroundings, feel unable to feel emotions - out of body experiences * derealisation = surrounds don't seem real

Answer 21

* sweating, hot flushes * SOB * paraesthesia * dizziness * choking * chest pain, palpations

Answer 22

* 1.4% 1 year prevalence

Answer 23

* intermittent episodes of anxiety occuring in spec circumstances * anxiety out of prop to threat * can lead to anticipatory anxiety and habitual avoidance of the circumstances

Answer 24

* fear of spiders e.g. * onset in childhood usually * 1 yr prev ~4%

Answer 25

* fear of performance failure and negative evaluation in social situations * onset in teenage years usually * 1 yr prev 7% which reduces in adults

Answer 26

* symptoms provoked by being away from home, in situations which can't be left easily such as crowded or confined spaces e.g. supermarkets, cinemas * in severe cases ppt may be housebound

Answer 27

* ppts often constitutionally vulnerable to anxiety symptoms which they may exp and misinterpret in certain situations * conditioning and avoidance maintain the symptoms as can the response of family members

Answer 28

* Genetics * personality traits e.g. dependent personality traits * learning theories - conditioning and avoidance * family influences e.g. overprotective

Answer 29

* 1 yr prev = 2% * F =M

Answer 30

* Obsession can be a thought, impulse or action * there is a sense of complusion associated with it * it is resisted leading to anxiety * it's recognised as nonsensical and is recognised as coming from within the patient

Answer 31

* thoughts - e.g. single words, usually unpleasant * impulses - or urges to perform violent or embarassing acts

Answer 32

* ruminations - endless internal debates abt trivial problems * rituals - counting or cleaning, checking

Answer 33

encephalitis lethargica, Gille de la Tourette syndrome

Answer 34

* severe reaction to extremely stressful circumstances

Answer 35

* hyper-arousal * re-experiencing aspects of the stress e.g. flashbacks, dreams, thoughts * avoidance of reminders

Answer 36

* reaction to stressful experience which is understandanle and in prop e.g. divorce * symptoms can be v variable but can include many anxiety symptoms * worries usually focused on the stressor

Answer 37

* symptoms of both equally present * neither dominates * neither symptoms severe enough to meet criteria for an anxiety or a depressive disorder

Answer 38

* psychological treatments are the treatment of choice * include counselling, CBT

Answer 39

exposure therapy

Answer 40

thought stopping

Answer 41

* antidepressants - anxiolytic affects used for GAD and panic attacks * BBs useful for palpations and tremor from anxiety

Answer 42

Stressful life events eg relationship problems, physical illness, threatened loss of employment (contrast losses - which tend to provoke depression)

Answer 43

- CBT theory states that in GAD worrying abour worry maintains anxiety and leads to unsuccessful attempts to control it

Answer 44

* phobias are acquired not innate * Evolutionary theory suggests that increased likelihood of fear towards certain objects (snakes, spiders, being alone, the dark) conferred a survival advantage to our ancestors, leading to natural selection

Answer 45

1 - pavlovian conditioning 2 - maintained by operant conditioning

Answer 46

- initial acquisition of a phobia - (association of a conditioned with unconditioned response) eg lost and anxious when out walking as a child and see a cat leading to cat phobia

Answer 47

- maintains the phobia - Contact with cats causes anxiety (punishment) leading to less contact, plus avoidance of all cats brings reward of no anxiety (= negative reinforcement).

Answer 48

- catastrophic misinterpretation of body systems - panic occurs and is maintained by an inappropriately learned response to normal physiological symptoms (eg palpitations)

Answer 49

Selective attention to body symptoms and avoidance of anxiety provoking situations also reinforces behaviour.

Answer 50

* earlier onset * clinical themes: exactness, sexual, odd rituals, symmetry * asosicated with increased rates of bipolar disorder

Answer 51

* later onset * more aggressive obsessions and cleaning compulsions * associated with increased rates of panic disorder

Answer 52

* OCD represents defensive regression to anal stage * (defensive triad of orderliness, obstinacy and parsimony ie stinginess). - utilisation of defence mechanisms

Answer 53

* Reaction formation = feeling or behaving in a way which is opposite of unconscious unacceptable impulses (eg excessive prudery if increased sex drive)

Answer 54

attempting to cause past thoughts not to have occurred

Answer 55

separation of an idea from its associated affect

Answer 56

environmental stress especially life events indicating increased responsibility

Answer 57

* rituals (checking, cleaning etc), * avoidance and reassurance seeking produce short-term relief from anxiety symptoms but cause long-term worsening of problems (negative reinforcement of behaviour, operant conditioning)

Answer 58

* states that OCD kept going by exaggerated appraisal of threat, assuming excessive responsibility for consequences, and attempts to suppress recurrent worrying thoughts

Answer 59

* Offer info, education, self help and support groups * involve family/carers (drop reassurance/safety seeking), involve religious or community leaders (if OCD/culture boundary unclear) - involves a stepped care model

Answer 60

* only gets involved if comorbitidy. severe or treatment resistant cases

Answer 61

CBT (under 10 therapist hrs) using individual, phone, structured self help or group approach

Answer 62

1) Offer either any SSRI or CBT (over 10 therapist hrs): both equally effective 2) Increase dose after 4-6 weeks if no response

Answer 63

- 12 months and then discharge back to PC if well - Teach individual to adapt techniques learned to new symptoms

Answer 64

1) Offer SSRI and CBT in combination

Answer 65

2) No response after 12 wks (or patient not engaged): different SSRI, and then/or 3) Clomipramine up to BNF max (+ECG+BP if significant CVS disease)

Answer 66

Refer to “Specialist multidisciplinary team with expertise in OCD/BDD” whose roles are to: advise, assess, treat, educate + increase skills of other professionals

Answer 67

* more emphasis on age approproate family, indiv and group interventions * recommends CBT first line 12 weeks for all OCD even if severe * then consider adding SSRI

Answer 68

* same as OCD (CBT/SSRI, stepped care, specialist teams) but * fluoxetine is the first choice drug 1) * then other SSRIs then try adding in buspirone.

Answer 69

* Includes crisis reaction * e.g.s accident, battle, criminal assult, domestic fire * onset - immediate or within minutes vs within 6 months for PTSD usually

Answer 70

* duration 0-72 hrs, PTSD is over 1 month - lifelong

Answer 71

Traumatic event + the RAHR symptom clusters

Answer 72

- Re-experiencing - Avoidance - Hyperarousal - Reaction - altered cognitions and mood

Answer 73

* thoughts, dreams, flashbacks * dissociative reactions - derealisation, depersonalisation, losing conciousness * distress or reactivity when exposed to traumatic reminders

Answer 74

* of thoughts, feelings, people, places, conversations, activities, objects or situations associated with the trauma or that evoke memories of it

Answer 75

* Irritable, aggressive, self destructive or reckless behaviour * Hypervigilance (scanning for danger) * Exaggerated startle response (eg jumps to loud noise) * Sleep disturbance. Difficulty concentrating.

Answer 76

- altered cognitions and mood - began/ worse after trauma - negative emotions and beliefs

Answer 77

Inability to recall an important aspect of the trauma (amnesia)

Answer 78

interest/participation in normal activities

Answer 79

one month and clinically sig distress or functional impairment

Answer 80

* An event or series of events of an extremely prolonged or repetitive nature, most commonly where escape is difficult or impossible * Symptoms of PTSD - RAHR plus BAR

Answer 81

Beliefs - persistent beliefs as self as dimished, defeated or worthless Affect - problems in affect regulation Relationships - difficulties in sustaining relationships

Answer 82

pre-morbid personality

Answer 83

stressor event

Answer 84

victim's enviornment

Answer 85

* genetics * personality * childhood abuse, adult trauma, drug and alcohol abuse * neurotic disorder

Answer 86

* Extreme, prolonged or repeated stress -> overactivity of normal defence mechanisms, involving 3 catacholamine systems

Answer 87

locus coeruleus/noradrenaline system -> activity of amygdala, hippocampus, hypothalamus and cerebral cortex

Answer 88

prefrontal cortex activity

Answer 89

physiological arousal + NA + A secretion

Answer 90

- CBT - psychoeducation - EDMR

Answer 91

- Psychoeducation about reactions to trauma, strategies for managing arousal and flashbacks - processing trauma related memories - overcoming avoudance - improving function (work/ social relationships)

Answer 92

* eye movement desensitisation reprocessing - should use repeated in- session bilateral stimulation for specific target memories (often visual images) until memories no longer distressing, plus teaching of self-calming/techniques to manage flashbacks within and between sessions,

Answer 93

- not first line, usually added onto CBT/ EMDR * venlafaxine or any SSRI e.g. sertraline or paroxetine

Answer 94

* antipsychotics like risperidone can be added for disabling symptoms like hyperarousal, or if not responding to other symptoms

Answer 95

* Role of therapist in exposure work = to encourage patient to describe trauma as if they were in the situation now * Therapist first presents rationale for exposure * ppt rates fear/distress at the beginning, middle and end

Answer 96

* rewind and hold technique - encourage ppt to stop and go back over the hot stop to allow habitation to occur

Answer 97

a) challenging their automatic negative thoughts and underlying assumptions eg using a diary of situation, thoughts, evidence for/against thought being true b) getting patient to suggest more rational ,alternative, balanced explanations.

Answer 98

* production of symptoms and signs of illness in absence of physical pathology * involuntary * not automatic * usually involves signs of CNS

Answer 99

* F>M 6:1 * commoner in developing countries * usually presents before 40

Answer 100

- partial or complete loss of normal integration between memories of the past, awareness of identity + immediate sensations + bodily movements

Answer 101

traditionally mental symptoms + signs in absence of organic brain disease.

Answer 102

* Narrowing of field of consciousness (restricted awareness) which may be limited to one area of experience eg amnesia, stupor, fugue, trance, Ganser’s syndrome, multiple personality

Answer 103

* Conversion disorder = traditionally physical symptoms + signs occurring in organs under voluntary (not autonomic) control (usually nervous system) * eg paralysis, weakness, bizarre gait, abnormal movements, dysphonia, blindness, pseudoseizures, numbness.

Answer 104

* Female sex * Family history * Childhood abuse and neglect * Environmental stress (e.g. redundancy, divorce) * Emotional trauma * Substance abuse

Answer 105

* address environmental stressors and substance abuse issues * assess severity, duration and impact on normal life * evaluate for co-existing depression

Answer 106

* low intensity psychological interventions * includes individual non-facilitated self-help, individual guided self-help and psychoeducational groups.

Answer 107

* high intensity psych intervention * pharmacological treatment - SSRI or SNRI (ventafaxine)

Answer 108

* referral to specialist care * if steps 1-3 didn't work * or if risk of SH/ suicide, significant co-morbitiries or self neglect

Answer 109

* thoughts affect behaviour, emotions and physiological state * behaviours affect thoughts, emotions and physiological state - CBT addresses these domains

Answer 110

* Identifying and re-evaluating negative thoughts, beliefs and patterns of thinking * Learning more effective problem-solving and decision-making strategies

Answer 111

* Using mindfulness to deal with “uncontrollable” and racing thoughts, allowing you to let go of unnecessary thoughts without getting caught up in them

Answer 112

* Changing unhelpful behaviours such as social isolation, avoiding situations, procrastination and inactivity * Learning to be more assertive and communicate more effectively * Pursuing pleasurable activities and interests that promote happiness and make life more meaningful and fulfilling

Answer 113

* Learning how to experience and accept negative emotions without becoming overwhelmed * Techniques to transform painful emotions into more manageable feelings * Strategies to help tolerate emotional distress and manage extreme emotional reactions such as intense anger, anxiety or sadness

Answer 114

* Breathing exercises and relaxation techniques to calm physiological responses and reduce stress levels * Mindfulness practices to cope with stress and physical discomfort or pain * Improving sleep, diet and exercise habits to improve physical well-being

Answer 115

* activation of SNS * body's fight or flight response activates -> adrenaline, NA and ACTH release * allows us to peform well in a short term situation

Answer 116

* individuals with high neuroticism scores were more likely to feel anxious * correlation between anxiety, introversion and neuroticism

Answer 117

* limiting alcohol and caffiene * sleeping well * deep breathing * exercising and setting small daily goals * distracting yourself - e.g. music, books, podcasts

Answer 118

* Resilience factors (RFs) are psychological resources that buffer the potentially negative effects of stress on mental health.

Answer 119

* the ways in which individuals view and engage with the world * the availability and quality of social resources * specific coping strategies

Answer 120

* anxiety (especially chronic) can hinder our ability to filter things that we think of as a threat in order for our brains to accurately concentrate on the retrieval of info necessary for problem solving

Answer 121

* nurses * occupational therapists * psychologists * MH support workers * consultant psychiatrists

Answer 122

* provide medical support * putting patients in touch with other agencies * short term work for a specific mental health diagnosis which requires short term support * physical health monitoring

Answer 123

* support w employment support * psychological approaches * support with day to day activities and functioning

Answer 124

* Primary care - GP * community - MH teams * hospitals and in specialist services * this is primary, secondary and tertiary care

Answer 125

is going to create intergrated community mental health servcies

Answer 126

GP - refer to secondary services but these can also be accessed through the single point of access

Answer 127

specialised, include teams like community MH teams, crisis resolution and home treatment teams and hospital care

Answer 128

- Running alongside primary and secondary services are voluntary services: support provided in the community, usually by charities and other non-profits. - You can often access these services without a referral

Answer 129

highly specialised treatment like forensic MH services or specialist psychotherapy services

Answer 130

* removing traditional divisions between different tiers of care * so that people get less disjointed care

Answer 131

* aims to remove divisions such as those between hospials and GPs, physical and mental health and the NHS & local authority

Answer 132

between the NHS and other health and care organisations. Such as the local authority, voluntary sector and social enterprise sector

Answer 133

* 4th leading casue of disability worldwide * point prevalence 2-5%

Answer 134

F32 Depressive Episode

Answer 135

* F31 Bipolar Affective Disorder * F33 Recurrent (Unipolar) Depressive Disorder

Answer 136

- genetics - Gender – twice as common in women - Childhood experience – e.g. loss of parent, lack of parental care, abuse - Personality – especially neuroticism - Social environment – life stresses, lack of social network etc - Physical illness

Answer 137

* Education * Lifestyle changes - diet, alcohol, sleep hygiene * Physical health problems improved * Problem- solving - helping resolve trigger factors like unemployment or marital problems

Answer 138

* attempt at relieving a person's psychological distress using psychological means * different methods of counselling - CBT, CAT, psychodynamic

Answer 139

* Confiding relationship for listening and talking * Release of emotion * Giving information * Provision of rationale to make problems understandable * Restoration of morale

Answer 140

* Self-help materials – This is not a form of psychotherapy and no CBT skills or training are required by the individual reading the self-help material (e.g. books/ websites).

Answer 141

* Assisted self-help - computerized CBT, self-help material presented to a support group or individuals by a health worker, such as a graduate mental health worker or assistant psychologist

Answer 142

* CBT approaches - Specific CBT interventions for specific problem areas, e.g. anxiety management, coping with voices etc.

Answer 143

* Formulation driven CBT– This is a form of psychotherapy, the patients are not fully able to help themselves and have sought help from a trained professional.

Answer 144

1) Self help materials 2) assisted self help 3) CBT approaches 4) formulation driven CBT

Answer 145

* Patient and therapist agree problem list and goals. Treatment is a collaborative partnership * Focuses on ‘here and now’

Answer 146

* socratic questioning used by the therapist * open therapeutic process * homework used

Answer 147

* Underlying beliefs centre around being helpless or unloveable * Trigger events typically involve loss or ‘failure’ * This produces negative cognitions about self/ future/ world which reinforce underlying beliefs, and affect mood and behaviour

Answer 148

* These negative thoughts are maintained by distorted information processing (e.g. overgeneralization, personalization, selective abstraction)

Answer 149

* Activity monitoring and scheduling (mastery and pleasure) * Distraction * Systematic desensitization

Answer 150

progressive muscular relaxation, imagery, breathing control etc

Answer 151

* identifying and challenging negative thoughts using thought records -replacing with balanced thoughts * identifying cognitive biases * working on deeper levels of cognition like behavioural experiments to challenge dysfunctional assumptions

Answer 152

* Social problems * Past history of depression * Chronic disease e.g. diabetes, heart disease, chronic obstructive pulmonary disease, cancer * Alcoholism * Bereavement * Old age

Answer 153

* Risk of suicide * Feeling of hopelessness * Chronic pain * Disabling symptoms * Severe and prolonged symptoms

Answer 154

* Young adults tend to sleep a lot, overeat, withdraw and show self-neglect.

Answer 155

* Older adults often present with insomnia, anxiety, anorexia, poor self-care and exacerbation of pre-existing physical conditions like painful arthritis, constipation, head and neck and back pain

Answer 156

* BBS and psychoactive medications can cause depressive symptoms

Answer 157

* mania = period of elation - high mood * can be mild (hypomania) or severe (mania)

Answer 158

* mania + depression = bipolar disorder/ manic depression

Answer 159

* tiredness * headache * stress * low mood * backache * sleep problems * chest pains * indigestion * dizziness * pain

Answer 160

* shock, denial, numbness, guilt, sadness, weeping, resolutuon * Emotional and practical support is normally sufficient.

Answer 161

* if symptoms are more intense e.g. clinical depression or if they're prolonged (beyond 6 months) or if they're delayed in onset * Counselling, “guided mourning” and occasionally medication may be needed.

Answer 162

* Black and Asian races present less often to their GP with “depression” * Some groups are more likely to complain of physical symptoms eg Mediterranean (“nerves, headache”), China & Asia (“weak, tired”),

Answer 163

* migration and not speaking the local language are risk factors for suicide * refer to specific services e.g. Refugee council and use a professional translator

Answer 164

* 4+ symptoms for at least 2 weeks include at least 2 of the first 3 core symptoms

Answer 165

* severe depression can present with psychotic symptoms e.g. delusions or hallucinations

Answer 166

Depression may be more significant and respond to antidepressants if somatic (“biological”) symptoms* are present: sleep/app/wt change, anhedonia, loss of libido, constipation, amenorrhoea

Answer 167

* 4 symptoms * distressed but able to continue functioning

Answer 168

* 5/6 symptoms * great difficulty continuing w normal functioning

Answer 169

* 7 to 10 symptoms * totally unable to work or function

Answer 170

* Appearance * behaviour * speech * thoughts * perceptiuon * mood * cognition * insight

Answer 171

* Drugs: steroids, contraceptive pill, digoxin, beta blockers

Answer 172

* Any physical illness eg hypothyroidism, heart disease, stroke, cancer, MS * Other mental disorders eg psychosis, dementia, alcohol excess, illicit drug abuse

Answer 173

* linked to reduced levels of serotonin and noradrenaline * Some bipolar patients have enlarged cerebral ventricles on CT scan

Answer 174

* Depression is an independent risk factor for osteoporosis (10% drop in bone density) & coronary heart disease (2-4 times increase in angina, MI & sudden death)

Answer 175

dep plus mania.

Answer 176

dep plus hypomania

Answer 177

* elated or irritable mood * high energy/ libido * reduced sleep and appetite * rash behaviour and debts are risks * grandiose, paranoid delusions

Answer 178

* avoiding alcohol and drugs * no over stimulation * ensure sleep and regular routine

Answer 179

* Antidepressants eg SSRIs * Anti-psychotics (if psychotic) * Lithium (if treatment resistant), * ECT (if life threatening) mania

Answer 180

* Antipsychotics eg olanzapine+/-mood stabilisers eg lithium * ECT (if treatment resistant) * Lorazepam (if aggressive)

Answer 181

if depressive symptoms present than less than2 weeks - milder short period of low mood due to stressful life events

Answer 182

- low intensity psychosocial interventions - guided self help based on CBT princuples, behavioural activation and problem solving techniques

Answer 183

- antidepressants and CBT or interpersonal therapy - high intensity psychological interventions - 16-20 sessions over 3-4 months

Answer 184

Crisis or home treatment teams, inpatient admission, ECT

Answer 185

individual CBT, or mindfulness (if now well but 3 or more episodes = group mindfulness-based CBT)

Answer 186

* mild: not unless prolonged * moderate to severe: drugs and therapy

Answer 187

1. SSRIs 2. other SSRI or mirtazepine or lofepramine, 3. Venlafaxine / TCA/ MAOI 4. Add lithium / antipsychotic eg quetiapine / mirtazapine 5. ECT

Answer 188

mild to moderate

Answer 189

* Physical treatments (drugs & ECT) work best in moderate to severe depression.

Answer 190

* A therapeutic conversation ie talking = exchange of information + instillation of hope * A therapeutic relationship (alliance) between therapist and ‘client’/patient * A therapeutic rationale ie an explanation followed’ by therapist & patient * A therapeutic base ie regular meetings in time & place (eg 1 hour every week)

Answer 191

* used for severe/ life threatening depression requiring a rapid response (not eating or drinking, acutely suicidal, retarded, psychotic) or if other treatments are ineffective

Answer 192

* ECT involves giving a short acting IV general anaesthetic plus a muscle relaxant.

Answer 193

* A pulsed electric current is then passed through the brain to produce a brief (15-60sec) grand mal seizure. Patients vary, but often need 6 to 12 sessions, given twice weekly

Answer 194

Bipolar I disorder often leads to problems with day-to-day life and hospital admissions, whereas in bipolar II disorder there are no psychotic features and less impact on function.

Answer 195

* In hypomania, there is increased energy and activity with persistently elevated mood, which occurs without delusion or hallucinations.

Answer 196

* patterns of cycles in bipolar disorder can be negatively influenced by drinking, stress, ilict drugs and other medical conditions

Answer 197

* PMH - HIV infection, syphilis, thyroid disease and epilepsy), which can may cause symptoms of mania through their effects on the brain.

Answer 198

- antipsychotics - medium to longer term: mood stabilisers - antidepressants and benzodiazepines

Answer 199

valproate and lithium

Answer 200

should usually be stopped during the manic phases

Answer 201

short term use, sometimes used for severe agitation

Answer 202

secondary mania or depression.

Answer 203

* Speech. Pressure of speech will usually be obvious during manic phase. Slowed speech is characteristic of the depressive phase.

Answer 204

* Thoughts. Thoughts may be racing and flight of ideas will be present. * Grandiose ideas may come up during the review.

Answer 205

* Energy. The person will usually appear very energetic and hyperactivity is common.

Answer 206

* Eye contact. In the depressive phase, eye contact may be reduced.

Answer 207

* Affect. Patients may be tearful and apathetic during the depressive phase.

Answer 208

* valid informed consent needed * right to withdraw at any time * carers/ advocates should be involeved to facilitate informed discussions

Answer 209

* if informed consent is not possible, ECT should only be given if it does not conflict with a valid advance decision, and the person's advocate or carer should be consulted.

Answer 210

* assess clinical status after each ECT treatment and stop treatment when remission has been achieved or sooner if side effects outweight the potential benefits * Assess cognitive function before the first ECT treatment and monitor at least every three to four treatments, and at the end of a course of treatment.

Answer 211

* addenbrooke's cognitive assessment mainly used - measures new learning, retrograde amnesia and subjective memory impairment

Answer 212

* Effective when other treatments don’t work * Most effective with most severe illness

Answer 213

* Multiple brief anaesthetics * Acute confusional states * Memory impairment: anterograde and retrograde

Answer 214

anticonvulsants and lithium

Answer 215

* headache * muscle aches * distressed * tearful * frightened * temporary memory loss

Answer 216

* damage to tongue, teeth or lips because ECT causes contraction of the jaw muscles

Answer 217

* memory problems * personality change * lost skills * 'feel like a different person;

Block 33 Week 1 Flashcards

Anxiety and Depression (254 cards)