1
Q
4 risk factors for mental illnes
A
- genetics
- biology
- personality
- environment
2
Q
MENTAL STATUS EXAM COMPONENT
indicates level of ability to look after themselves
A
APPEARANCE
3
Q
MENTAL STATUS EXAM COMPONENT
indicator of cognitive status
A
SPEECH
4
Q
MENTAL STATUS EXAM COMPONENT
- figity
- catatonic
- unusual gestures
- repetitive movements
A
MOTOR ACTIVITY
5
Q
MENTAL STATUS EXAM COMPONENT
- frightened of people
- level of comfort with interaction
- hostile or polite
- withdrawn
- different cultures may interact differently
A
INTERACTION
6
Q
MENTAL STATUS EXAM COMPONENT
patients description of how they’re feeling
A
MOOD
7
Q
MENTAL STATUS EXAM COMPONENT
nurses observation of patient’s behaviour
A
AFFECT
8
Q
MENTAL STATUS EXAM COMPONENT
no emotional response
A
FLAT
9
Q
MENTAL STATUS EXAM COMPONENT
inappropriate state of elation
A
EUPHORIC
10
Q
MENTAL STATUS EXAM COMPONENT
quickly shifting emotions
A
LABILE
11
Q
MENTAL STATUS EXAM COMPONENT
exaggerated sense of ability & self-importance
A
EXPANSIVE
12
Q
MENTAL STATUS EXAM COMPONENT
ability to identify and recognize own surroundings
A
PERCEPTIONS
13
Q
MENTAL STATUS EXAM COMPONENT
experiencing something that isn’t there
A
HALLUCINATION
14
Q
MENTAL STATUS EXAM COMPONENT
seeing or hearing something that isn’t there
A
SENSORY HALLUCINATION
15
Q
MENTAL STATUS EXAM COMPONENT
getting orders from voices
A
COMMAND HALLUCINATIONS
16
Q
MENTAL STATUS EXAM COMPONENT
seeing something that isn’t there
A
ILLUSION
17
Q
MENTAL STATUS EXAM COMPONENT
what patients are thinking
A
THOUGHT CONTENT
18
Q
MENTAL STATUS EXAM COMPONENT
repetitive intrusive thought or impulse
A
OBSESSION
19
Q
MENTAL STATUS EXAM COMPONENT
unreasonable fear
A
PHOBIA
20
Q
MENTAL STATUS EXAM COMPONENT
- false belief that is deeply imbedded in them
- eg. believing they’re elvis presley
A
DELUSION
21
Q
MENTAL STATUS EXAM COMPONENT
how they deliver those thoughts
A
THOUGHT PROCESSES
22
Q
MENTAL STATUS EXAM COMPONENT
sudden halt in train of thought
A
THOUGHT BLOCKING
23
Q
MENTAL STATUS EXAM COMPONENT
providing too much detail
A
CIRCUMSTANTIALITY
24
Q
MENTAL STATUS EXAM COMPONENT
- jumping from one idea to another
- not in phases
eg. bipolar disorder in manic phase, or people with schizophrenia
A
FLIGHT OF IDEAS
25
MENTAL STATUS EXAM COMPONENT
* incoherent mixture of words and phrases
* gibberish
WORD SALAD
26
MENTAL STATUS EXAM COMPONENT
| * state of wakefulness
SENSORIUM & COGNITION
27
MENTAL STATUS EXAM COMPONENT
| awake, alert, unconscious
LOC
28
MENTAL STATUS EXAM COMPONENT
| time, place, person
ORIENTATION
29
MENTAL STATUS EXAM COMPONENT
| ability to recall past experience
MEMORY
30
MENTAL STATUS EXAM COMPONENT
* level of distractibility
* eg. are they able to pay attention
ATTENTION & CONCENTRATION
31
MENTAL STATUS EXAM COMPONENT
| level of intelligence
COMPREHENSION & ABSTRACT REASONING
32
MENTAL STATUS EXAM COMPONENT
| patient's understanding of the problem
INSIGHT & JUDGMENT
33
MENTAL STATUS EXAM COMPONENT
| is a symptom of mental illness
PSYCHOSIS
34
PEOPLE WITH _________________:
* are not able to comprehend reality
* thoughts and behaviours are very disorganized
* difficulty communicating with others
PSYCHOSIS
35
CODED CLASSIFICATION
* Psychiatric diagnosis
* American Psychiatric Association
DSM-V
36
DEFINITION
| a state of tension, dread, or impending doom, arising from external influences that threaten to be overwhelming
ANXIETY
37
WHAT KIND OF ANXIETY?
| characterized by persistent, excessive and unrealistic worry about everyday things.
GENERALIZED ANXIETY DISORDER
38
WHAT KIND OF ANXIETY?
| begins in childhood and adolescence but may begin in one’s twenties
GENERALIZED ANXIETY DISORDER
39
WHAT KIND OF ANXIETY?
| always anticipate disaster
GENERALIZED ANXIETY DISORDER
40
WHAT KIND OF ANXIETY?
| worry about everything
GENERALIZED ANXIETY DISORDER
41
WHAT KIND OF ANXIETY?
| generally begins in childhood
GENERALIZED ANXIETY DISORDER
42
WHAT KIND OF ANXIETY?
| can develop panic disorder
GENERALIZED ANXIETY DISORDER
43
WHAT KIND OF PHOBIA?
* fear of wide open spaces
* afraid of being trapped (eg. bridge) and being unable to save themselves
* people will avoid crowded places
AGORAPHOBIA
44
WHAT KIND OF ANXIETY?
Marked and persistent fear that is excessive and unreasonable, cued by the presence or anticipation of a specific object or situation
SPECIFIC PHOBIAS
45
WHAT KIND OF ANXIETY/PHOBIA?
debilitating fear of situations in which an individual fears humiliation or embarrassment when under the scrutiny of others.
SOCIAL PHOBIA
| SOCIAL ANXIETY DISORDER
46
DEFINITION
| unwanted, repetitive thoughts that lead to feelings of fear, anxiety, or guilt
OBSESSION
47
DEFINITION
| behavior or thoughts used to decrease the fear or guilt associated with obsessions
COMPULSION
48
people that tear out their hair
TRICHOTILLOMANIA
49
people who are constantly picking at their skin
EXCORIATION
50
_____________ IS A sign of depression
CUTTING
51
Preceded by a traumatic event
POST TRAUMATIC STRESS DISORDER (PTSD)
52
persistent re-experience of traumatic event - flashbacks - continually re-experiencing the event
POST TRAUMATIC STRESS DISORDER (PTSD)
53
avoidance of stimuli associated with the trauma; experiences a numbing that was not present before the trauma
POST TRAUMATIC STRESS DISORDER (PTSD)
54
experiences symptoms that were not present before the trauma
* sleep disturbances
* poor concentration
* angry outbursts
* hypervigilance
POST TRAUMATIC STRESS DISORDER (PTSD)
55
WHAT KIND OF DISORDER?
* Formerly called hypochondriasis
* Patients may "double-doctor" because they believe that they are not being properly treated
* High health anxiety accompanied by somatic symptoms
SOMATIC SYMPTOMS DISORDER
56
WHAT KIND OF DISORDER?
* High health anxiety without somatic symptoms
* No symptoms
* patients often want to be tested for everything
ILLNESS ANXIETY DISORDER
57
WHAT KIND OF DISORDER?
* particularly challenging disorder
* patients deliberately falsify their symptoms to assume "sick role"
* become evasive and angry with further questioning
*
FACTITIOUS DISORDER
58
WHAT KIND OF FACTITIOUS DISORDER?
| creating illness to get attention
MUNCHAUSEN SYNDROME
59
WHAT KIND OF FACTITIOUS DISORDER?
| making someone else sick
MUNCHAUSEN SYNDROME BY PROXY
60
WHAT KIND OF DISORDER?
* where factitious disorder is intentional, this is unintentional
* symptoms are neurological, but not accounted for with neurological disease
* stress is manifested by neurological symptoms
* eg. pseudo seizures, involuntary tremors
CONVERSION DISORDER
61
WHAT KIND OF DISORDER?
* Pain in one or more anatomic sites and causes impairment in one or more areas of functioning
* May be associated with (1) psychologic factors (2) psychologic and general medical condition
* May be acute or chronic
PAIN DISORDER
62
WHAT KIND OF DISORDER?
* clinical condition
* affects how a person thinks, feels and behaves
* people feel sad and hopeless
DEPRESSIVE
63
WHAT KIND OF DEPRESSION?
| severe non-functioning depression
MAJOR DEPRESSIVE DISORDER
64
WHAT KIND OF DEPRESSION?
| Symptoms must be present most of the day, nearly every day for at least 2 weeks
MAJOR DEPRESSIVE DISORDER
65
WHAT KIND OF DEPRESSION?
Emotional: Depressed mood, anhedonia (don't take pleasure in things), irritability that is outside of their personality norm
MAJOR DEPRESSIVE DISORDER
66
WHAT KIND OF DEPRESSION?
| Cognitive: Poor concentration, feelings of worthlessness, guilt, thoughts of death, ruminate, can become delusional
MAJOR DEPRESSIVE DISORDER
67
WHAT KIND OF DEPRESSION?
| Behavioral: Change in appetite, insomnia/hypersomnia, fatigue, psychomotor agitation/retardation
MAJOR DEPRESSIVE DISORDER
68
WHAT KIND OF DEPRESSION?
| Social: Withdrawal from family and social interactions
MAJOR DEPRESSIVE DISORDER
69
WHAT KIND OF DEPRESSION?
* low level of depression
* depressed yet functional
* chronically negative, pessimistic, gloomy
* not as productive, but still functional
PERSISTENT DEPRESSIVE DISORDER
70
WHAT KIND OF DEPRESSION?
| Depressed mood and three symptoms for most of the day nearly every day for at least 2 years
PERSISTENT DEPRESSIVE DISORDER
71
WHAT KIND OF DEPRESSION?
| Emotional: Depressed mood, anhedonia, irritability
PERSISTENT DEPRESSIVE DISORDER
72
WHAT KIND OF DEPRESSION?
| Cognitive: Poor concentration and decision-making, low self-esteem, inadequacy, guilt, brooding, pessimistic
PERSISTENT DEPRESSIVE DISORDER
73
WHAT KIND OF DEPRESSION?
| Behavioral: Chronic fatigue
PERSISTENT DEPRESSIVE DISORDER
74
WHAT KIND OF DEPRESSION?
| Social: withdrawal, relationships become strained
PERSISTENT DEPRESSIVE DISORDER
75
3 NEUROTRANSMITTERS ASSOCIATED WITH DEPRESSION
SEROTONIN
DOPAMINE
NOREPINEPHRINE
76
WHAT IS THIS CALLED?
when somebody has had their first episode of depression, the hardwiring (electrophysiology) of brain is changed
makes the brain more vulnerable to episodes of depression
KINDLING
77
PETSCAN FINDINGS FOR DEPRESSION
LESS NEUROTRANSMITTER ACTIVITY
78
WHAT KIND OF DISORDER?
- used to be called manic depression
- characterized by mood cycles
BIPOLAR DISORDER
79
WHICH BIPOLAR?
| have manic episodes that are so severe that immediate hospitalization is required
BIPOLAR DISORDER 1
80
WHICH BIPOLAR?
| more functional
BIPOLAR DISORDER 2
81
SCHIZOPHRENIA IS OFTEN CONFUSED WITH THIS DISORDER:
DISSOCIATIVE IDENTITY DISORDER
82
WHICH DISORDER?
Combination of disordered thinking, perceptual disturbances, behavioral abnormalities, affective disruptions, and impaired social competency
SCHIZOPHRENIA
83
WHICH DISORDER?
| caused by very strong genetic predisposition, runs in families
SCHIZOPHRENIA
84
WHICH DISORDER?
| can be caused by drug abuse
SCHIZOPHRENIA
85
WHICH DISORDER?
| no cure, but if it's managed properly then people can function with it
SCHIZOPHRENIA
86
WHICH DISORDER?
| people with it lack insight
SCHIZOPHRENIA
87
WHAT TYPE OF SYMPTOMS?
| Loss of normal function that is normally seen in mentally healthy adults
NEGATIVE
88
WHAT TYPE OF SYMPTOMS?
* Inability to understand sensory information
* Blunted or flat affect; anhedonia
* Lack of motivation, impaired problem solving
* Decreased activity level, minimal self-care
* Limited speech
* Social Withdrawal, isolation, inadequate social and occupational skills
NEGATIVE
89
WHAT TYPE OF SYMPTOMS?
| Behaviours not normally seen in healthy individuals
POSITIVE
90
WHAT TYPE OF SYMPTOMS?
* Hallucinations (hear voices that are not there)
* Delusions
POSITIVE
91
SCHIZOPHRENIA diagnosis occurs when ______________ symptoms are present (symptoms that healthy people don't have)
POSITIVE
92
Neurocognitive Impairment PRESENT IN PEOPLE WITH SCHIZOPHRENIA
* Disorganized thinking
| * Disorganized behaviour
93
SUBSTANCE USE VS. SUBSTANCE-INDUCED DISORDER: uses it habitually
SUBSTANCE USE
94
SUBSTANCE USE VS. SUBSTANCE-INDUCED DISORDER:
* withdrawals when trying to cut down
* cravings
* spend a lot of time trying to get substance
* double-doctor
* give up social activities
* develop tolerance to it
SUBSTANCE USE
95
```
SUBSTANCE USE VS. SUBSTANCE-INDUCED DISORDER:
substance specific set of symptoms
* drunk
* lack of judgement
* slurred speech
```
SUBSTANCE-INDUCED
96
SUBSTANCE USE VS SUBSTANCE-INDUCED DISORDER:
* Substance intoxication and withdrawal
* Substance/medication-induced mental disorders
SUBSTANCE-INDUCED
97
medical term is "ethanol"
ALCOHOL
98
“Moderate ALCOHOL consumption”
3 DRINKS PER DAY
| 9 DRINKS PER WEEK
99
3 SYMPTOMS OF Alcohol withdrawal
* shaking
* delirium tremors
* nausea
100
Wernicke-Korsakoff syndrome IS RELATED TO DEFICIENCY IN THIS
THIAMINE
101
THESE ARE SIGNS OF WHAT?
* flat face
* low-set eyes
* nasal bridge is flat
* flat filtrum
* thin upper lip
* cognitively delayed
FETAL ALCOHOL SYNDROME
102
COMPLICATIONS OF WHAT?
* pupilary constriction
* comatose
* respiratory depression
OPIOID INTOXICATION
103
antidote for overdose
narcan
104
SIGNS OF WHAT?
* they think they're going to die but they won't
* severe symptoms
OPIOID WITHDRAWAL
105
_______________ is a very weak opioid to decrease severity of withdrawal symptoms
methadone
106
WHAT ARE THESE: morphine, fentanyl, oxys, dilaudid, heroine
NARCOTICS
107
WHAT IS COCAINE & AMPHETAMINES?
STIMULANTS
108
THESE promote release of dopamine and norepinephrine
STIMULANTS
109
THESE ARE used therapeutically for weight loss, ADHD, and narcalepsy
STIMULANTS
110
THESE stimulate the central nervous system & increases the amount of wakefulness and focus
STIMULANTS
111
THESE affect the sympathetic nervous system, increases heart rate, breathing and blood pressure
STIMULANTS
112
overdose ON THESE CAN CAUSE cardiac arrest, heart failure, dangerous arrythmias
STIMULANTS
113
WHAT DISORDER?
“an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment”
PERSONALITY DISORDER
114
WHAT DISORDER?
PEOPLE ARE
* still functional
* maladaptive personalities
* have a defect on the way they see the world
* rarely seek treatment because they think it's everyone else's problem
* tend to have difficult relationships with lots of people
PERSONALITY DISORDER
115
WHAT DISORDER?
* personal traits, social traits that we develop as children
* usually our personalities remain stable over time
PERSONALITY DISORDER
116
WHAT CLUSTER OF PERSONALITY DISORDER?
1. PARANOIA
2. SCHIZOID
3. SCHIZOTYPAL
A - ODD CENTRIC
117
WHAT CLUSTER OF PERSONALITY DISORDER?
1. NARCISSISTIC
2. HISTRIONIC
3. BORDERLINE
4. ANTISOCIAL
B - DRAMATIC-EMOTIONAL
118
WHAT CLUSTER OF PERSONALITY DISORDER?
1. AVOIDANT
2. DEPDENDENT
3. OBSESSIVE
C - ANXIOUS-FEARFUL
119
WHICH PERSONALITY DISORDER?
distrust and suspicious; see others’ motives as malevolent, tense, irritable, always on guard, short-tempered, don't interact well with others
PARANOIA
120
WHICH PERSONALITY DISORDER?
emotionally restricted and unable to take pleasure in activities, friendships, or social relationships, aloof, detached from other people, no desire to build friendships, indifferent to praise or criticism
SCHIZOID
121
WHICH PERSONALITY DISORDER?
| sensory distortions, ideas of reference in addition to emotional detachment, eg. Unibomber, brief psychotic episodes
SCHIZOTYPAL
122
WHICH PERSONALITY DISORDER?
preoccupied with success, beauty; arrogant, sense of entitlement; successful, no humility, fragile self-esteem, need continual praise
NARCISSISTIC
123
WHICH PERSONALITY DISORDER?
very dramatic, manipulative, excessive emotional expression accompanied by attention-seeking behaviours, superficial friendships
HISTRIONIC
124
WHICH PERSONALITY DISORDER?
instability in mood, thinking, self-image, and personal relationships, react emotionally to every little situation, poor coping skills, impulsive, poor relationships
BORDERLINE
125
WHICH PERSONALITY DISORDER?
psychopaths/sociopaths – a “stunning lack of conscience”; deceitful, manipulative, charming, manipulative, do not care if they hurt anybody, gain power at expense of victims, blame the victim, not themselves, hair-trigger temper
ANTISOCIAL
126
WHICH PERSONALITY DISORDER?
fearful of criticism, disapproval or rejection, avoids social interactions, low self-esteem, withholds thoughts and feelings, close to social phobia, withdrawn
AVOIDANT
127
WHICH PERSONALITY DISORDER?
unable to make decisions independently, clinging, submissive, cannot express negative emotions, fear of separation, do not stand up for themselves, choose bad relationship over no relationship, zero self-confidence, put up with mistreatment, suffer in silence
DEPENDENT
128
WHICH PERSONALITY DISORDER?
preoccupation with perfection, organization, structure, excessive devotion to work, self-criticism and inability to forgive own errors, insistence on others’ conforming to own methods, aware of social status, pompous, arrogant, conform to rules, dependable, loyal
OBSESSIVE-COMPULSIVE
LINDSAY - PATHO 2
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