Intro To Psychiatry

Front 1

What is the science that deals with mental processes and behavior?

Back 1

Psychology

Front 2

What is a person trained and educated to perform psychological research, testing, and therapy.

Back 2

Psychologist

Front 3

What is the branch of medicine that deals with diagnoisis, tx, prevention of mental and emotional disorders?

Back 3

Psychiatry

Front 4

A physician who specializes in:

Back 4

psychiatrist

Front 5

A mark of infamy or disgrace;
sign of moral blemish;
stain or reproach caused by dishonorable conduct;
reproachful characterization.

A mark or characteristic indicative of a history of a disease or abnormality

Back 5

STIGMA

Front 6

What can I do to COMBAT stigma?

Back 6

1. Educate: mental illness is really disease, common, treatable.

2. Share your own experiences with mental illness

3. Support people with mental illness.

Front 7

Explain the usefulness of DSM-IV:

Back 7

1. Published by the APA.
2. Guides clinicians to diagnose and describes psychiatric disorders.
3. Used in conjunction with clinical judgement
4. Creates consistency for clinicians and researchers.
5. Covers Children and Adults
6. Includes statistics, background info, ICD-9.

Front 8

AXIS I:

Back 8

- CLINICAL DISORDER, OTHER conditions that require clinical attention.

1. Dx: Schizo, depression, body dysmorphic disorder.
2. REPORT all disorders: more than one psychiatric dx.
- but list most important problem first.

Front 9

Axis II:

Back 9

- Personality disorders or mental retardation.
+ nonmaladaptive personality features and defense mechanism:
Such as: histrionic, narcissistic, antisocial, borderline, personality disorder.
- Notes development disorders:
mental retardation and autistic disorders
- "principal diagnosis" or "reason for visit"
- "deferred" vs. "none"

Front 10

Axis III:

Back 10

General Medical Condition revelevant to pt's mental disorder:
1. alzheimer's disease, diabetes, hypothyro, HTN, gout, osteo
2. worsen to mental disorder
3. lead to psychological reactions
4. influence tx.

Front 11

Axis IV:

Back 11

Psychosocial and Enviromental Problems:
1. family or personal stress
2. positive or negative life stressors
3. enviromental difficulty.
, etc.within a year.

Front 12

Axis V:

Back 12

Global Assessment of Functioning:
- clinican assesment indication patients current level of function.
- 0 = unable to assess
- 100 = superior functioning

Front 13

How to overcome a CHALLENGING PT: altered mental status

Back 13

1. Redirect the patient politely.
2. Be calm and respectful
3. Ask directed questions with simply answers.

Front 14

What types of history should be getting from an psychiatric patient:

Back 14

1. Psychiatric History
2. Social History
3. Medication History
4. Mental Status Examination (MSE)

Front 15

Mental Status Examination:

Back 15

1. Appearance, activity, attitude toward interviewer
2. Mood and Affect
3. Speech, language, sensorium
4. Insight and Intelligence
5. Thought and perceptual disturbances.

Front 16

What is mood?

Back 16

- sustained feelings
** subjectively reported by patient.

Front 17

What is the affect?

Back 17

- current observable emotion.
** observational reported by clinican
** fluctuating changes in emotion.

1. blunted, flat, inappropriate, labile, restricted.

Front 18

What is speech, language, sensorium?

Back 18

- quality, rate, volume, sensorium (level of conciousness/alertness of patient..)

Front 19

What is the insight and intelligence?

Back 19

refers to patients awarness taht they have a mental illness and the consequences mental illness has on their life.
- poor insight = noncompliant with meds
- average, below or above average.

Front 20

Thougth Content;
normal vs. abnormal
type of delusions

Back 20

Perceptual disturbances:
Hallucinations vs. illusions.

Front 21

Affect

Back 21

describes the patient’s current emotional tone, as expressed through facial expression and tone of voice. Affect refers to more fluctuating changes in emotion (“weather”). Affect is objectively observed by the clinician. Examples include sadness, elation, and anger.

Front 22

Blunted Effect

Back 22

the intensity of emotional expression is reduced, but not absent

Front 23

Flat Effect

Back 23

no change in expression occurs throughout the course of the interview, as in schizophrenia or depression. There is an absence or near absence of any signs of expression.

Front 24

Inappropriate Effect

Back 24

when affect observed does not match the behavior displayed by a patient. For example, a depressed patient who is laughing would display inappropriate affect.

Front 25

labile

Back 25

abnormal variability in affect with repeated, rapid, and abrupt shifts in expression

Front 26

restricted or constricted

Back 26

mild reduction in the range and intensity of emotional expression

Front 27

alogia

Back 27

poverty of sepech, not able to carry on a logical converstation

Front 28

anhedonia

Back 28

lack of interest, in previously enjoyed activities

Front 29

avolition

Back 29

lack of goal-directed behavior, lack of motivation

Front 30

blocking

Back 30

a person suddenly stops speaking without an obvious reason

Front 31

Catatonic behavior

Back 31

motor abnormalities including patients with rigid posture, an absence of movement or excessive types of certain movements (purposeless agitation not influenced by external stimuli) and failure to communicate effectively (i.e. echolalia – senseless repetition or echopraxia – repetition by imitation of another’s movements). Rule out paranoia or medication-induced adverse effects.

Front 32

Circumstantial speech

Back 32

lacks a clear direction because of excess unnecessary information, although the point is eventuallly made.

Front 33

Compulsions

Back 33

actions performed in response to the obsessions or to control anxiety associated with the obsession.

Front 34

Delusions

Back 34

fixed falso reliefs that not based in reality or consistent with the pts religion or culture. Maybe persuctory, bizarre, grandiose, jealousy, somatic.

Front 35

bizarre

Back 35

a phenomenon that the person's culture would regard as totally implausible

Front 36

grandiose

Back 36

inflated appraisal of one's worth, power, knowledge, importance, or identity.

Front 37

jealousy

Back 37

one's sexual partner is unfaithful

Front 38

persecutory

Back 38

the central theme of teh delusion is that one is being attacked, harassed, cheated, persecuted, conspired against.

Front 39

Somatic

Back 39

related to the appearance of function of one's body.

Front 40

flight of ideas

Back 40

over-productive, rapid speech during which the patient jumps rapidly from one idea to the next. These ideas are connected to each other by association, distracting stimuli, or plays on words.

Front 41

hallucinations

Back 41

false sensory impressions or perceptions that occur in absence of an external stimulus. May be auditory, visual, olfactory, or gustatory and may be continuous or intermittent.

Front 42

Ideas of reference

Back 42

the belief that an external event has a meaning that is specific to the person. For example, the belief that a news broadcast is speaking specifically to them

Front 43

Illusions

Back 43

visual misperceptions involving a misinterpretation of a real sensory stimulus. This may be experienced by people without psychiatric illness

Front 44

insight

Back 44

refers to patient awareness that they have a mental illness and the consequences the mental illness will has on their life

Front 45

Judgement

Back 45

is the ability to make decisions appropriate to the situation and may be impaired in a variety of mental illness

Front 46

judgement

Back 46

is the ability to make decisions appropriate to the situation and may be impaired in a variety of mental illnesses

Front 47

Looseness of association (“derailment”)

Back 47

– when there is no connection between thoughts. For example, a patient may believe that the blue flag outside their window is a sign that the world is going to end.

Front 48

Mood –

Back 48

describes sustained feelings (“climate”). Mood is subjectively reported by the patient and may be described as euthymic, depressed, irritable, etc.
.

Front 49

Mutism –

Back 49

the patient does not respond even though they are aware of the discussion

Front 50

Obsessions

Back 50

– unwanted thoughts or ideas that intrude into a person’s thinking. The patient recognizes these as abnormal

Front 51

Over-activity –

Back 51

Over-activity – an increase in purposeful movements or agitation and an include pacing; hand wringing; picking at clothing, skin, or hair; inability to sit still during the interview; excessive hand gestures

Front 52

Perseveration

Back 52

– repetition of an original answer to subsequent questions

Front 53

Pressured speech

Back 53

Pressured speech – speech that is increased in amount, accelerated, and difficult or impossible to interpret. Often patients continue to talk, even if no one is listening.

Front 54

Tangential Speech

Back 54

Tangential speech – like circumstantial speech, however the point is never made

Front 55

Thought broadcasting

Back 55

– the belief that one’s thoughts are broadcasted out loud so they are available to others

Front 56

Thought blocking

Back 56

– usually occurs when a hallucination or delusion intrudes into the person’s thinking or when upsetting issues are discussed.

Front 57

Thought insertion

Back 57

– the idea that one’s thoughts are not their own, but rather inserted into their mind.

Front 58

Under-activity

Back 58

– patient moves less than expected