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33 Cards in this Set
- Front
- Back
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What is psychiatry?
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That branch of medicine concerned with understanding and managing abnormalities of the way we think, feel and behave
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What are psychiatric disorders?
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Illnesses or disease states, manifest by abnormalities of thinking, feeling and behaving, that cause the individual significant distress or significantly impair their ability to work, play and love.
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Why are psychiatric disorders important? (4)
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-Common:
(-20% of the community in 12 months -40% over a lifetime -both in community and hospital practice) -start early in life -frequently persist -cause high levels of disability and distress |
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Based on a 2007 National Mental Health Survey, order the following in terms of 12-month prevalence:
-Any affective disorder -Substance use disorder -Any anxiety disorder |
-Any anxiety disorder (14.4%)
-Any affective disorder (6.2%) -Substance use disorder (5.1%) |
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Regarding burden of disease, order the following from highest to lowest DALYs (YLL + YLD)
-Neonatal -Congenital -Genitourinary -Digestive -Chronic respiratory -Nervous system -Cancer -Cardiovascular -Mental -Injury -Musculoskeletal -Diabetes -Infectious -Respiratory infections -Other |
-Cardiovascular
-Cancer -Mental (19%) -Nervous system -Injury -Chronic respiratory -Musculoskeletal -Digestive -Diabetes -Other -Genitourinary -Infectious -Congenital -Respiratory infections -Neonatal |
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Regarding burden of disease, order the top 10 of the following from highest to lowest YLL:
-Neonatal -Congenital -Genitourinary -Digestive -Chronic respiratory -Nervous system -Cancer -Cardiovascular -Mental -Injury -Musculoskeletal -Diabetes -Infectious -Respiratory infections -Other Regarding burden of disease, what category of those above has the highest YLD? |
-Cardiovascular
-Cancer -Injury -Chronic respiratory -Nervous system -Digestive -Diabetes -Other -Infectious -Congenital Mental disorders (yet doesn't come into the top 10 for YLL) |
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What % of the health budget is allocated to mental disorders?
How much is spent on mental disorders in Australia annually? How many mental health related PBS-subsided prescriptions are there per year? How much are these worth? What % of these scripts are for antidepressants and antipsychotics? What are the direct and indirect costs per person in Australia for: -bipolar disorder? -schizophrenia? Who incurs most of these costs? |
8% (but 19% of total burden of disease due to illness)
$4.7b 20 million prescriptions worth $700m 90% for ADs and APs bipolar $16000 schizophrenia $50000 Carers and the person with the illness incur most of the costs |
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What are the 10 main categories covering the scope of psychiatric interest?
Define/name some disorders that fit in these categories. |
Organic disorders - delirium, dementia, medical illness presenting as psych
Psychotic disorders - schizophrenia, delusional disorders Mood disorders - major depression, bipolar disorder (may also be psychotic) Anxiety disorders - panic, phobias, OCD, PTSD Personality disorders - lifelong maladaptive patterns of interacting with the world and self Somatoform disorders - psychiatric disorders that present as physical illness e.g. conversion disorder Substance disorders - abuse, dependence, withdrawal, intoxication Other disorders - sleep disorders, paraphilias, Munchausen's, childhood disorders Intense reactions - adjustment disorders, pathological bereavement Role problems - abnormal illness behaviour, abnormal treatment behaviour |
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What are the two classificatory systems in psychiatry?
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DSM-IV and ICD-10
both are categorical |
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Describe how the following can move from normality to a disorder:
-grief -shyness -suspiciousness -mood swings |
Grief->depression; pathological grief
Shyness->normal social anxiety->social phobia Suspiciousness->delusions Mood swings->bipolar disorder |
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What are the factors for an individual that feed into the biopsychosocial (cultural) model? (3)
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Pathophysiological effects
Individual genetic vulnerability Environmental stressors |
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Give examples of how stress interacts with genetic factors in psychiatric disorders.
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-effect of violence in childhood upon the individual is moderated by a functional polymorphism of the MAO-A gene
-individuals with the short form of the 5HT TLPR gene may be more vulnerable to depression in the context of environmental stress |
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According to the National Survey of Mental Health in Australia, what is the prevalence in males of:
-disorders of substance use + anxiety + affective -disorders of substance use + anxiety NO affective -disorders of affective + anxiety NO substance use -disorders of substance use + affective NO anxiety -substance use disorder alone -anxiety disorder alone -affective disorder alone |
0.8%
1.4% 0.3% 0.6% 8.4% 3.6% 1.4% |
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According to the National Survey of Mental Health in Australia, what is the prevalence in females of:
-disorders of substance use + anxiety + affective -disorders of substance use + anxiety NO affective -disorders of affective + anxiety NO substance use -disorders of substance use + affective NO anxiety -substance use disorder alone -anxiety disorder alone -affective disorder alone |
0.8%
0.9% 3.1% 0.3% 2.4% 7.3% 3.2% |
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A study looking at the WA population found which medical conditions had a higher death rate in the mentally ill than the general population?
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cancer
heart attack other heart disease stroke other circulatory disease respiratory system diseases accidental death suicide |
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Regarding the early history of psychiatry, what did the Babylonians and Mesopotamians believe in? (4)
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Spirit invasion
Sorcery Demonic malice Evil eye |
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What are some broad themes proposed in Greek philosophy regarding psychiatry and by whom? (3)
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-emergence of introspection
-life is rational -reflection on madness - not from external forces Socrates, Plato, Aristotle |
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How did the Greeks use early theatre to relate to psychiatry and what psychiatric/philosophical themes were explored?
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-characters contributing to outcomes
-not just fate and gods -theatre becoming therapy -playing out madness, forcing the unthinkable into the open, restoring reason -collective catharsis -internal conflict as a dimension of madness |
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What are some broad themes proposed in Greek medicine regarding psychiatry and by whom? (3)
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-all illness is natural
-illness has a rational explanation -the 'sacred disease' epilepy had a rational explanation -all madness was within medicine's bounds Hippocrates 5th century BCE |
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Describe the four humours that provided a somatic theory for madness
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-yellow bile - choler - overheats, raving, mania
-black bile - melancholic - dejection, depression -blood - sanguine -phlegm - phlegmatic -providing a somatic theory for madness |
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In 2nd century CE, what did Aretaeus describe?
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-description of melancholia and furor
-possible description of mania and depression |
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What were some of Christianity's early themes regarding man and psychiatry? (4)
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-man is not rational
-man is a sinner -mental illness is a manifestation of sin or punishment -man is the battle ground of god and the devil |
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Who has hunted in the European Witch Hunt from 1450-1750?
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mostly women
-midwifes -cooks -healers -practiced magic in society -mostly unmarried |
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What was the status of women during the European Witch Hunt? (4)
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-morally and intellectually inferior
-no physical or economic power -must be using sorcery -easily accused |
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What factors cause the decline of witch hunts?
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-got clearly out of control
-the Enlightenment -scientific revolution -literacy -rise of professions and bureaucracy -capitalist centralised economies |
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What were the themes in British psychiatry introduced in the 18th/19th century?
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-moral therapy replaced chains
-physical constraint replaced by moral control -little role of doctors -approach resulted in cure, optimism -concept of partial insanity, could be cured |
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In the mid 19th century, what actions did the British Medical Profession carry out after being frustrated about lay success?
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-asserted right as primary diagnosticians
-by 1840s had specialised journals -tried to convince others that public asylums under medical control was best -1850 Asylum Act In the 1850s asylums were in full swing with moral therapy used as it was humane and therapeutically sound |
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Who were some early trials about leading to the rise in criminal insanity?
When was the Criminal Lunatic Act established? When did psychiatry organise itself as a profession? |
Earl Ferrers 1760
James Hadfield 1800 Daniel McNaughton Robert Peel 1800 1830s-1840s |
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What was Freud's broad approach to psychiatry?
Who were his influences? |
If told all, using free association, unsconscious repressions which were the basis of neurosis would find release.
Charcot/Breuer Darwin |
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Who were Emil Kraepelin's influences?
What was his emphasis regarding psychiatry? What were his achievements? |
Morel, Kahlbaum, Hecker, Falret
emphasis on course and prognosis, not on biological psychiatry; form vs content -dementia praecox (schizoprenia) vs manic depressive psychosis -basis of modern Western psychiatry |
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What were Wagner-Jauregg's key career points?
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-1883 erysipelas - remission from psychosis
-1887 suggested malaria for psychosis -experimented with tuberculin for GPI -1917 inoculated actress with blood from malaria sufferer -1927 Nobel Prize |
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Who developed ECT?
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Ugo Cerletti in 1938 in Rome
-not a cure for schizophrenia -relief of symptoms -role in depression |
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What were some of the first psychiatric medications available in the 20th century?
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-chlorpromazine
-imipramine -lithium |
