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24 Cards in this Set
- Front
- Back
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One-half of all lifetime cases of mental illness begin by age...
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14
three-quarters by age 24. |
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Define psychiatric illness
(o) |
Any of various conditions characterized by impairment of an individual's normal cognitive, emotional, or behavioral functioning, and caused by social, psychological, biochemical, genetic, or other factors, such as infection or head trauma.
Also called emotional illness, mental illness, mental disorder. |
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what is the difference btw primary and secondary psychiatric disorders?
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Primary psychiatric disorders
No underlying medical disorder to account for the diagnosis Not caused by medication Not caused by substance abuse or withdrawal Secondary psychiatric disorders Due to a medical condition Due to a medication(s) Due to substance abuse or withdrawal |
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Identify the domains of psychiatric illness (6)
(o) |
Some People Can Eat Bad Eggs
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Identify the classification systems used to diagnose psychiatric illness
(o) |
Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR)
Published by the American Psychiatric Association (2000) Most recent update of criteria: DSM-IV (1994) Current DSM bases diagnostic codes on ICD-9-CM International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) Published by the US government in 1979 Official coding system in the US for all diseases (Ch.5 Mental Dis) Revises codes annually but has not kept up with diagnostic changes in the DSM |
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What is an important thing to remember about the DSM IV and diagnosis it gives
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Contains a listing of psychiatric disorders, diagnostic codes, and criteria for each disorder
Also contains text with information about the disorder (e.g., associated features, prevalence, course, familial patterns, age-,culture- and gender-specific features, differential diagnosis) ***Does NOT contain information about presumed etiology or treatment**** |
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Describe the DSM-IV-TR multiaxial diagnostic system
(o) |
Axis I: Clinical Disorders (psychiatric)
Axis II: Personality disorders and traits, mental retardation, prominent defense mechanisms Axis III: General Medical Conditions Axis IV: Psychosocial and environmental problems (stressors) Axis V: Global Assessment of Functioning (1-100 scale) EXAMPLE Axis I 296.22 Major Depressive Disorder, single episode, moderate 305.00 Alcohol Abuse Axis II 301.6 Dependent Personality Disorder Axis III Hepatitis B Axis IV Threat of job loss Axis V GAF = 45 (current) |
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Almost all psychiatric diagnoses are made...
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CLINICALLY
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Identify the components of a psychiatric evaluation
(o) |
History (Identifying Data/Reason for admission or evaluation, Past Psychiatric History, Substance History, Mental Status Exam)
Exam (neuro/mental) Radiological and lab |
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SUMMARY SLIDE FOR LECTURE 2 OF PSYCH
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Psychiatric symptoms can be seen in many conditions
The etiology of most primary psychiatric disorders is not known Diagnosis is based primarily on history and mental status exam Physical exam, neurologic exam, lab, and other studies are performed to rule out possible non-psychiatric causes of psychiatric symptoms The DSM-IV-TR increases reliability of diagnosis |
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Compare content vs. form using a visual hallucination as an example.
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the fact that a person is experiencing a visual phenomenon with no sensory accounting for it (**form**) assumes more importance than what the patient sees (**content**).
[Karl Jaspers] |
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What Axis are:
-Clinical Disorders (psychiatric) |
Axis I
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What Axis are:
- Personality disorders and traits, mental retardation, prominent defense mechanisms |
Axis II
(developmental) |
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What Axis are:
- General Medical Conditions |
Axis III
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What Axis are:
- Psychosocial and environmental problems (stressors) |
Axis IV
(Child abuse, substance abuse, grieving, Divorce, Financial trouble, etc..) |
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What Axis are:
- Global Assessment of Functioning (1-100 scale) |
Axis V
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What axis is Dementia?
****** |
Axis I & III
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Give the Axes for each condition:
- Obsessive Compulsive Personality d/o? - Obsessive Compulsive d/o? - Mild Mental Retardation? - Dementia? - Personality Disorder NOS with Cluster B personality d/o traits with antisocial personality features? - Severe stressors? - GAF of 35 |
- Obsessive Compulsive Personality d/o?→ II (no idea what they're doing)
- Obsessive Compulsive d/o?→ I - Mild Mental Retardation?→ II - Dementia? → I & III **** - Personality Disorder NOS with Cluster B personality d/o traits with antisocial personality features? → II - Severe stressors? → IV - GAF of 35→ V |
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What axis would alcohol/opiate withdrawal be?
What about Hepatitis B? |
Opiate/Alcohol Withdrawal = I
HBV = III |
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What model should we use to assess a patient for a mental disorder?
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Biopsychosocial Model (Engel)
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You are a looking at a head CT for a patient with a suspected mental disorder and see enlarged ventricles. What are you thinking?
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Schizophrenia
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What is the 1st priority of psychiatric evaluation and assessment?
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Rule out biological cause!!
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A person is having cognitive problems. You suspect they have been drinking. What will their thiamine levels be like if they have been drinking?
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high
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You suspect a patient you have been treating for chronic supression to have been drinking. What will their GGT (gamma-glutamyl transpeptidase) be like if they've been drinking?
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high
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