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Questions and Answers
What is a fundamental aspect of the Calgary Cambridge Model in communication?
What is a fundamental aspect of the Calgary Cambridge Model in communication?
Which of the following is NOT a key component of professionalism and leadership in a healthcare setting?
Which of the following is NOT a key component of professionalism and leadership in a healthcare setting?
Which statement correctly describes social determinants of health?
Which statement correctly describes social determinants of health?
What essential knowledge should one have regarding pharmacology?
What essential knowledge should one have regarding pharmacology?
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What underlies the pathological and immunological processes of disease?
What underlies the pathological and immunological processes of disease?
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Which common mental disorder is characterized by persistent low mood occurring most of the day, more days than not?
Which common mental disorder is characterized by persistent low mood occurring most of the day, more days than not?
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Globally, morbidity and mortality trends are best described by which study?
Globally, morbidity and mortality trends are best described by which study?
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What role do public health and health promotion encompass?
What role do public health and health promotion encompass?
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Which symptom is commonly associated with depression?
Which symptom is commonly associated with depression?
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How can physical conditions like anaemia mimic depression?
How can physical conditions like anaemia mimic depression?
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Which of the following is essential in microbiological diagnostic investigation?
Which of the following is essential in microbiological diagnostic investigation?
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In which context would mild and stable mental disorders typically be managed?
In which context would mild and stable mental disorders typically be managed?
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What symptoms can mimic anxiety or depression in conditions like anaemia or thyroid dysfunction?
What symptoms can mimic anxiety or depression in conditions like anaemia or thyroid dysfunction?
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Which of the following mental disorders is linked to inflammation associated with sepsis?
Which of the following mental disorders is linked to inflammation associated with sepsis?
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How is depression associated with the immune system?
How is depression associated with the immune system?
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What is one impact of hypoxia on mental health as mentioned in the content?
What is one impact of hypoxia on mental health as mentioned in the content?
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Which of the following is NOT a risk factor for depression and inflammation?
Which of the following is NOT a risk factor for depression and inflammation?
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What is a common presentation of depression that can overlap with physical health issues?
What is a common presentation of depression that can overlap with physical health issues?
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Why might a consultation for a physical illness indicate the need to assess for depression?
Why might a consultation for a physical illness indicate the need to assess for depression?
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What are common feelings associated with anxiety?
What are common feelings associated with anxiety?
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Which of the following physical symptoms is typically NOT associated with anxiety?
Which of the following physical symptoms is typically NOT associated with anxiety?
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How can hypoxia influence mental health symptoms?
How can hypoxia influence mental health symptoms?
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What does a Mental State Examination (MSE) aim to provide?
What does a Mental State Examination (MSE) aim to provide?
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Which component does NOT play a role in the recognition of mental health conditions during a primary care consultation?
Which component does NOT play a role in the recognition of mental health conditions during a primary care consultation?
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What assessment tool is primarily structured yet implemented during patient interviews?
What assessment tool is primarily structured yet implemented during patient interviews?
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What is one of the key aspects assessed in a Mental State Examination?
What is one of the key aspects assessed in a Mental State Examination?
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Which statement about the impact of chronic physical health conditions on mental health is true?
Which statement about the impact of chronic physical health conditions on mental health is true?
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What was the percentage increase in anxiety disorders due to the pandemic in 2020?
What was the percentage increase in anxiety disorders due to the pandemic in 2020?
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Which of the following is NOT considered part of the biopsychosocial approach?
Which of the following is NOT considered part of the biopsychosocial approach?
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What rank does depression hold as a leading cause of Disability Adjusted Life Years (DALYs)?
What rank does depression hold as a leading cause of Disability Adjusted Life Years (DALYs)?
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What is a common misconception about severe mental illness regarding morbidity?
What is a common misconception about severe mental illness regarding morbidity?
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What is the main focus of health anxiety as discussed in the learning outcomes?
What is the main focus of health anxiety as discussed in the learning outcomes?
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Which of the following is a common mental disorder that co-occurs with non-communicable diseases?
Which of the following is a common mental disorder that co-occurs with non-communicable diseases?
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What approach emphasizes the interaction between biological, psychological, and social factors in health?
What approach emphasizes the interaction between biological, psychological, and social factors in health?
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Which of the following is a risk factor common to both mental illness and non-communicable diseases?
Which of the following is a risk factor common to both mental illness and non-communicable diseases?
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Health anxiety can be beneficial until it becomes what?
Health anxiety can be beneficial until it becomes what?
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Which of the following strategies improves outcomes and reduces costs in managing comorbidity of mental and physical illnesses?
Which of the following strategies improves outcomes and reduces costs in managing comorbidity of mental and physical illnesses?
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Which of the following describes the combination of depression and anxiety under common mental disorders?
Which of the following describes the combination of depression and anxiety under common mental disorders?
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What significant change did the WHO Mental Health Action Plan for 2018 emphasize?
What significant change did the WHO Mental Health Action Plan for 2018 emphasize?
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What is crucial for effectively managing self-care in mental health?
What is crucial for effectively managing self-care in mental health?
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What is one of the primary roles of public health in relation to social determinants of health?
What is one of the primary roles of public health in relation to social determinants of health?
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Which characteristic is essential when discussing the principles of pharmacology?
Which characteristic is essential when discussing the principles of pharmacology?
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In the context of managing self and engaging with others, which aspect is emphasized in professionalism?
In the context of managing self and engaging with others, which aspect is emphasized in professionalism?
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Which aspect of the Calgary Cambridge Model is particularly important for effective communication?
Which aspect of the Calgary Cambridge Model is particularly important for effective communication?
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Which statement best describes global trends in morbidity and mortality?
Which statement best describes global trends in morbidity and mortality?
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What is a significant factor underlying immunological processes in diseases?
What is a significant factor underlying immunological processes in diseases?
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What factor is commonly associated with both depression and inflammation?
What factor is commonly associated with both depression and inflammation?
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Which of the following reflects effective strategies for collaboration in a healthcare team?
Which of the following reflects effective strategies for collaboration in a healthcare team?
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Which symptom is most directly indicative of anxiety rather than a physical health condition?
Which symptom is most directly indicative of anxiety rather than a physical health condition?
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How might sepsis complicate mental health symptoms according to the information provided?
How might sepsis complicate mental health symptoms according to the information provided?
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What defines the characteristics of medically important microbiological organisms?
What defines the characteristics of medically important microbiological organisms?
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What chronic condition is suggested to have a bidirectional relationship with anxiety?
What chronic condition is suggested to have a bidirectional relationship with anxiety?
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Which of the following is a characteristic finding during a Mental State Examination (MSE)?
Which of the following is a characteristic finding during a Mental State Examination (MSE)?
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What underlying mechanism links depression and autoimmune responses?
What underlying mechanism links depression and autoimmune responses?
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Which symptom is LEAST likely to be associated with both anxiety and a physical condition like anemia?
Which symptom is LEAST likely to be associated with both anxiety and a physical condition like anemia?
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Which of the following psychosocial stressors can contribute to both depression and inflammation?
Which of the following psychosocial stressors can contribute to both depression and inflammation?
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Which of the following symptoms is NOT typically associated with depression?
Which of the following symptoms is NOT typically associated with depression?
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In what way might depression be recognized during a primary care consultation for a physical illness?
In what way might depression be recognized during a primary care consultation for a physical illness?
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How does depression potentially influence the symptoms of anaemia?
How does depression potentially influence the symptoms of anaemia?
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Which mental process is associated with low iron levels in relation to depression?
Which mental process is associated with low iron levels in relation to depression?
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What common mistake might clinicians make when assessing comorbidities of mental and physical illnesses?
What common mistake might clinicians make when assessing comorbidities of mental and physical illnesses?
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How can the symptoms of sepsis mislead in the context of major depressive disorder?
How can the symptoms of sepsis mislead in the context of major depressive disorder?
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What is a key factor that connects inflammation with depression in the context of mental health management?
What is a key factor that connects inflammation with depression in the context of mental health management?
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Which aspect is NOT typically assessed during a Mental State Examination?
Which aspect is NOT typically assessed during a Mental State Examination?
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What role does the basal ganglia play in the relationship between depression and physical health conditions like hypoxia?
What role does the basal ganglia play in the relationship between depression and physical health conditions like hypoxia?
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What statement best describes the effect of physical health conditions on mental health?
What statement best describes the effect of physical health conditions on mental health?
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Which component of the biopsychosocial approach emphasizes the individual’s relationship with their environment?
Which component of the biopsychosocial approach emphasizes the individual’s relationship with their environment?
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Which diagnosis is frequently overlooked in patients with chronic illness, though it is particularly prevalent?
Which diagnosis is frequently overlooked in patients with chronic illness, though it is particularly prevalent?
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What is the rank of depression in terms of Disability Adjusted Life Years (DALYs) as reported?
What is the rank of depression in terms of Disability Adjusted Life Years (DALYs) as reported?
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Which of the following best describes the trend in anxiety disorders during the pandemic in 2020?
Which of the following best describes the trend in anxiety disorders during the pandemic in 2020?
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What is one consequence of comorbid physical and mental illnesses?
What is one consequence of comorbid physical and mental illnesses?
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Which condition is NOT typically associated with health anxiety becoming pathological?
Which condition is NOT typically associated with health anxiety becoming pathological?
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Which of the following best describes the relationship between mental disorders and non-communicable diseases?
Which of the following best describes the relationship between mental disorders and non-communicable diseases?
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How does health anxiety maintain well-being until it becomes pathological?
How does health anxiety maintain well-being until it becomes pathological?
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Which factor is NOT considered a risk factor for both mental illness and non-communicable diseases?
Which factor is NOT considered a risk factor for both mental illness and non-communicable diseases?
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What role does the biopsychosocial approach play in understanding patient interactions?
What role does the biopsychosocial approach play in understanding patient interactions?
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What was a significant component of the WHO Mental Health Action Plan for 2018?
What was a significant component of the WHO Mental Health Action Plan for 2018?
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Which of the following is NOT typically part of a mental state examination (MSE)?
Which of the following is NOT typically part of a mental state examination (MSE)?
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In the context of engaging with patients and communities, which approach is most effective for managing self-care?
In the context of engaging with patients and communities, which approach is most effective for managing self-care?
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What is a primary symptom of severe mental disorders like schizophrenia and bipolar disorder?
What is a primary symptom of severe mental disorders like schizophrenia and bipolar disorder?
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Study Notes
Introduction to Psychiatry
- Dr Caragh Behan is a Senior Clinical Lecturer in the Department of Psychiatry
- Professor Charlotte Kamel is the Head of Department of Psychiatry at RCSI-Bahrain.
FFP1 Learning Outcomes
- Effective communication, collaboration, and interventions as part of a team.
- Global trends in morbidity and mortality using Global Burden of Disease study data.
- Knowledge of the Calgary Cambridge Model in communication.
- Application of professionalism, leadership, and resilience in managing self and engaging with patients, colleagues, and communities.
- Understanding of biomolecular, cellular, and biochemical fundamentals to life, and principles of pharmacology.
- Social determinants of health and the breadth and function of public health and health promotion.
- Pathological and immunological processes underlying disease.
- Characteristics of medically important microbiological organisms and pathogenesis of bacterial infections.
- Principles of microbiological diagnostic investigation.
Integrating Mental Health with Other Non-Communicable Diseases
- Mental health and wellbeing are crucial for reducing the global burden of non-communicable diseases (NCDs).
- The WHO Mental Health Action Plan for 2013-20 outlines strategies.
- The "Big Four" NCDs: cardiovascular disease, diabetes, cancer, and respiratory diseases, are central to this plan.
- This approach expanded to a 5 x 5 framework in 2018 including mental disorders and environmental contributors.
- Cardiovascular diseases, diabetes, cancer, and respiratory diseases are often co-occurring with common mental disorders and severe mental illnesses.
- Common mental disorders include depression and anxiety.
- Severe mental disorders include schizophrenia and bipolar disorder.
- Risk factors like tobacco, unhealthy diet, physical inactivity, harmful alcohol use, and adverse environmental factors are common to both.
- Collaborative care, integrating mental health treatment into primary care, is supported by evidence.
- Awareness about mental illness and physical illness comorbidity at the secondary care level improves outcomes and reduces costs.
- Multidisciplinary team work is essential for improved professionalism.
- Inclusion of mental health in medical curriculum from early stages is crucial.
ALO 1 & ALO 2: Common Mental Disorders
- Common psychiatric disorders often present as physical illnesses:
- Depression
- Anxiety
- These are primarily managed in primary care (mild, stable cases).
- Depression's relevance to conditions like anaemia, inflammation, or sepsis:
- Depression is associated with anaemia due to its effect on the basal ganglia.
- Low iron levels can affect both movement and emotional processing in the basal ganglia.
- Depression is associated with sepsis due to inflammation, post-viral symptoms, and post-COVID conditions.
- Both sepsis and depression can cause fatigue, weakness, dizziness, mood changes, and cognitive impairment.
- Presenting symptoms of conditions like anaemia, thyroid dysfunction, and post-viral symptoms may mimic anxiety/depression and vice versa.
- Depression is linked to a chronic low-grade inflammatory response and activation of cell-mediated immunity.
- Psychosocial stressors, poor diet, physical inactivity, obesity, smoking, altered gut permeability, atopy, dental care, sleep, and Vitamin D deficiency are common risk factors for both.
- Anxiety's relevance to conditions like anaemia, inflammation, or sepsis:
- Anxiety may present as, or resemble, the symptoms of many conditions.
- There's a bidirectional association between anxiety and anaemia, particularly iron deficiency anaemia.
- Low energy and altered cognition due to hypoxia can lead to mental health symptoms including fatigue, weakness, dizziness, mood changes, and cognitive impairment.
- Sepsis and its implications will be discussed in FFP2 and year 2.
ALO 4: Mental State Examination (MSE)
- MSE provides a snapshot of a patient's thoughts, emotions, and behaviors at the time of observation.
- It helps to identify the presence and severity of any mental condition.
- It helps to identify the presence of risk to self or others (further discussed in later years).
- The MSE is structured, but conducted during the interview while the patient is talking.
- The MSE content includes:
- Appearance
- Behaviour
- Speech
- Mood and Affect
- Thought Form
- Thought Content
- Cognition
- Insight and Judgment
- Risk assessment
Biopsychosocial Approach
- The biopsychosocial approach considers the patient's environment:
- Physical environment
- Social environment
- Psychological factors
- It emphasizes the complex interplay of conditions.
ALO6: Disease Burden and Outcomes
- The burden of disease according to WHO:
- 1 in 8 people worldwide live with a mental disorder.
- There was a 26% increase in anxiety disorders and a 28% increase in depressive disorders in one year due to the pandemic (2020).
- Depression and anxiety were the 13th and 24th leading causes of Disability Adjusted Life Years (DALYs).
- The effect of comorbidity:
- People with a chronic physical health condition are twice as likely to have poor mental health.
- People with severe mental illness experience earlier morbidity and mortality than their peers.
- These lead to worse outcomes and increased costs.
- Under-recognition and treatment are significant problems.
Common Mental Disorders - Depression
- Depression is characterized by persistent low mood, most of the day, more days than not.
- It is associated with biological symptoms like disrupted sleep, low energy, altered appetite, and altered cognition.
- More severe forms can lead to altered thinking, including suicidal thoughts.
- Other terms for depressed mood: dysphoric mood, dysthymic mood.
### Common Mental Disorders - Anxiety
- Anxiety manifests as feelings of anxiety or worry, persistent or intermittent, generalized or specific.
- It is associated with biological symptoms such as disrupted sleep, easily fatigue, irritability, restlessness, increased energy, altered cognition (difficulty concentrating, paying attention, memory, feeling of impending danger or doom).
- Physical symptoms like headaches, muscle aches, stomach aches, unexplained pains, rapid heartbeat, breathing rapidly, sweating, trembling, feeling weak, and pins and needles in extremities may also be present.
Introduction to Psychiatry
- Psychiatry is the study and treatment of mental health conditions.
- This course will prepare students to better treat patients with mental health conditions.
FFP1 Learning Outcomes
- Students will be able to use effective strategies for communication, collaboration, and interventions as part of a team.
- Students will be able to describe global trends in morbidity and mortality using data from the Global Burden of Disease study.
- Students will be able to articulate their knowledge of the Calgary-Cambridge Model of communication.
- Students will be able to explain the application of professionalism, leadership, and resilience to managing themselves and engaging with patients, colleagues, and communities.
- Students will be able to describe biomolecular, cellular, and biochemical fundamentals of life, as well as the principles of pharmacology.
- Students will be able to describe the social determinants of health and the breadth and function of the public health and health promotion roles.
- Students will be able to explain the pathological and immunological processes underlying disease.
- Students will be able to identify the characteristics of medically important microbiological organisms and the pathogenesis of bacterial infections.
- Students will be able to explain the principles of microbiological diagnostic investigation.
Activity Learning Outcomes
- Students will be able to describe common psychiatric disorders that can present as physical illnesses, with reference to conditions taught in FFP1. These include conditions like anaemia, immunology, and inflammation.
- Students will be able to develop an appreciation of the intersection of psychiatry and other medical specialties.
- Students will be able to outline the impact of the individual's environment or system on their physical and mental health using the biopsychosocial approach.
- Students will be able to describe how health anxiety is useful for maintaining health and where health anxiety becomes pathological.
- Students will be able to outline the components of a Mental State Examination (MSE).
- Students will be able to describe how engaging effectively with patients, colleagues, and communities requires managing the self and practicing self-care using a biopsychosocial approach.
Integrating Mental Health into Non-Communicable Diseases
- Mental health and wellbeing are key to reducing the global burden of Non-Communicable Diseases (NCDs).
- WHO Mental Health Action Plan for 2013-2020
- The “Big Four” NCDs: cardiovascular disease, diabetes, cancer, and respiratory diseases
- The 5x5 approach to NCDs: emphasizes integrating mental disorders and environmental contributors.
- There is a common co-occurrence of NCDs with common mental disorders and severe mental illnesses.
- These disorders include depression, anxiety, schizophrenia, and bipolar disorder.
- Risk factors for both NCDs and mental illness include: tobacco use, unhealthy diet, physical inactivity, harmful alcohol use, and environmental risk factors.
- Collaborative care models are effective for integrating mental health treatment into primary care.
- Awareness of mental illness and physical illness comorbidity in secondary care improves outcomes and reduces costs.
- Multidisciplinary team work is key to managing these conditions.
- Mental health should be included in the medical curriculum at an early stage.
Common Mental Disorders
- Common mental disorders include depression and anxiety.
- These can be treated in primary care.
- These conditions can be relevant to physical illnesses.
- It is important to be aware of these conditions during a primary care consultation.
Depression
- Depression involves persistent low mood, occurring for most of the day, more days than not.
- People with depression often experience biological symptoms.
- These symptoms include disruptions in sleep, low energy, appetite changes, and altered cognition.
- In more severe forms, depression is associated with altered thinking and suicidal ideation.
- Key terms used to describe depression include: depressed, dysphoric, and dysthymic moods.
Depression and Physical Illness
- The symptoms of depression can be similar to the symptoms of physical illnesses like anemia or inflammation.
- Depression is associated with anemia.
- Low iron influences the basal ganglia.
- The basal ganglia is responsible for movement and the processing of emotional stimuli.
- Low energy and altered cognition are often associated with hypoxia.
- Hypoxia can result in physical, cognitive, and mental health symptoms, such as fatigue, weakness, dizziness, mood changes, and cognitive impairment.
- Depression is also associated with sepsis, inflammation, and post viral syndrome.
- Acute sepsis can lead to encephalopathy, which involves fluctuating mental state changes, inattention, and disorganized thinking.
Anxiety
- Anxiety involves persistent feelings of worry, which can either generalize or be specific.
- Anxiety can cause a variety of biological symptoms, such as disrupted sleep, fatigue, irritability, restlessness, and altered cognition.
- Anxiety can also cause physical symptoms like headaches, muscle and stomach aches, rapid heartbeat, rapid breathing, sweating, trembling, weakness, and numbness or tingling in the extremities.
Anxiety and Physical Illness
- The symptoms of anxiety can mimic those of various medical conditions.
- Anxiety is bidirectionally associated with anemia.
- Iron deficiency anemia can result in low energy, altered cognition, and hypoxia.
- Sepsis is another condition that can be associated with anxiety.
Mental State Examination
- The MSE provides a snapshot of a patient's thoughts, emotions, and behaviors at the time of observation.
- It is used to identify the presence and severity of mental illness.
- It can also be used to identify risk to self or others.
- The MSE is conducted during the interview while the patient is talking.
Content of the Mental State Examination
- Appearance
- Behaviour
- Speech
- Mood and Affect
- Thought Form
- Thought Content
- Cognition
- Insight and Judgement
- Risk Assessment
Biopsychosocial Approach
- The biopsychosocial approach takes into account an individual's physical environment, social environment, and psychological factors to develop a better understanding of a patient's needs.
- This approach assumes a complex interplay of factors influences health.
Burden of Disease
- 1 in 8 people in the world live with a mental disorder.
- The pandemic saw a 26% increase in anxiety disorders and a 28% increase in depressive disorders within a year.
- Depression and anxiety ranked 13th and 24th in leading causes of Disability-Adjusted Life Years (DALYs).
Effect of Comorbidity
- Individuals with chronic physical health conditions are twice as likely to have poor mental health.
- Individuals with severe mental illness experience earlier morbidity and mortality than their peers.
- Comorbidity leads to worse outcomes, increased costs, and under-recognition and treatment.
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Description
Test your knowledge on the fundamentals of psychiatry, including effective communication and collaboration in healthcare teams. Explore global health trends, medical microbiology, and the social determinants of health. This quiz is designed for students studying psychiatry and public health principles.
