Mental Illness - Introduction
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Questions and Answers

What is the definition of mental illness?

  • A mood disorder
  • A health problem that significantly affects how a person feels, thinks, behaves, and interacts with others (correct)
  • A health problem that affects physical health
  • A temporary reaction to daily stressors

    • What is the primary factor associated with the development of Schizophrenia?

  • Nutritional deficiencies
  • Environmental influences
  • Genetic susceptibility (correct)
  • Social activities

    • Which of the following are examples of negative symptoms of Schizophrenia? (Select all that apply)

  • Social withdrawal (correct)
  • A lack of interest in the world (correct)
  • Excessive mood behaviors
  • Loss of motivation

    • List one cognitive symptom of Schizophrenia.

    <p>Poor short- and long-term memory</p> Signup and view all the answers

    Define Major Depressive Disorder (MDD).

    <p>Characterised by discrete episodes of at least 2 weeks’ duration involving clear-cut changes in affect, cognition, and neurocognitive functions and inter-episode remissions</p> Signup and view all the answers

    Patients with Schizophrenia can experience disorganised thinking in their speech.

    <p>True</p> Signup and view all the answers

    Is GAD (Generalised Anxiety Disorder) more common in females than in males?

    <p>True</p> Signup and view all the answers

    Match the following mental illnesses with their descriptions:

    <p>Schizophrenia = Characterised by disruptions in thinking and perception Bipolar Disorder = Involves periods of mania and depression PTSD = Develops after experiencing a traumatic event Anorexia Nervosa = Restriction of energy intake with intense fear of weight gain</p> Signup and view all the answers

    The goal of treatment for Schizophrenia is to ease the symptoms and reduce the risk of ________.

    <p>relapse</p> Signup and view all the answers

    Match the Antipsychotic medication with its associated risk of side effects:

    <p>First generation antipsychotics (D2 receptor antagonists) = Higher risk of extrapyramidal symptoms Second generation antipsychotics (5-HT2A / D2 receptor antagonists) = Lower risk of extrapyramidal symptoms, but higher risk of metabolic side effects</p> Signup and view all the answers

    What is a major symptom of Major Depressive Disorder (MDD)?

    <p>Loss of interest or pleasure in activities</p> Signup and view all the answers

    How long must a person experience specific symptoms to be diagnosed with PTSD?

    <p>one month or longer</p> Signup and view all the answers

    PTSD symptoms typically persist for weeks and sometimes months only.

    <p>False</p> Signup and view all the answers

    What type of exercise has been the main focus in studies on exercise and Major Depressive Disorder (MDD)?

    <p>Aerobic exercise</p> Signup and view all the answers

    Resistance training has been shown to improve symptoms of Major Depressive Disorder (MDD).

    <p>True</p> Signup and view all the answers

    What lifestyle factors, in addition to exercise, have been indicated to improve MDD symptoms?

    <p>Dietary modification, smoking cessation, sleep hygiene</p> Signup and view all the answers

    A person seeking health care for a mental illness is known as a:*

    <p>consumer</p> Signup and view all the answers

    Which of the following is incorrect*

    <p>a psychiatrist is an allied health professional</p> Signup and view all the answers

    Delusions and hallucinations are characteisitcs of which of the following?*

    <p>Schizophrenia</p> Signup and view all the answers

    Selective Mutism is characteized as which of the following?*

    <p>anxiety disorder</p> Signup and view all the answers

    Which of the following is correct?*

    <p>Bipolar 1 disorder involves periods of mania</p> Signup and view all the answers

    Which of the following drug classes is most commonly used to treat MDD?*

    <p>SSRIs</p> Signup and view all the answers

    Which of the following is incorrect involving PTSD?*

    <p>Impacts more males than females</p> Signup and view all the answers

    Which of the following can complement exercise to assisnt MDD treatment*

    <p>All of the above</p> Signup and view all the answers

    Which type of exercise is most effective for treating GAD?

    <p>high intensity aerobic exercise</p> Signup and view all the answers

    What is the difference btw a mental illness and a mental health problem?*

    <p>A mental illness is a health problem that significantly affetcs how a person feels, thinks, behaves, and interacts with other and is diagnosed in accordance to the DSM-5. A mental health problem does not meet the diagnostic criteria and is often expereicned temporarily as a reaction to life stress.</p> Signup and view all the answers

    What are the 3 aetiological factors thought to contribute to the development of mental illness*

    <p>biological, psychological, and environmetal factors</p> Signup and view all the answers

    Are the 3 aetiological factors equally resonsible for the development of all mental illnesses?*

    <p>No</p> Signup and view all the answers

    Explain the roles and responsiblities of a psycologist and a psychiatrist*

    <p>A Psychiatrist is a medical doctor that is responsible for diagnosing, treating, and preventing mental, emotional and behavioral disorders. A psychologist is an allied health professional who specializes in human behavior and can assist in managing how an individual thinks, feels, behaves and reacts.</p> Signup and view all the answers

    Explain the term Mania and what are some of the characteristics of a manic episode?*

    <p>Mania is a distinct period of abnormally and persistently elevated, expansive or irritable mood and increased activity or energy. It is characterized by inflated self-esteem, decreased need for sleep, more talkative than usual, racing thoughts, easily distracted.</p> Signup and view all the answers

    What behaviors are characteristics of a binge-eating episode?*

    <p>eating much more rapidly than normal, eating to feeling uncomforatbly full, eating large amounts of food when not hungry, eating alone becaue of embarassment of large volume of food, feeling isgusted with oneself, depressed or guilty afterwards.</p> Signup and view all the answers

    Explain the costs and benefits associated with the 1st gen and 2nd gen antipsychotics *

    <p>1st gen are associated with a higher risk of extrapyraidal symtoms (dystonia, parkinsonism, Tardive dyskinesia) where 2nd gen have a lower risk. However 2nd gen have a higher risk of metabolic side effects such as diabetes, hypertenstion, and hyperlipidaemia</p> Signup and view all the answers

    What are the 2 classes of medications used to treat MDD and what are their possible side effects?*

    <p>SSRIs (selective serotonin reuptake inhibitors) and SNRIs (selective norepinephrine reuptake inhibitors) and both can cause stomach upset, weight change, decreased sexual desire, fatigue, dizziness, insomnia, headaches</p> Signup and view all the answers

    Outline the biological and psychosocial mechanisms by which exercise may improve symptos in MDD*

    <p>Biological= affects neuropasticity, inflammation, neuroendocrine response, and oxidative stress. Psychosocial= self-esteem, social support, and self efficacy</p> Signup and view all the answers

    What does 'mane' mean when its next to a medication?

    <p>means its taken in the morning</p> Signup and view all the answers

    What are 2 examples of mood disorders?

    <p>BPD anf MDD</p> Signup and view all the answers

    Explain the differences btw BPD 1 and 2

    <p>BPD 1 involves more severe mania and less severe or absent depressive episodes where type 2 involves less severe mania but more severe depressive episodes</p> Signup and view all the answers

    When combined with a mental illness, what factor increases death rates most significantly?*

    <p>Being unemployed</p> Signup and view all the answers

    People with Schizophrenia have an increased risk of which of the following?*

    <p>All of the above</p> Signup and view all the answers

    What is an appropriate strategy to use when working with those who have a mental illness?*

    <p>Discourage self-selection</p> Signup and view all the answers

    Which setting are you most likely to work with consumers with Schizophrenia *

    <p>in-patient hospital care</p> Signup and view all the answers

    Compare and contract the ability of antipsychotic medications and exercise to improve symptoms in people with schizophrenia*

    <p>Exercise appears to have a favorable impact on the positive, negative, cognitive, and mood symptoms associated with schizophrenia. Antipsychotics are typically effective at reducing positive symptoms, but have a limited effect on negative and cognitive symtpms. Additionally 30% of people dont respond to the medication</p> Signup and view all the answers

    What are some of the secondary effects of PTSD that can be improved with exercise?*

    <p>depressive symptoms, sleep distrubances, substance use disorder, quality of life</p> Signup and view all the answers

    What is the role of GPs in managing mental illness? *

    <p>(1) make a diagnosis and/or refer to a psychiatrist. (2) prescribe medication (3) refer as approproate to medical and allied health professinals</p> Signup and view all the answers

    Study Notes

    Mental Illness - Introduction

    • 1 in 5 adults and 1 in 7 young people experienced a mental illness in the past 12 months
    • In Australia, approximately $11.6 billion was spent on health services in 2020-21, representing 7.3% of the total government health expenditure
    • Mental illness has an extensive impact on individuals, families, and the community more broadly

    Terminology

    • Mental Illness - A health problem that significantly affects how a person feels, thinks, behaves, and interacts with others
    • Mental Health Problem - Does not meet the diagnostic criteria for a mental illness, often experienced temporarily as a reaction to life stress, and can progress to mental illness if not managed effectively
    • Mental Health Consumer - A person who lives with, or is in the process of recovering from, a mental illness or mental health problem
    • Recovery-Oriented Approach - An approach to mental health care that includes principles of self-determination and personalised/individualised care, emphasizing hope, social inclusion, goal-setting, and self-management

    Aetiology of Mental Illness

    • The aetiology of mental illness is believed to be related to a combination of three factors: biology, psychology, and environment
    • Mental illness is associated with personal distress and/or problems functioning in social, work, or family activities

    Treatment Provision

    • Psychologist - A registered allied health professional who specialises in human behaviour and can assist with managing how an individual thinks, feels, behaves, and reacts
    • Psychiatrist - A medical doctor who has completed specialised training in psychiatry, responsible for diagnosing, treating, and preventing mental, emotional, and behavioural disorders

    Types of Mental Illness

    • Psychotic Disorders (Schizophrenia and Schizoaffective Disorder)
    • Mood Disorders (Major Depressive Disorder and Bipolar Disorder)
    • Trauma- and Stressor-Related Disorders (PTSD and Acute Stress Disorder)
    • Anxiety Disorders (Generalised Anxiety Disorder, Panic Disorder, and Phobias)
    • Feeding and Eating Disorders (Anorexia Nervosa and Binge-Eating Disorder)

    Psychotic Disorders

    • Psychotic disorders are a group of mental illnesses characterised by abnormal thinking and perceptions
    • Schizophrenia - A mental illness in which there is an abnormal interpretation of reality, characterised by two or more of the following: delusions, hallucinations, disorganised speech, grossly disorganised or catatonic behaviour, or negative symptoms
    • Schizoaffective Disorder - The concurrent presence of schizophrenia and a mood disorder

    Mood Disorders

    • Mood disorders are a group of mental illnesses where a disturbance in a person's emotional state is the main underlying feature
    • Major Depressive Disorder (MDD) - Characterised by discrete episodes of at least 2 weeks' duration involving clear-cut changes in affect, cognition, and neurocognitive functions, with inter-episode remissions
    • Bipolar Disorder - Characterised by periods of mania followed by periods of depression

    Manic Episodes

    • Mania is a distinct period of abnormally and persistently elevated, expansive or irritable mood and abnormally and persistently increased activity or energy
    • Mania is characterised by inflated self-esteem or grandiosity, decreased need for sleep, more talkative than usual, racing thoughts, easily distracted by external stimuli, increased goal-directed activity, and excessive involvement in activities that have a high potential for painful consequences

    Trauma- and Stressor-Related Disorders

    • A form of anxiety that develops after experiencing a traumatic or stressful event
    • Associated with intense feelings of fear, horror, anger, sadness, and hopelessness
    • Post-Traumatic Stress Disorder (PTSD) and Acute Stress Disorder are two examples
    • Symptoms include flashbacks, intrusive memories and nightmares with physical symptoms, heightened vigilance, irritability, and lack of focus/concentration, avoidance, detachment, and dissociation

    Anxiety Disorders

    • Anxiety disorders are a group of mental illnesses characterised by feelings of excessive worry and fear
    • Can cause physical symptoms such as a fast heart rate, sweating, shakiness, and so on
    • There are many anxiety disorders, including Generalised Anxiety Disorder, Social Anxiety Disorder, Separation Anxiety Disorder, Panic Disorder, and Selective Mutism

    Feeding and Eating Disorders

    • Feeding and eating disorders create a persistent disturbance of eating or eating-related behaviour
    • They result in the altered consumption of food
    • Can significantly impair physical health or psychosocial functioning
    • Anorexia Nervosa - Characterised by restriction of energy intake relative to requirements, leading to a significantly low body weight
    • Binge-Eating Disorder - Characterised by eating a very large amount of food in a discrete time window, and by having little to no control of eating behaviour during that episode

    Schizophrenia

    • Schizophrenia is a severe mental illness that affects how a person thinks, acts, expresses emotions, perceives reality, and relates to others
    • Characterised by disruptions in thinking that affect language, perception, and one's sense of self
    • Affects about 1% of the Australian population
    • Usual onset is at 15-25 years of age
    • It affects slightly more males than females### Schizophrenia
    • Positive symptoms:
      • Hearing voices, seeing things that aren't there, smelling odors that don't exist, or feeling something touch that is not there
      • Disorganized thinking and speech
      • Disorganized or abnormal motor behavior
    • Negative symptoms:
      • Lack of interest in the world
      • Social withdrawal
      • Diminished emotional expression
      • Inability to act spontaneously
      • Reduced sense of purpose
      • Avolition
    • Cognitive symptoms:
      • Confusion, difficulty understanding information, and using it to make decisions
      • Difficulty focusing or paying attention to relevant stimuli
      • Poor short- and long-term memory
      • Reduced capacity to use information correctly
      • Inability to recognize one's own cognitive limitations
    • Mood symptoms:
      • Loss of motivation
      • Loss of interest or pleasure in things
      • Excessive mood behaviors, including excessive fluctuation in mood
      • Periods of time doing very little followed by periods of time being extremely active
    • Pathophysiology:
      • Results in structural brain abnormalities (cerebral atrophy, smaller medial temporal lobes, increased size of the third and lateral ventricles)
      • Results in functional brain abnormalities (abnormalities in neurotransmission due to excess or deficient amounts of dopamine, serotonin, and/or glutamate)
    • Management:
      • Goal is to ease symptoms and reduce the risk of relapse
      • Treatments include medications (antipsychotics), psychotherapy, hospitalization, and electroconvulsive therapy

    Antipsychotic Medications

    • First-generation antipsychotics (D2 receptor antagonists):
      • Examples: chlorpromazine, fluphenazine
      • Associated with a higher risk of extrapyramidal symptoms (dystonia, parkinsonism, tardive dyskinesia)
    • Second-generation antipsychotics (5-HT2A/D2 receptor antagonists):
      • Examples: olanzapine, clozapine
      • Associated with a lower risk of extrapyramidal symptoms, but a higher risk of metabolic side effects (diabetes, hypertension, hyperlipidaemia)

    Major Depressive Disorder (MDD)

    • Characterized by:
      • Sad, empty, or irritable moods
      • Accompanied by related changes that significantly affect an individual's capacity to function
      • Affects about 10% of the Australian population
      • Lifetime incidence is slightly higher in females than in males
    • Symptoms:
      • Feelings of sadness, tearfulness, emptiness, or hopelessness
      • Loss of interest or pleasure in most or all normal activities
      • Tiredness and lack of energy
      • Sleep disturbances
      • Angry outbursts, irritability, or frustration
      • Changes to appetite
      • Anxiety, agitation, and restlessness
      • Slowed thinking, speaking, or body movements
      • Feelings of worthlessness or guilt
      • Trouble thinking, concentrating, making decisions, and remembering things
      • Frequent or recurrent thoughts of death, suicidal thoughts, or suicide attempts
    • Diagnosis:
      • Person must be experiencing five or more symptoms during the same 2-week period
      • At least one symptom must be either depressed mood or loss of interest or pleasure
    • Aetiology:
      • Complex mental illness that involves a combination of genetic, environmental, and psychosocial factors
      • Risk factors include abuse, age, chronic disease or illness, conflict, death or loss, gender, family history, major events, stress, and substance misuse
    • Management:
      • Range of management strategies available, including pharmacological interventions (SSRIs, SNRIs), exercise interventions, psychotherapy, transcranial magnetic stimulation, and electroconvulsive therapy

    Post-Traumatic Stress Disorder (PTSD)

    • Characterized by:
      • Intense and disturbing thoughts and feelings
      • Typically caused by an exposure to an actual or threatened death, serious injury, or sexual violence
      • Symptoms usually occur within three months of exposure, but may appear later
      • Symptoms usually persist for months and sometimes years
      • Affects an estimated 12% of the Australian population
      • Women are twice as likely as men to be diagnosed with PTSD
    • Behaviors and presentations:
      • Intrusive thoughts (e.g. reliving the event, distressing memories, nightmares)
      • Avoidance (e.g. avoiding thinking or talking about the event, places, activities, or people that remind the individual of the event)
      • Cognitive and mood changes (e.g. memory problems, concentration difficulties, negative thoughts about self and others, hopelessness, emotional numbness, and detachment)
      • Physical and emotional reactions (e.g. easily startled or frightened, feeling tense or 'on edge', self-destructive behavior, sleeping problems, irritability, angry outbursts, aggressive behavior, shame or guilt)
    • Diagnosis:
      • Person must experience all of the following symptoms for one month or longer
      • At least one intrusive symptom, at least one avoidance symptom, at least two arousal and reactivity symptoms, and at least two cognition and mood symptoms
      • Symptoms must be serious enough to significantly interfere with daily function, such as work, school, or relationships with friends and family
    • Aetiology:
      • No precise explanation for why some people develop PTSD while others do not
      • Multifactorial, like most mental illnesses
      • Personality traits may provide a predisposition to symptoms
      • Individual differences in the regulation of brain chemistry and hormone responses to traumatic and stressful experiences may, in part, explain why some people develop PTSD while others do not
    • Risk factors:
      • Exposure to intense or long-lasting trauma or stress
      • Experiencing trauma earlier in life
      • Occupations related to traumatic and stressful events
      • Pre-existing mental illnesses or a family history of mental illness
      • Substance misuse/abuse
      • Limited support systems
      • Family history of PTSD

    Exercise and Mental Health

    • Evidence for exercise in MDD:
      • Bi-directional relationship between physical health behaviors and psychological well-being
      • MDD is associated with more than a doubling of the risk for mortality and non-fatal CVD events
      • Even sub-clinical elevations in depressive symptoms are associated with a worse prognosis in patients with established CAD
      • Physical activity/exercise is inversely related to MDD development
      • Exercise reduces symptoms in people with MDD
      • Supervised exercise programs are more effective than unsupervised programs
      • Exercise is as effective as an SSRI for the treatment of MDD
      • Resistance training improves MDD symptoms
      • Lifestyle factors can act additively or synergistically with exercise to improve MDD symptoms
    • Evidence for exercise in anxiety disorders:
      • Less RCTs have been performed to investigate the effect of exercise on anxiety
      • Research in anxiety has heavily favored aerobic exercise
      • Aerobic exercise has been shown to be effective at reducing symptoms in those with diagnosed anxiety disorders (mostly GAD) and those with raised anxiety (but no diagnosed condition)
      • Higher intensity aerobic exercise has been shown to be more effective than lower intensity aerobic exercise
      • Physiological mechanisms hypothesized to be responsible for the benefits of exercise for anxiety have some overlap with those proposed for MDD

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    Description

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