Podcast
Questions and Answers
Approximately what proportion of people may experience a psychiatric illness at some point in their lives?
Approximately what proportion of people may experience a psychiatric illness at some point in their lives?
- 1 in 20
- 1 in 4 (correct)
- 1 in 10
- 1 in 2
Why can diagnosing psychiatric disorders be particularly challenging?
Why can diagnosing psychiatric disorders be particularly challenging?
- Patients are always reliable reporters of their own symptoms.
- Psychiatric disorders always present with obvious physical symptoms.
- Symptoms of psychiatric disorders can overlap with 'normality' and other conditions. (correct)
- There are definitive diagnostic tests for all psychiatric conditions.
Excluding which of the following is a critical first step in diagnosing psychiatric disorders?
Excluding which of the following is a critical first step in diagnosing psychiatric disorders?
- Childhood trauma
- Organic causes (correct)
- Socioeconomic factors
- Genetic predispositions
What does the acronym ACPVU stand for in the context of acute confusional states?
What does the acronym ACPVU stand for in the context of acute confusional states?
Which of the following is NOT typically considered as potential cause of acute confusional state?
Which of the following is NOT typically considered as potential cause of acute confusional state?
What approximate percentage of women experience depression?
What approximate percentage of women experience depression?
According to the DSM-5 criteria, how many symptoms must be present during the same 2-week period to diagnose depression?
According to the DSM-5 criteria, how many symptoms must be present during the same 2-week period to diagnose depression?
Which of the following is a newly added disorder in the DSM-5-TR (2022)?
Which of the following is a newly added disorder in the DSM-5-TR (2022)?
Which of the following is a component of depression management in primary care?
Which of the following is a component of depression management in primary care?
What is the estimated prevalence of mania in the general population?
What is the estimated prevalence of mania in the general population?
Which of the following is a key feature of mania?
Which of the following is a key feature of mania?
What is a standard initial management strategy for someone experiencing an acute episode of mania?
What is a standard initial management strategy for someone experiencing an acute episode of mania?
Besides long term medication what is another important aspect in the long-term management of mania?
Besides long term medication what is another important aspect in the long-term management of mania?
According to the Yerkes-Dodson law, how does anxiety affect performance levels?
According to the Yerkes-Dodson law, how does anxiety affect performance levels?
When does anxiety become considered pathological?
When does anxiety become considered pathological?
Which of the following is considered a somatic symptom of anxiety?
Which of the following is considered a somatic symptom of anxiety?
Which of the following best describes generalised anxiety disorder (GAD)?
Which of the following best describes generalised anxiety disorder (GAD)?
A patient presents with symptoms of both mania and depression. This most likely indicates which condition?
A patient presents with symptoms of both mania and depression. This most likely indicates which condition?
A patient reports experiencing a depressed mood, diminished interest in activities, insomnia, and fatigue for the past month. According to DSM-5 criteria, which of these symptoms MUST be present for a diagnosis of depression?
A patient reports experiencing a depressed mood, diminished interest in activities, insomnia, and fatigue for the past month. According to DSM-5 criteria, which of these symptoms MUST be present for a diagnosis of depression?
According to the DSM-5, an individual experiencing significant distress and impairment due to persistent thoughts of death or suicide would meet criteria for which symptom of depression?
According to the DSM-5, an individual experiencing significant distress and impairment due to persistent thoughts of death or suicide would meet criteria for which symptom of depression?
A patient presents with acute confusion. Which pre-existing condition, if not properly managed, is LEAST likely to be a direct cause of this state?
A patient presents with acute confusion. Which pre-existing condition, if not properly managed, is LEAST likely to be a direct cause of this state?
In managing a patient with mania, when might it be ethically justifiable to consider detaining them against their will?
In managing a patient with mania, when might it be ethically justifiable to consider detaining them against their will?
Combining the DSM-5 diagnostic framework with the Yerkes-Dodson Law what might be an optimal intervention strategy for an individual experiencing mild anxiety in relation to an upcoming exam?
Combining the DSM-5 diagnostic framework with the Yerkes-Dodson Law what might be an optimal intervention strategy for an individual experiencing mild anxiety in relation to an upcoming exam?
A psychiatrist is evaluating a patient who reports experiencing both depressive and manic episodes. The psychiatrist is considering a diagnosis of Bipolar I Disorder. What is the MOST critical factor that differentiates Bipolar I Disorder from Bipolar II Disorder?
A psychiatrist is evaluating a patient who reports experiencing both depressive and manic episodes. The psychiatrist is considering a diagnosis of Bipolar I Disorder. What is the MOST critical factor that differentiates Bipolar I Disorder from Bipolar II Disorder?
Imagine a patient presents with symptoms meeting DSM-5 criteria for major depressive disorder, alongside self-reported symptoms of anxiety. They are resistant to antidepressant medication and traditional psychotherapy. Considering the updated DSM-5-TR (2022) guidelines and recent advances in psychiatric care, what would be the MOST comprehensive and evidence-based approach to manage this complex case?
Imagine a patient presents with symptoms meeting DSM-5 criteria for major depressive disorder, alongside self-reported symptoms of anxiety. They are resistant to antidepressant medication and traditional psychotherapy. Considering the updated DSM-5-TR (2022) guidelines and recent advances in psychiatric care, what would be the MOST comprehensive and evidence-based approach to manage this complex case?
Approximately how many individuals may experience a psychiatric illness during their lifetime?
Approximately how many individuals may experience a psychiatric illness during their lifetime?
Why is excluding organic causes a critical first step in diagnosing psychiatric disorders?
Why is excluding organic causes a critical first step in diagnosing psychiatric disorders?
According to the information provided, what does the 'C' in the ACPVU acronym stand for, relating to acute confusional states?
According to the information provided, what does the 'C' in the ACPVU acronym stand for, relating to acute confusional states?
Which of the following is LEAST likely to be a direct potential cause of acute confusional state?
Which of the following is LEAST likely to be a direct potential cause of acute confusional state?
What is the approximate prevalence of depression among women, based on the information?
What is the approximate prevalence of depression among women, based on the information?
According to the DSM-5, how many symptoms must be present during the same 2-week period for a diagnosis of depression?
According to the DSM-5, how many symptoms must be present during the same 2-week period for a diagnosis of depression?
Which of the following disorders was added in the DSM-5-TR (2022)?
Which of the following disorders was added in the DSM-5-TR (2022)?
Which option is a component of depression management in primary care?
Which option is a component of depression management in primary care?
In managing a patient experiencing an acute episode of mania, what is a standard initial management strategy?
In managing a patient experiencing an acute episode of mania, what is a standard initial management strategy?
Besides long-term medication, what is another crucial aspect of the long-term management of mania?
Besides long-term medication, what is another crucial aspect of the long-term management of mania?
According to the Yerkes-Dodson law, what is the relationship between anxiety and performance levels?
According to the Yerkes-Dodson law, what is the relationship between anxiety and performance levels?
When is anxiety considered pathological?
When is anxiety considered pathological?
Which option best describes Generalised Anxiety Disorder (GAD)?
Which option best describes Generalised Anxiety Disorder (GAD)?
A dental patient reports symptoms of both mania and depression. This most likely indicates which condition?
A dental patient reports symptoms of both mania and depression. This most likely indicates which condition?
You are assessing a patient who states 'I feel like I'm losing it, I'm so irritable, and I just can't seem to avoid doing anything'. Relating to the symptoms of anxiety, what kind of symptoms are they experiencing?
You are assessing a patient who states 'I feel like I'm losing it, I'm so irritable, and I just can't seem to avoid doing anything'. Relating to the symptoms of anxiety, what kind of symptoms are they experiencing?
A patient is admitted in an acute episode of mania. As the medical professional, what is the most important thing to consider?
A patient is admitted in an acute episode of mania. As the medical professional, what is the most important thing to consider?
According to DSM-5 criteria, which of the following symptoms must be present for a diagnosis of depression?
According to DSM-5 criteria, which of the following symptoms must be present for a diagnosis of depression?
A patient experiencing mania requires a hospital admission. What statement would justify detaining them against their will?
A patient experiencing mania requires a hospital admission. What statement would justify detaining them against their will?
A student is being assessed for performance level with an upcoming exam. According to the Yerkes-Dodson Law, what is the most appropriate intervention for someone experiencing mild anxiety?
A student is being assessed for performance level with an upcoming exam. According to the Yerkes-Dodson Law, what is the most appropriate intervention for someone experiencing mild anxiety?
A psychiatrist is evaluating a patient who reports experiencing both depressive and manic episodes. The psychiatrist suspects either Bipolar I or Bipolar II Disorder. What is the MOST critical factor that differentiates Bipolar I Disorder from Bipolar II Disorder?
A psychiatrist is evaluating a patient who reports experiencing both depressive and manic episodes. The psychiatrist suspects either Bipolar I or Bipolar II Disorder. What is the MOST critical factor that differentiates Bipolar I Disorder from Bipolar II Disorder?
A patient demonstrates symptoms of major depressive disorder. They are resistant to antidepressant medication and traditional psychotherapy. According to the DSM-5-TR (2022) guidelines and recent advances in psychiatric care, what would be the MOST comprehensive evidence-based approach to deal with this complex case?
A patient demonstrates symptoms of major depressive disorder. They are resistant to antidepressant medication and traditional psychotherapy. According to the DSM-5-TR (2022) guidelines and recent advances in psychiatric care, what would be the MOST comprehensive evidence-based approach to deal with this complex case?
Insanely Difficult: A patient presents with initial presentation matching the DSM-5 criteria for Generalised Anxiety Disorder (GAD). Despite consistent adherence to Cognitive Behavioral Therapy (CBT) and a stable dosage of a Selective Serotonin Reuptake Inhibitor (SSRI) for over one year, the patient continues to report persistent anxiety symptoms and impaired functionality in daily life. Considering the latest advancements in neurobiological understanding and treatment-resistant anxiety, what would be the MOST theoretically sound and comprehensively targeted next-line intervention strategy?
Insanely Difficult: A patient presents with initial presentation matching the DSM-5 criteria for Generalised Anxiety Disorder (GAD). Despite consistent adherence to Cognitive Behavioral Therapy (CBT) and a stable dosage of a Selective Serotonin Reuptake Inhibitor (SSRI) for over one year, the patient continues to report persistent anxiety symptoms and impaired functionality in daily life. Considering the latest advancements in neurobiological understanding and treatment-resistant anxiety, what would be the MOST theoretically sound and comprehensively targeted next-line intervention strategy?
What differentiates psychosis from neurosis?
What differentiates psychosis from neurosis?
What is a key feature of 'trait anxiety'?
What is a key feature of 'trait anxiety'?
Which of the following is a common behavioral characteristic associated with panic attacks?
Which of the following is a common behavioral characteristic associated with panic attacks?
Which of the following techniques is a management technique used to treat patients with anxiety?
Which of the following techniques is a management technique used to treat patients with anxiety?
Which of the following medications is typically prescribed for the short-term management of anxiety?
Which of the following medications is typically prescribed for the short-term management of anxiety?
Which of the following strategies focuses on creating a supportive environment for preventing anxiety?
Which of the following strategies focuses on creating a supportive environment for preventing anxiety?
Why does avoidance reinforce anxiety?
Why does avoidance reinforce anxiety?
What is the nature of fear in phobias?
What is the nature of fear in phobias?
What is a typical behavioral consequence of a phobia?
What is a typical behavioral consequence of a phobia?
What characterises obsessions in Obsessive Compulsive Disorder?
What characterises obsessions in Obsessive Compulsive Disorder?
How do compulsions relate to obsessions in OCD?
How do compulsions relate to obsessions in OCD?
Which treatment strategies are used to treat Obsessive Compulsive Disorder?
Which treatment strategies are used to treat Obsessive Compulsive Disorder?
What is the primary characteristic of hypochondriasis?
What is the primary characteristic of hypochondriasis?
What is a common misinterpretation made by someone experiencing hypochondriasis?
What is a common misinterpretation made by someone experiencing hypochondriasis?
What is a key challenge in managing patients with hypochondriasis?
What is a key challenge in managing patients with hypochondriasis?
What is a critical first step in managing a patient who you suspect may have hypochondriasis?
What is a critical first step in managing a patient who you suspect may have hypochondriasis?
In managing a patient with hypochondriasis, what precaution should be taken with medical investigations such as scans and blood tests?
In managing a patient with hypochondriasis, what precaution should be taken with medical investigations such as scans and blood tests?
What type of treatment is used to manage Hypochondriasis?
What type of treatment is used to manage Hypochondriasis?
What is a characteristic feature of alcohol abuse?
What is a characteristic feature of alcohol abuse?
Apart from detoxification, what symptoms does alcohol abuse often lead too?
Apart from detoxification, what symptoms does alcohol abuse often lead too?
What is the primary cause of Wernicke's encephalopathy?
What is the primary cause of Wernicke's encephalopathy?
What are three clinical signs that indicate Wernicke's Encephalopathy?
What are three clinical signs that indicate Wernicke's Encephalopathy?
What is one of the impacts of Korsakoff's Syndrome on someone?
What is one of the impacts of Korsakoff's Syndrome on someone?
What do the letters of the CAGE questionnaire stand for?
What do the letters of the CAGE questionnaire stand for?
What physical sign is commonly present as a result of eating disorders?
What physical sign is commonly present as a result of eating disorders?
What distinguishes psychosis from neurosis?
What distinguishes psychosis from neurosis?
Which statement best describes 'trait anxiety'?
Which statement best describes 'trait anxiety'?
What is a typical physical symptom observed during panic attacks associated with hyperventilation syndrome?
What is a typical physical symptom observed during panic attacks associated with hyperventilation syndrome?
What is the purpose of relaxation and breathing techniques in the management of anxiety?
What is the purpose of relaxation and breathing techniques in the management of anxiety?
Which medication is MOST appropriate for the short-term management of acute anxiety symptoms?
Which medication is MOST appropriate for the short-term management of acute anxiety symptoms?
Which strategy is most suitable in creating a supportive environment for preventing anxiety?
Which strategy is most suitable in creating a supportive environment for preventing anxiety?
In the context of anxiety management, why might avoidance of anxiety-provoking situations be counterproductive?
In the context of anxiety management, why might avoidance of anxiety-provoking situations be counterproductive?
What best describes the nature of fear in phobias?
What best describes the nature of fear in phobias?
What is a typical behavioral outcome associated with phobias?
What is a typical behavioral outcome associated with phobias?
What is the central characteristic of obsessions in Obsessive-Compulsive Disorder (OCD)?
What is the central characteristic of obsessions in Obsessive-Compulsive Disorder (OCD)?
In what way are compulsions related to obsessions in Obsessive-Compulsive Disorder (OCD)?
In what way are compulsions related to obsessions in Obsessive-Compulsive Disorder (OCD)?
Which strategies are commonly used to manage Obsessive-Compulsive Disorder?
Which strategies are commonly used to manage Obsessive-Compulsive Disorder?
Someone with hypochondriasis is MOST likely to misinterpret which experience?
Someone with hypochondriasis is MOST likely to misinterpret which experience?
When managing a patient suspected of hypochondriasis, which step MUST be taken first?
When managing a patient suspected of hypochondriasis, which step MUST be taken first?
Why is caution advised when ordering medical investigations, like scans and blood tests, for patients with hypochondriasis?
Why is caution advised when ordering medical investigations, like scans and blood tests, for patients with hypochondriasis?
Which treatment approach is MOST likely to be used in managing hypochondriasis?
Which treatment approach is MOST likely to be used in managing hypochondriasis?
What behavioural characteristic is MOST indicative of alcohol abuse?
What behavioural characteristic is MOST indicative of alcohol abuse?
What issue, apart from detoxification, commonly requires attention in individuals with alcohol abuse?
What issue, apart from detoxification, commonly requires attention in individuals with alcohol abuse?
Which deficiency is the primary cause of Wernicke's encephalopathy?
Which deficiency is the primary cause of Wernicke's encephalopathy?
Which triad of clinical signs is characteristic of Wernicke's Encephalopathy?
Which triad of clinical signs is characteristic of Wernicke's Encephalopathy?
What cognitive impairment is typically associated with Korsakoff's Syndrome?
What cognitive impairment is typically associated with Korsakoff's Syndrome?
In the CAGE questionnaire used to screen for alcohol abuse, what does the 'C' stand for?
In the CAGE questionnaire used to screen for alcohol abuse, what does the 'C' stand for?
What oral manifestation is sometimes observed in individuals with eating disorders?
What oral manifestation is sometimes observed in individuals with eating disorders?
What is a core characteristic of anorexia nervosa?
What is a core characteristic of anorexia nervosa?
Which of the following is characteristic of bulimia nervosa?
Which of the following is characteristic of bulimia nervosa?
In the management of eating disorders, what is a primary initial step?
In the management of eating disorders, what is a primary initial step?
Which of the following indicates anorexia nervosa rather than bulimia nervosa?
Which of the following indicates anorexia nervosa rather than bulimia nervosa?
Which of the following is a key feature of Body Dysmorphic Disorder (BDD)?
Which of the following is a key feature of Body Dysmorphic Disorder (BDD)?
In dental practice, what is the MOST appropriate action when encountering a patient with Body Dysmorphic Disorder (BDD)?
In dental practice, what is the MOST appropriate action when encountering a patient with Body Dysmorphic Disorder (BDD)?
What is the typical age of onset for schizophrenia?
What is the typical age of onset for schizophrenia?
Which of the options best describes schizophrenia?
Which of the options best describes schizophrenia?
Which of the following is a 'positive' symptom of schizophrenia?
Which of the following is a 'positive' symptom of schizophrenia?
What is a 'negative' symptom of Schizophrenia?
What is a 'negative' symptom of Schizophrenia?
Which of the following is a key component in the comprehensive management of schizophrenia?
Which of the following is a key component in the comprehensive management of schizophrenia?
What is an important consideration for dental practitioners treating patients with schizophrenia?
What is an important consideration for dental practitioners treating patients with schizophrenia?
What action is imperative when a patient expresses suicidal ideation?
What action is imperative when a patient expresses suicidal ideation?
What characterises paranoia?
What characterises paranoia?
What is a core feature of Borderline Personality Disorder (BPD)?
What is a core feature of Borderline Personality Disorder (BPD)?
What is the primary treatment approach for Borderline Personality Disorder (BPD)?
What is the primary treatment approach for Borderline Personality Disorder (BPD)?
What primarily characterises dementia?
What primarily characterises dementia?
What is the focus of lectures regarding ADHD (ADD)?
What is the focus of lectures regarding ADHD (ADD)?
Which statement accurately reflects the relationship between psychiatric disorders and a patient's capacity?
Which statement accurately reflects the relationship between psychiatric disorders and a patient's capacity?
Insanely Difficult: A patient presents with classic symptoms of Anorexia Nervosa, including severe food restriction, distorted body image, and a BMI of 15. They are also exhibiting signs of severe malnutrition, including cardiac arrhythmias and electrolyte imbalances. As the lead physician orchestrating this patient's comprehensive treatment plan, what would be the MOST ethically challenging decision to implement while striving to balance immediate life-saving interventions with long-term psychological recovery?
Insanely Difficult: A patient presents with classic symptoms of Anorexia Nervosa, including severe food restriction, distorted body image, and a BMI of 15. They are also exhibiting signs of severe malnutrition, including cardiac arrhythmias and electrolyte imbalances. As the lead physician orchestrating this patient's comprehensive treatment plan, what would be the MOST ethically challenging decision to implement while striving to balance immediate life-saving interventions with long-term psychological recovery?
Which of the following behaviours is a key characteristic of anorexia nervosa?
Which of the following behaviours is a key characteristic of anorexia nervosa?
What behaviour is specifically associated with bulimia nervosa?
What behaviour is specifically associated with bulimia nervosa?
What is considered a primary focus in the initial management of eating disorders?
What is considered a primary focus in the initial management of eating disorders?
A patient presents with constant worry over a slight imperfection on their face, leading to significant distress and impairment in social functioning. What condition does this presentation align with?
A patient presents with constant worry over a slight imperfection on their face, leading to significant distress and impairment in social functioning. What condition does this presentation align with?
Why should dental practitioners exercise particular caution when treating patients who have Body Dysmorphic Disorder (BDD)?
Why should dental practitioners exercise particular caution when treating patients who have Body Dysmorphic Disorder (BDD)?
Which of the following statements best describes Schizophrenia?
Which of the following statements best describes Schizophrenia?
Which of the following is classified as a 'positive' symptom of schizophrenia?
Which of the following is classified as a 'positive' symptom of schizophrenia?
Poverty of speech, flat emotions and a lack of motivation are examples of what kind of symptoms in Schizophrenia?
Poverty of speech, flat emotions and a lack of motivation are examples of what kind of symptoms in Schizophrenia?
Which approach is a key component in the comprehensive management of schizophrenia?
Which approach is a key component in the comprehensive management of schizophrenia?
What potential effects of schizophrenia should a dental practitioner be aware of when providing treatment?
What potential effects of schizophrenia should a dental practitioner be aware of when providing treatment?
What is the most appropriate immediate response for a healthcare provider when a patient expresses suicidal ideation?
What is the most appropriate immediate response for a healthcare provider when a patient expresses suicidal ideation?
What is a primary characteristic of paranoia?
What is a primary characteristic of paranoia?
A patient with Borderline Personality Disorder (BPD) is MOST likely to exhibit which of the following?
A patient with Borderline Personality Disorder (BPD) is MOST likely to exhibit which of the following?
Which of the listed treatments is the most evidence-based approach for managing Borderline Personality Disorder (BPD)?
Which of the listed treatments is the most evidence-based approach for managing Borderline Personality Disorder (BPD)?
What is the primary characteristic of dementia?
What is the primary characteristic of dementia?
What are lectures regarding ADHD primarily focused on?
What are lectures regarding ADHD primarily focused on?
Which statement reflects the relationship between psychiatric disorders and a patient's capacity to make decisions?
Which statement reflects the relationship between psychiatric disorders and a patient's capacity to make decisions?
Insanely Difficult: A patient with a long-standing history of Schizophrenia presents to the dental clinic with severe tooth pain and a complex dental condition requiring extensive treatment. The patient concurrently exhibits active psychotic symptoms, including auditory hallucinations and paranoid delusions focused on the dental staff. Given the ethical principles of autonomy, beneficence, non-maleficence, and justice, and considering that the patient is deemed to have fluctuating capacity, what is the MOST ethically justifiable approach to proceed with dental treatment?
Insanely Difficult: A patient with a long-standing history of Schizophrenia presents to the dental clinic with severe tooth pain and a complex dental condition requiring extensive treatment. The patient concurrently exhibits active psychotic symptoms, including auditory hallucinations and paranoid delusions focused on the dental staff. Given the ethical principles of autonomy, beneficence, non-maleficence, and justice, and considering that the patient is deemed to have fluctuating capacity, what is the MOST ethically justifiable approach to proceed with dental treatment?
Insanely Difficult: Consider three patients: Patient A with Anorexia Nervosa and cardiac arrhythmias, Patient B with severe Body Dysmorphic Disorder requesting irreversible surgical interventions, and Patient C with acute suicidal ideation. Evaluate the ethical challenges posed by each case and rank them in order of complexity based on the degree of ethical conflict, immediacy of risk, and potential for long-term harm.
Insanely Difficult: Consider three patients: Patient A with Anorexia Nervosa and cardiac arrhythmias, Patient B with severe Body Dysmorphic Disorder requesting irreversible surgical interventions, and Patient C with acute suicidal ideation. Evaluate the ethical challenges posed by each case and rank them in order of complexity based on the degree of ethical conflict, immediacy of risk, and potential for long-term harm.
What percentage of the population is estimated to experience mania?
What percentage of the population is estimated to experience mania?
Which of the options is a typical feature of mania?
Which of the options is a typical feature of mania?
In acute mania presentations, what intervention is often required?
In acute mania presentations, what intervention is often required?
Which of the following aspects is of great importance in the long-term management of mania?
Which of the following aspects is of great importance in the long-term management of mania?
According to the symptoms of anxiety, 'butterflies' in your stomach are a type of what symptom?
According to the symptoms of anxiety, 'butterflies' in your stomach are a type of what symptom?
Which of the options defines 'trait anxiety'?
Which of the options defines 'trait anxiety'?
What clinical intervention is most appropriate for the long-term management of Anxiety?
What clinical intervention is most appropriate for the long-term management of Anxiety?
What strategy would NOT be used to create a supportive environment for a dental patient to prevent anxiety?
What strategy would NOT be used to create a supportive environment for a dental patient to prevent anxiety?
Why does avoidance of anxieties reinforce anxiety?
Why does avoidance of anxieties reinforce anxiety?
What type of fear is experienced in phobias?
What type of fear is experienced in phobias?
Which of the behaviours is a result of a phobia?
Which of the behaviours is a result of a phobia?
Which of the following describes obsessions in Obsessive Compulsive Disorder?
Which of the following describes obsessions in Obsessive Compulsive Disorder?
What combination of treatment strategies are often used to help a patient with Obsessive Compulsive Disorder?
What combination of treatment strategies are often used to help a patient with Obsessive Compulsive Disorder?
What is a typical interpretation made by someone experiencing hypochondriasis?
What is a typical interpretation made by someone experiencing hypochondriasis?
What is the first step in managing a patient who you suspect may have hypochondriasis?
What is the first step in managing a patient who you suspect may have hypochondriasis?
When taking medical investigations on a patient with Hypochondriasis, what should a doctor consider?
When taking medical investigations on a patient with Hypochondriasis, what should a doctor consider?
What is the most common treatment approach when treating Hypochondriasis?
What is the most common treatment approach when treating Hypochondriasis?
What behaviour would suggest potential alcohol abuse?
What behaviour would suggest potential alcohol abuse?
Apart from detoxification, what is another common issue that arises from alcohol abuse?
Apart from detoxification, what is another common issue that arises from alcohol abuse?
What causes Wernicke's Encephalopathy?
What causes Wernicke's Encephalopathy?
What clinical triad indicates Wernicke's Encephalopathy?
What clinical triad indicates Wernicke's Encephalopathy?
What is the main symptom experienced with Korsakoff's Syndrome?
What is the main symptom experienced with Korsakoff's Syndrome?
In the CAGE questionnaire, what does the letter 'G' stand for?
In the CAGE questionnaire, what does the letter 'G' stand for?
What oral manifestation may be present as a result of eating disorders?
What oral manifestation may be present as a result of eating disorders?
A morbid fear of and going to great lengths to avoid obesity is a characteristic of which eating disorder?
A morbid fear of and going to great lengths to avoid obesity is a characteristic of which eating disorder?
Bulimia nervosa is typically associated with what behaviours?
Bulimia nervosa is typically associated with what behaviours?
In managing eating disorders, what is the focus of the initial management?
In managing eating disorders, what is the focus of the initial management?
Restriction of food intake and a body weight 15% below normal are characteristics of which eating disorder?
Restriction of food intake and a body weight 15% below normal are characteristics of which eating disorder?
Disproportionate worry over a small or perceived defect in appearance, is symptomatic of which condition?
Disproportionate worry over a small or perceived defect in appearance, is symptomatic of which condition?
Why should dental practitioners provide extra care when treating patients with Body Dysmorphic Disorder (BDD)?
Why should dental practitioners provide extra care when treating patients with Body Dysmorphic Disorder (BDD)?
At what age does schizophrenia usually develop?
At what age does schizophrenia usually develop?
Which of the options is the best description of Schizophrenia?
Which of the options is the best description of Schizophrenia?
What symptoms are classified as 'positive' symptoms of Schizophrenia?
What symptoms are classified as 'positive' symptoms of Schizophrenia?
In the comprehensive management of schizophrenia, what is a key component?
In the comprehensive management of schizophrenia, what is a key component?
What possible effect of schizophrenia must dental practitioners be aware of while giving treatment?
What possible effect of schizophrenia must dental practitioners be aware of while giving treatment?
What is the immediate action to take when a patient expresses suicidal ideation?
What is the immediate action to take when a patient expresses suicidal ideation?
What describes Paranoia?
What describes Paranoia?
What is the treatment approach for Borderline Personality Disorder (BPD)?
What is the treatment approach for Borderline Personality Disorder (BPD)?
What is a main characteristic of Dementia?
What is a main characteristic of Dementia?
What is the relationship between psychiatric disorders and a patient's capacity?
What is the relationship between psychiatric disorders and a patient's capacity?
Insanely Difficult: A seasoned psychiatrist is evaluating a patient displaying a unique combination of treatment-resistant symptoms involving elements of Generalised Anxiety Disorder (GAD), Obsessive-Compulsive Disorder (OCD), and subtle indications of Body Dysmorphic Disorder (BDD). Traditional therapeutic and pharmacological approaches have yielded minimal improvement. The patient has an intense fear of contamination but it is centered around their perceived halitosis causing extreme disturbances in their daily life. Which of the following approaches would have the MOST theoretical support for this complex case?
Insanely Difficult: A seasoned psychiatrist is evaluating a patient displaying a unique combination of treatment-resistant symptoms involving elements of Generalised Anxiety Disorder (GAD), Obsessive-Compulsive Disorder (OCD), and subtle indications of Body Dysmorphic Disorder (BDD). Traditional therapeutic and pharmacological approaches have yielded minimal improvement. The patient has an intense fear of contamination but it is centered around their perceived halitosis causing extreme disturbances in their daily life. Which of the following approaches would have the MOST theoretical support for this complex case?
What percentage of women are estimated to experience depression?
What percentage of women are estimated to experience depression?
In the context of mania, which statement is MOST accurate regarding gender prevalence?
In the context of mania, which statement is MOST accurate regarding gender prevalence?
According to the DSM-5 diagnostic criteria for depression, and based upon the symptoms listed which MUST be present for a diagnosis?
According to the DSM-5 diagnostic criteria for depression, and based upon the symptoms listed which MUST be present for a diagnosis?
According to the information provided, what is a key element of mania?
According to the information provided, what is a key element of mania?
A patient experiencing an acute manic episode may require detention if:
A patient experiencing an acute manic episode may require detention if:
Regarding the Yerkes-Dodson law, what is the relationship between anxiety and performance?
Regarding the Yerkes-Dodson law, what is the relationship between anxiety and performance?
Which of the following presentations defines generalised anxiety disorder (GAD)?
Which of the following presentations defines generalised anxiety disorder (GAD)?
The slides mention "Butterflies" in your stomaach. This is associated with what type of symptom of anxiety?
The slides mention "Butterflies" in your stomaach. This is associated with what type of symptom of anxiety?
How does 'trait anxiety' manifest?
How does 'trait anxiety' manifest?
What is the primary characteristic of psychosis, differentiating it from neurosis?
What is the primary characteristic of psychosis, differentiating it from neurosis?
In the context of phobias, what is the nature of the experienced fear?
In the context of phobias, what is the nature of the experienced fear?
What is a common behavioural consequence of a phobia?
What is a common behavioural consequence of a phobia?
Which statement best describes obsessions in Obsessive Compulsive Disorder (OCD)?
Which statement best describes obsessions in Obsessive Compulsive Disorder (OCD)?
What is the relationship between compulsions and obsessions in OCD?
What is the relationship between compulsions and obsessions in OCD?
What combination of treatment strategies is typically used in the management of Obsessive Compulsive Disorder (OCD)?
What combination of treatment strategies is typically used in the management of Obsessive Compulsive Disorder (OCD)?
What action should be prioritised in the management of a patient suspected of having hypochondriasis?
What action should be prioritised in the management of a patient suspected of having hypochondriasis?
In managing patients with hypochondriasis, why is it important to minimise unnecessary medical investigations such as scans and blood tests?
In managing patients with hypochondriasis, why is it important to minimise unnecessary medical investigations such as scans and blood tests?
Which of the following would be the MOST appropriate treatment approach for managing hypochondriasis?
Which of the following would be the MOST appropriate treatment approach for managing hypochondriasis?
Excessive consumption and binge drinking are characteristic of which of the following?
Excessive consumption and binge drinking are characteristic of which of the following?
A patient presenting with multi-system problems, especially cardiac and liver issues and/or nutritional deficiencies. What issue is MOST likely?
A patient presenting with multi-system problems, especially cardiac and liver issues and/or nutritional deficiencies. What issue is MOST likely?
What deficiency primarily causes Wernicke's Encephalopathy?
What deficiency primarily causes Wernicke's Encephalopathy?
What cluster of signs indicates Wernicke's Encephalopathy?
What cluster of signs indicates Wernicke's Encephalopathy?
Insanely Difficult: Which of the following interventions demonstrates the MOST comprehensive approach to addressing the multifaceted challenges presented by this complex presentation?
Insanely Difficult: Which of the following interventions demonstrates the MOST comprehensive approach to addressing the multifaceted challenges presented by this complex presentation?
What distinguishes neurosis from psychosis?
What distinguishes neurosis from psychosis?
What is the MOST accurate description of 'trait anxiety'?
What is the MOST accurate description of 'trait anxiety'?
Which of the following is commonly associated with panic attacks and hyperventilation syndrome?
Which of the following is commonly associated with panic attacks and hyperventilation syndrome?
What is the role of relaxation and breathing techniques in anxiety management?
What is the role of relaxation and breathing techniques in anxiety management?
Which strategy is MOST suitable in creating a supportive environment to prevent anxiety in a dental setting?
Which strategy is MOST suitable in creating a supportive environment to prevent anxiety in a dental setting?
What is a typical behavioral outcome associated with untreated phobias?
What is a typical behavioral outcome associated with untreated phobias?
What describes the characteristics of obsessions in Obsessive-Compulsive Disorder (OCD)?
What describes the characteristics of obsessions in Obsessive-Compulsive Disorder (OCD)?
Which strategy BEST describes the treatment strategies commonly used to manage Obsessive-Compulsive Disorder?
Which strategy BEST describes the treatment strategies commonly used to manage Obsessive-Compulsive Disorder?
Which of the following BEST describes anorexia nervosa?
Which of the following BEST describes anorexia nervosa?
In managing eating disorders, what is a primary focus of the initial management?
In managing eating disorders, what is a primary focus of the initial management?
What characteristic describes Paranoia?
What characteristic describes Paranoia?
What is characteristic of Dementia??
What is characteristic of Dementia??
According to the DSM-5 criteria, what is a mandatory inclusion for diagnosing depression?
According to the DSM-5 criteria, what is a mandatory inclusion for diagnosing depression?
What is the estimated prevalence of depression among men?
What is the estimated prevalence of depression among men?
Which of the following is a symptom of mania?
Which of the following is a symptom of mania?
According to the Yerkes-Dodson law, what happens when anxiety becomes too high?
According to the Yerkes-Dodson law, what happens when anxiety becomes too high?
Which of the following is a psychological symptom of anxiety?
Which of the following is a psychological symptom of anxiety?
What is the primary characteristic of Generalised Anxiety Disorder?
What is the primary characteristic of Generalised Anxiety Disorder?
What is a typical short term treatment for anxiety?
What is a typical short term treatment for anxiety?
How might a dentist create confidence and prevent a patient from experiencing anxiety?
How might a dentist create confidence and prevent a patient from experiencing anxiety?
What is the typical dental manifestation of eating disorders?
What is the typical dental manifestation of eating disorders?
What is a major consideration when treating a patient with body dysmorphic disorder?
What is a major consideration when treating a patient with body dysmorphic disorder?
What is the immediate action you should take when a patient exhibits suicidal ideation?
What is the immediate action you should take when a patient exhibits suicidal ideation?
What does paranoia involve?
What does paranoia involve?
What is the treatment approach for patients with Borderline Personality Disorder?
What is the treatment approach for patients with Borderline Personality Disorder?
What treatment strategies are used to manage Obsessive Compulsive Disorder?
What treatment strategies are used to manage Obsessive Compulsive Disorder?
Excessive alcohol consumption and harmful use can lead to which condition?
Excessive alcohol consumption and harmful use can lead to which condition?
A patient is displaying Ataxia, Nystagmus and Ophthalmoplegia. Which condition is most likely?
A patient is displaying Ataxia, Nystagmus and Ophthalmoplegia. Which condition is most likely?
Which vitamin deficiency is the main contribution to Wernicke's Encephalopathy?
Which vitamin deficiency is the main contribution to Wernicke's Encephalopathy?
Which option is NOT an element of the CAGE questionnaire?
Which option is NOT an element of the CAGE questionnaire?
What is a key feature of anorexia nervosa?
What is a key feature of anorexia nervosa?
What differentiates anorexia nervosa from bulimia nervosa?
What differentiates anorexia nervosa from bulimia nervosa?
In managing someone who has hypochondriasis, what is the first step a medical professional should take?
In managing someone who has hypochondriasis, what is the first step a medical professional should take?
Insanely Difficult: A patient presents with treatment-resistant Generalised Anxiety Disorder. They have persistent contamination fears centered on perceived halitosis, causing extreme disturbances in their daily life. Traditional therapeutic and pharmacological approaches have yielded minimal improvement. Which of the following approaches would have the MOST theoretical support for this complex case?
Insanely Difficult: A patient presents with treatment-resistant Generalised Anxiety Disorder. They have persistent contamination fears centered on perceived halitosis, causing extreme disturbances in their daily life. Traditional therapeutic and pharmacological approaches have yielded minimal improvement. Which of the following approaches would have the MOST theoretical support for this complex case?
Insanely Difficult: A patient with a complex psychiatric history now has functional neurological symptom disorder. They claim they cannot feel any anaesthesia in their mouth, despite testing. What should a dentist do?
Insanely Difficult: A patient with a complex psychiatric history now has functional neurological symptom disorder. They claim they cannot feel any anaesthesia in their mouth, despite testing. What should a dentist do?
Insanely difficult: A patient presents to the dental clinic in an acute episode of mania and requires urgent dental treatment. The dentist is unable to perform the treatment due to the patient's disinhibition and loud rapid speech. What should a dentist do here?
Insanely difficult: A patient presents to the dental clinic in an acute episode of mania and requires urgent dental treatment. The dentist is unable to perform the treatment due to the patient's disinhibition and loud rapid speech. What should a dentist do here?
Flashcards
Acute Confusional State
Acute Confusional State
A state of altered mental function often caused by underlying medical conditions like hypoxia, infection, epilepsy, hypoglycemia, drug/alcohol withdrawal, stroke/MI, or raised intracranial pressure.
Depression
Depression
A mood disorder characterized by persistent sadness, loss of interest or pleasure, and other physical and psychological symptoms.
DSM-5 Criteria for Depression
DSM-5 Criteria for Depression
According to DSM 5, diagnosis requires 5 or more symptoms over 2 weeks, must include depressed mood or diminished interest/pleasure.
Depression Management (Primary Care)
Depression Management (Primary Care)
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Depression Management (Secondary Care)
Depression Management (Secondary Care)
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Mania
Mania
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Mania Features
Mania Features
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More Mania Features
More Mania Features
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Mania Management
Mania Management
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More Mania Management
More Mania Management
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Anxiety
Anxiety
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Yerkes-Dodson Law
Yerkes-Dodson Law
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Pathological Anxiety
Pathological Anxiety
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Anxiety Symptoms
Anxiety Symptoms
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Generalised Anxiety Disorder
Generalised Anxiety Disorder
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Psychiatric Illness Prevalence
Psychiatric Illness Prevalence
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Psychiatric Disorder Diagnosis
Psychiatric Disorder Diagnosis
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Trait Anxiety
Trait Anxiety
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Hyperventilation Syndrome
Hyperventilation Syndrome
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Phobia
Phobia
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Obsessions
Obsessions
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Compulsions
Compulsions
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Hypochondriasis
Hypochondriasis
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Alcohol Abuse
Alcohol Abuse
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Wernicke's Encephalopathy
Wernicke's Encephalopathy
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Korsakov's Syndrome
Korsakov's Syndrome
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CAGE Questionnaire
CAGE Questionnaire
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Eating Disorders
Eating Disorders
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Desensitisation
Desensitisation
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'Flooding' (Anxiety Treatment)
'Flooding' (Anxiety Treatment)
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Alcohol Abuse Screening - CAGE
Alcohol Abuse Screening - CAGE
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Benzodiazepine (Short Term)
Benzodiazepine (Short Term)
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Antidepressants (Long Term)
Antidepressants (Long Term)
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Panic attacks
Panic attacks
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Education (Anxiety Management)
Education (Anxiety Management)
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Relaxation/breathing techniques
Relaxation/breathing techniques
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Empathy (Anxiety Prevention)
Empathy (Anxiety Prevention)
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Ambience of clinical environment
Ambience of clinical environment
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Confident, professional but friendly manner
Confident, professional but friendly manner
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Anxiety avoidance
Anxiety avoidance
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Psychosis
Psychosis
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Neurosis
Neurosis
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OCD - Antidepressants
OCD - Antidepressants
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Alcohol Abuse Questionnaire
Alcohol Abuse Questionnaire
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Alcohol Abuse - Thiamine Deficiency
Alcohol Abuse - Thiamine Deficiency
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Anorexia Nervosa
Anorexia Nervosa
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Bulimia Nervosa
Bulimia Nervosa
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Eating Disorder: Nutritional Support
Eating Disorder: Nutritional Support
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Eating Disorder: Treat Complications
Eating Disorder: Treat Complications
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Eating Disorder: Psychological Resolution
Eating Disorder: Psychological Resolution
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Body Dysmorphic Disorder (BDD)
Body Dysmorphic Disorder (BDD)
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Schizophrenia
Schizophrenia
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Schizophrenia: Positive Symptoms
Schizophrenia: Positive Symptoms
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Schizophrenia: Negative Symptoms
Schizophrenia: Negative Symptoms
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Schizophrenia: Dental Aspects
Schizophrenia: Dental Aspects
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Suicidal Ideation
Suicidal Ideation
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Paranoia
Paranoia
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Borderline Personality Disorder (BPD)
Borderline Personality Disorder (BPD)
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Dementia
Dementia
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Body Dysmorphic Disorder
Body Dysmorphic Disorder
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Schizophrenia Management
Schizophrenia Management
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What is paranoia?
What is paranoia?
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How to handle suicide?
How to handle suicide?
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Borderline Personality Disorder - Treatment
Borderline Personality Disorder - Treatment
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Borderline Personality Disorder (BPD) Definition
Borderline Personality Disorder (BPD) Definition
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Anorexia Nervosa Key Features
Anorexia Nervosa Key Features
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Summarise what we learnt
Summarise what we learnt
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What is Generalised Anxiety Disorder?
What is Generalised Anxiety Disorder?
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Compulsions in OCD
Compulsions in OCD
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Alcohol abuse - the CAGE
Alcohol abuse - the CAGE
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What is alcohol abuse?
What is alcohol abuse?
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Describe a phobia
Describe a phobia
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Describe Hypochondriasis
Describe Hypochondriasis
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Hypochondriasis - Next Steps
Hypochondriasis - Next Steps
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Anxiety management
Anxiety management
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Anorexia Nervosa - Next Steps
Anorexia Nervosa - Next Steps
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Body Dysmorphic Disorder cause
Body Dysmorphic Disorder cause
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Anxiety management: What is Education?
Anxiety management: What is Education?
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Acute Confusional State Urgency
Acute Confusional State Urgency
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Depression Management in Primary Care
Depression Management in Primary Care
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Depression Management in Secondary Care
Depression Management in Secondary Care
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Mania - Immediate Care
Mania - Immediate Care
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Mania - Long Term Care
Mania - Long Term Care
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Managing Anxiety
Managing Anxiety
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Anxiety - Preventative steps
Anxiety - Preventative steps
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CAGE alcohol questions
CAGE alcohol questions
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Hypochondriasis - Treatment
Hypochondriasis - Treatment
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Anorexia Nervosa - Characteristics
Anorexia Nervosa - Characteristics
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Dementia Details
Dementia Details
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Study Notes
Psychiatry Overview
- Psychiatric illness is common, affecting up to 1 in 4 people.
- Psychiatric illness in dental patients may be encountered.
- Dental and medical professionals may be impacted.
- Insight into psychiatric conditions is important for handling cases.
Diagnosis of Psychiatric Disorders
- Diagnosing psychiatric disorders can be difficult.
- Organic causes must be excluded.
- The presentation and classification of conditions are important.
- There is an overlap between 'normality' and other conditions.
- Diagnostic tests are few.
- Psychiatric disorders are often 'syndromic'.
Acute Confusional State (ACPVU)
- Potential causes: Hypoxia, Infection, Epilepsy, Hypoglycaemia.
- Potential causes: Drug or alcohol withdrawal, Stroke/MI.
- Raised intracranial pressure may also be a cause.
Depression
- Depressed mood is a feature of normal life.
- Depression is common: 10% of men, 20% of women.
- Severe cases occur in 1-3% of the population.
Diagnosis of Depression - DSM 5
- The Diagnostic and Statistical Manual of Mental Disorders (DSM 5) diagnostic criteria need 5 or more symptoms over a 2-week period, one of which must be depressed mood, or markedly diminished interest or pleasure in all activities.
- Symptoms might include: weight loss, increased or decreased appetite, insomnia or hypersomnia.
- Symptoms might include: psychomotor agitation or retardation, fatigue/loss of energy.
- Symptoms might include feelings of worthlessness or inappropriate Guilt.
- Symptoms might include: diminished ability to think or concentrate, recurrent thoughts of death or suicide.
- Depression must result in clinically significant distress or impairment of function.
Updated Guidelines – DSM-5-TR 2022
- There has been an update of diagnostic text.
- Disorders added in include: Prolonged Grief Disorder and Unspecified Mood Disorder.
- Disorders added in also include Stimulant-Induced Mild Neurocognitive Disorder.
Depression - Management, Primary Care
- Supportive counselling and social intervention are key.
- 'Social Prescribers' can be helpful.
- Antidepressant medication can also be used.
Depression - Management - Secondary Care
- Medication review is important.
- Formal therapies can be considered.
- Community team support is also important.
- Additional strategies are also good.
Mania
- Mania affects 1% of the population.
- Elevated mood can be 'normal'.
- Most patients with mania also experience depression, i.e., bipolar disorder.
- Male and female risk is equal.
Mania - Features
- Elated or irritable mood for more than 1 week or resulting in hospital admission is a sign.
- Other features: Overactivity, reduced need for sleep, and risk taking.
- Other features: Disinhibition, distractibility, and inflated self-esteem.
- Other features: Delusions, hallucinations, loud, rapid speech and 'racing' thoughts
Mania - Management
- Acute presentations often require extensive community support and/or hospital admission.
- Insight can be lost, which means detaining may be needed if the patient at risk.
- Maintaining a safe environment and medication are also needed.
- Extensive support and rehabilitation should be given.
- Education is of great importance.
- Long term medication is often required.
Anxiety Disorders
- Anxiety is a universal and 'normal' response to a perceived threat or danger.
- Anxiety enhances performance by increasing arousal (sympathetic nervous system) Yerkes-Dodson.
- Anxiety Becomes pathological when it interferes with the functioning of the individual.
Symptoms of Anxiety - Psychological
- Fear of loss of control, irritability, a sense of dread, avoidance, and panic.
Symptoms of Anxiety - Somatic
- Palpitations, shortness of breath, chest pain, 'butterflies', sweating, dry mouth, nausea.
Generalised Anxiety Disorder
- Anxiety is not confined to a specific situation, but experienced on most days.
- 'Trait anxiety' is said to exist in those who have always been prone to worrying.
- Anxiety levels typically rise further in stressful situations.
- Generalised Anxiety Disorder may result in 'panic attacks'.
Hyperventilation Syndrome 'Panic Attacks'
- Overwhelming feeling of panic leads to hyperventilation.
- It is strongly associated with avoidance.
- Attacks are usually short-lived.
- Can be treated with CBT and pharmacological management.
Anxiety - Management - Treatment
- Treatment includes education and relaxation/breathing techniques.
- Desensitisation and 'flooding' may be explored.
- Short term benzodiazepine and long-term antidepressants may be considered.
Anxiety - Management - Prevention
- Empathy and education can help prevent anxiety
- Ambiance of the clinical environment and having a confident, professional but friendly manner can help too.
Anxiety - Management
- Avoidance is a common feature.
- Avoidance reduces anxiety levels but reinforces the avoidance.
Neurosis and Psychosis
- Psychosis implies a lack of insight into the disorder e.g. some types of severe depression and loses contact with reality.
- Neurosis involves an insight and contact with reality is never lost.
Phobias
- Irrational fear, out of proportion to the stimulus.
- Cannot be reasoned away, linked to a particular stimulus.
- 'Odontophobia' in dentistry
- Leads to avoidance.
Obsessive Compulsive Disorder - Obsessions
- It involves Intrusive and distressing impulses, thoughts or images that come from within.
Obsessive Compulsive Disorder - Compulsions
- These are the responses to obsessions, e.g., rituals.
- Until the compulsion has been satisfied, levels of anxiety increase.
Obsessive Compulsive Disorder - Management
- Includes Antidepressants and behavioral therapy, often in combination.
- Psychiatric services are also made available.
Hypochondriasis
- Abnormal preoccupation with the state of health or body functions.
- There may be other conditions present
- Normal signs are often interpreted as a sign of disease, or exaggerate its severity.
- A dental abscess being interpreted as oral cancer is a common example given.
- It is difficult (or impossible) to convince patients about a psychological component e.g. atypical facial pain.
- Caution is needed to ensure that organic disease has been excluded.
- Some patients will attend multiple practitioners.
Hypochondriasis - Management
- Exclude 'organic' cause.
- Check if an underlying mental illness is present.
- Investigations e.g. scans and blood tests may reinforce the issue and so need care.
- Seek psychiatric help early.
- Treatment to deal with an underlying disorder, e.g., anxiety or depression. is possible.
- May be pharmacological.
- Behavioral and cognitive techniques used.
Alcohol Abuse
- Excessive consumption/'binge' drinking are signs.
- Harmful use and dependency are common symptoms.
- Detoxification - drug protocols are used for treatment.
- It is not unusual to see inpatients who have alcohol abuse issues.
- There are Multi-system problems (especially cardiac, liver)
- Nutritional deficiencies- multi-vitamins can reduce deficiency.
Wernicke's Encephalopathy
- Thiamine deficiency leads to triad of: Nystagmus, Ophthalmoplegia, Ataxia.
- Other signs such as altered consciousness and confusion may be present.
Korsakov's Syndrome
- Decrease in ability to acquire new memories.
- May follow Wernicke's.
- Patients may confabulate.
Alcohol Abuse-CAGE Questionnaire
- CAGE (cut down, annoyed, guilty, eye-opener) questionnaire is used.
- C - Have you ever felt you should cut down?
- A - Are you annoyed if people comment on your drinking?
- G - Do you feel guilty about the amount you drink?
- E - Have you ever drunk early in the morning as an eye-opener?
- 2 out of 4 indicates a potential problem.
- Eating disorders include anorexia nervosa and bulimia nervosa.
Eating Disorders - Anorexia Nervosa
- A morbid fear of becoming obese is a key characteristic.
- A distorted body image is also usual.
- Food intake is restricted, with avoidance of 'fattening' foods.
- Body weight is typically 15% below normal.
- Amenorrhoea may be present.
- Laxatives, diuretics, or excessive amounts of exercise might be used.
Eating Disorders - Bulimia Nervosa
- Morbid fear of becoming obese.
- Preoccupation with eating and a strong compulsion to eat impacts sufferers.
- Binge eating, followed by guilt and self-induced vomiting are common (Russell's Sign).
Eating Disorders - Management
- Management focuses on ensuring adequate levels of nutrition, which may require admission and an NG tube.
- Complications, both physical and psychological, must be treated.
- Underlying psychological issues must be resolved individually or in groups.
Body Dysmorphic Disorder (BDD)
- Constant worry over a small or perceived defect in appearance is displayed.
- Particular care is required in aesthetic medicine/surgery.
- Those suffering should be cared for in cosmetic dentistry and orthognathic surgery.
- Referral to a liaison psychiatrist is advised.
Schizophrenia
- It is a serious psychiatric condition.
- The age of onset is usually in early to mid adulthood.
- Early and late onset cases exist.
- Occurrence is equal in males and females.
- Disturbances in thinking, perception, emotion, and behavior may lead to disintegration of personality.
- It is a syndrome and not a 'split personality'.
Schizophrenia - Positive Symptoms
- Contact with reality is reduced, with normal emotions disturbed.
- Delusions, often of persecution, may be experienced.
- Hallucinations, frequently auditory, may occur.
- Passivity, with thoughts inserted/withdrawn or made available to others, may be present.
- Thought disorder and disturbed conceptual thinking are shown in patient's speech.
Schizophrenia - Negative Symptoms
- Poverty of speech is likely.
- Slow thought and movement.
- 'Flat' emotions, apathy, and social withdrawal.
- Lack of motivation.
Schizophrenia - Management
- Medication, such as anti-psychotic drugs and depot injections, are used (clozapine not first line).
- Psychological approaches include CBT, psycho-education, and family therapy.
- Social support involves financial assistance, occupational therapy, housing, and employment.
Schizophrenia - Possible Dental Aspects
- General health/hygiene is an important consideration.
- Delusions may affect dental treatment.
- Hallucinations, including somatic pain, may be experienced.
- Drug, alcohol, and smoking behavior requires reviewing.
- The effects of medication may impact oral health.
Suicide
- 'Suicidal ideation' requires being taken seriously.
- Never ignore someone mentioning suicidal feelings.
- Accurate documentation of any suicidal ideation is important.
- Have Crisis Team numbers to hand.
Paranoia
- A person experiencing paranoia refers events to themselves with little or no evidence.
- It has a psychotic implication.
- It may be a symptom of other disorders, such as paranoid schizophrenia and psychotic depression.
Borderline Personality Disorder (BPD)
- It is a disorder of mood which affects feelings, thoughts, and interactions.
- Impulsivity, emotional instability, and upsetting thoughts are present.
- Worry about abandonment is a sign.
- Aetiology is uncertain but is related to neglect/abuse.
Borderline Personality Disorder - Treatment
- Psychotherapy can be useful.
Dementia
- Acquired impairment of global cognitive function is usually progressive and largely irreversible.
- Dementia will be covered in a lecture on older people.
ADHD (ADD)
- ADHD will be covered in a lecture on paediatrics.
Conclusions
- Psychiatric disorders are common.
- It does not necessarily impact on capacity.
- May impact on dental management
- It is important to outline knowledge of underlying disorders.
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