Psychology and Mental Health

Psychosis is a state of delusion where a person's reality and fantasy are blurred, characterized by disorganization, disorientation, and various conditions such as schizophrenia and organic brain syndromes.

Psychotic episodes can be caused by mind-altering substance use, intense stress, delusional disorders, and schizophrenia, and may last for brief periods or a lifetime.

Schizophrenia is a complex disorder that is not easily defined or treated, typically occurring in early adulthood with symptoms becoming more prominent over time.

Influences contributing to schizophrenia include brain damage, genetics, neurobiological influences, and psychological and social influences.

Patients with schizophrenia may display symptoms such as delusions, hallucinations, mutism, flat affect, lack of interest and pleasure, erratic speech, emotional responses, and excessive or lack of motor behavior.

The pneumonic POSTMAP is used to assess patients with psychosis, covering consciousness, orientation, activity, speech, thought, memory, affect, and perception.

When managing patients with psychosis, a safe environment is created, and usual methods of reasoning are unlikely to be effective.

Patients with psychosis require simple, consistent, and firm direction, and may require paramedic backup for administration of sedative or anti-anxiety drugs if they are not compliant and pose a danger to themselves or others.

Depression is a significant factor contributing to suicide, and patients experiencing depression should be considered for immediate intervention.

Warning signs of suicide or suicidal ideation include an air of tearfulness, sadness, deep despair, hopelessness, avoiding eye contact, speaking slowly or haltingly, and a sense of vacancy.

Delirium is a condition of impaired cognitive function, characterized by disorientation, hallucinations, or delusions, and agitation marked by restless and irregular physical activity.

Mood disorders are among the most prevalent mental disorders, affecting up to 21% of the US population, and include unipolar mood disorders (depression or mania) and bipolar mood disorders (alternating between mania and depression).

Mania is characterized by abnormally exaggerated happiness, joy, or euphoria, with hyperactivity and insomnia, and may involve a flight of ideas, delusions of grandeur, and a high probability of getting into trouble.

Major depressive episodes affect over 7% of adults in the US, more frequently affecting women than men, and may occur at any age.

Neurotic disorders are a collection of mental disorders without psychotic symptoms, lacking intense psychopathology, and are treated with phacologic agents and counseling.

Anxiety disorders are characterized by fear and apprehension, with generalized anxiety disorder involving unproductive worrying and phobias involving an unreasonable fear or dread of a specific situation or thing.

Panic disorders or panic attacks are characterized by sudden, overwhelming feelings of fear and dread, accompanied by various symptoms, and are more likely to affect women.

The consequences of autonomic nervous system discharge and hyperventilation contribute to the intense feelings of anxiety during panic attacks.

Medical and legal considerations are complex with patients undergoing a behavioral crisis or psychiatric emergency, and legal problems are reduced when the patient consents to care.

Mental incapacity can take many forms, such as irresponsibility under temporary but severe stress, depression, or other conditions.

A patient in a mentally unstable condition may resist attempts to provide care, but leaving them alone may expose healthcare providers to civil action for abandonment or negligence.

Implied consent is assumed with a patient who is not mentally competent to grant consent in a non-life-threatening situation.

Patients have the right to refuse care, but may not be considered competent to refuse treatment or transport if impaired by mental illness, medical condition, or intoxication.

Law enforcement personnel can place a person in protective custody to provide emergency care and medical direction may order transport of a patient who does not initially give consent to transport.

When in doubt, healthcare providers should consult their supervisor, medical control, law enforcement, and always err on the side of treatment and transport.

Restraints must be ordered by a physician or law enforcement officer, and their use should be justified to protect themselves and others from bodily harm or to prevent the patient from committing self-harm.

PTSD can occur after exposure to or injury from a traumatic event, affecting an estimated 7-8% of the general population.

Symptoms of PTSD include feelings of helplessness, anxiety, anger, and fear, avoiding things that remind them of the trauma, and a nervous system arousal that continues and is not easily suppressed.

Veterans are more likely to harm themselves or attempt to combat, and may develop heart disease earlier than expected, have a higher incidence of type 2 diabetes, and sustain a loss of brain gray matter.