Wilson's Disease and Psychiatric Symptoms
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Questions and Answers

What type of auditory hallucination involves hearing one's own thoughts as if they were spoken?

  • Inner monologue
  • Thought insertion
  • Thought withdrawal
  • Thought echo (correct)

Which of the following describes thought insertion?

  • An individual perceives their thoughts being taken away without permission.
  • An individual hears voices giving them instructions.
  • An individual experiences their thoughts spoken back to them.
  • An individual feels someone is adding thoughts to their mind against their will. (correct)

What is a distinguishing characteristic of thought withdrawal?

  • Hearing external auditory compliments
  • Experiencing conversation between distinct voices
  • Feeling as though thoughts are being erased from one's mind (correct)
  • Thinking that one's thoughts are echoing back

Which auditory hallucination involves hearing voices in a dialogue or argument?

<p>Hearing two distinct voices (B)</p> Signup and view all the answers

What is NOT an example of thought echo?

<p>Hearing a voice instructing you to act (D)</p> Signup and view all the answers

Which of the following is a misconception about thought insertion?

<p>It is the feeling of having one's thoughts echoed. (C)</p> Signup and view all the answers

When experiencing an auditory hallucination of songs, which of these cognitive phenomena is being described?

<p>Hearing thoughts as music (A)</p> Signup and view all the answers

Which statement best characterizes the experience of hearing a voice giving compliments?

<p>It indicates an auditory hallucination. (C)</p> Signup and view all the answers

What is the primary function of the Cornell Scale for Depression in Dementia (CSDD)?

<p>To measure the severity of depressive symptoms in individuals with dementia (C)</p> Signup and view all the answers

Which scale is used for providing a general assessment of a patient's overall functioning?

<p>Clinical Global Impression (CGI) (C)</p> Signup and view all the answers

What is NOT a purpose of the Cornell Scale for Depression in Dementia?

<p>To diagnose depression (B)</p> Signup and view all the answers

Which of the following statements about the Clinical Global Impression (CGI) is accurate?

<p>It incorporates considerations of functional impairment and clinical condition. (D)</p> Signup and view all the answers

What does the Global Assessment of Functioning (GAF) primarily assess?

<p>The overall level of functioning in psychological, social, and occupational domains (D)</p> Signup and view all the answers

What is the primary purpose of the Beck Depression Inventory (BDI)?

<p>To measure the severity of depressive symptoms (A)</p> Signup and view all the answers

Which population does the Geriatric Depression Scale (GDS) specifically target?

<p>Older adults with symptoms of depression (C)</p> Signup and view all the answers

How is the Beck Depression Inventory (BDI) typically administered?

<p>As a self-report questionnaire completed by the individual (D)</p> Signup and view all the answers

What type of symptoms does the GDS focus on assessing?

<p>Common depression symptoms in older adults (A)</p> Signup and view all the answers

Which of the following statements about the BDI is accurate?

<p>It includes individual self-reported symptoms. (A)</p> Signup and view all the answers

What is one of the main assessments carried out by the BDI?

<p>Severity of sadness and guilt (D)</p> Signup and view all the answers

Which of the following is NOT a focus of the GDS?

<p>Evaluating cognitive function (C)</p> Signup and view all the answers

What distinguishes the BDI from the GDS in their application?

<p>BDI is for individuals diagnosed with depression, GDS is for older adults. (A)</p> Signup and view all the answers

Which statement regarding ECG findings is incorrect?

<p>U waves are always abnormal (A)</p> Signup and view all the answers

What is referred to as tachycardia in ECG findings?

<p>A rate of 100 bpm or above (A)</p> Signup and view all the answers

What should be the first step in taking a psychiatric history?

<p>Gathering information about the patient's medical history (A)</p> Signup and view all the answers

Which of the following statements accurately describes U waves on an ECG?

<p>U waves can sometimes be seen in healthy individuals (C)</p> Signup and view all the answers

Which condition is associated with prolonged flat T waves in ECG findings?

<p>Hypokalaemia (D)</p> Signup and view all the answers

Which action is least relevant when taking a psychiatric history?

<p>Conducting an immediate physical examination (C)</p> Signup and view all the answers

What heart rate is classified as bradycardia?

<p>Less than 60 bpm (B)</p> Signup and view all the answers

Which of the following best describes a normal PR interval on an ECG?

<p>0.12-0.20 seconds (B)</p> Signup and view all the answers

Which of the following best describes autoscopic hallucinations?

<p>Experiencing oneself as being outside of one's body (A), Experiencing a visual representation of oneself in a mirror (C)</p> Signup and view all the answers

Who first identified the concept of first rank symptoms as associated with schizophrenia?

<p>Kurt Schneider (A)</p> Signup and view all the answers

Which statement accurately reflects the nature of first rank symptoms?

<p>Indicates abnormal perceptions or experiences strongly linked to schizophrenia (C)</p> Signup and view all the answers

What is a common medical condition associated with autoscopic hallucinations?

<p>Epilepsy (A)</p> Signup and view all the answers

Which of the following experiences is NOT a characteristic of first rank symptoms?

<p>Feeling a physical sensation that corresponds with a visual image (D)</p> Signup and view all the answers

How does the quantity of first rank symptoms relate to the prognosis of schizophrenia?

<p>Higher numbers of symptoms indicate a worse prognosis (A)</p> Signup and view all the answers

What type of hallucination involves feeling sensations on the skin that are not caused by an external source?

<p>Tactile hallucinations (D)</p> Signup and view all the answers

Which of the following statements about first rank symptoms is false?

<p>Only individuals with schizophrenia experience first rank symptoms (A), They are commonly found in various personality disorders (D)</p> Signup and view all the answers

Which type of hallucination is characterized by hearing voices externally?

<p>Extracampine hallucinations (D)</p> Signup and view all the answers

What type of hallucination occurs during the transition from sleep to wakefulness?

<p>Hypnopompic hallucinations (C)</p> Signup and view all the answers

Which hallucination type is associated with the transition from wakefulness to sleep?

<p>Hypnagogic hallucinations (D)</p> Signup and view all the answers

Which type of hallucination may occur as a result of medical conditions like brain tumors?

<p>Extracampine hallucinations (B)</p> Signup and view all the answers

What form of hallucination is often perceived as real during the waking transition?

<p>Hypnopompic hallucinations (D)</p> Signup and view all the answers

Which hallucination type can vary in form, from simple shapes to complex scenes during sleep transitions?

<p>Hypnopompic hallucinations (B)</p> Signup and view all the answers

Which type of hallucination might not involve any sensory perception?

<p>Functional hallucinations (C)</p> Signup and view all the answers

What type of hallucination could potentially be misattributed to external stimuli due to its vividness?

<p>Hypnopompic hallucinations (A)</p> Signup and view all the answers

Flashcards

Thought Echo

A type of auditory hallucination where a person hears their own thoughts repeated, as if spoken aloud.

Thought Insertion

A delusional belief that someone or something is putting thoughts into a person's mind without their consent.

Auditory Hallucination

A sensory experience where a person hears sounds that are not present.

Thought Withdrawal

A delusional belief that someone or something is taking thoughts out of a person's mind without their consent.

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Delusion

A strongly held false belief that is not shared by others and is not based in reality.

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Auditory

Relating to the sense of hearing.

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Hallucination

A false sensory experience that seems real, and has no basis in reality.

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Mental health

The state of well-being of a person that includes one's emotional, psychological, and social well-being.

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CSDD use

Measures the severity of depressive symptoms in dementia patients.

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CGI use

Provides a general assessment of a patient's overall functioning, considering symptoms, impairment, and condition.

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GAF use

Measures overall functioning of a patient.

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Depression in dementia

Common in dementia patients and negatively impacts their quality of life.

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Depression Risk factors

Identifying these factors helps in preventing depression in those at risk with dementia.

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ECG finding: Bradycardia

A heart rate of less than 60 bpm.

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ECG finding: Tachycardia

A heart rate of 100 bpm or above.

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ECG finding: Hypokalaemia

Flat or prolonged T waves on an ECG.

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ECG finding: U wave

Not always abnormal, can appear in healthy individuals or conditions like hypokalemia.

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ECG finding: PR interval

Normal range is 0.12-0.2 seconds.

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Psychiatric history 1st step

Gather the patient's medical history, including previous psychiatric treatment or diagnoses, and relevant medical conditions.

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Psychiatric history focus

Patient's medical history, including previous psychiatric treatment or diagnoses and relevant medical conditions.

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Psychiatric Disorder evaluation first approach

Gathering information about the patient's medical history is the first step in evaluating a psychiatric disorder.

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Extracampine Hallucination

A hallucination perceived as coming from outside the body, often involving sounds like voices.

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Hypnopompic Hallucination

A vivid hallucination experienced during the transition from sleep to wakefulness.

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Hypnagogic Hallucination

A vivid hallucination occurring as you fall asleep, often perceived as real.

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What type of hallucination involves hearing voices from outside?

Extracampine hallucinations occur outside the visual field, like hearing voices from external sources.

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What type of hallucination occurs during the transition from sleep to wakefulness?

Hypnopompic hallucinations are vivid hallucinations experienced while waking up.

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What type of hallucination occurs during the transition from wakefulness to sleep?

Hypnagogic hallucinations are vivid hallucinations experienced while falling asleep.

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Hallucination Cause

Hallucinations often arise from the brain misinterpreting information. This could be due to medical conditions like seizures or brain tumors.

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Hallucination Perception

Hallucinations are often perceived as real, and are not under the individual's control. They can be simple or complex.

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BDI (Beck Depression Inventory)

A self-report questionnaire used to assess the severity of depressive symptoms in individuals already diagnosed with depression.

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GDS (Geriatric Depression Scale)

A tool specifically designed to assess symptoms of depression in older adults, considering age-related commonalities.

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Purpose of BDI and GDS

Both the BDI and GDS are used to measure the severity of depressive symptoms, but are tailored for different populations.

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BDI Administration

The BDI is typically administered as a self-report questionnaire, where individuals answer questions about their own experiences.

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Depression Assessment Tools

There are various tools like BDI and GDS used to assess depression, each tailored to specific demographics.

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Benefits of Depression Assessments

Assessment tools like BDI and GDS are crucial for diagnosing depression, measuring its severity, and monitoring treatment effectiveness.

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Depression Diagnosis

Depression diagnosis involves using assessment tools, clinical interviews, and observation to determine the presence and severity of depression.

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Depression Treatment Evaluation

Assessment tools can be used to monitor the effectiveness of treatment for depression by tracking symptom changes over time.

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Autoscopic Hallucination

A hallucination where a person sees their own body or reflection, often in a mirror, or experiences an out-of-body sensation.

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Kinaesthetic Hallucination

A false sensory experience involving the feeling of movement or bodily sensations, even without actual movement.

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Functional Hallucination

A hallucination triggered by a real sensory stimulus, but the perception becomes distorted or altered.

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Tactile Hallucination

A false sensory experience involving the feeling of touch, such as a tingling sensation or feeling something crawling on the skin.

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First Rank Symptoms

A set of symptoms, identified by Kurt Schneider, strongly associated with schizophrenia, including thought insertion, thought withdrawal, thought broadcasting, delusions of control, and auditory hallucinations.

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What are first rank symptoms?

A group of symptoms strongly associated with schizophrenia. They indicate a deeper level of disturbance than other symptoms and help distinguish schizophrenia from other mental illnesses.

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Are First Rank Symptoms Diagnostic?

No, while first rank symptoms are highly suggestive of schizophrenia, their presence alone doesn't guarantee a diagnosis. Other assessments and factors are needed.

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Schneiderian First Rank Symptoms

Another name for first rank symptoms, referencing the psychoanalyst Kurt Schneider who categorized them.

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Study Notes

Wilson's Disease

  • An inherited disorder causing copper accumulation in the body, primarily liver and brain.
  • Caused by mutations in the ATP7B gene, responsible for copper transport and excretion.
  • Accumulation in the liver can lead to cirrhosis.
  • Accumulation in the brain leads to neurological symptoms like tremors, speech difficulties, and psychiatric issues.
  • Diagnosis involves clinical presentation, lab tests, and genetic testing.
  • Treatment aims at removing excess copper and preventing further accumulation.

Psychiatric Symptoms

  • Running commentary: A voice providing continuous commentary on thoughts, feelings, or actions.
  • Thought echo: Hearing one's thoughts repeated as if spoken aloud.
  • Thought insertion: Thoughts being inserted into the mind without consent.
  • Thought withdrawal: Thoughts being taken out of the mind without consent.
  • Thought broadcast: Belief that one's thoughts are being transmitted to others.
  • Delusional perception: A normal perception altered or manipulated by an external force.
  • Somatic passivity: Belief one's body is being controlled by an external force.
  • Made affect: Belief one's feelings are controlled by an external force.
  • Made volition: Belief one's impulses or behavior are controlled by an external force

Assessment of Psychiatric Disorders

  • Important first step: Observing the patient's behaviour and appearance.
  • Question type: Open-ended questions for detailed information about symptoms, treatment, and medical history.
  • Mental State Examination (MSE) steps: Observing patient behaviour and appearance, followed by open-ended questioning about symptoms, treatment, and medical history.
  • Alcohol Abuse Screening: NICE recommends the AUDIT screening tool.
  • FAST (Fast Alcohol Screening Test): A simple ten-question test to screen for excessive drinking, but not to diagnose alcoholism.
  • Psychiatric History Focus: Current mental state, symptoms, functioning level, and past psychiatric history.

Psychiatric Scales

  • YMRS (Young Mania Rating Scale): Measures severity of manic symptoms in bipolar disorder. (11 items)
  • CAMDEX (Cambridge Mental Disorders of the Elderly Examination): Used to diagnose cognitive disorders in older adults (40 items)
  • MADRS (Montgomery-Ã…sberg Depression Rating Scale): Measures severity of depressive symptoms in those with a depressive disorder.
  • HAMD (Hamilton Depression Rating Scale): Measures severity of depressive symptoms.
  • HAMA (Hamilton Anxiety rating scale): Measures severity of anxiety symptoms.
  • BASDEC (Brief Assessment Schedule Depression Cards): Screens for depression in at-risk individuals.
  • CSDD (Cornell Scale for Depression in Dementia): Measures depressive symptom severity in individuals with dementia.
  • CGI (Clinical Global Impression): General assessment of a patient's overall functioning (symptoms, functional impairment, overall clinical condition).
  • GAF (Global Assessment of Functioning): Comprehensive assessment of a patient's overall functioning in various aspects of life.
  • AIMS (Abnormal Involuntary Movement Scale): Measures severity of abnormal involuntary movements (e.g., tardive dyskinesia). (Used with antipsychotics)
  • SAS (Simpson-Angus Scale): Measures side effects of antipsychotic medication, particularly (extrapyramidal) EPS symptoms.
  • Y-BOCS (Yale-Brown Obsessive Compulsive Scale): Measures severity of obsessive-compulsive symptoms in OCD patients.
  • BPRS (Brief Psychiatric Rating Scale): Measures severity of symptoms for a range of psychiatric disorders (anxiety, depression, thought disorder, hostility).
  • PANSS (Positive And Negative Syndrome Scale): Measures severity of symptoms in schizophrenia, particularly positive and negative symptoms.
  • BDI (Beck Depression Inventory): Measures severity of depressive symptoms, self-report based.
  • GDS (Geriatric Depression Scale): Specifically designed to assess symptoms of depression in older adults. (Focuses on common issues)
  • EDPS (Edinburgh Postnatal Depression Scale): Screens for depression and anxiety in recently given birth women.
  • BPRS (Brief Psychiatric Rating Scale): Measures severity of symptoms of psychiatric disorders.
  • LUNSERS (Liverpool University Neuroleptic Side Effects Rating Scale): Measures severity of neuroleptic-induced side effects like Parkinsonism, akathisia, dystonia.
  • DESS (Discontinuation-Emergent Signs and Symptoms scale): Measures severity of symptoms during withdrawal from medication.
  • Types of hallucinations: Auditory, visual, olfactory, gustatory, tactile (haptic).

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Description

Explore the inherited disorder of Wilson's Disease, characterized by copper accumulation in the body leading to serious health issues, including liver cirrhosis and neurological symptoms. Additionally, delve into psychiatric symptoms associated with mental health, including thought disturbances and delusions. This quiz covers mechanisms, symptoms, diagnosis, and treatment.

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