Psychiatric and cognitive disorders

Disturbances of attention

• distractibility

• Selective inattention

• Hypervigilance

Disturbances of consciousness

• disorientation

• Delirium

• Confusion

• Sundowner syndrom

Motor behavior

Behavioral and motor if expressions of impulses, drives, wishes, motivations, and cravings

Disturbances of motor behaviors

• Echopraxia: imitation of another persons movement

• Catatonia: immobility or rigidity

• Stereotypy: repetitive, abnormal, non-goal directed movement

• Psychomotor agitation: excessive motor and cognitive activity due to inner tension

• Hyperactivity

• Psychomotor retardation: slow motor and cognitive activity

• Agression

• Acting out

• Akathisia: restless, urgent need for movement, usually medication side effect

• Ataxia: bad coordination during movement

Disturbances of perception

• Hallucinations:false sensory events

• Illusions: misperceptions of real sensory events

• Agnosia: inability to understand the significance of sensory input

• Visual agnosia: inability to recognize people and objects

• Astereognosis: inability to identify objects through touch

• Apraxia: cant carry out specific motor tasks

• Adisdiadochokinesia

Disturbances with conversation and dissociation

• depersonalization: unreality of ones self or the environment

• Derealization: sense that the environment is not real

• Fugue state

• Dissociation

Shortened screening tools to assess mental status and cognitive functioning

• Mini mental state exam

• Short portable mental

• Montreal cognitive assessment

• St. Louis university mental

Functional implications of psychotic disorders

• difficulty interacting with environment due to sensory processing difficulties

• Poor social boundaries and norms

• Poor communication skills

• Difficulty with ADLs

Antipsychotic Medication side effects

• Dry mouth

• Blurred vision

• Constipation

• Parkinsonism

• Dystonias

• Akasthisia

• Cardiovascular disorders

• Postural hypotension

Complications of antipsychotic meds

• neuroleptic malignant syndrome

  • Autonomic emergency with increased blood pressure, tachycardia, sweating, convulsions, coma

• Tardive dyskinesia

  • Abnormal, involuntary movement of the head limbs in trunk, slow, rhythmic, automatic, movements

• Neuroleptic induced Parkinsonism

  • Parkinson’s symptoms

Second generation antipsychotics can cause

Metabolic syndrome

• Cluster of symptoms that cause risk for heart disease and stroke

Manic episode impact on function

• lack of inhibition during manic episodes

• Poor judgement can lead to dangerous situations

Lithium side effects

• Excessive thirst

• Tremors

• Excessive urination

• Weight gain

• Nausea

• Diarrhea

• Cog impairment

Lithium toxicity early symptoms

• Motor disturbances

Anticonvulsants side effects

Drowsiness, ataxia, weight gain, sedation

Major depressive episodes

• sleep disturbances

• Psychomotor retardation

• Fatigue

• Poor mood

• Decreased concentration

• irritability

Side effects of antidepressants

• nausea

• Headache

• Sexual dysfunction

• Insomnia

• Dry mouth

• Blurred

• Vision

• SedatioN

• Orthostatic hypotension

• Hyperrrtension

• Dizziness

• Anxiety

• Sweating

If taking MAOI’s what foods must be avoided

• Aged cheeses

• Pickled foods

• Cured or smoked meats

• Liver

• Yogurt

• Sour cream

• fruits that need to ripen

• Some beans

• Chocolate

• Beer, red wine

• Soy products

• Yeast

Most dangerous time for self destructive or suicidal behaviors

When depression begins to lift and person becomes mobilized