Clinical Correlations

Approximately ______% of the US adult population experiences signs and symptoms of a recognized mental disorder each year

26%

~_______% of patients with psychological problems do not seek care

~50%

there are _______ million adults (_____% ) with perceived or unmet need did not receive mental health services

5.8 million; 44%

list the most common mental problems (in order of prevalence):

1. anxiety/phobias

2. substance abuse

3. major depression

4. obsessive-compulsive disorders

what is anticipatory grief?

grieving someone who is still alive - person may feel guilt, sadness, anger, isolation, exhaustion

for these patients, validate that anticipatory grief is normal and connect to resources

neurodegenerative diseases are dyadic. what does this mean?

the disease has effects on both the patient and the caretaker - this is a very complex relationship

basically, when dealing with the oral/mental/physical health of a patient with a neurodegenerative disease, you must also take into consideration the oral/mental/physical health of the caretaker

T/F: neurodegenerative diseases can mimic depression and anxiety in the early stages, leading to misdiagnosis

true

T/F: prevalence of depression depends on the disorder but is extremely high in patients with neurodegenerative diseases

true

T/F: depression and anxiety rates are higher in care takers than the general population

true - can be as much as 3x more likely

what does NPI stand for?

neuropsychiatric inventory

this can be used to screen for mental health disorders in patients with neurodegenerative diseases and caretakers

what are some oral health considerations for patients with neurodegenerative diseases?

1. know the health care decision maker (HCDM)

2. xerostomia

3. difficulty with oral hygiene

4. implant survival

5. difficulty with dentures

6. infrequent dental care

Patients with NDD and their care partners may struggle to:

1. Prioritize oral hygiene at home

2. Come to appointments (financial, physical, time barriers)

3. Complete complicated or lengthy treatment plans

4. Difficulty with dentures

5. Navigate the healthcare system

anxiety disorders have a lifetime prevalence of _____%

25%

depressive disorders have a ______% prevalence in women

20-25%

what is panic disorder? what are the symptoms?

recurrent episodes of intense anxiety with peak of 10 minutes

symptoms:

1. Shortness of breath

2. Diaphoresis (sweating)

3. Hot flashes

4. Tremors

5. Palpitations

6. Chest pain

7. Fainting/dizziness

8. Paresthesia

9. Chills

10. Nausea/ abdominal distress

11. Fear of loss of control

12. Fear of dying

how can you modify the environment for a patient with a NDD?

1. reduce environmental stimuli

2. familiar faces

3. careful communication

4. back off if agitation appears

5. involve the care partner

6. make the space wheelchair accessible

7. modify the verbal and nonverbal communication

what is MINICog?

a two-part test (5 questions total) to screen for dementia or mild cognitive impairment

score of 0-3 = impaired

score of 4-5 = normal

what is somatic symptom disorder?

patient experiences exaggerated symptoms

what is factitious disorder?

lying about symptoms, faking illness, self induced lesions (Munchausen Syndrome/ Munchausen Syndrome by proxy)

shoutout gypsy rose blanchard

what is collusion?

patient withholds info and wants you to assist/help

what is secondary gain?

patient seeks attention or avoidance; drug procurement

what are some oral effects of psychological disorders?

1. altered diet

2. poor oral self-care

3. obsessive self-care

4. traumatic injuries

5. generalized dental erosion

6. cervical notching (abrasion, erosion, abfraction)

7. bruxism

8. NUG

9. Gingivitis

10. periodontitis

11. Caries

12. TMD and facial pain