Patho - Ch 7 - mental Health Disease and Disorders

definitions + disease templates

Integration and cost of care

• 1 in 5 of US population is diagnosed with a mental health disorder each year

• people with depression, schizophrenia commonly live 10-20 years LESS than those without chronic medical conditions

• mental health disorders are not always covered by insurance

What is M.S.E?

It is an evaluation called Mental Status Examination to help further diagnose a patient

Mental Statuse Examination abbreviation + meaning

“ I AM A STAR”

• insight

• affect

• mood

• appearance

• speech

• thought process

• ability (cognition)

• reality

What are hallucinations considered?

false PERCEPTIONS

What are delusions considered?

false BELIEFS

• Persistent exaggerated thoughts or thoughts or actions that reflect exaggerated fear ______

obsessive compulsive disorder

• recurrent episodes of apprehension, terror, or impending doom is _____

panic disorder

• fear of being in specific situations with large groups or being alone _____

agoraphobia

What is the only effective treatment against substance related and addictive disorders?

total abstinence

Depressive illness: description

depression can occur in anyone of any age or gender

• from peri-portum (pregnant women), seasonal patterns, or persistant depression

• 7% of adults (32yr+)

• 13% of adolescents (12-17 yr)

Depressive illness: etiology

• changes in the brain function or structure

• decrease serotonin levels

• possibly from other medical conditions like cancer

• some medications may cause depression (substance abuse or prescribed medication)

• can be generational

Depressive illness: signs/symptoms

• feeling of worthlessness, hopelessness, guilt, despair, and more

• difficulty doing life functions

• thoughts of suicide/death

• may cause anxiety, eating disorders, weight lose

Depressive illness: diagnosis

• do a MSE

• symptoms must be present over 2 weeks plus a change from previous function

• if suicidal: emotions/mood my flip - has settled on this as the final decision

Depressive illness: treatment

• lifestyle changes

• MAJOR: electric colvulsion therapy (ECT)

• depends on evaluation

• medications: serotonin increasers, antidepressants (3-6 weeks)

never stop medications suddenly

• vitamin D supplements for seasonal depression

Depressive illness: therapy

• yoga, exercise, meditation

• life style changes, have a routine

• counseling, family therapies

• sleep and diet changes

• herbal treatments

Depressive illness: prognosis

• Mild/moderate: proper treatment leads to good results

• major: long term treatment but improve quality of life and suicide prevention precautions

Depression illness: prevention

• practice effective stress management

• avoid drugs/alcohol

• exercise

• sleep habits

• some medication

• psychiatric intervention

• socializing

Post Traumatic Stress Disorder: description

trauma and stressor related after a traumatic event

• through war, disaster, sexual assault, childhood abuse

• common in veterans

• 8% of the poulation

PTSD: etiology

personal experiences of some form of trauma

• part of the brain where emotional reactions are effected (amygdala)

• fear response → fight or flight

PTSD: signs/symptoms

flashbacks, nightmares, emotional numbing, avoidance, outburst

• might not occur for weeks, months, or even years after event

• feeling detached from oneself: “dreamlike”

• panic attacks

PTSD: diagnosis

• must reach a level of difficulty functioning

• cognitive, affectivity, impulse control or interpersonal function

2 changes in emotional response

PTSD: treatment

psychotherapy, medications, having a support system, exposure therapy, cognitive restructuring

PTSD: therapy

therapists

coping mechanisms

meditations/yoga

cognitive brain therapy

PTSD: prognosis

longer than 3. months is chronic = symptoms lessen over time

• unlikely for complete recovery

PTSD: prevention

no known prevention

Substance-related and addictive disorder: description

addiction to alcohol or psychoactive drugs that can be life threatening

• interfers with mental and physical health

• soon creates tolerance

• men are more common

Substance-related & addictive disorders: etiology

50-60% due to genetic factors

• addiction occurs after trying to handle anxiety coping-skills (self medicating)

• not just one particular thing effecting: environmental, chemical, psychological

Substance-related & addictive disorders: signs/symptoms

• alcohol: unable to control a drinking craving → dependent on alcohol + body adapts & withdrawal = may cause seizures

• psychoactive drugs: needle marks, euphoric states, pupils constricted, hallucinations

Substance-related & addictive disorders: diagnosis

not always easy to diagnose

• toxicology screens

• urine drug tests

• self reporting

• mental health evaluation

RED FLAG: running out of meds early

Substance-related & addictive disorders: treatment

• total abstinence from alcohol/drug

• medications but maybe a risk

• replace the desire with something healthy

Substance-related & addictive disorders: therapy

• acupuncture

• absences of substance

• yoga for mindfulness

• motivational therapies

• herbal therapies

Substance-related & addictive disorders: prognosis

can recover completely but no cure

relapse is common after treatment

Substance-related & addictive disorder: prevention

constructive activities

• school based prevention approaches

• education

Anorexia nervosa: description

imposing starvation and irrational fear of gaining weight

• skeletal like body

Anorexia nervosa: etiology

cause is unknown

mental health disorder

environmental circumstances

may be caused by other disorders like cancer

Anorexia nervosa: signs/symptoms

• weight lose/semi-starvation

• 25% loss of original body weight

• food avoidance, vomiting, excessive exercise

• side affect from depression, anxiety, or substance abuse

Anorexia nervosa: diagnosis

no specific diagnostic test

physical examination

Anorexia nervosa: treatment

reverse effect of malnutrition and improving nutritional therapy

Anorexia nervosa: prevention

no specific prevention

relapses are frequents

needs family support

death may occur

Bulimia nervosa: description

repetitive gorging with food followed by self induced vomiting

Bulimia nervosa: etiology

unknown cause

psychological factors (SA, family, etc)

self identity conflicts

Bulimia nervosa: signs/symptoms

hidden behavior

normal body weight

may have signs of malnutrition

signs of depression

damage to teeth (from vomiting)

heart issues

Bulimia nervosa: diagnosis

physical examination and lab tests

psychological exams

Bulimia nervosa: treatment

long term treatment

psychotherapy

regain control of eating

nutritional therapists

Bulimia nervosa: prognosis/prevention

unknown prevention

Social anxiety

fear of embarrassing oneself in public/social situation

generalized anxiety

excessive or unrealistic worry

panic disorder

recurrent episodes of apprehension, terror or doom

recovery

express that clients are never fully cured from a mental health issue but have developed skills to successfully live

stigma

negative belief around a personal trait

Bipolar disorder

manic-depressive episoded

high is manic and low is depressive

Bipolar I: at least one manic with or without depressive

Bipolar II: at least one depressive and maybe one long manic (not severe)

echolalia

pathological senseless repetition of a word or phrase just spoken

alogia

inability to speak owing to a mental condition or symptoms of dementia

avolition

decrease motivation

gustatory

associated with the sense of taste or eating

decopensate

failure or inability to act appropriately to acute episodes of mental illness

folate

form of vitamins B complex