1. 2017/2018

2. Psychiatry Phase 3A Revision Session Jennifer McMurran 15/10/18
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3. Terms Definition and implication for diagnosis: Illusion Hallucination
Over-valued idea
Delusion
Delusional perception
From the UoS psychiatry handbook
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4. Terms Definition and implication for diagnosis: Thought alienation
Thought insertion
Thought withdrawal
Thought broadcast
Thought echo
Thought block
From the UoS psychiatry handbook
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5. Terms Definition and implication for diagnosis: Concrete thinking
Loosening of association
Circumstantiality
Perseveration
From the UoS psychiatry handbook
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6. Terms Definition and implication for diagnosis:
Confabulation Somatic passivity Made acts & feelings Delirium Catatonia / stupor Psychomotor retardation
Flight of ideas Thought disorder
From the UoS psychiatry handbook
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7. Terms Definition and implication for diagnosis: Poverty of speech
Poverty of thought
Pressure of speech
From the UoS psychiatry handbook
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8. Terms Definition and implication for diagnosis:
Anhedonia Flattening of affect
Incongruity of affect
Blunting of affect
From the UoS psychiatry handbook
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9. Terms Definition and implication for diagnosis: Belle indifference
Depersonalisation
Derealisation
Conversion/dissociation
Stereotypy/mannerism
Obsession/compulsion
From the UoS psychiatry handbook
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10. Topics Addictive behaviours Personality and identity Anxiety Self-harm
Mood problem
Cognitive impairment
Psychosis
Learning disability
Liaison (including eating disorders)
From the UoS psychiatry handbook
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11. ICD-10 http://apps.who.int/classifications/icd10/browse/2016/en#/V
ICD 11 is on it’s way but not yet and handbook says ICD-10. Also DSM 5.
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12. Addictive behaviours
What are the 6 features of the dependence syndrome?
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13. Addictive behaviours 1 – Craving 2 – Difficulty controlling use
3 – Physical withdrawal
4 – Tolerance
5 – Neglect of other activities
6 – Persistent use despite consequences
Oxford handbook of clinical specialties 9th edition
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14. Addictive behaviours
How many of the 6 features need to be present for dependence syndrome?
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15. Addictive behaviours 3 features
Oxford handbook of clinical specialties 9th edition
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16. Addictive behaviours Which 2 drugs are used to reduce off opiates?
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17. Addictive behaviours Methadone and Buprenorphine
Oxford handbook of clinical specialties 9th edition
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18. Addictive behaviours What is Naltrexone used for?
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19. Addictive behaviours
Opioid antagonist – blocks euphoria, prevents relapse
Oxford handbook of clinical specialties 9th edition
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20. Addictive behaviours
Opioid antagonist – blocks euphoria, prevents relapse
Oxford handbook of clinical specialties 9th edition
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21. Addictive behaviours What is delerium tremens?
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22. Addictive behaviours
Alcohol withdrawal – tachycardia, hypotensive, tremor, fits, hallucinations e.g. insects crawling under skin
Oxford handbook of clinical specialties 9th edition
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23. Personality and identity
Name as many personality disorders as you can
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24. Personality and identity
Paranoid
Schizoid
Schizotypal
Antisocial (psychopathic)
Borderline
Histrionic
Narcissistic
Avoidant
Dependent
Obsessive-compulsive
Oxford handbook of clinical specialties 9th edition
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25. Anxiety What types of anxiety are there?
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26. Anxiety GAD Panic disorder Phobia PTSD Social anxiety disorder OCD
Oxford handbook of clinical specialties 9th edition
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27. Anxiety What is the definition of Generalized anxiety disorder?
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28. Anxiety Anxiety + 3 somatic symptoms for at least 6 months
Oxford handbook of clinical specialties 9th edition
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29. Anxiety What suggests anxiety in a child?
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30. Anxiety Thumb-sucking Nail-biting Bed-wetting Foodfads
Oxford handbook of clinical specialties 9th edition
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31. Anxiety What is the management of anxiety?
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32. Anxiety Symptom control Regular exercise Meditation CBT Relaxation
Behavioural therapy (e.g graded exposure)
Medication (Benzodiazepines, SSRIs, Azapirones, older antihistamines, beta blockers)
Hypnosis
Oxford handbook of clinical specialties 9th edition
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33. Self-harm
Key questions to ask in a suicide assessment following attempt about before the attempt?
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34. Self-harm Before: Precipitant? Planned/impulsive? Final acts
Precautions against discovery?
Alcohol used?
(accessed 15/10/18)
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35. Self-harm
Key questions to ask in a suicide assessment following attempt about during the attempt?
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36. Self-harm During: -Method? -Alone? -Where? -Thoughts?
-Did they think it would kill them?
-What did they do straight after?
(accessed 15/10/18)
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37. Self-harm
Key questions to ask in a suicide assessment following attempt about after the attempt?
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38. Self-harm
After:
-Call anyone? How did they get to hospital? Who found them?
-Feelings when help arrived?
-Feelings about attempt now?
-Current mood?
-Still feeling suicidal?
-If went home what would they do for next few days?
-If felt same again, what would you do differently?
-protective factors
-Accepting of treatment?
(accessed 15/10/18)
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39. Mood problem How is Depression diagnosed?
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40. Mood problem
Anhedonia plus at least 4 of the following for at least two weeks
-poor appetite and weight loss/increased appetite
-early waking and diurnal mood variation
-Psychomotor retardation/agitation
-decreased libido
-decreased concentration
-ideas of worthlessness/guilt/self-reproach
-recurrent thoughts of death/suicide/attempts
Oxford handbook of clinical specialties 9th edition
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41. Mood problem How is Depression classified?
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42. Mood problem Mild/moderate/severe With/without biological features
With/without delusions or hallucinations
Bipolar/unipolar
Oxford handbook of clinical specialties 9th edition
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43. Cognitive impairment What causes of delirium are there?
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44. Cognitive impairment CNS Infection Vascular Metabolic Endocrine Toxic
Deficiency (thiamine, B12, folate, nicotinic acid)
Oxford handbook of clinical specialties 9th edition
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45. Cognitive impairment What types of dementia are there?
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46. Cognitive impairment Alzheimer’s Huntington’s Lewy-body Pick’s CJD
Parkinson’s
Vascular
Toxic
Endocrine
Infective
Other CNS
Deficiency (thiamine, B12, folate, nicotinic acid)
Oxford handbook of clinical specialties 9th edition
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47. Psychosis Causes of psychosis?
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48. Psychosis Affective Substance abuse Medical (e.g brain tumour)
Schizophrenia
Schizophrenia-like non affective disorders
Oxford handbook of clinical specialties 9th edition
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49. Psychosis What is the name for symptoms you look for in schizophrenia?
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50. Psychosis Schneider’s first rank symptoms
Oxford handbook of clinical specialties 9th edition
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51. Learning disability Causes of learning disability?
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52. Learning disability Chromosomal
Antenatal – infection, alcohol, hypoxia, nutrition, hypothyroidism
Perinatal – cerebral palsy
Post-natal – injury, infections, environment
Oxford handbook of clinical specialties 9th edition
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53. Liaison (including eating disorders)
Diagnosic criteria for anorexia?
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54. Liaison (including eating disorders)
1 – Weight <85% predicted
2 – Fear of weight gain
3 – Disproportionate idea of body
4 – Amenorrhoea in women or decreased libido in men
Oxford handbook of clinical specialties 9th edition
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