Scribd
Upload
17 views8 pages

Psychiatric Concepts 2024

The document outlines various psychiatric concepts including definitions of obsessions and compulsions, risk factors for psychotic disorders, and treatment guidelines for conditions such as anxiety and depression. It discusses the side effects of medications like SSRIs and atypical antipsychotics, as well as personality disorders and their characteristics. Additionally, it covers specific syndromes and disorders, their symptoms, and management strategies.

Uploaded by

dr Mahde
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
17 views8 pages

Psychiatric Concepts 2024

The document outlines various psychiatric concepts including definitions of obsessions and compulsions, risk factors for psychotic disorders, and treatment guidelines for conditions such as anxiety and depression. It discusses the side effects of medications like SSRIs and atypical antipsychotics, as well as personality disorders and their characteristics. Additionally, it covers specific syndromes and disorders, their symptoms, and management strategies.

Uploaded by

dr Mahde
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 8

Psychatric concepts

Dr Hajir algammody

An obsession is an intrusive, unpleasant and unwanted


thought. A compulsion is a senseless action taken to reduce
the anxiety caused by the obsession

Family history is the strongest risk factor for psychotic


disorders

When stopping a SSRI the dose should be gradually reduced


over a 4 week period

Lithium levels should be checked every 3 months once a


stable dose has been achieved

SSRIs are the first-line pharmacological therapy for


generalised anxiety disorder
SSRI + NSAID = GI bleeding risk - give a PPI

Paranoid personality disorder may be diagnosed in patients


who are overly sensitive and can be unforgiving if insulted,
question loyalty of those around them and are reluctant to
confide in others

Severe depression can mimic dementia but gives a pattern of


global memory loss rather than short-term memory loss - this
is called pseudodementia

Triptans should be avoided in patients taking a SSRI

Benzodiazepines enhance the effect of GABA, the main


inhibitory neurotransmitter

Atypical antipsychotics commonly cause weight gain

Charles-Bonnet syndrome - peripheral visual impairment is a


risk factor

Alcohol withdrawal
• symptoms: 6-12 hours
• seizures: 36 hours
• delirium tremens: 72 hours

Tardive kinesia can present as chewing, jaw pouting or


excessive blinking due to late onset abnormal involuntary
choreoathetoid movements in patients on conventional
antipsychotics

Olanzapine has a higher risk than other atypicals for


dyslipidemia and obesity

Patients with obsessive-compulsive personality can be rigid


with respect to morals, ethics and values and often are
reluctant to surrender work to others

Antidepressants should be continued for at least 6 months


after remission of symptoms to decrease risk of relapse

Common features of PTSD

• re-experiencing e.g. flashbacks, nightmares


• avoidance e.g. avoiding people or situations
• hyperarousal e.g.hypervigilance, sleep problems
Acute dystonia - sustained muscle contraction such as
torticollis or oculogyric crisis

Anorexia features

• most things low


• G's and C's raised: growth hormone, glucose,
salivary glands, cortisol, cholesterol, carotinaemia

A male with a history of alcohol or drug abuse and deliberate


self harm should be considered to be at high risk of suicide

SSRIs are associated with hyponatraemia

Patient with a fixed, false belief (delusion) that they are


infested by 'bugs' → delusional parasitosis

Paroxetine - higher incidence of discontinuation symptoms

Patients with dependant personality disorder require


excessive reassurance from others, seek out relationships and
require others to take responsibility for major life decisions
Charles-Bonnet syndrome causes unpleasant visual
hallucinations in a third of sufferers

If CBT or EMDR therapy are ineffective in PTSD, the first line


drug treatments are venlafaxine or a SSRI

Elderly patients with depression are less likely to complain of


low mood and instead may present with health anxiety,
agitation and sleep disturbance

Duloxetine mechanism of action = serotonin and


noradrenaline reuptake inhibitor

Patients with antisocial personality disorder often fail to


conform to social norms, and show lack of remorse, deception
and irresponsibility

Dosulepin - avoid as dangerous in overdose

Patients with avoidant personality disorder are fearful of


criticism, being unliked, rejection and ridicule
Illness anxiety disorder (hypochondriasis) is the persistent
belief in the presence of an underlying serious disease, e.g.
cancer

Gastrointestinal side-effects such as diarrhoea are seen in


SSRI discontinuation syndrome

Lofepramine - the safest TCA in overdosage

Narcisstic personalities lack empathy, have a sense of


entitlement and take advantage of others to achieve their
own need

Hyperprolactinaemia is uncommon with certain atypical


antipsychotics - consider other causes such as prolactinoma if
prolactin raised

Korsakoff's syndrome is a complication of Wernicke's


encephalopathy. It's features include: anterograde amnesia,
retrograde amnesia, and confabulation

Antipsychotics may cause akathisia (severe restlessness)


Antipsychotics in the elderly - increased risk of stroke and
VTE

Functional neurological disorder (conversion disorder) -


typically involves loss of motor or sensory function

Sertraline is the SSRI of choice post myocardial infarction

Borderline personality disorder is associated with impulsivity,


feelings of emptiness, fear of abandonment and unstable self
image

Patients with Charles-Bonnet syndrome experience persistent


or recurrent complex visual or auditory hallucinations
however generally have full insight into their condition

Lying or exaggerating for financial gain is malingering, for


example someone who fakes whiplash after a road traffic
accident for an insurance payment

PTSD management - trauma-focused cognitive behavioural


therapy or EMDR
Erotomania (De Clerambault's syndrome) is the presence of a
delusion that a famous is in love with them, with the absence
of other psychotic symptoms

Haloperidol - dopamine D2 receptor antagonist, blocking


dopaminergic transmission in the mesolimbic pathways

Chlordiazepoxide or diazepam are used in the treatment of


delirium tremens/alcohol withdrawal

Unexplained symptoms

• Somatisation = Symptoms
• hypoChondria = Cancer

Cotard syndrome is characterised by a person believing they


are dead or non-existent

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy