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Psych Misc

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imo132's version from 2016-11-21 02:00

Section

Question Answer
Section 19Brought in by doctor
Section 20Brought in by ambulance
Section 22Brought in by police
Sick roleExempt from social responsibilities, own their condition but are excluded from society, in undesirable state, obliged to comply with Rx
GGTSensitive marker of EtOH abuse, not specific, raised in 30% harmful drinkers, 50% dependent, 2 week half life, alcohol most common elevator
CDTCarbohydrate-deficient transferrin, specific marker of EtOH use, only 60% sensitive, 2 week half life, raised in pregnancy, PBC
Antidepressant use2-4 weeks to start working, SE straight away, not addictive, can have alcohol, must completely treat episode to prevent relapse, don't cease suddenly
Increase in BDNFVia AD, lithium, ECT, CBT, exercise
Brain in depressionSmaller hippocampus & orbitofrontal regions due to poor neurogenesis & survival of neurons
AD use in depression6 months if brief first episode, up to 2 years if long first episode (years), lifelong if 3 previous episodes
AD ineffective after 1 monthIncrease dose, switch to more potent class, use lithium, atypical AP
Interpersonal therapy12-20 sessions in brief intervention, for grief, dispute, role transition, lack of relationships, effective in half
Psychodynamic therapy35% effective
MesolimbicFor pleasurable sensations, delusions & hallucinations
MesocorticalCognitive (DLPFC) & affective (VMPFC) symptoms
NigrostriatalFor motor function & movement
Capgras delusionPerson holds a delusion that a friend, spouse, parent has been replaced by an identical-looking impostor
Fregoli delusionA belief that different people are in fact a single person who changes appearance or is in disguise
Cotard delusionA belief that he or she is already dead, does not exist, is putrefying, or has lost his or her blood or internal organs
Yellow bileMania
Black bileDepression
PhlegmEpilepsy
WitchesObry, malleus maleficorum
DescartesEnlightenment
McNaughton's rulesIf you believed the act was lawful it was okay
Moral managementPinel, Connolly
MorelDegeneration theory
12 month MI rates20%
Lifetime MI rates40%
CBTFrom Epicteus, Ellis & Beck, 25% dropout
Avoidant/dismissivePseudo-independent attachment, becomes borderline personality, need to keep therapy going, difficulty coping between sessions
Traumatised patientsShow fragmented sentences, monosyllabic phrases, confused time scale, disconnection, dissociation, act as if experience is in present
Dismissive/avoidant attachment styleI have to do it myself, others are not helpful or reject me, I am shameful when needy, I minimize feeling, I focus on material success
Preoccupied/ambivalent attachment styleI can't do it myself as I am untrustworthy, others are unreliable, I feel anxious, angry, lost in memories, helpless
Disorganised attachment styleI can't do it, others will make it worse, helpers are frightening, I feel disconnected & confused & afraid
Avoidant/dismissive separationDon't seem to mind separation but HR & BP show stress
Ambivalent/preoccupied separationBecome distressed but don't settle on reunion, clinging attachment
Disorganised separationChild's behaviour incoherent, child is in dilemma, parent is frightening so child freezes, becomes aggressive
Polyvagal theoryFrom Porges, social soothing via myelinated PS vagal nerve, fight/flight via SNS activation, withdrawal/freeze via unmyelinated vagal nerve
Dismissing narrativeStory lacking detailed memories (idealising account) or conflicting memories via semantic memories
Preoccupied narrativeLacks semantic structure, lost in memory or angry affect, cannot progress with agency
Disorganised attachmentWith borderline personality, from fragile, depressed caregiver who becomes hostile & angry
Sleep restrictionUses sleep diary, avoid naps, same wake time, if sleep >90% increase time in bed by 15-30 min, if <85% decrease by same
CBT for sleepIf >30 min to fall asleep or >30 min awake during night for >3 nights/week, not due to illness, not in bipolar (sleep restriction induces mania)
Behavioural activation historyFrom Lewinsohn & Ferster
Mentally illMood disturbance, delusions, hallucinations, thought disordered, sustained irrational behavior, needs protection from serious harm (homicide, suicide, reputation), no less restrictive Rx
Mentally disorderedIrrational, require protection from physical harm, no less restrictive Rx
Biological factorsSLE, thyroid, roaccutane, champix
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