Mental Status Exam
...
Brain Scans including CT scan, PET scan, MRI, SPECT
PET- detects alzheimersMRI- detects frontotemporal dementiaCT-magneticSPECT-nuclear imaging uses radioactive
delirium and dementia
dementia is a deterioration of cognitive function- it's death of the brain over timeimpaired social and occupational functioneither mild or major depending on your ability to live alonedelirium- a state of mental confusion-temporary, typically due to drugs or an injury
alzheimers
death of brain tissue that normally kills the person in 12 yearsmarked by no short term memory and irritability and depressionlots of plaques(frontal crotex) and neurofibrillary tangles(hippocampus)79% heritability ApoE4 allele and chromosome 19
strokes
can cause vascular dementia, a series of strokes increases the chances
tumors
can cause headaches, memory loss etc. 1st signs are often psychological- mimic depression or anxiety in limbic system
parkinsons
tremors, rigidity, shuffling walk, loss of control of speech and facial expressiondestruction of the substantia nigra in the basal gangliacaused by pesticides deficit in dopamine-so sometimes a dopamine pump is used
Huntington's korea
Chorea is an abnormal involuntary movement derived from the Greek word "dance". It is characterized by brief, abrupt, irregular, unpredictable, non-stereotyped movements. In milder cases, they may appear purposeful; the patient often appears fidgety and clumsy.
pick's disease
pick bodies in neurons, leads to frontotemporal dementia(which is the one that makes you crazy rude)
General paresis
problem with mental function due to damage to the brain from untreated syphilis.Abnormal mental function including hallucinations and false ideas (delusions)Brief, sharp, "lightning" pains that occur with tabes dorsalisDecreased mental functionEye changes and abnormal pupil responseMood changesOveractive reflexesPersonality changesSpeech changes
encaphalitis
inflammation of the brain tissue by viruses-can cause dementia
pellagra
Pellagra is classically described by "the three Ds": diarrhea, dermatitis, dementia.a vitamin deficiency disease most frequently caused by a chronic lack of niacin (vitamin B3 or synonym: vitamin PP (from: Pellagra Preventing factor)) in the diet. It can be caused by decreased intake of niacin or tryptophan,[1] and possibly by excessive intake of leucine
meningitis
inflammation of covering membranes by bacteria-can cause dementia
korsakoff's
Korsakoff syndrome is a chronic memory disorder caused by severe deficiency of thiamine (vitamin B-1). Korsakoff syndrome is most commonly caused by alcohol misuse, but certain other conditions also can cause the syndromeKorsakoff syndrome is often, but not always, preceded by an episode of Wernicke encephalopathy, which is an acute brain reaction to severe lack of thiamine. Wernicke encephalopathy is a medical emergency that causes life-threatening brain disruption, confusion, staggering and stumbling, lack of coordination, and abnormal involuntary eye movements
What are personality disorders?
longstanding, pervasive, inflexible, extreme, and persistent patterns of behavior and inner experienceunstable positive sense of selfunable to sustain close relationships
What are the controversies/difficulties in diagnosing them?
low diagnostic reliability and high comorbidity- the people who have them also rarely think anything is wrong, so they're hard to treat because they're so ingrained
Where is the most bias regarding diagnosis of personality disorders?
women
What personality disorders existed in DSM-IV but are discontinued in DSM-5? Know the basics descriptions of them and any controversies/difficulties with them.
Passive-aggressive PDSelf-destructive PDSadist PDDepressive PD
Legal and civil commitment
civil commitment- a set of procedures by which a person who is deemed mentally ill and dangerous but who has not broken a law can be deprived of liberty and placed in a psychiatric hospitallegal- a procedures that confines a person in a mental hospital either for determination of competency to stand trail or after acquittal by reason of insanity
Predicting dangerousness
most accurate when:there is past violence is the violence is in the distant past, then they were in trouble, and nothing changed, they'll do it againif they're on the brink of a violent act(holding a gun)
Patient's rights
least restrictive alternativeright to treatmentright to refuse treatment
Insanity defense and its legal bases
the legal argument that a defendant should not be held responsible for an illegal act if it is attributable to mental illness or intellectual disability that interferes with rationality or that results from some other excusing circumstance
Guilty but mentally ill verdict
the person can be found legally guilty of a crime, and the person's mental illness plays a role in how they are dealt witheven a seriously ill person can be held morally and legally responsible and be committed in a way that makes sense for them
Wyatt v. Stickney, 1972
right to treatment came out of it- the judge ruled that treatment is the only justification for the civil commitment of people with mental illness to psychiatric hospital- then only 250 patients per dr, and overall made rules about conditions
O'Connor v. Donaldson. 1975
a man sued twp hospital state doctors who had kept him in the hospital for 14 years without treatment
Youngberg v. Romeo, 1982
decided that it was up to the dr to decide if restraints were required. weakened Wyatt
Ethical issues in relation to sexual intimacies with clients
...
Competency to stand trial
must be decided before they can decide is they're responsible
Tarasoff and duty to warn
if you know that someone is at risk, you have to let them know
Issues relating to homelessness
...
Levels of prevention
...