Mental Health new material

2 + present for 1 month unless disrupted by tx

must have symptoms for 6 months with 1 month of psychosis

Delusions

Hallucinations (illusions)

Disorganized speech

Disorganized/catatonic behavior

negative affect symptoms

-flat; alogia;avolition;anhedonia

limited speech interaction

lack of desire or emotion

lack of insight/awareness

phobias/odd manors/ritualistic

diag. code is based on the subtype

lower life expectancy-20-40% make 1 attempt

starts between adol. and mid thirties

women start later than men-

substance abuse

anxiety d/o

increased tendency towards violence

decreased volumes of grey and white matter

grey matter losee

-early onset

-drug triggers

Genetic predisposition

-1st degree relatives

Schizo.

Persistant

chronic

may be progressive

full remission is rare

preoccupation with delusions and or frequent auditory hallucinations

-grandiose

-persecutory

DOES NOT HAVE:

disorganized speech/behavior

catatonic behavior

flat/innappropriate affect

2 +

motoric immpbility

excessive motor activity

extreme negativitism

peculiarities of voluntary movement

echolalia - repition/mimic of speech

Echopraxia - repition/mimic of movement

Psychosis without meeting the criteria of:

-paranoid

-disorganized

-catatonic

identical to schizophrenia

-does not have to include impairment in occupational/social performance

-diag. usually provisional

meet the criterion for schizophrenia in adddition to having one or more:

Major depressive

Manic

Mixed episode

-remissive episodes w/ mood symptoms

must have psychosis for 2 weeks w/o mood symptoms

bipolar type

depressive type

Non bizzare delusions - situations could occur in real life

schizo. criteria are NOT MET

behavior/interactions not impaired

Erotomatic type- someone of higher status is in love with them

Grandiose type- inflated worth

Jealous type - sexual partner unfaithful

Somatic type- has a physical defect or diagnosis

Mixed type- 1 + above

psychosis

1 day to one month with eventual return to premorbid level of fx

with marked stressors

without marked stressors

post pardum onset- within 4 weeks of delivery

starts with hospitalization during an acute severe psychotic episode

-drastic decompensate in fx abilities

-goal is usually to stabilize with rx

*psychotripic rx (direct affect on brain)

*antipsychotic drugs-limited dopamine uptake

educationon disorder and medication compliance

goal setting

acceptance of an ongoing need for services

GOAL IS TO STABILIZE psychosis

group work is the most common ot treatment approach

-strutured tasks

-expressive activities

-functional living skills

-psychoeducation

-social skills training

-voccational training

1. substance use disorders

-dependance

-abuse

2. Substance induced disorders

-intoxication

-withdrawal

-delirium

-persisting dementia

-persisting amnesia

-psychosis

mood d/o

anxiety d/o

sexual disfunction

sleep d/o

tolerance, Withdrawal, taken for longer periods of time than intended, persistent desire, noability to cut down use, time devoted to obtain drug to limit withdrawal, acitivites given up for use, use is continued despite knowledge of maladaptive beha

with/without psychological dependance

early full or partial remission

sustained full or partial remission

agonist therapy - drug has been with drawn completely or now use diff. drug

controlled environment

Pattern of substance use leading to impairment within a 12 month period w/

substance use resulting in failure to meet obligations

substance use in situations that might be hazardous

substance related legal problems

substance related social issues

substance intoxication

substance withdrawal

Type of substance induced disorder

development of reversable substance related syndrome due to exposure substance

-physiological

-psychological

drug dependant signs and symptoms

type of substance induced disorder

occurs when phsyical and physiological distress occurs when a drug is withdrawn or no longer available

starts w/ disruption of use

depends on type of drug, length of use, tx philisophy

relapse is common

interaction between social and interpersonal factors leads to use

treatments aimed t coping strategies, routines, healthy balance among occupations (time management)

Drug dependence is a disease of the mind, spirit and body

tx includes a process of : meeting, sponsorship, spirituality, engagment/interaction

OTS lead or organize these events

psychological conflicts lead to drug use, usually unmet needs from family interaction, substance abuse is a PREFERRED DEFENCE STRUCTURE

interventions promote- healthy coping strategies and developing insight into conflictus

behavior created through a process of change

five steps to create a behavioral change

1. precontemplation

2. comtemplation

3. preperation

4. action

5. maintenance

substance use is a set of activities and replace other occupations of valuse in ther persons life

tx aimed at:  introduction and replacement of valued occuaptions into the persons life

Lessen the negative impact from use

tx aimed at: identifying negative consequences

reduction strategies from use - DD contracts

- may not include stopping use

Reinforcement for sobriety

punishment from use

advocate

tx aimed at helping client choose supportive and reinforcing tx environments for sobreity

DSM- IV:

anorexia

bulimia

DSM- V:

will likely include obesity

including failure to thrive

Refusal to maintain healthy body weight for stature

intense fear of gaining weight

disturbance in perception about weight shape or size

women - amenorrhea (no period for 3 cycles)

two types:

1. restricting type

2. binge/purging

Recurrent episodes of binge eating

-discrete period of time

-lack control

innappropriate compesatory actions to prevent weight gain

-purging

-laxitivies

-excessive exercise

both occur at least twice a week for 3 months

broader umbrella of addiction

addiction is a persistance, compulsive dependence on a substance or behavior

-substance abuse

*alcohol & drug

-process addiction

*eating & Gambling

All have anxiety they need to control

Dependent on target of addiction

Theoretical approach believed

Aim at altering behavior and or treating the underlying cause

DSM- IV - 6 disorders

impulse controle issue not necessarily addictive behavior

-intermittent explosive d/o

-impulse control d/o not otherwise spec.

failure to resist stealing

-stealing is not designed to express anger or vengeance and is not a response to psychosis

-addicitive behavior

*build up of tension prior to theft which is released upon theft

*theft provides pleasure

Deliberate, purposeful, and repeated fire setting which includes a obsession or fascination with fire and or the consequences of fire

Addictive behavior

Preoccupation with gambling

as disorder persists there is a need to increase gambling stakes to achieve desired excitement

unable to control, cut down, stop

used to escape other problems/inflate mood

gambles again to catch even after lose

pulling out ones hair so there there is noticable hair loss

addictive behavior

anxiety

involve branch offs of other addictive treatments

also anxiety tx

most effective combinatioins of both

*time management etc.

Repeated discrete episodes of aggressive behaviors that result in serioes assaults and or destruction of property

*discrete- defined period of time

-Degree of aggression is almost always out of proportion to the precipitating factor or stressors

anger management technique

-cog. behavioral technique- matching response to precept

family counseling

-belief that much of the behavior is learned

*relaxation training,r ole playing

RX: antidepressants

development of emotional and or behavioral symptoms and signs in response to an identifiable stressor (beginning within 3 months of the stressors and lasts 6 months)

doesnt mark another axis 1 or 11 disorder or is not accounted for by bereavement

1. acute

2. chronic

Subtypes:

w/ depressed mood, w/ anxiety, w/mixed anxiety and depressed mood, w/ disturbances of conduct, w/ mixed disturbances of emotions and conduct

coping strategies

anxiety meds.

some start or have bases events in infancy

increasing acceptance that almost all psychiatric disorders can occur at any age

DSM IV

IQ = or below 70

concurrent deficits in adaptive age approp. fx

Mild: 50-70/MOD: 50-70/ Severe: 20-40/profound:below 20

must be diagnosed in childhood and usually occurs in infancy

NOT progressive

children dont learn

pre imposed cap on learning

children with MR DO develop slower, and learn differently

Physical d/o - disease process (early meningitis)

genetic syndromes

early insult/injury

at risk with presence of severe poverty in nutrition, developmental stimuli

untreated jaundice

associated w/ CP

inntensity

timing

duration

achievement in a specified academic area is substantially below typical for age, school experience, IQ

-2 s.d. between IQ and achievement in diagnosed area

1. reading disorder

2. mathmatics disorder

3. disorder or written expression

4. learning d/o not spec.

disorder that affects an individuals ability to read and write and can involve:

word fluency issues

articulation issues

comprehension issues

-ability to turn written images into understandable language

developmental coordination disorders

motor coordination is substantially below age and intelligence expectations

disturbance in ADLS and/or achievement in academics

1. expressive language disorder

2. mixed receptive-expressive language d/o

3. phonological disorder

4. stuttering

5. not otherwise spec.

below age appropriate with:

vocabulary

sentence production and/or appropriate sentence structure

interferes with social and or academic performance

expressive language disorder combined with difficulty in understanding:

words

sentences

types of words

spatial terms

specific topics

formally called developmental articulation disorder

incorrect production or replacement of sounds for age with respect to culture and dialect

causes difficulties socially or academically

most common letter sounds: l, r, s, th, ch

disturbance in fluency during the production of words which includes:

-sound and syllable repetition

-sound prolongations

-interjections

-broken word production

usually begins between 2-7 years

severe and pervasive impairment in several areas of development

1. autistic

2. rhetts syndrome

3. childhood disintergrative disorder

4. aspergers disorder

Autistic/ aspergers/not otherwise spec.

less accpeted because seen as oingoing progressive: rhetts syndrome and childhood disintergrative disorder

6 + symptoms with at least 1 from each broad topic

delay must have started in one area prior to age 3

generally not seen as progressive

disagreement among ongoing progression and sudden abrupt changes

2 +

impairment in nonverbal interaction

failure to develop peer relationsihps

lack of spontaneous seeking to share interests, enjoyment, and achievement

lack of social and or emotional reciprocity

May have 1 or 2 social relationships

no spoken language development

stereotyped, repetitive, and or idosyncratic use of language

lack of varied, spontaneous social imitative or make-believe play

individuals CAN communicate expressive and or receptively

Restricted and preoccupying patterns of interests

inflexible adherance to routines and or rituals

stereotyped and or repetitive movement patterns

impairment in sociall interaction in 2 +

use of nonverbal behaviors

development of peer relationships

seeking and shairing enjoyment and achievement

social and or emotional reciprocity

*same repitivie and stereotyped behaviors as autism

neurological disorder

occurs in females mostly

normal birth and development with sudden change in develoment between 5 and 48 months

no cure

genetic

deceleration of head growth

loss of previously aquired purposful motor skills

loss of social interaction

expressive and receptive language loss

1. early onset phase

2. rapid destructive stage

3. plateau phase

4. late motor deterioration phase

late onset autism

hellers syndrome

disintergrative psychosis

*believed to have a neuro. basis

*progression of losses more common than with autsim

*lesion

Normal development for many years (at least till age 2) with a sudden (over several months) loss of skills in:

language

social interaction

non verbal communication

play

motor skills

physical skills such as bowel and bladder control