MENTAL HEALTH SUMMARIES
MENTAL HEALTH SUMMARIES
## **Mental Health Psychiatry Quick Summary**
### **Eating Disorders**
Eating disorders are mental disorders characterized by severe disturbances in eating behaviors.
#### **Causes**
- **Genetic factors**: Family history of eating disorders.
- **Occupational stress**: High-pressure environments.
- **Social and cultural factors**: Societal pressure to conform to certain body standards.
- **Physical and psychiatric conditions**: Depression, body dysmorphic disorder.
---
### **Anorexia Nervosa**
Anorexia nervosa is an eating disorder characterized by refusal to maintain a minimal normal body weight for height and age.
#### **Diagnostic Criteria**
- Symptoms persist for at least 6 months.
- Refusal to maintain minimal normal body weight.
- Preoccupation with body image, size, and weight.
- Distorted perception of body size and weight.
- Post-menarche individuals may develop amenorrhea (absence of menstruation).
#### **Classification/Types**
1. **Restrictive Anorexia Nervosa**:
- Maintains body size through dietary restriction, fasting, or excessive exercise.
2. **Binge/Purging Anorexia Nervosa**:
- Maintains body size through compensatory mechanisms like self-induced vomiting, enemas, or diuretics.
#### **Clinical Features**
| **Psychological** | **Physical** | **Behavioral** |
|---------------------------------|----------------------------------|------------------------------------|
| Emotional lability | Lethargy | Frequent weighing |
| Low self-esteem | Amenorrhea | Excessive talking about food |
| Social isolation | Poor skin conditions | Reading recipes |
| Depression | Dehydration | Cooking for others |
| Obsessive-compulsive behaviors | Abdominal bloating | Lying about eating |
| | | Hiding food |
| | | Drinking excessive water |
#### **Management**
- **Restore body weight**: Consult a nutritionist for a balanced diet plan.
- **Chemotherapy**: Use antidepressants like fluoxetine.
- **Psychotherapy**:
- Cognitive Behavioral Therapy (CBT).
- Family counseling.
- Group therapy.
---
### **Bulimia Nervosa**
Bulimia nervosa is an eating disorder characterized by episodes of binge eating followed by compensatory mechanisms to maintain body weight.
#### **Diagnostic Criteria**
- Binge eating: Consuming large amounts of food in a short period with a sense of lack of control.
- Compensatory mechanisms: Vomiting, fasting, excessive exercise, or use of laxatives.
- Symptoms occur at least twice a week for 3 months.
- Preoccupation with body image, size, and weight.
- Bulimia nervosa should not co-occur with anorexia nervosa.
#### **Clinical Features**
| **Psychological** | **Physical** | **Behavioral** |
|---------------------------------|----------------------------------|------------------------------------|
| Emotional lability | Lethargy | Frequent weighing |
| Low self-esteem | Tooth enamel erosion | Use of laxatives/enemas |
| Social isolation | Amenorrhea | Disappearing after meals |
| Depression | Poor skin conditions | Calluses on fingers (from vomiting)|
| Anxiety | Dehydration | Moving food around the plate |
| | Abdominal bloating | |
#### **Types**
1. **Purging Bulimia Nervosa**:
- Compensatory mechanisms include vomiting, laxatives, or diuretics.
2. **Non-Purging Bulimia Nervosa**:
- Compensatory mechanisms include fasting or excessive exercise.
#### **Management**
- **Restore body weight**: Consult a nutritionist.
- **Chemotherapy**: Use antidepressants like fluoxetine.
- **Psychotherapy**:
- Cognitive Behavioral Therapy (CBT).
- Family counseling.
- Group therapy.
---
### **Sleep Disorders**
Sleep disorders involve disturbances in the amount, quality, or timing of sleep.
#### **Physiology of Sleep**
- **Non-Rapid Eye Movement (NREM)**: Lower brain activity.
- **Rapid Eye Movement (REM)**: Brain activity similar to being awake.
#### **Stages of NREM Sleep**
| **Stage** | **Arousal** | **Vital Signs** | **Other Activity** |
|-----------|---------------------------|---------------------------|-----------------------------------|
| 1 | Easily aroused | Normal | Sweating, myosis, loss of skin response |
| 2 | Transition | Slight drop | Sweating, myosis, loss of skin response |
| 3 | Difficult to arouse | Dropping | Sweating, sleep terrors, sleepwalking |
| 4 | Difficult to arouse | Dropping | Sweating, sleep terrors, sleepwalking |
#### **Functions of Sleep**
- Restorative.
- Energy conservation.
- Thermoregulation.
- Homeostasis.
#### **Effects of Sleep Deprivation**
- Depression.
- Ego disorientation.
- Delusions.
- Hallucinations.
#### **Sleep Requirements**
- Newborn baby: 13–17 hours.
- 2-year-old: 11–13 hours.
- Adult: 6–9 hours.
- 10-year-old: 10–11 hours.
---
### **Classification of Sleep Disorders**
1. **Dyssomnias**:
- Disorders involving deficits in the amount, quality, or timing of sleep.
- Types:
- Sleep apnea.
- Primary insomnia.
- Primary hypersomnia.
- Narcolepsy.
2. **Parasomnias**:
- Disorders involving abnormal behaviors during sleep.
- Types:
- Night terrors.
- Nightmares.
- Sleepwalking.
- Sleep talking.
- Bruxism (teeth grinding).
---
### **Puerperal Psychotic Disorders**
Puerperal disorders are mental disorders that occur within 6 weeks after delivery.
#### **Causes**
- **Biological**: Hormonal imbalances, obstetric complications.
- **Psychological**: Previous history of mental disorders, life events like bereavement.
- **Sociological**: Lack of support, marital problems.
#### **Types**
1. **Baby Blues**:
- Occurs 4–5 days after delivery.
- Symptoms: Irritability, tearfulness, emotional lability.
- Management: Support and counseling; no medication required.
2. **Postnatal Depression**:
- Occurs 2–4 weeks after delivery.
- Symptoms: Low mood, insomnia, fatigue, suicidal thoughts.
- Management:
- Biological: SSRIs (e.g., fluoxetine), TCAs (e.g., amitriptyline).
- Psychological: CBT, family counseling.
- Sociological: Resolve marital conflicts.
3. **Puerperal Psychosis**:
- Occurs 1–3 weeks after delivery.
- Symptoms: Hallucinations, delusions, agitation, suicidal or infanticidal thoughts.
- Management:
- Biological: Antipsychotics (e.g., risperidone).
- Psychological: Family counseling, CBT.
- Sociological: Involve social welfare for support.
---
### **Personality Disorders**
Personality disorders are enduring patterns of inner experience and behavior that deviate from cultural expectations.
#### **Classification (DSM-IV)**
- **Cluster A**: Paranoid, schizoid, schizotypal.
- **Cluster B**: Antisocial, borderline, histrionic, narcissistic.
- **Cluster C**: Avoidant, dependent, obsessive-compulsive.
#### **Management**
- **Psychotherapy**: CBT, environmental manipulation.
- **Medication**: Antidepressants, antipsychotics for comorbid conditions.
---
### **Epilepsy/Seizures**
Epilepsy is a neurological disorder characterized by recurrent seizures.
#### **Stages of Seizures**
1. **Pre-Ictal Stage**: Early signs like mood changes, epigastric discomfort.
2. **Ictal Stage**: Tonic-clonic movements, loss of consciousness.
3. **Post-Ictal Stage**: Confusion, fatigue, headache.
#### **Management**
- **Acute Management**: Diazepam, phenobarbital.
- **Long-Term Management**: Carbamazepine, sodium valproate.
---
### **Mental Retardation**
Mental retardation is characterized by subaverage intellectual functioning and limitations in adaptive behavior.
#### **Causes**
- **Biological**: Infections, malnutrition, head injuries.
- **Psychological**: Abuse, low self-esteem.
- **Sociological**: Lack of support, stigma.
#### **Management**
- **Primary Prevention**: Improve socioeconomic conditions, genetic counseling.
- **Secondary Prevention**: Early detection and intervention.
- **Tertiary Prevention**: Rehabilitation, vocational training.
---
### **Anxiety Disorders**
Anxiety disorders involve excessive fear or anxiety that interferes with daily functioning.
#### **Types**
1. **Generalized Anxiety Disorder (GAD)**.
2. **Panic Disorder**.
3. **Phobic Anxiety Disorder**.
4. **Obsessive-Compulsive Disorder (OCD)**.
#### **Management**
- **Biological**: SSRIs (e.g., fluoxetine), benzodiazepines.
- **Psychological**: CBT, exposure therapy.
---
### **Psychotropic Drugs**
Psychotropic drugs are used to manage mental disorders.
#### **Classification**
1. **Antipsychotics**: Haloperidol, risperidone.
2. **Antidepressants**: Fluoxetine, amitriptyline.
3. **Mood Stabilizers**: Lithium, sodium valproate.
#### **Side Effects**
- **Antipsychotics**: Extrapyramidal symptoms, tardive dyskinesia.
- **Antidepressants**: Weight gain, sexual dysfunction.
---
### **Community Psychiatry**
Community psychiatry focuses on providing mental health services in community settings.
#### **Roles of Clinical Officers**
- Consultative, clinical, therapeutic, educational, and advocacy roles.
- Promote mental health awareness and early intervention.
#### **Levels of Prevention**
1. **Primary Prevention**: Mental health promotion.
2. **Secondary Prevention**: Early detection and treatment.
3. **Tertiary Prevention**: Rehabilitation and reducing residual effects.
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