Mental Health across the lifespan

Question 1

Impact of mental health disorders on life expectancy?

Answer 1

Bipolar; reduction between 9-20 years
Schizophrenia; reduction between 10-20 years
Drug and alcohol abuse; between 9-24 years
Recurrent depression; between 7-11 years

Question 2

When does depression tend to start?

Answer 2

Peak age of onset; 13-15 years

Early adulthood

Question 3

What is the peak age of onset of BAD?

Answer 3

16-20 years

Question 4

Different types of bipolar affective disorder?

Answer 4

Type 1 
Type 2 
Mixed
Rapid cycling
Ultrarapid cycling
Cyclothymic

Question 5

At what age can you diagnose personality disorders?

Answer 5

After age 18

Question 6

Common illnesses in childhood and adolescence?

Answer 6

ADHD

ASD

Question 7

When is separation anxiety considered normal?

Answer 7

Age 7 months through preschool years

Question 8

What are disruptive behaviours called in those under 12?

Answer 8

Oppositional defiant disorder

Question 9

What are disruptive behaviours called in those over 12?

Answer 9

Conduct disorder

Question 10

What is a common presentation of trauma and attachment disorders?

Answer 10

PTSD type symptoms (anger, avoidance)
Oppositional behaviours
Quasi psychotic symptoms
High co-mob with other mental illnesses

Question 11

What are presentations seen in primary age children that tend not the be related to a mental illness?

Answer 11

Developmental appropriate anxiety (stranger, separation, specific phobia) 
Hyperactivity and short attention span
Grandiose ideas and overtalkativeness
Imaginary friends
Intense interest
Onset of non impairing tics

Question 12

What are presentations seen in secondary age children that tend not the be related to a mental illness?

Answer 12

Mood swings
Sullenness, withdrawal, irritability
Sleep changes
Peer pressure influencing thoughts (superficial self harming, voicing suicidal thoughts without features of mental illness)
Rituals and OCD type behaviour
Intrusive thoughts and pseudohallucinations

Question 13

Who should be involved in the treatment of children and young adults with mental disorders?

Answer 13

Mental health team from an MDT approach
Family (therapy, parenting courses)
School
Social; child protection, children’s reporter

Question 14

What is puerperal psychosis?

Answer 14

Acute, sudden onset of psychotic symptoms, manic symptoms/disinhibition, confusion
Psychiatric emergency due to safeguarding issues
Presents between 2-4 weeks postpartum

Question 15

Risk factors for puerperal psychosis?

Answer 15

Previous thyroid disorder
Previous episode
Family history 
First pregnancy
C-section 
Perinatal death

Question 16

How many women experience postnatal depression?

Answer 16

1 in 10 women

50-75% of women will experience a short lived postnatal blues

Question 17

Onset of postnatal depression?

Answer 17

1-4 weeks postpartum

Question 18

Risk factors for postnatal depression?

Answer 18

Family or personal history of depression or anxiety
Complicated pregnancy
Traumatic birth 
Relationship difficulties
History of abuse/trauma
Lack of supprort
financial difficulties

Question 19

Characteristics of delirium?

Answer 19

Acute onset
Hours to weeks
Fluctuates (worse at night(
Attention decreased or hyperalert

Question 20

Causes of delirium?

Answer 20

I WATCH DEATH:
Infections: UTI, pneumonia, encephalitis
Acute: electrolyte disturbances, dehydration, acidosis/alkalosis, hepatic/renal failure, Toxins/drugs; opiates, aspirin, indomethacin, dilantin
CNS pathology; stroke, TIA, tumours, seizures, haemorrhage, infection
Hypoxia; anaemia, pul/cardiac failure, hypotension
Deficiencies; thiamine, B12
Endocrine; thyroid, hypo/hyperglycemia, adrenal dysfunction, hyperparathyroid
Acute vascular shock; hypertensive encephalopathy
Trauma; head injury, post-op, hypo/hyperthermia
Heavy metals; lead, mercury, manganese

Question 21

What is pseudodementia?

Answer 21

Fluctuating loss of memory
Vagueness
Good insight into memory loss
Depressed mood
Not progressive
Frequent "I don't know" answers
Responds to medication/ ECT

Question 22

Risk factors for late onset depression?

Answer 22

Genetic susceptibility
Life events
Social factors (loneliness, financial hardship)
Poor physical health (esp vascular disease)