Cours 6 : Mental Illness and Mental Health Care, Part II

Transcription

1 UE1-Anglais Pr. Bernier Le 14/12/2017 à 8H 30 Ronéotypeur : Roxane BIDAUD Cours 6 : Mental Illness and Mental Health Care, Part II 1 /8

2 Sommaire I) Chapter I: Mood Disorders, depression and Bipolar Disorder 2. Fill the blanks 3. Reading comprehension 4. True or False 5. Case study II) Chapter II: The causes of schizophrenia 2. Reading Comprehension 3. True or False III) Chapter III : Schizophrenia, symptoms & diagnosis 2. Fill the blanks 3. Reading Comprehension 4. True or False IV) Chapter IV: Schizophrenia, prognosis & treatment 2. True or false 4. Recap 2 /8

3 I) Chapter I: Mood Disorders, depression and Bipolar Disorder An affective disorder marked by alternating episodes of mania and depression Maniac Depressive illness : La psychose maniacodépressive, maniaque dépressive Not aware Unconscious/unaware : Inconscient, ignorant de To remove from consideration, exclude Rule out : exclure (comme possibilité) 2. Fill the blanks (p 3-4 du polycopié) 1 er blanc : elation 2 ème blanc : affective disorders 3 ème blanc : elation 4 ème blanc : unipolar disorders 3. Reading comprehension Compare the prevalence of depression and bipolar disorder Explain the symptoms of depression The prevalence for depression is most important than the prevalence of bipolar disorder. Number one is anxiety disorder, number 2 is depression. 10% of unipolar disorders (depression), only 2% for bipolar disorders Feeling of intense sadness, it may follow a recent loss or other sad event but it s out of proportion to that event and persists beyond an inappropriate lenght of time Symptoms are: sadness, decrease of pleasure, changing appetite, insomnia, anxiety, isolation, trouble concentrating, recurrent thoughts of death, hopelessness 4. True or False -Unipolar disorders are anxiety disorders whereas bipolar disorders are mood disorders : FALSE Both are mood disorders -Unipolar disorder is more common than bipolar disorder : TRUE Unipolar=10% of prevalence, Bipolar=2% of prevalence -Patients with mania or depression are frequently unaware of their conditions : TRUE 10% of the people who see their doctor for what they think is a psysical problem are usually experiencing depression 5. Case study (p7/23 sur le polycopié) Denis s medical history Cause of his relapse Symptoms Treatment Results of treatment Anxiety dating back to childhood Financial setbacks (problem) Depression, no suicidal ideation, drink alcohol heavily, unsucessful to cut down Stop Lorazepam because of its interaction with alcohol Counseling and monitoring Anti-psychotic (not function) Selective Serotonine Reuptake Inhibitors Work Well 3 /8

4 True or false? -Dennis s physician stopped his treatment with lorazepam because it was not longer effective against his anxiety : FALSE Because of the risk of interaction between Lorazepam and alcohol II) Chapter II: The causes of schizophrenia A group of psychotic disorders usually characterized by withdrawal from reality, illogical patterns of thinking, delusions, and hallucinations, and accompanied in varying degrees by other emotional, behavioral, or intellectual disturbances. The disease often associated with dopamine imbalances in the brain and defects of the frontal lobe, may have an underlying genetic cause A chronic degenerative disease of the central nervous system in which gradual destruction of myelin occurs in patches throughout the brain or spinal cord or both, interfering with the nerve pathways and causing muscular weakness, loss of coordination, and speech and visual disturbances It occurs chiefly in young adults and is thought to be caused by a defect in the immune system that may be of genetic or viral origin To set off ; initiate To fire or explode (a weapon or an explosive charge) Schizophrenia : la schizophrénie Multiple Sclerosis/La sclérose en plaque Trigger :déclencher 2. Reading Comprehension (p 9 du polycopié) The causes of schizophrenia. Parental or family responsibility Sex ratio and onset of schizophrenia Its consequences The causes of schizophrenia are biological and environmental : mother infant blood type, influenza infection during the 2 nd trimester of pregnancy, oxygen deprivation at birth Sex ratio seems equal. The onset is 18 for males and 25 for females Consequences are social difficulties, difficulty to keep a job and on care for oneself. Risk to be homeless 3. True or False -Schizophrenia is caused by a mentally unhealthy environment : FALSE It s worsened or triggered by a mentally unhealthy environment but it s not the cause 4 /8

5 -Living in an urban environment is a serious risk factor for schizophrenia: TRUE You have more cases in cities, access to doctors are less difficult to diagnosis, more stress, easily access to drugs -Despite the fact that a significant percentage of people with schizophrenia have been found to use substances, a clear causal connection between substance abuse and schizophrenia is difficult to establish : TRUE In some cases, drugs trigger schizophrenia Or schizophrenia can lead to drugs abuse III) Chapter III : Schizophrenia, symptoms & diagnosis Reduction in stenght, value or quality A false beliefregarding the self or persons or objects outside the self that persists despite the facts and occurs in some psychotics states The delusion that thoughts have been «taken out» of the patient s mind. It often accompanies thought blocking. The patient may experience a break in the flow of their thoughts believing that the missing thoughts have been withdrawn from their mind by some outside agency. This delusion is one of Schneider s first rank symptoms for schyzophrenia Impairment: une détérioration, un affaiblissement, une diminution Delusion: un délire Thought insertion : l insertion ou le retrait de pensées, le délire d influence 2. Fill the blanks (p 11) 1 er blanc: Positive symptoms 2 ème blanc: Negative Symptoms 3 ème blanc: Cognitive Impairment 3. Reading Comprehension The difference between delusions and hallucinations The difference between «positive» and «negative» symptoms Delusions are irational believes (Hands up they want to fly Hallucinations are perceptions that are not real (voices that are not there) «Positive»are something that are additional to normal experience : delusion, hallucination, «Negative» are loss or absence of certain behavior or emotion (Schizophrenia, anhedonia, asociality) 4. True or False -Poverty of speech is a sign of disorganized thinking : FALSE Poverty of speech is a negative symptoms They are different disorganized thinking is more positive -The schizophrenic patient can identify the onset of his disease: FALSE They have difficulties to be releable 5 /8

6 -Another name for «multiple personality disorder» (MPD) is schizophrenia: FALSE Schizophrenia you can hear voices but you don t become someone else -Symptoms of schizophrenia include delusions, hallucinations, and blunted affect : TRUE ` IV) Chapter IV: Schizophrenia, prognosis & treatment Willingness to follow a prescribed course of treatment To fall or slide back into a former state. To regress after partial recovery from illness Adherence, compliance : l observance Relapse : une rechute 2. True or false -Without drugs, the relapse rate for schizophrenia within the first year is about 70-80% :TRUE % of patients with schizophrenia are not compliant with their prescribed drug therapy because their memory problems :FALSE It s 50% -Generally, the goal of psychotherapy is to eliminate symptoms in order to improve the patients quality of life: FALSE It s to improve the patient quality of life -Jack s case provides an example of the benefits of desinstitutionalization: FALSE Positive: own apartment, a job, social interaction Negative: relapse rate was hight, doesn t have a girlfriend, money issue, afraid of becoming overwhelmed 4. Recap (p 16) -Patient who are «deinstituionalized» : a and e Can live with their family May become non-compliant -Family therapy aims to: c Improve communication Improve compliance -Diagnostic categories of mental illnesses are based on : a and d The course of the illness Descriptions of speech and behavior -Different anxiety disorders include: b and e -«Unipolar» disorder refers to: c -Patients with schizophrenia frequently have: a, d, e -Match the following categoriesof drugs with the illnesses they are use to threat : Selective serotonin reuptake inhibitors (SSRIs) Depression D2 (dopamine) receptor antagonists Psychotic disorders (e.g schyzophrenia) GABA receptor agonists Anxiety disorders Mood stabilizers Mania Depressive illness 6 /8

7 -Use the examples in the second column to describe each of the following approaches to psychotherapy Dynamic psychotherapy Cognitive-behavioral therapy (CBT) Behavioral therapy Interpersonal therapy Understanding unconscious sources of conflict and early childhood experiences Developing awareness of thoughts and feelings, testing unrealistics assumptions and beliefs Unlearning conditioned behaviors and learning new behaviors through observation and role playing Understanding relationships and modifying communication strategies 7 /8

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