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Summary Mental Health Core Conditions

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A condensed summary of the mental health core conditions for the Leeds MBChB year 3 syllabus

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MENTAL HEALTH CORE CONDITIONS SUMMARY
Condition Summary Epidemiology Pathophysiology Prognosis Aetiology Risk Factors S/S Investigations DDs Treatment Complications

Stimulant effects of
Withdrawal; tolerance; Detoxification and Mallory-Weiss tears;
Increased tolerance to alcohol mediated by a
Chronic course; FHx of alcoholism; jaundice; ascites; supportive medical delirium tremens;
the effects of alcohol, dopaminergic pathway
relapse is Combination of genetic, anti-social social, economic, legal, Other psychiatric care; specialist seizures; alcohol liver
presence of withdrawal More common in projecting from the Diagnostic interview;
Alcohol symptoms and Western countries nucleus accumbens; common, though social, psychological behaviour; high psychological alcohol breath; ALT; disorder; other treatment; disease; cirrhosis;
dependence better with help and environmental anxiety; low problems; abdominal substance use psychosocial nutritional disorders;
impaired control over M>F repeated, excessive AST; FBC
from support factors responsiveness to pain; HTN; peripheral disorder interventions; Wernicke
quantity/frequency of alcohol intake sensitises
groups (e.g. AA) effects of alcohol neuropathy; broad- pharmacotherapy to encephalopathy and
drinking this pathway and leads to
based gait; flushing prevent relapse Korsakoff psychosis
dependence

Amyloid hypothesis:
Chronic, progressive
beta-amyloid
impairment of cognitive Cortical atrophy in the Genetics; trisomy Memory loss; Supportive treatment;
accumulates into dense
function with senile Most common temporal, frontal and 21; cerebrovascular disorientation to time environmental controls;
plaques causing MMSE; FBC; U&Es; Pneumonia;
Alzheimer’s plaques and neural type of dementia parietal areas causing Progressive disease; obesity; and place; nominal Delirium; cholinesterase
inflammation, neuritic LFT; TSH; vitamin institutionalisation; UTI;
loss; characterised by reduction in brain weight; decline with hyperlipidaemia; dysphasia; misplacing depression; other inhibitors; management
disease injury and cell death B12; CT/MRI head; falls and their
ADL impairment, Elderly and black cholinergic neurones are some plateaus low education; items; apathy; decline form of dementia of behavioural and
genetic testing complications
memory loss, and M<F damaged in the basal traumatic brain in ADLs; personality psychological
Tau hypothesis: tau
behavioural forebrain injury; smoking changes symptoms
proteins accumulate into
abnormalities
neurofibrillary tangles

Eating disorder and Low BMI; missing Bulimia nervosa; <18y/o: talking therapy Malnutrition; fatigue;
Depression;
serious psychological meals/avoiding food; schizophrenia; (CBT, MANTRA, osteoporosis; fertility
Endocrine abnormalities Children/young addiction; criticised
condition in which there Young women, Multifactorial; factors taking appetite depression; SSCM), dietary advice problems; loss of libido;
Anorexia are common with adults treated for eating habits; body
is desire to keep one’s typically starting in that differ with age of suppressors; cessation Diagnosed clinically; malabsorption poor circulation;
anorexia, such as low anorexia have a dysmorphia;
nervosa body weight as low as mid-teens development (e.g. of periods; BMI syndrome; new >18y/o: family talking arrhythmias; hypotension;
GnH, low T4/T3 and high better outcome anxiety; low self-
possible by not eating M<F puberty for young teens) lightheadedness; T1DM; adrenal therapy, individual heart failure; oedema;
cortisol than adults esteem; sexual
enough food, exercising alopecia; dry skin; insufficiency; cancer; talking therapy, dietary seizures; memory loss;
abuse
too much, or both extreme exercise amphetamine use advice renal failure; anaemia

Drug therapy
Bimodal onset in Abnormal response to Restlessness/ Panic disorder;
given for 6-8wks Anti-anxiety
Anxiety (GAD) ≥6 months of excessive adolescence and stress; multiple to determine Increase in life stresses; nervousness; easily social phobia; OCD; medication; CBT; Co-morbid depression/
worry, disproportionate care residents; also neurotransmitter presence of physical or Physical/emotional fatigued; muscle Clinical diagnosis; PTSD; somatisation; substance abuse; over-
(generalised to any risk, causing common during/ involvement; changes in
efficacy; recurs
emotional trauma; stress or trauma tension; irritability; poor TFT depression;
meditation; exercise;
utilisation of healthcare
under stress; sleep hygiene
anxiety disorder) distress/impairment after pregnancy cerebral blood flow in depression in genetic factors concentration; sleep substance-induced education resources
M<F response to stress disturbance anxiety
30-60%

Behavioural changes;
Increased mortality;
Fluctuating Injury; alcohol; poor altered cognition;
Acute disturbance of PINCH ME Thorough Hx and Depression; Admission and increased time of
Hospitalised or Unknown; possibly course with nutrition; infection; inattention; agitation/
consciousness, (Pain, Infection, observation; dementia; anxiety; monitoring; correct admission; infection;
long-term care cholinergic deficiency, possible rapid lack of stimulation; lethargy; wandering/
Delirium attention, cognition and residence; 50% of dopaminergic excess, recovery or Nutrition, Constipation, hypoglycaemia; withdrawn; FALLS and examine for any thyroid disease; precipitating factors; dementia; falls; pressure
perception; may be Hydration, Medication, precipitating factors; non-convulsive optimise treatment of sores; incontinence;
>65y/o in hospital and/or inflammation months-long urinary retention; LOSS OF APPETITE as
hypoactive/hyperactive Electrolytes) blood test for cause epilepsy comorbidities malnutrition; functional
recovery many others warning signs; may be
impairment; distress
hypo/hyperactive

Coarsening of AD; LBD; bipolar;
Group of rare brain MMSE; CT/MRI
Rate of personality; self- major depression; Financial crisis;
disorders that primarily head; FBC; ESR/ Supportive care;
Tissue deposition of deterioration Genetics-related focal Genetic mutation; neglect; apraxia; loss of substance abuse; dangerous driving;
Dementia affect frontal and Unknown abnormally aggregated related to neuro-degeneration of head trauma; language fluency or CRP; TFT; U&Es, VD; brain tumour; benzodiazepine; SSRIs; problems with parenting
(frontotemporal) temporal lobes (a/w LFTs; B12; folate; treatment of recurrent
proteins presenting frontal or temporal lobes thyroid disease comprehension; hyperthyroidism; (if dependent children);
personality, behaviour genetic testing with infections; valproate
symptoms Parkinsonisms; normal pressure legal crisis
and language) positive FHx
memory impairment hydrocephalus

Fluctuating cognition;
Protein-based Lewy
Neurodegenerative Unknown; toxic protein recurrent visual Short-acting
bodies accumulate in Treatment is MMSE; FBC; U&Es; AD; PD; Pneumonia;
disease of the CNS aggregation, abnormal hallucinations; sleep benzodiazepines;
Dementia characterised by the Elderly vulnerable sites in the symptomatic and phosphorylation and FHx disorder; depression; TFT; B12; folate; frontotemporal/ cholinesterase inhibitor; institutionalisation;
(Lewy body) M>F brain; distribution and unlikely to urinalysis; CT/MRI vascular dementia; dysphagia; urinary
presence of Lewy other mechanisms may Parkinsonisms; falls; SSRIs; carbidopa/
density correlate with prevent decline head prion disease incontinence; falls
bodies be involved postural hypotension; levodopa
clinical symptoms incontinence


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