13.04.15 Lecture notes

Suicide assessment

• • Characteristics of the act

    • Seriousness

    • Planning

    • Intent

    • Rescue

  • Characteristics of the person

    • Personality

    • Psychiatric illness

    • Physical illness

    • Hopelessness

  • Circumstances

    • Socioeconomic

    • Isolation

    • Berevement

Personality disorder

• • Personality?

    • Charcteristics, Behaviours, Thought processes, Interactions, Feelings

    • Predictable / Stable over time

  • Personality disorder?

    • Maladaptive, Inflexible

    • Deviation from cultural norms

    • Causing distress in self or others

    • Developemental origin (must be >18 for diagnosis)

    • No other cause apparent

  • Clusters

    • A - Mad

      • Odd, Eccentric, Suspicious

      • Paranoid, Schizoid, Schizotypal

    • B - Bad

      • Dramatic, Emotional, Erratic

      • Antisocial, Borderline, Histrionic, Narcissistic

    • C - Sad

      • Anxious, Fearful

      • Avoidant, Dependent, OCD

Triangle

Assessment tools

• • SCID-II, SCID-IV

  • Eysenck

  • MMPI

  • NEO PI-R (Ocean)

  • SAPAS

Alcohol dependency syndrome - PR COST TO REWIRE

• • PR - Primacy of drink (over other activities)

  • CO - Compulsion to drink

  • ST - Stereotypical pattern of drinking

  • TO - Tolerance

  • RE - Relief of withdrawal symptoms by drinking

  • WI - Withdrawal symptoms

  • RE - Reinstatement after abstinance

Notes

• • Dr Killary

  • Personality disorder (rasberry ripple) vs Mental illness (cherry)

  • Can't properly define personality disorder as a disease

    • Always had it/part of who they are

    • No physical cause apparent

    • No diagnostic test

  • P drugs for Panic

    • Citalopram

    • Paroxetine

  • SSRIs can paradoxically increase anxiety in the short term

  • Agomelatine: Melatonergic antidepressant for the treatment of major depressive disorder

  • Mindfulness-based therapy

  • Dialectical behavour therapy (esp. for BPD)

  • Categorical (assignment of categories) vs Dimensional (quantification of attributes) diagnosis

    • Dimensional systems work best in describing phenomena that are distributed continuously and that do not have clear boundaries

    • Report clinical attributes that might be subthreshold in a categorical system

  • Cyclothymia