Mental health articles

OF mental health care and mentally ill

Risk factors for child mental health problems

The presence of risk factors can alert the GP to probe more carefully for the symptoms of a psychiatric disorder in a child with a non-specifi c presentation. Important family factors include parental physical and mental disorder and domestic violence. The risk may be mediated through a number of routes: parenting may be suboptimal, children […]

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Anxiety disorders in older adults

Anxiety disorders are as common in older adults as they are in younger populations (10–15%) with substantial numbers presenting to primary care (10–18%). There is evidence that anxiety disorders are recognised and treated even less often than depression, with the physiological symptoms (Box 15.5) being frequently over-investigated. Generalised anxiety disorder and specifi c phobias are […]

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Alcohol withdrawal states Withdrawal syndrome

Not every heavy drinker will suffer a withdrawal syndrome, but, for most who do, it is unpleasant Onset: three to six hours after last drink Duration: fi ve to seven days Common withdrawal symptoms: headache, nausea, vomiting, sweating and tremor. Generalised (grand mal) convulsions may occur during withdrawal Delirium tremens This occurs in about 5% […]

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Classifi cation of alcohol-related disorders

Acute intoxication:  at low doses, alcohol may have stimulant effects, but these give way to agitation and, ultimately, sedation at higher doses. ‘Drunkenness’ may be uncomplicated or may lead to hangover, trauma, delirium, convulsions or coma Pathological intoxication:  a state in which even small quantities of alcohol produce sudden, uncharacteristic outbursts of violent behaviour Harmful […]

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Managing alcohol dependence

Managing alcohol dependence Detoxification Alcohol dependence usually requires controlled withdrawal (detoxifi cation) with an attenuation therapy (such as a benzodiazepine), as abrupt cessation of alcohol can induce one of the withdrawal states (Box 14.5). Detoxifi cation is increasingly taking place in the community, but inpatient detoxifi cation is recommended for those at risk of suicide, […]

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Recognising problem drinking

Recognising people with alcohol-related problems is diffi cult – probably less than 20% are known to their general practitioner (although problem drinkers consult their GP twice as frequently as those whose alcohol consumption is within the safe limits), and a large proportion are missed in accident and emergency departments. Recognition is particularly diffi cult among […]

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Alcohol-related problems

18,500 deaths a year in England and Wales are related to alcohol consumption 300 of these deaths are the direct result of alcoholic liver damage (the true fi gure is probably many times higher but is hidden by under-reporting on death certifi cates) Just over 1 in 1000 people die per year of an alcohol-related […]

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Prevalence of alcohol-related problem

Prevalence of alcohol-related problems as follows: 1 As with any drug of addiction, there are four levels of alcohol use. Social drinking: only about 10% of the population are teetotal. 2 At risk consumption: this is the level of alcohol intake that, if maintained, poses a risk to health. The Health of the Nation gives […]

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Mental Health Problems in Old Age

The health service has changed apace since the fi rst edition of this ABC. Top-down management of services has made sweeping changes in the mental health services for adult’s of working age, achieved with (from an older adult’s perspective) massive fi nancial investment. Older adults mental health services have also had to change, responding to […]

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How to prescribe opioids

General practitioners may use blue FP10 (MDA) prescriptions, which allow daily instalments on a single prescription, thus reducing the risk of overdose or diversion into the black market. Prescriptions for controlled drugs must: • • • • • • Be written in indelible ink Be signed and dated by the doctor State the form and […]

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