Presentaties ISMC - Psychiatrie
30 important questions on Presentaties ISMC - Psychiatrie
What are the advised doses and half-lives for substances used to treat co-morbid insomnia?
- Mirtazapine: 3.75-15 mg, T1/2 20-40 h
- Trazodone: 25-100 mg, T1/2 1 and 8 h
- Amitriptyline: 10-75 mg, T1/2 20 h
- Doxepine: 3-6 mg, T1/2 8-24 h
- Quetiapine: 25-100 mg, T1/2 6 h
What is the first treatment choice for co-morbid insomnia and its benefits?
- Cognitive Behavioral Therapy for Insomnia (CBT-I) is the first choice.
- Effective in psychiatric patients.
- Customized to individual needs and disorders.
What are the symptoms and medical history of the 50-year-old man described?
- Symptoms:
- - Falls asleep rapidly
- - Snores loudly
- - Frequent short awakenings
- - Not refreshed in the morning
- - Problems with concentration and memory
- - Low mood
- - Kicking, talking, snoring
- Medical History:
- - OSAS and limb movements
- - Fears relapse in depression
- - Obesity
- - Hypertension
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What considerations are there regarding prescribed psychiatric medication for insomnia?
- Assess sleep issues and medication effects.
- Possible actions: replace medication, reduce dose, or change administration time.
What is the relevance of monitoring sleep disturbances in individuals with a mental disorder?
- Mental disorders and Insomnia symptoms are interlinked.
- Insomnia disorder can increase:
- - Risk of development and relapse.
- - Psychopathology.
- - Impedes recovery.
- Treatment for both is crucial for recovery.
What was the treatment for the man's obstructive sleep apnea syndrome (OSAS) and its effects?
- Treatment:
- - CPAP (Continuous Positive Airway Pressure)
- Effects:
- - Significant improvement in mood
- - Improvement in hypertension
How does sleep medication affect insomnia when CBT-I is unavailable or ineffective?
- Enhances Sleep Onset Latency (SOL), continuity, and Total Sleep Time (TST).
- Reduces N3 and REM sleep.
- Risks include hangover effects, tolerance, dependency, rebound insomnia.
What effects do sleep treatments have on PTSD recovery?
- Most treatments improve sleep issues in PTSD patients.
- Sleep treatments show the strongest impacts specifically on sleep problems.
- Differences in daytime PTSD symptoms are not evident among treatments.
What are the advised usage strategies for sleep medication in co-morbid insomnia?
- Short or intermittent use is recommended.
- May involve off-label prescription psychotropic drugs.
What does the study by Manber et al. investigate regarding disturbed sleep and recovery?
- Examines disturbed sleep's effect on recovery.
- 30 participants with depression and insomnia.
- 12 weeks of treatment: Escitalopram, CBT-I, or placebo.
- Measures remission: Insomnia Severity Index (ISI) ≤7 and HAM-D17 ≤7.
- Citalopram with CBT-I is more effective than placebo.
What sleep study findings are detailed for the patient?
- AHI (Apnea-Hypopnea Index): 45
- Many oxygen desaturations and arousals
- Sleep stages include frequent awakenings
How does disturbed sleep affect psychiatric inpatients in terms of aggression?
- Aggression is a risk factor for recidivism.
- Poor sleep and insomnia are linked to increased aggressiveness.
- Poor sleep correlates with higher aggression scores.
What are the key topics covered in the International Sleep Medicine Course?
- Comorbidity of mental disorders and sleep disorders
- Relationships between mental disorders and sleep disorders
- Relevance of identifying and treating comorbid sleep disorders
- Treatment of comorbid insomnia
What findings were shown in the meta-analysis regarding sleep and aggression?
- Poor sleep quality and short duration correlate with higher aggression.
- Psychiatric populations exhibit this correlation more strongly.
What are the factors contributing to insomnia over time according to Spielman & Glovinsky?
- Predisposing factors: Night-type, stress reactive
- Precipitating factors: Job loss, depression, caring for newborn
- Perpetuating factors: Too much time in bed, conditioning, worry
- Residual persistent insomnia can occur after remission of mental disorders.
What does the study by Baglioni et al. reveal about sleep disturbances in mental disorders?
- No specific sleep alterations are noted for individual mental disorders.
- Sleep continuity disturbances are very common.
- These disturbances are considered transdiagnostic symptoms in psychiatry.
What is the relationship between insomnia and depression according to the studies?
- Insomnia is a risk factor for depression.
- Studies show varying odds ratios for depression risk due to insomnia.
- CBT-I significantly reduces the one-year incidence of depression compared to sleep education.
Who is associated with the topic of "Psychiatry and Sleep" in the context of the International Sleep Medicine Course?
- Marike Lancel is linked to "Psychiatry and Sleep."
- Affiliated with:
- - Centre of Expertise on Sleep and Psychiatry, GGZ Drenthe, Assen, NL
- - Department of Clinical Psychology & Experimental Psychopathology, University of Groningen, NL
What disclosure is provided in the International Sleep Medicine Course?
- The disclosure states there is no conflict of interest.
- This is related to the International Sleep Medicine Course (ISMC).
What is the relevance of monitoring sleep disturbances in individuals with a mental disorder?
- Mental disorders lead to insomnia symptoms.
- Treatment targets mental disorders.
- Residual insomnia symptoms may persist even after treatment.
- Monitoring is essential for comprehensive care.
What is the relevance of monitoring sleep disturbances in individuals with mental disorders according to the chart?
- Sleep disturbances influence suicidal behaviors.
- Mental disorders analyzed:
- PTSD
- Panic disorder
- Schizophrenia
What do the aethiological models in the provided information describe?
- Disturbed sleep may lead to a mental disorder.
- Mental disorder (particularly with medication) may result in disturbed sleep.
- A dual pathway shows disturbed sleep and mental disorder influencing each other.
What are the aetiological models between disturbed sleep and mental disorders?
- Disturbed sleep can lead to a mental disorder.
- A mental disorder, often influenced by medication, can result in disturbed sleep.
What is a possible relationship according to aethiological models between disturbed sleep and mental disorders?
- Disturbed sleep may lead to mental disorder
- Explained through aethiological models
- Explored in the context of sleep and psychiatry
What is the prevalence of insomnia disorder in general and psychiatric populations?
- General population: 4-10%
- Psychiatric population: >40% with affective and anxiety disorders
How common is OSAS among psychiatric inpatients?
- Prevalence among psychiatric inpatients: 24%
- General population: 3-7%
What percentage of individuals with ADHD have DSPS?
- ADHD population: >30%
- General population: 0.2-3%
Describe the frequency of RLS in general and psychiatric populations.
- General population: 5-10%
- Psychiatric population: Approximately 20% in MDD
Explain the prevalence of frequent nightmares in different populations.
- General population: 5%
- Psychiatric population: >60% in PTSD
What are some practical implications for sleep and mental disorders co-occurrence?
- Many patients have both mental and sleep disorders
- Underdiagnosis issues due to symptom overlap
- Lack of training in sleep medicine and mental disorders
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