The document discusses behavior management of patients with mental disorders in dental settings. It begins with an overview of classification systems for mental disorders like the ICD-10 and DSM-5. Key points include the various causes of mental disorders like genetics, biology, trauma, and stress. The history of understanding and treating mental illness is explored from ancient times to modern developments. Behavior management is defined as guiding people to change actions through identifying negative behaviors and reinforcing positive alternatives. Important considerations for behavior management of patients with mental disorders in dental settings include communication, reinforcement, and choosing the least restrictive techniques.
The association of neuropsychiatric disorders with cerebrovascular disease has been recognized by clinicians for over 100 years. Disease of the vascular system contribute greatly to the sum total of psychiatric disability, chiefly in the elderly population, mainly as a result of stroke, cerebrovascular accidents & subarachnoid haemorrhage.
The association of neuropsychiatric disorders with cerebrovascular disease has been recognized by clinicians for over 100 years. Disease of the vascular system contribute greatly to the sum total of psychiatric disability, chiefly in the elderly population, mainly as a result of stroke, cerebrovascular accidents & subarachnoid haemorrhage.
Dementia Home Care in India: Overview and Challenges ARDSICON 2015Swapna Kishore
Dementia Home Care in India: Overview and Challenges--- A presentation made at ARDSICON 2015, the 19th National Conference of ARDSI (Alzheimer's and Related Disorders Society of India), held at Mumbai, India.
If you are concerned about dementia home care, also see the pages at: http://dementiacarenotes.in/caregivers
Introduction
The commencement of psychiatric training is a daunting task for any medical officer. Whilst exposure to mental illness and the institutional systems which operate around it may occur during graduate medical training programs and some junior resident medical officer rotations, nothing prepares the new trainee in psychiatry for their many responsibilities in this early phase of their careers.
Didactic content is provided for psychiatric trainees by the NSW Institute of Psychiatry and local training networks, however information on how to provide safe and effective care to people with mental illnesses is invariably acquired in the course of working in acute mental health settings. With this in mind, the contributors to this resource have attempted to provide accessible overviews of the kind of information which might be needed in the course of working in acute adult mental health settings.
This resource is set out in a series of themes. It does not seek to provide a comprehensive reference, nor does it attempt to summarize text-books or the current literature in psychiatry. Each contributor has written a brief account of different topics of relevance to practice in acute adult psychiatry. The style of writing aims to provide the reader with a grasp of the necessary information, which can be absorbed rapidly by the inexperienced psychiatric trainee. Whilst not a manual of ‘how to be a registrar’, it aims to provide a ready reference to both common and classic challenges in the setting of acute adult mental health.
Adjustment disorders are commonly seen in primary care settings in which the 1-year prevalence varies from 11% to 18% of those with any clinical psychiatric disorder. [Casey PR et al., 1984]
A recent study [Maercker A et al., 2012] in the general population found the prevalence of adjustment disorder to be 0.9%,
Frontotemporal dementia (FTD) is a term used to describe a group of neurocognitive disorders that encompass progressive dysfunction in executive functioning, behavior, and language. It is considered the third most common form of dementia following Alzheimer’s disease (AD) and dementia with Lewy bodies. As per its namesake, it is a cluster of syndromes that result from degeneration of the frontal and temporal lobes, and is subdivided into two categories that are unique in respect to their predominating presentations; namely, the behavioral subtype that accounts for about half of FTD cases, and the language subtype The language subtype is further subdivided into nonfluent and semantic variants of primary progressive aphasia (PPA), which are characterized by diverging localizations and underlying cerebral dysfunction
Dementia Home Care in India: Overview and Challenges ARDSICON 2015Swapna Kishore
Dementia Home Care in India: Overview and Challenges--- A presentation made at ARDSICON 2015, the 19th National Conference of ARDSI (Alzheimer's and Related Disorders Society of India), held at Mumbai, India.
If you are concerned about dementia home care, also see the pages at: http://dementiacarenotes.in/caregivers
Introduction
The commencement of psychiatric training is a daunting task for any medical officer. Whilst exposure to mental illness and the institutional systems which operate around it may occur during graduate medical training programs and some junior resident medical officer rotations, nothing prepares the new trainee in psychiatry for their many responsibilities in this early phase of their careers.
Didactic content is provided for psychiatric trainees by the NSW Institute of Psychiatry and local training networks, however information on how to provide safe and effective care to people with mental illnesses is invariably acquired in the course of working in acute mental health settings. With this in mind, the contributors to this resource have attempted to provide accessible overviews of the kind of information which might be needed in the course of working in acute adult mental health settings.
This resource is set out in a series of themes. It does not seek to provide a comprehensive reference, nor does it attempt to summarize text-books or the current literature in psychiatry. Each contributor has written a brief account of different topics of relevance to practice in acute adult psychiatry. The style of writing aims to provide the reader with a grasp of the necessary information, which can be absorbed rapidly by the inexperienced psychiatric trainee. Whilst not a manual of ‘how to be a registrar’, it aims to provide a ready reference to both common and classic challenges in the setting of acute adult mental health.
Adjustment disorders are commonly seen in primary care settings in which the 1-year prevalence varies from 11% to 18% of those with any clinical psychiatric disorder. [Casey PR et al., 1984]
A recent study [Maercker A et al., 2012] in the general population found the prevalence of adjustment disorder to be 0.9%,
Frontotemporal dementia (FTD) is a term used to describe a group of neurocognitive disorders that encompass progressive dysfunction in executive functioning, behavior, and language. It is considered the third most common form of dementia following Alzheimer’s disease (AD) and dementia with Lewy bodies. As per its namesake, it is a cluster of syndromes that result from degeneration of the frontal and temporal lobes, and is subdivided into two categories that are unique in respect to their predominating presentations; namely, the behavioral subtype that accounts for about half of FTD cases, and the language subtype The language subtype is further subdivided into nonfluent and semantic variants of primary progressive aphasia (PPA), which are characterized by diverging localizations and underlying cerebral dysfunction
Psychological and Behavioral Implications in Older Adults with CancerSpectrum Health System
Through Case Presentation and Dydactics, participants will gain an understanding of the psychological and behavioral impact cancer has on older adults.
How to Transition from Allopathic to Integrated Practice - IMM Brazil 2015Louis Cady, MD
In this lecture, Dr. Cady compares and contrasts the significance differences, both conceptually and practically, between the conventional practice of medicine and a more rational, functional, integrated approach. Tactical concepts and didactic tools to make the transition are reviewed.
This is a presentation I'd done during my Psychiatry residency. I evaluated the Preamble of the DSM5, evaluating how and why the new manual was conceived, the process of creation and review and the rationale behind these changes.
I also evaluated the reasons why DSM5 has come in for such attack, and did a critique of the very obvious shortcomings in the execution and implementation of the stated aims.
Learning Disabilities: Dynamic Registers Webinar – 14 December 2016NHS England
Specific challenges in working with dynamic registers: Kevin Elliott, Clinical Lead (Policy & Strategy), Transforming Care Programme, NHS England
Sarah Jackson, Strategic Case Manager (North),Children and Young People, Learning Disabilities and/or Autism Workstream, NHS England
Topics covered:
- Risk stratification
- Consent
- Children and Young People
- People with autism and no learning disability
In this webinar, Sandy Magaña, PhD, Professor of Disability and Human Development at the University of Illinois at Chicago, will discuss:
- Research on the mental and physical health of caregivers, including that of Latinos and African Americans
- Recognizing the importance of caring for yourself as a caregiver
- Recognizing signs of stress and depression
- Including others in caregiving
- Setting health goals for yourself
Learn how powerfully movement can influence mood and memory. As the Western population ages and we struggle with an unprecedented level of mental illness, movement is even more important than ever before.
Mental health refers to the maintenance of successful mental activity.
This includes maintaining productive daily activities and maintaining fulfilling relationships with others.
It also includes maintaining the abilities to adapt to change and to
cope with stresses.
Improving the Family Experience at the End of Life in Organ DonationAndi Chatburn, DO, MA
Communication skills strategies for improving family experience at the end of life for patients who die in the ICU after determination of brain death or after removing mechanical life support. Audience: Organ Procurement Organization staff and hospital administration
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
How to Create Map Views in the Odoo 17 ERPCeline George
The map views are useful for providing a geographical representation of data. They allow users to visualize and analyze the data in a more intuitive manner.
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
2. Tania Herschdörfer
AEGD
• Classification systems for Mental
Disorders (MD)
• Definition
• DSM-5 diagnostic criteria
• Causes of MD
• Statistics and facts of MD
• History
• Behavior management definition
• Important considerations in
behavior management of patients
with MD
• Conclussions
Outline
“The scream” Edvard Munch
3. ICD-10 International
Classification of Diseases
(ICD-11 2018)
DSM-5 Diagnostic and
Statistical Manual of Mental
Disorders
CLASSIFICATION SYSTEMS FOR
MENTAL DISORDERS
WHO (World Health Organization)
APA (American Psychiatric
Association)
4. WHO: “Mental disorders comprise a broad range
of problems, with different symptoms. However,
they are generally characterized by some
combination of abnormal thoughts, emotions,
behavior and relationships with others. Most of
these disorders can be successfully treated”.
MENTAL DISORDERS
Mental disorders WHO defiintion http://www.who.int/topics/mental_disorders/
5. DSM-5: "A mental disorder is a syndrome
characterized by clinically significant disturbance in
an individual's cognition, emotion regulation or
behavior that reflects a dysfunction in the
psychological, biological or developmental
processes underlying mental functioning”.
Mental disorder WHO defiintion http://www.who.int/topics/mental_disorders/
MENTAL DISORDERS
6. DSM-5 DIAGNOSTIC CRITERIA
• Neurodevelopmental disorders (Autism, CP, ID)
• Schizophrenia spectrum and other psychotic disorders
• Bipolar and related disorders
• Depressive disorders
• Anxiety disorders
• Obsesive-compulsive and related disorders
• Trauma and stressor related disorders
• Feeding and eating disorders
• Elimination disorders
• Medication-induced movement disorders and other adverse efects of medication
Armando Reveron
7. • Sleep-wake disorders
• Sexual disfunctions
• Gender dysphoria
• Disruptive, impulse control and conduct disorders (intermittent explosive disorder,
conduct disorder)
• Substance related and addictive disorders
• Neurocognitive disorders
• Personality disorders
• Paraphilic disorders
• Other mental disorders
• Other conditions that may be a focus of clinical attention
DSM-5 DIAGNOSTIC CRITERIA
9. CAUSES OF MENTAL DISORDERS
• Hereditary (genetics)
• More susceptible
• Multiple genes involved
• Interaction between these genes and
other factors (psychologycal trauma and
environmental stresors)
http://www.mayoclinic.org/diseases-conditions/mental-illness/basics/causes/con-20033813
10. CAUSES OF MENTAL DISORDERS
• Biology
• Abnormal balance of neurotransmitters
• Messages may not make it through the
brain correctly
• Defects or injury to certain areas of the
brain
http://www.mayoclinic.org/diseases-conditions/mental-illness/basics/causes/con-20033813
11. CAUSES OF MENTAL DISORDERS
https://www.bu.edu/cte/about/what-is-cte/
12. CAUSES OF MENTAL DISORDERS
• Psychological trauma (as a child) and
environmental stressors
• Severe emotional, phyical or sexual
abuse
• Significant early loss
• Neglect
• Disfunctional family life
• Changing Jobs or schools
• Substance abuse
http://www.mayoclinic.org/diseases-conditions/mental-illness/basics/causes/con-20033813
13. STATISTICS AND FACTS OF MENTAL
DISORDERS
http://www.mayoclinic.org/diseases-conditions/mental-illness/basics/causes/con-20033813
14. HISTORY
A depiction of trephanning from the painting cutting stone (Circa 1494) by Hieronymus Bosch.
15. HISTORY
Cyber Museum of Neurosurgery http://www.neurosurgery.org/cybermuseum/pre20th/treph
5000 B.C.
Supernatural phenomena
Demonic possession treated
with trephanation
17. HISTORY
Ancient Greece
• Stigma attached to
mental illness
• Divine punishment
• Locked up or put to
die
Foerschner, Allison M. “The History of Mental Illness: From ‘Skull Drills’ to ‘Happy Pills’.”(2010).
Drake, Robert E., et al. “The History of Community Mental Health Treatment and Rehabilitation for Persons with Severe Mental Illness.”
Community mental health journal 39.5 (2003): 427-40.
HISTORY
18. HISTORY
Ancient egyptians
• Recreational activities
Leeman, Eve. “Mental Illness: Learning from the Foibles of Earlier Generations.” The Lancet” 351.9100 (1998): 457.
HISTORY
19. Hippocrates
Supersticious
Medical
“Four essential fluids”; blood,
phlegm, bile, and black bile.
Imbalances in the body.
Phlebotomies, bloodletting,
purging, and diets
Changing the occupation and/or
environment of the patient
Leeman, Eve. “Mental Illness: Learning from the Foibles of Earlier Generations.” The Lancet” 351.9100 (1998): 457.
HISTORY
20. Middle Age
• Church
• Supernatural causes
(demonic possession).
Dain, Norman, PhD. “The Chronic Mental Patient in 19th-Century America.” Psychiatric Annals 10.9 (1980): 11,15,19,22.
HISTORY
21. Treatment:
• Persuade the demon out
• Insult the demon.
• Torture the possessed so
that demon would not
want to remain there
• Inmersion in hot water or
sulphur
Dain, Norman, PhD. “The Chronic Mental Patient in 19th-Century America.” Psychiatric Annals 10.9 (1980): 11,15,19,22
HISTORY
22. • First Mental Hospital:
Baghdad (729 BC)
• Aleppo and Damascus
• Mass establishment of
asylums and
institutionalization occured
much later
Leeman, Eve. “Mental Illness: Learning from the Foibles of Earlier Generations.” The Lancet” 351.9100 (1998): 457.
HISTORY
23. Asylums
• Not aimed to help the
mentally ill
• Abandoned or
sentenced by the Law
• Inhumane treatment
• Protect ashamed
families and prevent
disturbances in the
community
Leeman, Eve. “Mental Illness: Learning from the Foibles of Earlier Generations.” The Lancet” 351.9100 (1998): 457.
HISTORY
24. • Early XV centhury
• Madhouses or
asylums
HISTORY
31. • State Psychiatric Hospitals
• MHA 1909
• U.S. Community Mental Health
Centers Act of 1963
• Improve the lives of the mentally
ill in the United States
HISTORY
37. • Deinstitutionalization
• Incapable of living
independently
• Homeless (inadequeate
housing and follow up care)
• 1980s: 1/3 of homeless in
America were considered
severely mentally ill
HISTORY
38. BEHAVIOR MANAGEMENT
Process that guides people to change their
actions within a specific context.
American Academy of Pediatric Dentistry Reference Manual. Clinical Practice Guidelines V 37 / NO 6 15 / 16
39. BEHAVIOR MANAGEMENT
Identifying the negative behavior
changing the environment to reduce
negative behavior
offering positive reinforcement to
encourage desired alternatives
American Academy of Pediatric Dentistry Reference Manual. Clinical Practice Guidelines V 37 / NO 6 15 / 16
40. BEHAVIOR MANAGEMENT
• Medical
• Physical
• Psychological
• Social
• Dental
American Academy of Pediatric Dentistry Reference Manual. Clinical Practice Guidelines V 37 / NO 6 15 / 16
42. BEHAVIOR MANAGEMENT
• Nonpharmalogical and pharma-
logical BGT
• Control anxiety
• Encourage positive dental
attitude,
• Perform quality oral health care
safely and efficiently for infants,
children, adolescents, and
persons with special health care
needs.
American Academy of Pediatric Dentistry Reference Manual. Clinical Practice Guidelines V 37 / NO 6 15 / 16
43. BEHAVIOR MANAGEMENT
• Start with the less
stressful procedure
(unless emergency)
• Talk to
parents/caregivers
• Consistensy
• Positive reinforcement
https://sharklearn.nova.edu/webapps/blackboard/execute/content/file?cmd=view&content_id=_4716379_1&course
44. BEHAVIOR MANAGEMENT
• Modeling and shaping
• Voice control
• One voice
• T-S-D
• Count to 5
• Breaks
https://sharklearn.nova.edu/webapps/blackboard/execute/content/file?cmd=view&content_id=_4716379_1&course
45. BEHAVIOR MANAGEMENT
• Use the least restrictive
behavior technique
• Patient stabilizers
(papoose boards)
• Sedation
• OR
https://sharklearn.nova.edu/webapps/blackboard/execute/content/file?cmd=view&content_id=_4716379_1&course
46. • Wide range of behavior guidance techniques
• Tolerant
• Flexible
• Anticipate reactions
49. BEHAVIOR MANAGEMENT OF
PATIENTS WITH MENTAL
DISORDERS
• Mental development
• Past experiences
• Current emotional status
and level of understanding
• Remain attentive to
physical and or emotional
indicatorr of stress
American Academy of Pediatric Dentistry Reference Manual. Clinical Practice Guidelines V 37 / NO 6 15 / 16
Conversations with Dr. Steven Ellen
51. BEHAVIOR MANAGEMENT OF
PATIENTS WITH MENTAL
DISORDERS
GL (F21)
20 yo at the time of the
comprehensive exam
Psychiatric diagnosis
Schizophrenia
(DSM-5: Schizophrenia
spectrum and other
psychotic disorders)
Homestead
No transportation
54. BEHAVIOR MANAGEMENT OF
PATIENTS WITH MENTAL
DISORDERS
Caregivers and
environment influences
American Academy of Pediatric Dentistry Reference Manual. Clinical Practice Guidelines V 37 / NO 6 15 / 16
Conversations with Dr. Steven Ellen
Calkins, Susan D. et al. (2007). Caregiver Influences on Emerging Emotion Regulation: Biological and Environmental Transactions in Early
Development. Handbook of emotion regulation , (pp. 229-248). New York, NY, US: Guilford Press, xvii, 654 pp.
55. Caregivers and environmental influences
CH
54 yo white non hispanic female
Ex husband and caregiver for comprehensive evaluation
Psychiatric history:
Depression ( DSM-5 Depressive disorders)
Anxiety (DSM-5 Anxiety disorders)
BEHAVIOR MANAGEMENT OF
PATIENTS WITH MENTAL
DISORDERS
56. Missing teeth
Gingiva: edematous and inflamed
Fractured #8, multiple arrested and active
caries.
Patient has been in this Group Home for
the last 4 years.
Caregiver was unaware of the existence of
a lower RPD.
Caregivers and environmental
influences
57. Cancer screen not conclussive/ Lower RPD
Bleeding, heavy calculus, tissue overgrowth about 30 mm extending in the lingual surfaces on the
anterior área.
Caregivers and environmental influences
63. BEHAVIOR MANAGEMENT OF
PATIENTS WITH MENTAL
DISORDERSImportance of detailed
notes
DC (M 28)
Psyciatric history
Autism (DSM-5:
Neurodevelopmental
disorder)
Impaired vision and speech
Breaks, negotiation
Document it!
71. BEHAVIOR MANAGEMENT
• Early preventive care
American Academy of Pediatric Dentistry Reference Manual. Clinical Practice Guidelines V 37 / NO 6 15 / 16
Conversations with Dr. Steven Ellen at SNC NSU 2017.
Calkins, Susan D. et al. (2007). Caregiver Influences on Emerging Emotion Regulation: Biological and Environmental Transactions in Early
Development. Handbook of emotion regulation , (pp. 229-248). New York, NY, US: Guilford Press, xvii, 654 pp.
