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Simmons NURP 503 Exam 4 > 12: Depression in Adults > Flashcards

12: Depression in Adults Flashcards

1
Q

T/F Inflammatory markers become depressed with depression.

A

False. They become elevated, though unsure as to correlation.

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2
Q

T/F Once in remission, it is ok to stop medication and psychotherapy.

A

False. Do not stop both simultaneously. Work together to determine best course of action.

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3
Q

T/F Recovery can be delayed when depression and anxiety overlap.

A

True. Can be difficult to recognize both components.

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4
Q

Which type of depression: major depressive episode, dysthymic disorder, or double depression?
Dysthymic or major depression with anxiety symptoms.

A

Double depression

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5
Q

_____ of adults have anxiety.

A

3.1%

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6
Q

What medical illnesses mimic depression (5)?

A
  1. Hypothyroidism
  2. Low blood sugar
  3. Vitamin D deficiency
  4. Caffeine withdrawal
  5. Early dementia
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7
Q

T/F Severe or intractable depression patients may benefit from ECT.

A

True

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8
Q

Are women or men more commonly affected by depression?

A

Women 2:1. It is a 1:1 ratio when expanded criteria include depression related to substance abuse, anger attacks, aggression and irritability, and risk-taking behavior.

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9
Q

_____ of adults have unreported lifetime risk of schizophrenia.

A

1.1%

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10
Q

T/F Depression is often recurrent.

A

True. 50% recur after 1 episode without treatment. 70% after 2 episodes. 90% after 3 episodes.

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11
Q

Depression is often a comorbidity with what 5 conditions?

A
  1. Fibromyalgia
  2. Migraines
  3. PMS (severe)
  4. IBS
  5. Chronic fatigue
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12
Q

Risk factors for depression (4)?

A
  1. Genetic basis
  2. Personal/family hx of depression
  3. Parental loss, early life abuse or trauma
  4. Female (esp during hormonal shifts)
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13
Q

What medication is offered as a natural remedy to depression?

A

St. John’s Wort (900-1800 mg/day for a month)

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14
Q

T/F Moderate drinking (no more than 1/day) predisposes people to depression.

A

False

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15
Q

_____ of adults have bipolar disorder.

A

2.6%

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16
Q

_____ of adults have unreported lifetime risk of depression.

A

6.9%

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17
Q

T/F Antidepressants can be addictive.

A

False

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18
Q

What treatment is the most effective, statistically, but is not done in primary care?

A

Electroconvulsive Therapy (ECT)

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19
Q

Which type of depression: major depressive episode, dysthymic disorder, or double depression?
Not a major depression, but living at a subpar level.

A

Dysthymic disorder

20
Q

What type of depression: seasonal affective disorder, depression secondary to substance abuse, or postpartum depression?
Occurs directly after childbirth. Can be severe. Screen every woman.

A

Postpartum depression

21
Q

In pure depression, any antidepressant will yield _____% positive responses.

A

60-70%

22
Q

What are the 5 points of patient education regarding medication?

A
  1. Take medication as prescribed every day.
  2. It may take time to see a response.
  3. Do not stop taking medication without contacting me.
  4. Do not stop the medication just because you start to feel better.
  5. Call me with any concerns or questions.
23
Q

_____ of adults have a diagnosable personality disorder.

A

9%

24
Q

T/F When a woman presents with initial depression during a hormonal shift, treating the hormonal shift will often cure the depression.

A

False. Treat s/sx of hormonal fluctuation AND depression.

25
Q

T/F St. John’s wort works better in combination with SSRIs than tricyclics.

A

False. Do not combine St. John’s wort with prescription antidepressants.

26
Q

Which type of depression: major depressive episode, dysthymic disorder, or double depression?
Maintains mood/function until depression hits.

A

Major depressive episode

27
Q

What type of depression: seasonal affective disorder, depression secondary to substance abuse, or postpartum depression?
Depressed in fall/winter with less exposure to ambient light.

A

Seasonal affective disorder

28
Q

Antidepressants should be taken for a minimum of _____ from the time the patient feels well (remission).

A

4-6 months

29
Q

T/F 3 of 9 biomarkers are elevated when someone becomes depressed.

A

True. Potential for screening at-risk patients.

30
Q

Antidepressants must be taken daily to build up in the system. They may take _____ days to begin to work.

A

10-14 days

31
Q

What type of depression: seasonal affective disorder, depression secondary to substance abuse, or postpartum depression?
“Chicken or the egg” situation: difficult to determine which brought on the other. Attack on both angles.

A

Depression secondary to substance abuse

32
Q

What are the 5 traditional depressive signs?

A
  1. Sadness, tearfulness, depressed mood
  2. Sleep disturbance
  3. Appetite disturbance
  4. Poor concentration
  5. Suicidal ideation
33
Q

Which type of depression: major depressive episode, dysthymic disorder, or double depression?
Endorse the depression by sharing symptoms of fatigue, feeling down, lack of interest.

A

Double depression

34
Q

What is a concern with women who take St. John’s wort?

A

It may lower estrogen levels. Backup contraception should be used until levels are confirmed.

35
Q

_____ of adults have OCD.

A

1%

36
Q

T/F Majority of patients stop antidepressants before completing the full course.

A

True. 77%. 50% stop in the first 30 days. Important to stress why adherence is important, since it takes a while to see results.

37
Q

T/F Everyone should be tried off medication, usually within the first 12 months.

A

True. Collaborate with patient as to when that should happen. If fearful, remind patient that if depression recurs, you know which med works.

38
Q

Treatment with _____ will often relieve both sets of symptoms with double depression.

A

Antidepressants

39
Q

Which type of depression: major depressive episode, dysthymic disorder, or double depression?
Report anxiety symptoms, insomnia, racing thoughts, inability to sit still.

A

Double depression

40
Q

How can you minimize side effects of ECT?

A

Unilateral treatment

41
Q

Which type of depression: major depressive episode, dysthymic disorder, or double depression?
Single or recurrent. Most common type.

A

Major depressive episode

42
Q

T/F Depression is partly a personality weakness.

A

False. It is a medical condition. Brain scans show differences between depressed and normal brains. Normal brain shows more brain activity. Depressed brain has fewer areas of cognitive function lit up on MRI.

43
Q

What is the duration of treatment for ECT?

A

6-12 treatments over 4-6 weeks.

44
Q

What is the most effective depression treatment?

A

Psychotherapy + medication

45
Q

What adjunctive recommendations (not specific to depression) can be helpful (3)?

A
  1. Exercise
  2. Diet
  3. Sleep hygiene and daily structure
46
Q

T/F All depression merits treatment, no matter the cause.

A

True. Never insinuate that the patient is not trying hard enough or that they did this to themselves.

Simmons NURP 503 Exam 4 (17 decks)

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