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ATI Mental Health > 13 Depressive Disorders > Flashcards

13 Depressive Disorders Flashcards

1
Q

depression

A

mood (affective) disorder

  • widespread issue
  • ranking high among causes of disability
  • high risk of suicide
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2
Q

common morbidities w Depression

A
  • anxiety disorder (70% of pt)
  • psychotic disorder
  • substance use disorder
  • eating disorder
  • personality disorder
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3
Q

Depressive Disorders recognized by DSM-5

A 
1 Major Depressive Disorder
2 Seasonal Affective Disorder
3 Persistent Depressive Disorder
4 Premenstrual Dysphoric Disorder
5 Substance-Induced Depressive Disorder
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4
Q

Major Depressive Disorder

A

single or recurrent episode of unipolar depression

  • not assoc w mood swings
  • results in significant change in a client’s normal functioning
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5
Q

Major Depressive Disorder is assoc w atleast 5 of the following manifestations which must occur almost everyday for a min of 2 weeks

A

-depressed mood
-difficulty sleeping or excessive sleeping
-indecisiveness
decr ability to concentrate
-suicidal ideation
-incr/decr motor activity
-inability to feel pleasure
-incr/decr wt

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6
Q

MDD can be further diagnosed w more specific classification using the DSM-5

A

Psychotic Features

Postpartum onset

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7
Q

Psychotic Features

A

presence of auditory hallucination or delusion (client thinking they have a fatal disease)

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8
Q

Postpartum onset

A

beings w/in 4 wks of childbirth

-can include delusions

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9
Q

Seasonal Affective Disorder

A

form of depression that occurs seasonally

-usually winter bc less daylight

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10
Q

first line of tx for SAD

A

light therapy

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11
Q

Persistent Depressive Disorder

A

milder form of depressin

  • usually early onset (child-adolescent)
  • lasts atleast 2 yrs for adults
  • contains at least 3 manifestations of depression
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12
Q

Premenstrual Dysphoric Disorder

A
  • assoc w luteal phase of menses

- 2-6% of fem causes problems that can be severe enough to interfere w ability of pt to work/interact w others

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13
Q

Premenstrual Dysphoric Disorder

manifestations

A

-mood swing
-irritability
-depress
-anxiety
-difficulty concentrating
-lack energy
overeat
-hyper or insomnia
-breast tenderness
-aching
-bloating
-wt gain

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14
Q

Premenstrual Dysphoric Disorder

Tx

A
  • exercise
  • diet
  • relaxation therapy
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15
Q

what is the most significant risk factor for depression?

A

family/personal hx

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16
Q

risk factors for depression

A
  • fam hx
  • personal hx
  • female
  • 65+ yo
  • neurotransmitter deficiencies
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17
Q

neurotransmitter deficiencies that cause depression

A

serotonin (mood, sex, sleep, hunger, pain)
norepinephrine (attentn + behavior)
dopamine, acetylcholine, GABA, glutamate

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18
Q

expected findings in depression

A
  • anergia
  • anhedonia
  • anxiety
  • sluggish or unable to relac
  • vegetative findings
  • somatic reports [fatigue, GI, pain]
19
Q

vegetative findings in depression

A
  • change in eating
  • sleep disturbance
  • decr sexual activity
  • change in bowel habits
20
Q

anorexia is usually assoc w _____ + incr intake is assoc w ______

A

A: MDD
II: PMDD

21
Q

physical assessment findings in depression

A
  • blunted
  • poor grooming/hygiene
  • psychomotor retardation (more common)
  • psychomotor agitation
  • socially isolated
  • slowed speech, decr verbalization, delayed response like too tired to speak
22
Q

types of standardized screening

A
  • hamilton depression scale
  • beck depression inventory
  • geriatric depression scale
  • zung self rating
  • pt health questionnaire
23
Q

milieu therapy

A
  • suicide risk
  • self care
  • communication
  • maintenance of safe environment
  • counseling
24
Q

SSRI

drug names

A
  • citalopram
  • fluoxetine
  • setraline
25
Q

leading Tx for depression

A

selective serotonin reuptake inhibitors

26
Q

SSRI

A/E

A
  • nausea
  • headache
  • CNS stim (agitation, insomnia, anxiety)
  • sexual dysfunction (contact provider)
  • serotonin syndrome
  • wt gain w long term use
27
Q

avoid the use to ____ while on SSRI

A

st john’s wort

-incr risk of serotonin syndrome

28
Q

tricyclic antidepressant

drug name

A

amitriptyline

29
Q

tricyclic antidepressant

A/E

A
  • ortho hypotension: move slowly

- antichol effect: chew sugarless hum, high fiber diet, incr fluid intake

30
Q

monoamine oxidase inhibitors MAOI

drug name

A

phenelzine

31
Q

MAOI: phenelzine

pt teachings

A
  • due to HTN crisis, avoid foods high in tyramine

- avoid all meds including OTC w/o first discussing w provider

32
Q

atypical antidepressant

drug name

A

bupropion

33
Q

bupropion (atypcl antidprssnt)

teaching

A
  • observe for: headache, dry mouth, GI distress, constipatn, incr HR, nausea, restless, insomnia
  • monitor food intake + wt due to appetite suppresion
34
Q

bupropion (atypcl antidprssnt)

CI

A

at risk for seizures

35
Q

serotonin norepinephrine reuptake inhibitors SNRI

drug names

A

venlafaxine

duloxetine

36
Q

SNRI: venlafaxine, duloxetine

A/E

A
  • nausea
  • insomnia
  • wt gain
  • diaphoresis
  • sex dysfunction
37
Q

SNRI: venlafaxine, duloxetine

caution

A

pt w Hx of HTN

38
Q

st john’s wort

A

plant product

-relief of manifestations of mild depression

39
Q

st john’s wort

A/E

A
  • photosensitivity
  • skin rash
  • rapid HR
  • GI distress
  • ab pain
40
Q

light therapy

A

exposure of the face to 10k-lux light box 30 min/day

41
Q

types of alternative/complimentary therapies

A
  • light therapy
  • electroconvulsive
  • transcranial magnetic stimulation
  • vagus nerve stimulation
42
Q

Interpersonal Therapy

A

encourages client to focus on personal relationship that contribute to depressive disorder

43
Q

exercise on depression

A
  • helps improve + prevent relapse

- 30 min 3-5x/wk

ATI Mental Health (22 decks)

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