Ch. 12 Depression

Question 1

Depression commonly comorbid with what disorders

Answer 1

• Anxiety
• Psychotic disorders
• Substance use
• Eating disorders
• Personality disorders

Question 2

Diagnosis of MDD

Answer 2

Single episode or recurrent episodes of unipolar depression resulting in a significant change in a client’s normal functioning accompanied by at least 5 of specific clinical findings, which must occur almost everyday for a minimum of 2 weeks, and last most of the day

Question 3

Clinical findings

Answer 3

• Depressed mood
• Difficulty sleeping or excessive sleeping
• Indecisiveness
• Decreased ability to concentrate
• Suicidal ideation
• Increase or decrease in motor activity
• Inability to feel pleasure
• Increase or decrease in weight of more than 5% of total body weight over 1 month

Question 4

Pyschotic feature

Answer 4

The presence of auditory hallucinations or the presence of delusions

Question 5

Seasonal

Answer 5

Occurs during winter & may be treated with light therapy

Question 6

Dysthymic disorder

Answer 6

Milder form of depression
Usually has early onset & lasts 2 years in length for adults (1 year for children)
Contains 3 clinical findings of depression

Question 7

Acute phase characteristics

Answer 7

Severe clinical findings of depression

Question 8

Treatment of acute phase

Answer 8

• Usually 6-12 weeks
• Potential need for hospitalization
• Reduction of depressive manifestations is the goal of treatment
• Assess suicide risk, & implement safety precautions or one-to-one observation as needed

Question 9

Continuation phase characteristics

Answer 9

Increased ability to function

Question 10

Continuation phase treatment

Answer 10

• Generally 4-9 months

- Relapse prevention is the goal of treatment

Question 11

Maintenance phase characteristics

Answer 11

Remission of manifestations

Question 12

Maintenance phase treatment

Answer 12

May last for years

Prevention of future depressive episodes is the goal of treatment

Question 13

Risk Factors

Answer 13

• Family history & previous personal history
• Twice as common in females 15-40 than males
• Neurotransmitter deficiencies
• Being unmarried
• Comorbid substance use disorder

Question 14

Subjective manifestations

Answer 14

• Anergia
• Anhedonia
• Anxiety
• Sluggishness or feeling unable to relax and sit still
• Vegetative findings, including change in eating patterns, change in bowel habits, sleep disturbances, decreased interest in sexual activity
• Fatigue
• GI changes
• Pain

Question 15

Physical assessment findings

Answer 15

• Blunted affect
• Poor grooming, lack of hygiene
• Psychomotor retardation or agitation
• Socially isolated
• Slowed speech, delayed response

Question 16

Screening Tools

Answer 16

• Hamilton Depression Scale
• Beck Depression Inventory
• Geriatric Depression Scale

Question 17

St. John’s Wort Adverse Effects

Answer 17

Photosensitivity
Skin rash
Rapid HR
GI distress
Abdominal pain
Avoid foods with tyramine

Question 18

Light therapy

Answer 18

Inhibits nocturnal secretion of melatonin

Question 19

Exercise

Answer 19

Improves clinical findings of depression and may help to prevent relapse