Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

310 MENTAL HEALTH > Chapter 25 Depressive Disorders > Flashcards

Chapter 25 Depressive Disorders Flashcards

1
Q

Depression

A
  • One of the oldest and most frequently diagnosed psychiatric illnesses
  • Mood changes
  • Sadness, despair, and pessimism
  • Loss of interest
  • Possible changes in appetite, sleep patterns, or cognition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Epidemiology of Depression

A
  • More prevalent in women than men
  • Gender difference less significant between ages 44 and 65 years
  • After age 65, more prevalent in women
  • 2 to 1
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Epidemiology: Social class

A

Inverse relationship between social class and report of depressive symptoms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Epidemiology: Race and culture

A

No consistent relationship between race and affective disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Epidemiology: Marital status

A

Increased risk in single and divorced people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Biological Theories

A
  • Heritability: estimated 40-50%
  • Deficiency of norepinephrine, serotonin, and dopamine
  • Excessive cholinergic treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Major Depressive Disorder (MDD)

A
  • Depressed mood
  • Loss of interest or pleasure in usual activities
  • Symptoms present for at least 2 weeks
  • Impaired social and occupational functioning
  • No history of manic behavior
  • Not attributed to use of substances or another medical condition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Major Depressive Disorder: DSM-V

A
  • For atleast 2 weeks:
    • Depressed mood
      - and or
    • Markedly diminished interest or pleasure in all, or almost all, activities

Impairment in functioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

DSM-V MDD at least 5 of following symptoms

A

Depressed mood or irritability
Decreased interest or pleasure in activities
- Significant weight change (5%) or appetite changes
- Changes in sleep
- Change in activity
- Fatigue or loss of energy
- Guilt or worthlessness
- Concentration
- Suicidality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Mnemonic
Assessment: SIGECAPS

A
  • Sleep disorder
  • Interest deficit (anhedonia)
  • Guilt
  • Energy deficit
  • Concentration deficit
  • Appetite disorder, weight change
  • Psychomotor retardation or agitation
  • Suicidality
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Dysthymic Disorder

A
  • Mild
  • Sad or “down in the dumps”
  • No evidence of psychotic symptoms
  • Chronically depressed mood for:
    - Most of the day
    - Most days
    - At least 2 years
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Premenstrual Dysphoric Disorder

A
  • Depressed mood
  • Anxiety
  • Mood swings
  • Decreased interest in activities
  • Symptoms begin the week before menses
    • improve within a few days after onset of menses
      - Minimal or absent the week after menses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

MDD Consequences

A
  • Depression can be deadly
  • Risk for suicide
  • Emotional, cognitive, behavioral, and physical consequences
  • Metabolic changes in the prefrontal cortex and limbic system (emotional brain)
  • Structural changes in the hippocampus and prefrontal cortex
  • Diminished neurotrophic support
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Childhood Depression

A

< age 3: Feeding problems, tantrums, lack of playfulness and emotional expressiveness

Ages 3 to 5: Accident proneness, phobias, excessive self-reproach

Ages 6 to 8: Physical complaints, aggressive behavior, clinging behavior

Ages 9 to 12: Morbid thoughts and excessive worrying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are examples of adolescent depression manifestations?

A
  • Anger, aggressiveness
  • Running away
  • Delinquency
  • Social withdrawal
  • Sexual acting out
  • Substance abuse
  • Restlessness, apathy
  • 2 to 3 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Adolescent Depression

A

Depression vs. expected adolescent behavior
*Visible manifestation of behavioral change for several weeks

  • Most common precipitant to adolescent suicide
    *Perception of abandonment by parents or peer

-Treatment
* Supportive psychosocial intervention
* Antidepressant medication

17
Q

Depression in Older Adults

A
  • Grief
  • Significant percentage of suicides among elderly
    • Especially Caucasian males
  • Depression is often mistaken for neurocognitive disorder
  • Treatment
    * Antidepressants
    * Electroconvulsive therapy (ECT)
    * Psychosocial therapy
18
Q

Postpartum Depression

A

Postpartum depression
- Few weeks to several
months
- Hormonal changes,
tryptophan metabolism,
cell alterations
- Treatments
- Antidepressants and
psychosocial therapies

  • Symptoms
    *Fatigue, Irritability
    *Loss of appetite
    *Sleep disturbances,
    loss of libido
    *Concern about the inability
    to care for the infant
19
Q

Planning/Implementation for Depression

A

Examples of nursing diagnoses
- Self-care
- Powerlessness

Client goals and interventions
Client/family education

20
Q

Outcomes

A

Experienced no physical harm to self
Discusses feelings with staff and family members
Expresses hopefulness
Sets realistic goals for self
Able to identify aspects of self-control over life situations
Expresses personal satisfaction and support from
spiritual practices

21
Q

Treatments for depressive disorders

A

Individual psychotherapy
Group therapy
Family therapy
Cognitive therapy
Electroconvulsive therapy
Transcranial magnetic stimulation
Vagal nerve stimulation and deep brain stimulation
Light therapy

22
Q

Psychopharmacology

A
  • Tricyclic antidepressants
  • Selective serotonin reuptake inhibitors
  • Monoamine oxidase inhibitors
  • Serotonin-norepinephrine reuptake inhibitors
  • Estimated 30-50% of patients do not respond to first antidepressant prescription
  • Role of genetics
23
Q

Client/Family Education for Antidepressants

A

Continue to take medication for 4 weeks
 Do not discontinue the medication abruptly
 Report sore throat, fever, malaise, yellow skin,
bleeding, bruising, persistent vomiting or headaches,
rapid heart rate, seizures, stiff neck and chest pain to
physician
 All antidepressants: FDA black-box warning for
increased risk of suicidality in children and adolescents

24
Q

Selective Serotonin Reuptake Inhibitors action

A

Blocks the serotonin reuptake sites, allowing serotonin to remain active in the synapse longer
Can be used for OCD, bulimia (increase dosages), GAD, social phobia, PTSD

25
Q

Examples of selective serotonin reuptake inhibitors

A

 Fluoxetine—Prozac
 Fluvoxamine—Luvox
 Paroxetine—Paxil
 Sertraline—Zoloft
 Citalopram—Celexa
 Escitalopram—Lexapro
 Vortioxetine—Brintellix

26
Q

Common side effects of SSRIs

A
  • Both activation and sedation can occur
  • Increased dreaming
  • Hypomania, psychosis
  • Fine tremor
  • N and V/GI upset
  • Headaches
  • Sexual (over 30%) decreased libido, impotence, ejaculatorry disturbances, anorgasmia
  • Hyponatremia
27
Q

Serotonin Syndrome

A

Autonomic instability and
neuromuscular changes
Shivering
Sweating
Hyperthermia
Hypertension
Tachycardia
Myoclonus (sudden muscle
contractions)
Nausea, tremor
Hyperreflexia/clonus (overactive
reflexes)
Diarrhea
Mydriasis (pupil dilation)

Altered Mental Status
 Confusion
 Agitation
 Headache

28
Q

Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)

A

**Duloxetine—Cymbalta (neuropathy type pain & fibromyalgia)
**Venlafaxine—Effexor (monitor BP, especially with higher doses)
**Desvenlafaxine—Pristiq
**Levomilnacipran—Fetzima

Selective Serotonin
Reuptake Inhibitor
and Serotonin
Receptor Agonists
**Vilazodone–Viibryd

29
Q

Tricyclic Antidepressants (TCAs)

A

 Amitriptyline—Elavil, usually given for sleep
 Doxepin—Sinequan, usually given for sleep
 Nortriptyline—Pamelor, usually for sleep
 Clomipramine
 Amoxapine
 Imipramine
 Desipramine
 Protriptyline
 Trimipramine
 Maprotiline

30
Q

Common Side Effects of TCAs

A

 Drowsiness
 Excitement, nightmares, agitation, restlessness, insomnia, confusion, disturbed concentration, disorientation
 Hypomania, psychosis
 Tremor, akathisia
 Seizures
 Paresthesias
 Stuttering
 Anticholinergic
 Orthostatic hypotension
 Decreased libido, impotence,
anorgasmia
 Carbohydrate cravings,
hyperglycemia
 Easy to overdose, lethal
dose is 3 times therapeutic
dose

31
Q

Monoamine Oxidase Inhibitors

A

 Isocarboxazid—Marplan
 Phenelzine—Nardil
 Tranylcypromine—Parnate

32
Q

Common side effects of MAOIs

A

 Insomnia, nausea, agitation, confusion
 Do not take with SSRIs, cautiously with TCAs
 HTN crisis—typically when consuming tyramine-rich
food

33
Q

MAOI Client Education

A

 Avoid foods and medications
high in tyramine when taking
MAOIs

 These include:
 Aged cheese
 Wine; beer
 Chocolate; colas
 Coffee; tea
 Sour cream; yogurt
 Smoked and processed meats
 Beef or chicken liver
 Canned figs
 Caviar
 Raisins
 Pickled herring
 Yeast products
 Broad beans
 Soy sauce
 Cold remedies
 Diet pills

34
Q

Atypical Antidepressants

A

Bupropion (Wellbutrin): increases seizure risk, avoid
if epileptic, increases energy, weight loss, can
increase anxiety may increase sex drive, aid to quit
smoking
 Trazodone (Desyrel): often given for insomnia,
priapism possible
 Mirtazapine (Remeron): usually given for insomnia,
can increase appetite and weight

35
Q

Special Precautions

A

 Abrupt withdrawal
- SSRIs: can cause flu-like symptoms

 Lowering seizure threshold
- Bupropion–Wellbutrin

 Risk of Suicide
 Toxic in Overdose
- TCAs
- MAOIs

310 MENTAL HEALTH (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions