class 5-6 (mood & affect A-B) Flashcards

(65 cards)

1
Q

what is an emotion

A

a short-lived feeling about something specific
-emotions tell us about our mood

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2
Q

what is a mood

A

a mood is long-lasting (hours->dayys) & much more diffuse
-it is subjective

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3
Q

what is affect

A

the observable expression of a mood

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4
Q

depression in children/teenagers

A

-increased focus on this in recent years but most do not get the tx they need
-people dont believe them or they dont know how to express themselves
-presents differently in every case, may not have “common cues”
-stigma of teenagers being “moody”, lasts weeks->months

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5
Q

depression in older adults

A

-often misdiagnosed as one of the 3 D’s
-increased stigma
-generational differences + substance use = decreased change of a diagnosis

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6
Q

what is the risk assessment for suicide

A

SAD PERSONS scale

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7
Q

postpartum depression

A

starts in 1st month->1 year
-long lasting and requires treatment
-normalized after birth due to: changes in hormones, societal factors, stigma

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8
Q

baby blues

A

starts 3-4 days after birth & lifts on its own
-“acute version” of PDD, same criteria for Dx

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9
Q

risk factors for PPD

A

Hx depression
previous PPD
stressors (i.e. financial, marital, etc)
-unplanned pregnancy
-little to no support

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10
Q

treatment for PPD

A

CBT
supportive counselling
anti-depressant
ECT

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11
Q

edinburgh postnatal depression scale (EPDS)

A

-assists HCP to assess for ppd
-consists of 10 short statements->takes 5 mins
-based on previous 7 days
-has to be completed in it’s entirety
-if pt answers “yes” to thoughts of harm question: automatically referred regardless of other answers

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12
Q

disruptive mood dysregulation disorder

A

-irritability, anger, & frequent intense temper outbursts (verbal & behavioural, acts like this most of the day everyday)
-experience significant problems at home, in school (high rate of suspension), & with peers
-can occur with other disorders associated with irritability such as ADHD & anxiety
-dx: 3+ outbursts within a week & behaviour ongoing for 12 months

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13
Q

treatments for distruptive mood dysregulation disorder

A

CBT
DBT
individual/group/family therapy
meds for behaviours (no med for dx): stimulants, antidepressants, antipsychotics

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14
Q

persistent depressive disorder

A

-social distress
-they’ve “always felt this way”
-early teen onset
-chronic

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15
Q

premenstrual dysphoric disorder

A

occurs last week pre-menstrual period
-2-6% effected
-depressive symptoms

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16
Q

dysthymia/persistent depressive disorder

A

milder but more chronic than MDD
-2+ years of s&s
-affects social experiences “i’ve always felt like this”
-can be associated with other illnesses the person is experiencing
-duration &severity of symptoms are different from depression

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17
Q

major depressive disorder

A

-one of the most common mental disorders
-severe depressive mood symptoms: interferes with relationships, funtional status, employment
-persistent for min 2w, acute episode can last up to 5-6 months, chronic can last >2yr
-acute episode 50% chance of reoccurance during 1st yr of dx
-hallucinations/delusions can occur in severe cases
-can be related to physical illness ex:thyroid disorder
-NO HISTORY OF MANIA/HYPOMANIA

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18
Q

depression is characterized by:

A

-sadness
-loss of interest or pleasure
-feelings of guilt
-low self-worth
-disturbed sleep or appetite
-tiredness
-poor concentration

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19
Q

MDD S2IGECAPS meaning:

A

S-sadness (depressed mood)
S-sleep disturbance
I-interest reduced (anhedonia)
G-guilt and self blame
E-energy loss and fatigue (anergia)
C-concentration problems
A-appetite changes
P-psychmotor changes
S-suicidal thoughts
-must have at least 5 for at least 2 weeks

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20
Q

psychotic features of depression

A

delusions, disorganized thoughts, hallucinations (usually auditory)

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21
Q

melancholic features of depression

A

severe endogenous depression r/t internal (biological, cognitive, etc) stressor vs external one

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22
Q

atypical features of depression

A

overeating, oversleeping, anxiety (usually seen in younger generations)

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23
Q

catatonic features of depression

A

unresponsive, extreme psychmotor paralysis

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24
Q

seasonal (SAD) fall/winter features of depression

A

“normal mood” during spring/summer, decrease mood during cold dark years, responds well to light therapy

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25
how depression presents in men: mood
anger, aggressiveness, anxiousness, restlessness
26
how depression presents in men: emotional
feeling empty, sad, hopeless
27
how depression presents in men: behavioral
feeling tired easily, drinking excessively, using drugs, engaging in high-risk activities
28
how depression presents in men: sexual
reduced sexual desire, lack of sexual performance
29
how depression presents in men: cognitive
inability to concentrate, difficulty completing tasks, delayed responses during conversations
30
how depression presents in men: sleep
insomnia, restless sleep, excessive sleepiness
31
how depression presents in men: physical
fatigue, pains, headache, digestive problems
32
how depression presents in women: mood
iriitability
33
how depression presents in women: emotional
feeling sad or empty, anxious or hopeless
34
how depression presents in women: behavioral
withdrawing from social engagements, thoughts of suicide
35
how depression presents in women: cognitive
thinking or talking more slowly
36
how depression presents in women: sleep
waking early, sleeping too much
37
how depression presents in women: physical
decreased energy, increased fatigue, changes in appetite, increased cramps
38
how depression presents LQBTQ community
-lack of research -most often associated with what factors impact on the presentation of depression
39
depression: presentation in children & teens
-irritable, sad, withdrawn, or bored most of the time -does not take pleasure in things he or she used to enjoy -weight loss or gain -sleep changes: too much or too little -feel hopeless, worthless, or guilty -trouble concentrating, thinking, or making decisions -think about death or suicide a lot
40
depression: presentation in older adults
-loss of interest in activities they used to enjoy -express feelings of worthlessness or sadness -unusual outbursts of crying, agitation, or anger, or shows little emotion -sleep changes -change in eating patterns -complains about physical symptoms that do not have a cause -lack of energy -confused, difficulty concentrating, remembering things, making decisions, following through with plans -spends more time alone -talks about suicide
41
what are some things that have a causal relationship with depression
-family hx -hormones -difficult life or traumatic events -increased stress -chronic illness -addictive behaviours and patterns -societal trends -medications (birth control, beta blockers, PPI's, steroids, sedatives, anticonvulsants) -cultural or religious considerations (lack or words to describe deoression)
42
examples of other mental health screening tools for depression
mood disorder questionnaire patient health questionnaire (PHQ-9) edinburgh postnatal depression scale(EPDS)
43
assessment of depression in older adults
-explore predisposing and precipitating factors -S2IGECAPS -the geriatric depression scale "yes or no q's" -brief assessment schedule for the elderly (BASDEC) "true or false q's" -following a positive screening->complete bio-psycho-social assessment should be conducted
44
Recommendations for prevention and Treatment of depression in Older Adults
-a variety of interventions focused on reducing social isolation and/or loneliness -social prescribing -stepped care approach -higher levels of physical activity -instilling hope and positive thinking as therapeutic tools
45
top treatments for depression
cognitive behavioural therapy (CBT) interpersonal therapy behavioural activiation (similar to social prescribing, deliberate practicing a behaviour to get a positive emotional response
45
what do antidepressants target?
CNS and neurotransmitters
46
what do antidepressants address
anergia anadonia fatigue sleep/appetite disturbances
47
what factors to consider when choosing antidepressants
side effects, current medications, contraindications, affordability, patient preference
48
commonly prescribed SSRI's
-citalopram (Celexa) -escitalopram (Lexapro) -fluoxetine (Prozac) -fluvoxamine (Luvox) -Paroxetine (Paxil) -sertraline (Zoloft)
49
SSRI common adverse reactions
-sexual dysfunction -decreased appetite -sedation -sweating -bruising
50
SSRI rare reactions
-bleeding -hyponatremia -serotonin syndrome (combination of mental status changes & neuromuscular changes)
51
what is seen in serotonin syndrome
increased BP delirium sweating aggitation abdominal pain mental status changes
52
common SNRI's
-duloxetine (Cymbalta) -venlafaxine (Effexor)
53
common adverse effects of SNRI's
nervousness asthenia (physical weakness/energy) -increase in BP -hyponatremia
54
rare reactions with SNRI's
induction of hypomania
55
common prescribed serotonin modulator and reuptake inhibitors
-nefazodone (serzone) -trazodone (desyrel)
56
serotonin modulator and reuptake inhibitors adverse reactions
-dyspepsia -memory impairment -ataxia -parethesia -asthenia -increased cough -edema -incoordination -hypotension -syncope
57
rare adverse reactions of serotonin modulator and reuptake inhibitors
induction of hypomania postural hypotension priapism hepatic failure requiring liver transplant and/or death
58
common norepinephrine and dopamine reuptake inhibitor (NDRI)
bupropion (Wellbutrin)
59
adverse reactions for NDRI's
-dry mouth -constipation -weight loss -anorexia -insomnia -dizziness -headache -agitation -anxiety -tremors -tinnitus -rash -hypertension
60
rare adverse reactions in NDRI's
seizures hypomania (pts's with bipolar disorder)
61
commonly prescribed TCA's
-amitriptyline (Elavil) -Clomipramine (Anafranil) -Doxepin (Sinequan) -Desipramine (Norapramin) -Imipramine (Tofranil)
62
adverse reactions of TCA's
-blurred vision -urinary retention -heartburn -unusual taste in mouth -weakness -nervousness -restlessness -photosensitivity -rash and itching -application site reactions (topical doxepin)
63
important points about TCA's
-very effective with non-delusional depression -increase monitoring with dose adjustion: low n slow
64
rare adverse reactions of TCA's
-paralytic ileus* -hyperthermia* -lowered seizure threshold orthostatic hypotension -sudden death arrhythmias -QT prolongation -hepatic failure -increased intraocular pressure -rare induction of mania