Depression Flashcards
the most common mental health disorder
anxiety
older adults who are depressed are usually dx with
dementia and delirium
the theory of depression
complex interaction with genetics, the environment and individuals biology
the monomine deficiency hypothesis believes this
deficiency in serotonin and norepinephrine
individuals with depression have an increase in
cortisol
how do we determine cortisol over-production
dexamethasone suppression test (DST) - not used as a diagnosed tool
is DST (dexamethasone suppression test) used as a dx tool
no - aids in assessment
is there a dx test for depression
no, dx is based on structured clinical interview
the stress diathesis model of depression
if you have a genetic predisposition than you have an assault from the environment your likely to develop the disease
the most widely accepted explanation for mental illness and depression
stress diathesis model of depression
learned helplessness is attributed to the loss of
control
major depressive disorder is prevalent in this population
white - single - divorced
the father of cognitive theory
aaron beck
cognitive theory is based on
thoughts are related to feelings and behaviors
3 positions of cognitive theory
negative view of themselves, the world and the future
best treatment of mental illness/depression
psycho -therapy and meds (prefrontal lobe activity increases)
to dx major depressive disorder you must present with
*must have 5 of the 9 criteria in DSM
*anhedonia (loss of interest) and depressed mood
symptoms persist for >2weeks that effect quality of life
3 types of symptoms in major depressive disorder
mood (guilt)
cognitive effects (poor concentration, inattention)
physical (not sleeping/eating, weight loss)
psychotic subtype of MDD present with
hallucinations (auditory) or delusions
melancholic subtype of MDD present with
suicidal - everything is dark
most severe subtype of MDD
melancholic
atypical subtype of MDD present with
opposite the norm (gaining weight, sleeping too much)
catatonic subtype of MDD present with
negativism, waxy flexibility
postpartum subtype of MDD occurs within
4 weeks of childbirth
seasonal affective disorder of MDD onset occurs
in the Fall and subsides in the spring
ongoing low-grade depression that occurs over 2 yrs is classified as
persistent depressive disorder
due to an over-diagnosis of bipolar disorder in children, this dx was developed for the new DSM
disruptive mood dysregulation
disruptive mood dysregulation presents with
outbursts not in proportion to the situation (physical/verbal episodes)
what are the 6 sub-types of MDD
Psychotic features Melancholic features Atypical features Catatonic features Postpartum onset Seasonal affective disorder
when a clinician cannot determine whether a pt. has MDD or persistent depressive disorder they dx them with this
unspecified depressive disorder
pt with depressive symptoms 14 days before menstrual onset is dx with
premenstrual dysphoric disorder
dysthymia pt present like this
Eeyore - 2+yrs. of depressive symptoms - sleep/appetite disturbance - suicidal thoughts not r/t psychosis
difference between dysthymia and MDD
dysthymia does not present with psychosis
when does dysthymia usually occur
early childhood - teens - early adulthood
mnemonic for assessing depression
SIGECAPS
what does SIGECAPS stand for
sleep (increase/decreased) interest (diminished) guilt/low self-esteem energy (low) concentration (poor) appetite (increase/decrease) psycho-motor (agitation/retardation) suicidal ideation
difference between depression and grief
depression is diagnosable grief is not
with grief do symptoms resolve
yes -
can you have grief and depression
yes - grief can trigger depression
individuals with depression are always evaluated for risk of suicide, t or f
true
Mrs. Chauncey, 80 years of age, complains of stomach pain and is now mute and staring out of her window. She is refusing food. Which of the following interventions are appropriate?
Speak with her, although she may not answer
Continue to offer her food and fluids.
Regularly assess vital signs and skin turgor.
Mrs. Chauncey receives a visit from her priest. He runs out of her room and then pulls the nurse assistant back into her room. Mrs. Chauncey is cutting her left wrist (superficially) with the 5 x 7 glass from a framed photo of a grandchild. She is taken to the emergency department where her wrist is bandaged. Her daughter and son in law are notified. As her nurse, which of the following statements help clarify what has taken place?
“When your Mom’s priest arrived, he found her cutting her wrist with the glass from a framed photo.”
A nurse is caring for a client diagnosed with dysthymia. Which of the following defining characteristics are associated with this disorder? Select all that apply.
Insomnia or hypersomnia
Suicidal thoughts
Appetite disturbance
