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Disciplines (Cholley) > Depression > Flashcards

Depression Flashcards

1
Q

MDD: Functional implications

A
  • Impairment varies from mild to incapacitated
  • Can become catatonic & unable to care for themselves
  • Increased pain & physical illnesses
  • Decreased social interaction, physical activity, & role fxn
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2
Q

MDD: What are Beck’s postulates? (3)

A
  • View about self – negative
  • Views about environment – views as hostile & demanding
  • Views about future – expectation of suffering & failure
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3
Q

What does MDD commonly occur w/?

A

Substance-use disorders, panic disorders, obsessive-compulsive disorders, anorexia nervosa, bulimia nervosa, & borderline personality disorder

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4
Q

What is the work-up for mood disorders?

A

labs, neuro imaging, EEG, questionnaires, CXR, CT/MRI brain

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5
Q

Describe interpersonal psychotherapy (IPT). What does it focus on?

A
  • Short term psychodynamic therapy

- Focus on current relationships

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6
Q

Describe cognitive therapy

A
  • Monitor & identify automatic thoughts

- Behavioral activation

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7
Q

Describe mindfulness based cognitive therapy

A

Strategies, s/a meditation, to prevent relapse

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8
Q

What is the goal of behavioral couples therapy?

A

Enhance communication/satisfaction

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9
Q

What 2 tx are available for bipolar disorder? (2)

A
  • Psychoeducational approaches

- Family-focused tx

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10
Q

Electroconvulsive therapy is reserved for ….

A
  • Severe depression w/ high risk suicide
  • Depression w/ psychotic features
  • Tx non-responders
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11
Q

What is the fxn of ECT?

A

Induce brain seizure & unconsciousness

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12
Q

What is a side effect of ECT?

A

Memory loss

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13
Q

For pts in remission who experienced only 1 episode of MDD, how long should antidepressants be continued?

A

6-12 mos

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14
Q

For pts in remission who experienced 2 or more episodes of MDD, how long should antidepressants be continued?

A

15 mos - 3 yrs

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15
Q

In chronic MDD or MDD w/ concurrent dysthymia, how long should antidepressants be continued?

A

An additional 15-28 mos after acute phase of tx

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16
Q

Tx choice should be based on…

A
  • Clinical assessment
  • Presence of other disorders
  • Stressors
  • Pt preference
  • Rxn to previous tx
17
Q

Pts on antidepressants should be monitored closely for what? (3)

A
  • Worsening
  • Suicide
  • Unusual changes in behavior
  • Monitor esp. during initial few mos, or at time of dose changes.
18
Q

When should pts on antidepressants follow up? What should be assessed?

A
  • At least once within 1st month
  • 4-8 wks after until stable
  • After 6-9 mos on meds can f/u every 3-6 mos
  • Assess for adherence, side effects, suicidal ideation, & response
19
Q

What should you advise your pt?

A
  • Most need to be on meds for at least 6 mos
  • May take 2-6 wks to see improvement
  • Important to continue taking med as prescribed, even after he/she starts feeling better
  • Don’t stop meds w/out notifying provider 1st
  • Changing dose or schedule can help manage side effects
20
Q

What is the goal of tx w/ antidepressants in the acute phase?

A

Remission of MDD sx

21
Q

How often should pts who start/switch to a new Rx be seen?

A

Every 2 wks until stable

22
Q

How long should a medication trial last for?

A

8-12 wks

23
Q

If no side effects, how often should you increase one’s dose?

A

Every 2-3 wks until:

  • Remission achieved
  • Max dose achieved
  • Side effects limit titration
24
Q

What are consequences of failing tx?

A
  • Risk of relapse
  • Continued psychosocial limitations
  • Continued impairment at work
  • More utilization of medical services
  • Risk of suicide & substance abuse
  • Risk of tx resistance
25
Q

What are co-morbidities of depression?

A
  • Heart dz
  • Breast CA
  • Immunologic dz
  • Chronic pain
  • Multiple psychotic disorders

Disciplines (Cholley) (9 decks)

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