Depressive Disorders

Question 1

Seasonal depression is also called?

Answer 1

Seasonal affected disorder (SAD)
Most often in fall/winter

Question 2

Major depressive disorder (MDD) s/s

Answer 2

Depressed mood
Loss of interest or pleasure in usual activities
Impaired social/occupational functioning
Symptoms present for at least 2 weeks

Question 3

Persistent depressive disorder
comparing to
major depressive disorder?

Answer 3

PDD similar to or milder than MDD
Essential feature is chronically depressed mood
(Most of day, more days than not, for at least 2 years)
Early onset: before 21 y.o.
Late onset: after 21 y.o.

Question 4

Premenstrual dysphoric disorder (PMDD) s/s

Answer 4

Anxiety, mood swings, decreased interest in activities, depressed mood.
Improves shortly after onset of menstruation
Reoccur for majority of cycles over a year

Question 5

What can cause substance/medication induced depressive disorder?

Answer 5

Alcohol, opioids, street drugs, anesthetic, cardiac med, steroids, anticholinergic
Impressed mood associated with intoxication or withdrawal

Question 6

What is psychoanalytical theory?

Answer 6

A loss is internalized and becomes directed against ego

Question 7

What are the 3 cognitive distortions that causes depression?

Answer 7

Neg expectations of the environment, self, or future

Question 8

What is transactional model?

Answer 8

No clear explanation for depressive disorder, evidence continues to mount for multiple causation, this model recognizes combined effects on individual’s susceptibility to depression (genetic, biochemical, and psychosocial influences

Question 9

What does 40%-90% of youth with depression have?

Answer 9

Comorbid psychiatric conditions

Question 10

What’s used for childhood depression?

Answer 10

Parent and family therapy

Question 11

Signs of adolescence depression

Answer 11

Behavioral change that lasts for several weeks

Question 12

What is the third leading cause for teen death?

Answer 12

Suicide (perception of abandonment)

Question 13

What is the best clue for mood disorder?

Answer 13

Invisible manifested in behavior change that last for several weeks

Question 14

Whatbis senescense?

Answer 14

Bereavement overload, often confused for neurocognitive disorder

Question 15

Senescence tx

Answer 15

1. Antidepressant medication
2. Psychotherapies
3. Electroconvulsive therapy (ECT)

Question 16

What can cause postpartum depression?

Answer 16

Combination of hormonal, metabolic, and psychosocial influences

Question 17

Postpartum depression s/s

Answer 17

Fatigue, irritability sleep disturbances, loss of appetite and libido

Question 18

How long can postpartum depression last?

Answer 18

A few weeks to several months

Question 19

4 spheres of human functioning ex

Answer 19

1. Affective: apathy（冷漠）
2. Behavioral: social isolation
3. Cognitive: hallucination, self-blame, thoughts of suicide
4. Physiological: slow down of body

Question 20

What is transient depression’s symptoms like?

Answer 20

Not necessarily dysfunctional.
1. Affective: sadness, having the blues
2. Behavioral: some crying
3. Cognitive: difficulty getting mind off disappointment
4. Physiological: feeling tired and listless

Question 21

Mild depression 4 symptoms

Answer 21

Similar to normal grieving.
1. Affective: denial, anger, anxiety, helplessness
2. Behavioral: tearfulness, regression
3. Cognitive: preoccupied with loss, self-blame
4. Physiological: anorexia, insomnia

Question 22

Moderate depression 4 symptoms

Answer 22

Enduring for at least 2 years.
1. Affective: rejection, helplessness, low self-esteem
2. Behavioral: slow movements, slumped posture, limited verbalization
3. Cognitive: slowed thinking, difficulty concentrating, obsessive and repetitive thoughts
4. Physiological: anorexia or overeating, sleep disturbances, headaches, low energy

Question 23

Severe depression 4 symptoms

Answer 23

Intensification of moderate depression symptoms
1. Affective: feelings of total despair and worthlessness, flat affect, inability to feel pressure
2. Behavioral: psychomotor retardation, curled-up position, absence of communication, isolation
3. Cognitive: prevalent delusional thinking, confusion, suicidal thoughts
4. Physiological: general slow-down of the entire body

Question 24

What do you need to assess frequently on patient with depressive disorders?

Answer 24

Suicidal thoughts/ideation

Question 25

What is something you can do with the patient for their safety?

Answer 25

Encourage patient to help establish a safety plan

Question 26

How should you make rounds while patient is getting medication?

Answer 26

Make rounds at frequent, irregular intervals

Question 27

Short term goal for maladaptive grieving

Answer 27

Pt express feeling of loss

Question 28

Long term goal for maladaptive grieving

Answer 28

Pt express own position in loss

Question 29

What can you teach maladaptive grieving patients?

Answer 29

Tech about the stages of grieving and behaviors of each stage

Question 30

Short term goal for patients who have low self-esteem

Answer 30

Participate in own ADL, usually in 5 days

Question 31

Long term goal for patients who have low self-esteem

Answer 31

Able to solve problems

Question 32

For patients who feel powerless, what can we do?

Answer 32

Help patient set realistic goals
Help pt identify what they can control
Discuss areas in life that are not in patient’s control

Question 33

What is individual psychotherapy?

Answer 33

Focus on patient’s current interpersonal relations

Question 34

What is phase 1 of individual psychotherapy about?

Answer 34

Assessment, education, therapeutic contract

Question 35

What is phase 2 of the individual psychotherapy about?

Answer 35

Tx to resolve maladaptive grief reaction

Question 36

What is phase 3 of individual psychotherapy about?

Answer 36

Therapeutic contract terminated, individual has improved relationship skills and functioning

Question 37

What do cognitive therapy do?

Answer 37

Focus on changing “automatic thoughts”
Ex: personalizing, all or nothing, mind reading, discounting positives

Question 38

What is electroconvulsive therapy (ECT)?

Answer 38

Electrical currents applied to brain, causing grand mal (generalized) seizure.
Usually do this only if antidepressant med are not effective

Question 39

What does repetitive transcranial magnetic stimulation (rTMS) do?

Answer 39

Short pulses of magnetic energy, most effective in treating depression, equally effective as pharmacotherapy

Question 40

What does bright light therapy do?

Answer 40

Reduce melatonin, increase serotonin
Effective for short term tx for SAD

Question 41

What is vagal nerve stimulation (VNS)?

Answer 41

Electrode implantation under skin

Question 42

What is deep brain stimulation (DBS)?

Answer 42

Electrode implantation that requires craniotomy

Question 43

What’s the first line tx for depression?

Answer 43

Psychopharmacology

Question 44

Can patients stop med abruptly?

Answer 44

No!

Question 45

What should you educate pt on meds?

Answer 45

1. Avoid driving and operating machinery
2. Use sunscreen and protective clothing
3. Change positions slowly
4. Oral care
5. No alcohol or smoking
6. No double doses
7. Carry card describing meds

Question 46

What should patients taking psych meds carry with them at all times?

Answer 46

A card with all the meds they are taking described on there

Question 47

What should the patient avoid while taking MAOIs?

Answer 47

Foods high in tyramine!!

Question 48

What are some foods that are high in tyramine?

Answer 48

Wine, beer, chocolate, coffee, tea, cheese, yogurt, smoked meats, raisins, yeast products, soy sauce
(basically all the good stuff hhh)