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behavioral and mental health psychology > exam ii: ch14 - depressive disorders > Flashcards

exam ii: ch14 - depressive disorders Flashcards

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1
Q

what is the “single most disabling disease in the world”

A

depression

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2
Q

type of disorder; constant and severe irritability and anger
- dx: 6-18 yrs
- s/s in 2/3 (home, school, peers)
- onset: before 10yrs
- temper tantrums
- males > females

A

disruptive mood dysregulation disorder

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3
Q

how many s/s from dsm-5 to be dx with depression

A

at least 6 s/s for at least 2 weeks

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4
Q

type of depression; Low-level depressive feelings through most of each day, for majority of days
>2yrs adults
>1yr children/adolescents

A

persistent depressive disorder “dysthymia”

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5
Q

must have 2+ of the following s/s:
Dec appetite OR overeating
Insomnia/hypersomnia
Low energy, hopelessness
Low self-esteem
Difficulty thinking

A

dx of persistent depressive disorder

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6
Q

type of depression; Symptom cluster in last week prior to onset of women’s period

A

premenstrual dysphoric disorder

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7
Q

FDA approved meds for premenstrual dysphoric disorder?

A

fluoxetine, sertraline, paroxetine

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8
Q

s/s of the following:
Mood swings
Irritability, difficulty concentrating
Depression anxiety, feeling overwhelmed

A

premenstrual dysphoric disorder

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9
Q

tx for premenstrual dysphoric disorder

A

aerobic exercise, complex carbs, sufficient sleep

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10
Q

caused by long term illness that causes ongoing pain

A

depressive disorder d/t medical condition

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11
Q

full-blown depression during/after delivery, more serious than “baby blues”

A

postpartum depression

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12
Q

s/s of the following:
Exhaustion
Extreme sadness, anxiety
SI

A

postpartum depression

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13
Q

what is the first and only FDA approv med for postpartum depression

A

brexanolone (Zulresso)

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14
Q

type of depression; onset during winter, lack of sunlight contributing factor returns every year

A

seasonal affective disorder

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15
Q

s/s of the following:
Social withdrawal
Increased sleep
Weight gain

A

seasonal affective disorder

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16
Q

what are some risk factors of seasonal depressive disorder (5)

A
  • female
  • far from equator
  • fam hx
  • depression + bipolar
  • younger
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17
Q

what is the main reason for inpatient psych admission

A

major depressive disorder

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18
Q

type of depression; no manic or hypomanic episode, continued feelings of depressed mood or loss of interest or pleasure
- 18-25 yrs common
- chronic = lasts more than 2 years

A

major depressive disorders

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19
Q

5+ of the following s/s for 2wks-6mo:
Weight loss/appetite change
Sleep disturbances
Fatigue
Loss of ability to concentrate, impaired fxn
Recurrent thoughts of death

A

major depressive disorder

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20
Q

type of depression; prolonged use/withdrawal from drugs and alc, s/s longer than expected effects of substance

A

substance induced/med induced depression

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21
Q

what are meds that can lead to substance induced depression

A
  • antivirals
  • cardiovascular drugs
  • antidepressants
  • anticonvulsants
  • antipsychotics
  • smoking cessation meds
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22
Q

different from depression, someone CAN experience low moods that meet the criteria of major depression with manic episodes

A

bipolar disorder

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23
Q

difference between bipolar and depression

A

bipolar = manic and depressive states

depression = emphasis on the “lows” of depressed mood

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24
Q

what are co-curring medical problems that inc risk of depression

A

HTN, diabetes, cardiac issues, arthritis, backaches

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25
Q

model that states life events + biological predisposition affect the way we respond to stress

A

diathesis stress model

26
Q

how does the HPA axis lead to depression?

A

inc cortisol and CRH = depression

27
Q

questionnaire used to grade mood improvement (given before and after TMS) and assess suicide potential

A

PHQ-9 questionnaire

28
Q

inability to experience pleasure

A

anhedonia

29
Q

lack of energy

A

anergia

30
Q

what are vegetative signs and list examples

A

alterations in activities needed to support life and growth
- loss of appetite
- change in sleep pattern
- change in bowel/bladder habits
- neglected grooming
- libido decline

31
Q

t/f: pharm therapy for depression aims to cure the disease

A

f: targets the symptoms rather than being an actual cure

32
Q

what is the black box warning for all anti-depressants

A

inc in suicidal behavior + depressive thoughts

33
Q

how long to observe pt after first admin of antidepressant

A

first 7-14 days of tx

34
Q

class of the following meds:
paroxetine (Paxil)
fluoxetine (Prozac)
sertraline (Zoloft)
escitalopram (Lexapro)
citalopram (Celexa)
Fluvoxamine (Luvox)

A

selective serotonin reuptake inhibitors (SSRIs)

35
Q

what is the only FDA approved med for OCD

A

Luvox

36
Q

name that med class:
- good for depression + anxiety
- first line therapy, dec SE compared to other classes
- SE: agitation, sexual dysfunction, HA, serotonin syndrome, discontinuation syndrome

A

SSRIs

37
Q

s/s of the following:
Abd pain, diarrhea, sweating, fever, tachycardia, HTN, altered mental status, myoclonus, irritability, hositility

A

serotonin syndrome

38
Q

s/s of the following:
dizziness, insomnia, nervousness, irritability, nausea, agitation

A

discontinuation syndrome

39
Q

class of the following meds:
venlafaxine (Effexor)
desvenlafaxine (Pristiq)
duloxetine (Cymbalta):

A

serotonin norepinephrine reuptake inhibitors (SNRIs)

40
Q

name that med class:
- inhib serotonin and norepinephrine reuptake
- SE: HA, dizziness, insomnia, dry mouth

A

SNRIs

41
Q

med class of the following:
mirtazapine (Remeron)

A

serotonin norepinephrine DISinhibitor

42
Q

what is mirtazapine (Remeron) used for

A

antiemetic

43
Q

med class of the following:
Nortriptyline (Pamelor)
Amitriptyline (Elavil)
Imipramine (Tofranil)
Desipramine (Nopramin)

A

tricyclic antidepressants (TCA)

44
Q

name that med class:
- good for melancholic depression
- NOT first line d/t high risk OD
- SE: anticholinergic rxns, cardiovascular rxns
- Toxicity: dysrhythmias, MI, heart block
- DO NOT GIVE: heart issues, pregnant, seizures

A

tricyclic antidepressants (TCAs)

45
Q

s/s of the following:
dysrythmias, MI, heart block

A

TCA toxicity

46
Q

med class of the following:
Isocarboxazid (Marplan)
Phenelzine (Nardil)
Selegiline (EMSAM)
Tranylcypromine (Parnate)

A

monoamine oxidase inhibitors (MAOIs)

47
Q

name that med class:
- give when failed SSRI/TCA
- needs dietary restriction from tyramine
- stop taking SSRI, wait 2-5wks before starting
- SE: orthostatic hypotension

A

MAOIs

48
Q

t/f: need to maintain tyramine restriction for 2 weeks after MAOI stop

A

true

49
Q

med class of the following
bupropion (Wellbutrin)

A

norepinephrine dopamine reuptake inhibitor (NDRI)

50
Q

name that med class:
- inhib acetylcholine receptors to dec addictive aspect of nicotine, blocks reuptake of norepinephrine and dopamine
- benefits: NO sexual dysfxn, NO weight gain
- DO NOT GIVE: seizure, eating disorder, with benzos
SE: insomnia, tremors, weight loss, seizures, vomiting

A

NDRIs

51
Q

foods to avoid that have tyramine

A

avocados
figs
bananas
fermented/smoked meats
deli meats
fish
ALL cheese
soy sauce

52
Q

what treatment to opt for if pharm tx does not work

A

somatic treatments

53
Q

somatic tx:
- most effect tx for depression, helps with catatonia
- works quickly and better than bed BUT use of anesthesia = less common
- SE: confusion + memory loss

A

electroconvulsive therapy (ECT)

54
Q

where to place ECT leads for more dramatic results

A

bilaterally

55
Q

what criteria need to be met for ECT

A
  • suicidal and needs RRT
  • can’t take med
  • multiple med classes don’t work
  • okay for elderly even >85
56
Q

somatic tx;
- noninvasive, uses magnetic pulses to stimulate focal areas of cerebral cortex
- 30 tx sessions, 5 days/wk for 6 wks
- need to remove all metal from body

A

transcranial magnetic stimulation (TMS) or (rTMS)

57
Q

somatic tx;
- used for epilepsy
- electrode stim nerve to noost NMs, improve mood
- SE: voice alteration, hoarseness, neck pain, cough, parathesia, dyspnea

A

vagus nerve stimulation (VNS)

58
Q

somatic tx for seasonal affective depression

A

light therapy

59
Q

somatic tx;
- electrodes are surgically implanted into specific areas of the brain to stimulate regions ID’d to be underactive in depression

A

deep brain stimulation

60
Q

how does exercise help with depression

A

inc availability of serotonin
release of endorphins
benefit: no antidepressant SE

61
Q

in order to dx dysthymia, it needs to be occuring for at least how long?

A

2 years (adults)

behavioral and mental health psychology (17 decks)

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