Mental Health Disorders Flashcards
1
Q
Neurotransmitters that affect mood
A
- Norepinephrine
- Serotonin and GABA
- Dopamine
2
Q
How does serotonin and GABA affect the body?
A
- Well-being
- Calmness
- Decrease impulsivity
- Decrease aggression
- Helps with sleep
- Decreases sex drive
- Increases appetite
3
Q
How does norepinephrine and dopamine affect the body?
A
Enhances:
- Concentration
- Ambition
- Productivity
4
Q
Major Depressive Disorder: What is it?
A
- A constellation of signs and symptoms that have multifactorial causes, including life circumstances, biological predisposition, and epigenetic influences. Disturbances in cognitive, emotional, behavioral, and somatic regulations are common features of depression.
5
Q
Major Depressive Disorder: Diagnostic Criteria
A
- In adults, diagnostic criteria includes anhedonia or depression and any four or more of the following:
1. Change in appetite
2. Change in sleep pattern
3. Fatigue
4. Psychomotor retardation or agitation
5. Poor self-image
6. Concentration difficulty
7. Suicidal ideation
6
Q
What is anhedonia?
A
Is a loss of pleasure or interest in things that previously provided joy or pleasure. To be diagnosed with depressive disorder, depression and/or anhedonia must be present with other specifiers.
7
Q
Major Depressive Disorder: Etiology
A
- Still not well understood
- Impaired synthesis and/or metabolism of norepinephrine, serotonin, dopamine, and/or other neurotransmitters
- Evidence indicates genetic predisposition (30-40%)
- 60-70% of cases are related to specific environmental factors including adverse childhood events and ongoing or recent stress due to interpersonal adversities
8
Q
Major Depressive Disorder: Risk Factors
A
- Psychosocial stressors
- Postpartum period
- Physical or chronic illness, especially migraines and back pain
- Prior episodes of depression and suicide attempts
- Family history of suicide
- Alcohol or substance abuse
- Children with a history of being bullied or abused
- Retirement, aging
- Significant loss (death of a spouse, loss of job, divorce)
- Isolation
- Comorbidities
9
Q
Major Depressive Disorder: Assessment Findings in Children
A
- Anorexia
- Sleep disturbance
- Apathy and sluggishness
- Developmental delay
- Anxiety, irritability, cries easily, restlessness
- Aggression, hyperactivity
- School problems
- GI or other somatic complaints
- Poor self-esteem
- Cognitive dulling
- Suicidal thoughts or self-injury
- Withdrawal or increased clinging behaviors
10
Q
Major Depressive Disorder: Assessment Findings in Adolescents
A
- Similar to adults
- Impulsivity
- Fatigue
- Hopelessness
- Substance abuse
11
Q
Major Depressive Disorder: Assessment Findings in Adults
A
- Depressed mood for 2 weeks or longer and/or anhedonia (at least one must be present)
- Decreased or increased appetite
- Weight loss or gain
- Sleep disorder
- Psychomotor agitation or retardation
- Fatigue, loss of energy
- Feelings of worthlessness, inappropriate guilt
- Recurrent thoughts of death
- Difficulty thinking/concentrating or indecisiveness
12
Q
Major Depressive Disorder: Non-Pharmacologic Management
A
- Identify suicidal risk, plan, lethality, availability and intent
- Establish safe environment
- Provide community resources
- Psychoeducation
- Psychotherapy
- Electroconvulsive therapy (ECT)
- Light therapy
- Transcranial magnetic stimulation (TMS)
- Vagus nerve stimulation (VNS)
13
Q
Major Depressive Disorder: Psychoeducation
A
- Ongoing information about illness, symptoms, prognosis, and therapy
- Include interpersonal relationships, work, and other health-related needs
- Discourage major life changes while in a depressive state
- Help set realistic, attainable, concrete goals
- Educate about importance of avoiding alcohol
14
Q
Major Depressive Disorder: Psychotherapy
A
- Treatment of choice with or without pharmacologic interventions in mild to moderate depression
- Pharmacologic treatment works best when accompanied with psychotherapy
- Establish and maintain a supportive therapeutic relationship
- Remain available during times of crisis
- Maintain vigilance for signs of destructive impulses
- Strengthen expectations of help and hope for the future
- Enlist support of others in patient’s social network
15
Q
Major Depressive Disorder: Electroconvulsive therapy (ECT)
A
- Indicated for depression in which a rapid antidepressant response is imperative: depression coupled with psychotic features, catatonic stupor, mania, severe suicidality, suicidality in pregnancy, or severe nutritional compromise
- Indicated for patients who prefer this method of treatment, or who have responded unsatisfactorily to antidepressant medication in the past
- High rate of therapeutic success
- Chief side effects are transient postictal confusion and memory impairment that resolve in a few days
