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psychia > mood disorders > Flashcards

mood disorders Flashcards

1
Q

a mood disorder that causes a persistent feeling of sadness and loss of interest

A

depression

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2
Q

natural response to a loss

A

grief

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3
Q

painful feelings come in waves often intermixed with positive memories associated with loss (there is little relief)

A

grief

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4
Q

self esteem is maintained in this feeling

A

grief

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5
Q

what is the similarity between grief and depression

A

intense sadness and withdrawal from usual activities

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6
Q

this feeling causes decrease in interest or/and mood

A

depression

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7
Q

feelings of worthlessness and self loathing are common in this feeling

A

depression

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8
Q

what are other terms for major depressive disorder

A

clinical depression
major depression
unipolar depression

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9
Q

what is the dsm-v diagnostic criteria for major depressive disorder

A

at least 2 weeks of depressive episode
or
at least 4 of the following:
- anhedonia
- appetite disturbance
- sleep disturbance
- psychomotor agitation or retardation
- fatigue (throughout the day)
- feelings of worthlessness
- recurrent suicidal thoughts

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10
Q

what is the feeling of inability to experience pleasure

A

anhedonia

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11
Q

what are the two types of sleep disturbance

A

hypersomnia
insomnia

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12
Q

what do you call the type of sleep disturbance where th patient sleeps for long periods

A

hypersomnia

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13
Q

what is another term for persistent depressive disorder

A

dysthymia

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14
Q

how many weeks of depressive episode is it needed to diagnose major depressive disorder?

A

at least 2 weeks

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15
Q

what are the dsm-v diagnostic criteria for persistent depressive disorder

A

depressed mood for at least 2 years
or
at least two of the following
- appetite disturbance
- sleep disturbance
- fatigue
- feelings of worthlessness
- feelings of hopelessness
- poor concentration or difficulty making decision

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16
Q

what type of depression has
- anhedonia

A

major depressive disorder

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17
Q

what type of depression has appetite disturbance

A

major depressive disorder and persistent depressive disorder

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18
Q

what type of depression has sleep disturbance

A

major depressive disorder and persistent depressive disorder

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19
Q

what type of depression has psychomotor agitation or retardation

A

major depressive disorder

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20
Q

what type of depression has all day fatigue

A

major depressive disorder and persistent depressive disorder

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21
Q

what type of depression has feelings of worthlessness

A

major depressive disorder and persistent

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22
Q

what type of depression has feelings of worthlessness

A

major depressive disorder and persistent depressive disorder

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23
Q

what depression has recurrent suicidal thoughts

A

major depressive disorder

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24
Q

what depression has feelings of hopelessness

A

persistent depressive disorder

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25
Q

what depression has poor concentration or difficulty making decision

A

persistent depressive disorder

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26
Q

what is the exact cause of depression

A

unclear

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27
Q

what is the exact cause of depression

A

unclear

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28
Q

how many percentage of concordance rate do identical twins have when it comes to depressive disorder?

A

40-50%

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29
Q

what’s the probability of first degree relatives of depressed individuals developing depression

A

3x more likely

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30
Q

can adopted children develop mood disorders simply because their biological parents had mood disorders

A

yes

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31
Q

what are the monoamine neurotransmitters

A
  • serotonin
  • norepinephrine
  • dopamine
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32
Q

what monoamine neurotransmitter controls food intake

A

serotonin

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33
Q

what monoamine neurotransmitter controls sleep

A

serotonin

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34
Q

what neurotransmitter regulates emotions

A

serotonin

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35
Q

what neurotransmitter controls motivation

A

dopamine

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36
Q

what neurotransmitter controls cognition

A

dopamine

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37
Q

what neurotransmitter regulates emotional responses

A

dopamine

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38
Q

what neurotransmitter causes changes in attention

A

norepinephrine

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39
Q

what neurotransmitter causes changes in learning and memory

A

norepinephrine

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40
Q

what neurotransmitter causes changes in mood

A

norepinephrine

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41
Q

what neurotransmitter controls motivation, cognition; regulates emotional responses

A

dopamine

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42
Q

what neurotransmitter causes changes in attention, learning and memory, sleep and wakefulness, mood

A

norepinephrine

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43
Q

what are causes of dysregulation of neurotransmitters

A
  • too few are released
  • linger too briefly in synapses
  • releasing presynaptic neurons reabsorb them too quickly
  • conditions in the synapses do not support linkage with post synaptic receptors (monoamine oxidation)
  • number of postsynaptic receptors have decreased
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44
Q

what medications cause depression

A

CNS depressants
antihypertensives
ant-acne

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45
Q

what CNS disorders cause depression

A
  • cerebrovascular disorders
  • temporal lobe tumors
  • alzheimer’s disease
  • huntington’s disease
  • multiple sclerosis
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46
Q

what hormonal imbalances cause depression

A

adrenal dysfunction
- addison’s and cushing’s
estrogen - progesterone imbalance

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47
Q

what nutritional deficiencies cause depression

A

vitamin B complex deficiency
vitamin C deficiency

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48
Q

what are the b vitamins

A

b1 (thiamine)
b6 (pyridoxine)
b12 (cyanocobalamin)

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49
Q

what are CNS depressants

A

anxiolytics
antipsychotics
sedative-hypnotics

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50
Q

what is an example of antihypertensive that cause depression

A

propanolol

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51
Q

what anti-acne causes depression

A

isotretinoin

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52
Q

what feeling causes ambivalence

A

melancholia

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53
Q

what causes the formation of a weak ego and a punitive superego

A

melancholia

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54
Q

who created the concept of melancholia

A

sigmund freud

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55
Q

this imposes feeling of lack of control over life situation

A

learned helplessness

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56
Q

who created the idea of learned helplessness

A

seligman

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57
Q

this theory proposes that melancholia results to the formation of a weak ego and punitive superego, thus the development of depression

A

psychoanalytical theory by sigmund freud

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58
Q

this theory proposes that depressive illness is a result of having been abandoned by or otherwise separated from a significant other during the first 6 months of life

A

object loss theory

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59
Q

this theory proposes that the underlying cause of depressive affect is seen as cognitive distortions that result in negative, defeated attitudes

A

cognitive theory

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60
Q

what are the screening tests for depression

A

DASS - 21 (Depression, Anxiety and Stress Scale)
Hamilton Depression Rating Scale

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61
Q

this assesses for depression symptoms which will be used to determine severity of disease

A

hamilton depression rating scale

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62
Q

this is administered by a clinician

A

hamilton depression rating scale

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63
Q

this is a self-rating tool

A

DASS - 21

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64
Q

what are mHGAP protocol for management of depression

A
  • provide psychoeducation to the person and their carer
  • reduce stress and strengthen social supports
  • promote functioning in daily activities and community life
  • consider antidepressants
  • if available, consider referral for brief psychosocial treatments
  • do not manage the symptoms with ineffective treatments (i.e., vitamin injections)
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65
Q

t/f:
provide psychoeducation to the person only

A

false

provide psychoeducation to the person and their carer

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66
Q

t/f:
reduce stress and strengthen social supports

A

true

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67
Q

t/f:
promote functioning in daily activities and community life

A

true

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68
Q

t/f:
consider antipsychotics

A

false
consider antidepressants

69
Q

t/f:
give vitamin injections as supportive care

A

false
do not manage symptoms with ineffective treatments

70
Q

t/f:
if available, consider referral for brief psychosocial treatments

71
Q

t/f:
depression is a rare condition

A

false
depression is a very common condition that can happen to anybody

72
Q

t/f:
fatigue and avolition in a depressed person could be because they are just being weak and lazy

A

false
the occurrence of depression does not mean that the person is weak or lazy

73
Q

t/f:
you should tell a depressed person to be more cheerful to keep the sadness away

A

false
depression cannot be controlled by sheer willpower

74
Q

t/f:
the negative attitude of others may be due to the intangible nature of depression

75
Q

t/f:
people with depression would have negative but real opinions about themselves, their life and their future

A

false
people with depression tend to have unrealistic negative opinions about themselves, their life and their future

76
Q

t/f:
thoughts of self-harm or suicide are not that common but if they notice these thoughts, they should NOT act on them but instead tell a trusted person and seek help immediately

A

false
thoughts of self-harm and suicide are common

77
Q

what are the action-oriented stress reduction strategies

A
  • practicing assertiveness
  • time management
  • delegating
  • managing expectations, commitments, and setting boundaries
  • flexible or relaxed standards
  • changing habits
78
Q

what are the emotion-oriented stress reduction strategies

A
  • positive self talk
  • cognitive behavioral therapy
79
Q

what are the acceptance-oriented stress reduction strategies

A
  • diet and exercise
  • meditation and physical relaxation
  • avoiding social media sites which may exacerbate negative feelings
80
Q

this stress reduction strategy confronts the problem causing stress

A

action-oriented

81
Q

this stress reduction strategy changes our perspective about a stressful event; changes our response to stress

A

emotion-oriented

82
Q

this stress reduction strategy acknowledges that stress co-exists with us and focus on how we can feel better as individuals

A

acceptance-oriented

83
Q

t/f
starting previous social activities that the patient participated in before might trigger them to further sink into depression

A

false
starting social activities may potentially provide direct or indirect psychosocial support

84
Q

t/f:
you should advise the patient to let their changes in appetite dictate their eating habits

A

false
- patients should try to eat regularly despite changes in appetite

85
Q

t/f:
decision to start antidepressants shall be made both by the psychiatrist and the person

86
Q

t/f:
antidepressants could be addictive

A

false
antidepressants are not addictive

87
Q

t/f:
antidepressant medication is only taken during depressive episodes

A

false
regular intake of medication is important

88
Q

t/f:
side effects should be immediately reported to the physician

A

false
some side effects may be experienced within the first few days but they usually resolve

89
Q

t/f:
it may take several weeks before improvements in mood, interest or energy is noticed

90
Q

medication usually needs to be continued for at least how many moths after resolution of symptoms

A

9-12 months

91
Q

what is the time that it takes for the antidepressant to work

A

lag period

92
Q

why do u have too continue antidepressant medication 9-12 months after the resolution?

A

to prevent relapse

93
Q

what drugs are used for antidepressant therapy

A

SSRIs
TCAs
MAOIs

94
Q

what is the mechanism of action of selective serotonin reuptake inhibitor

A

it blocks the reuptake of serotonin

95
Q

why are selective serotonin reuptake inhibitors the first line of antidepressants

A

lower sedating, anticholinergic and cardiovascular side effects

96
Q

what is the timeline of psychopharmacologic effect of antidepressant

A

reduced insomnia = 3-4 days
appetite normalize = 5-7 days
energy returns = 4-7 days
mood improves = 7-10 days

97
Q

what SSRI is recommended for depression

A

fluoxetin (prozac)

98
Q

what program recommends fluoxetine (prozac) as first line drug

99
Q

what are side effects of SSRIs

A
  • sedation
  • insomnia
  • headache
  • dizziness
  • GI disturbances
  • changes in appetite
  • sexual dysfunction
100
Q

when do u give SSRIs at AM

A

when patient develops insomnia

101
Q

why do u give SSRIs at pm

A

because of its sedative effect

102
Q

what are the nursing interventions for people taking SSRIs

A

give in am if there is insomnia and pm if patient feels sedation
encourage drink adequate fluid report sexual difficulties

103
Q

what are the most common ssris in the philippines

A

escitalopram

104
Q

what are the side effects of escitalopram

A
  • drowsiness
    dizziness
    wight gain
    sexual dysfunction
    restlessness
    dry mouth
    headache nausea
    orthostatic hypotention
    diarrhea
105
Q

what are nursing responsibilities for escitalopram

A

check for orthostatic bp
assist client to rise slowly from sitting position
encourage use of sugar free beverages /hard candy
administer with food

106
Q

this occurs when there is inadequate washout period between taking MAOIs & SSRIs/ when MAOIs are combined with meperidine

A

serotonin syndrome

107
Q

what is a symptom of serotonin syndrome

A

changes in mental state

108
Q

this primarily blocks reuptake of norepinephrine and to some degree serotonin too

A

tricyclic antidepressants

109
Q

what is an example of tricyclic antidepressant

A

amitriptyline (elavil)

110
Q

what are the side effects of amitriptyline (elavil)

A
  • sedation
  • orthostatic hypotension
  • blurred vision
  • dry mouth and sore throat
  • difficulty urinating
  • nausea
  • weight gain
  • sexual dysfunction
111
Q

when do u administer amitriptyline (elavil)

A

hours of sleep

112
Q

what drug interferes with enzyme metabolism (monoamine oxidase)

A

Monoamine oxidase inhibitor

113
Q

how many weeks are the lag period of MAOIs

A

2-14 weeks

114
Q

how many weeks is the washout period of MAOIs

115
Q

what are the three monoamine oxidase inhibitors

A

tranylcypromine
phenelzine
isocarboxazid

116
Q

what ar ethe brand names of the three monoamine oxidase inhibitors

A

parnate
nardil
marplan

117
Q

what are the side effects of monoamine oxidase inhibitors

A
  • drowsiness
  • dry mouth
  • overactivity
  • insomnia
  • nausea
  • anorexia
  • constipation
  • orthostatic hypotension
118
Q

what are the nursing interventions for MAOIs

A
  • assist the client to rise from sitting
  • administer at AM
  • administer with food
  • ensure adequate liquids
  • educate importance of adhering to low tyramine diet
119
Q

what is the adverse reaction caused by MAOIs

A

hypertensive crisis (cheese reaction)

120
Q

this is a life threatening condition that can result when a client taking MAOIs ingests tyramine-containing foods

A

hypertensive crisi

121
Q

this is a trace monoamine

122
Q

what are the clinical manifestations of hypertensive crisis

A

severe hypertension (BP> 180 mmHg systolic)
hyperpyrexia
tachycardia
diaphoresis
tremors
cardia dysrhythmias

123
Q

when is the onset of hypertensive crisis

A

20-60 minutes after ingestion of tyramine containing foods

124
Q

what is the drug of choice for hypertensive crisis caused by tyramine and MAOI ingestion

A

phentolamine

125
Q

what drug class is phentolamine

A

adrenergic blocker

126
Q

how do you prevent hypertensive crisis

A

adhere to low tyramine diet

127
Q

what is a low tyramine diet

A

no processed foods
no canned goods
no aged cheese

128
Q

this involves delivery of an electrical impulse to the brain to cause a seizure

A

electro convulsant therapy

129
Q

what are the indications for ect

A
  • unresponsive to antidepression
  • patients who experience intolerable side effects at therapeutic levels
  • pregnant women
  • actively suicidal patients
130
Q

what are the ect pre-procedure care

A
  • facilitate signing of Informed consent
  • NPO post midnight
  • remove nail polish
  • instruct to void before procedure
  • start IV line
131
Q

what are the ect preprocedure meds:

A
  • atropine
  • metohexital (brevital) IV
  • succinylcholine (anectine) IV
132
Q

what is atropine used for in ect

A

anticholinergic to reduce secretions

133
Q

what is metohexital (brevital) IV used for in ect

A

for immediate anesthesia

134
Q

what is succinylcholine (anectine) IV used for in ect

A

for neuromuscular blocking effect

135
Q

why are muscle relaxants taken during ect

A

to prevent fractures caused by seizures

136
Q

what are the criteria of a good, induced seizure in ECT

A
  • monitor convulsions for at least 20 seconds
  • increased HR for 30-50 seconds
  • brain seizure as monitored by eeg for 30-50 secs
137
Q

what are the side effects of ect

A

mild confusion/brief disorientation
fatigue
headache
short term memory loss

138
Q

what are the post care for ect

A
  • mechanically ventilate with 100% oxygen until patient can become unassisted
  • monitor for respiratory problems
  • reorient patient
  • administer benzodiazepine IV when patient is agitated
139
Q

this focuses on how a person thinks about self, others and future and interprets their experiences

A

cognitive therapy

140
Q

this is the tendency to view everything in polar categories

A

absolute, dichotomous thinking

141
Q

this is when the patient arrives at specific conclusion without sufficient evidence

A

arbitrary inference

142
Q

this is when the patient focuses on a single detail while ignoring other bigger details

A

specific abstraction

143
Q

this comes coming to a conclusion despite too little experience

A

overgeneralization

144
Q

overestimating or underestimating the significance of something

A

magnification and minimalization

145
Q

self references blame for external factors

A

personalization

146
Q

what are the signs of manic bipolar disorder

A
  • brightly colored clothing
  • flamboyant
  • sexually suggestive
  • attention getting
  • pressured speech: unrelentingly rapid
147
Q

these are extreme mood swings from episodes of mania to episodes of depression

A

bipolar disorders

148
Q

what are the phases of bipolar disorder

A

mania/hypomania
depression
euthymia

149
Q

this is the bipolar disorder state of being in a natural mood

150
Q

this is characterized by hyper, expressive, irritable mood

151
Q

how many weeks does mania episode persists

152
Q

what are the signs and symptoms of bipolar disorder manic phase

A

hyperactivity
elevated mood
distractibility
insomnia, irritability, increased interest in sex
grandiosity
flight of ideas
anger, anorexia
speech is loud and rapid; suicidal
talkative

153
Q

this is the abnormal period where there is persistent elevated, expressive, irritable mood

154
Q

how many days is hypomania present

155
Q

what are the signs and symptoms of hypomania

A

grandiosity
decreased need for sleep
subjective sense that thoughts are racing
distractibility
increase in goal-directed activity
excessive involvement in high risk fun activities

156
Q

what are the types of bipolar disorder

A

bipolar type I
bipolar type II
cyclothymia

157
Q

the patient experienced mood swings between manic and major depression

A

bipolar type 1

158
Q

swings between major depression and hypomania

A

bipolar type II

159
Q

patient experiences mood swings between hypomania and dysthymia but never at the extreme of the spectrum

A

cyclothymia

160
Q

what is the criteria for cyclothymia

A

2 years no remission for 2 weeks

161
Q

what is the probability of developing bipolar disorder in first degree relatives

162
Q

what is the probability of developing bipolar for patient offspring

A

50% chance

163
Q

how much probability do identical twins have to develop bipolar

A

33% to 90%

164
Q

what is a biochemical cause of bipolar disorder

A

catecholamine or increase in epinephrine and norepinephrine

165
Q

what is the criteria of bipolar

A

at least 1 episode of mania

166
Q

this etiology means that mania serves ad defense against the feelings of depression

A

psychodynamic

167
Q

what is the defense mechanism of bipolar disorder

A

reaction formation

168
Q

what are the environmental etiology for bipolar

A

external stressors
nature of work
increased exposure to sunlight

psychia (1 decks)

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