Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psych Exam 1 > Mood Disorders > Flashcards

Mood Disorders Flashcards

You may prefer our related Brainscape-certified flashcards:
Psychology 101 flashcards GRE® Psychology flashcards
1
Q

Pervasive alteration in mood and affect

A

Elevated
Depressed
Cycling

Impairs functioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Contributing Factors: Biological

A

Hormonal dysregulation Neurotransmitter changes Neuroanatomy
Sleep neurophysiology Immunological disturbance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Contributing Factors: Genetic

A

Highly heritable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Contributing Factors: Psychosocial

A

Stress

Personality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Role of Stress and Mental illness

A

Stressful life events precede onset mood disorders
- Variable thought on degree of influence

Theory that brain’s biology changes
- Increases risk of subsequent episodes

Resilience important in determining impact of stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is Resilience?

A

The ability to adapt well to stress

- Emotional pain & distress experienced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Factors that promote resilience:

A

Caring and supportive relationships
The capacity to make plans and complete a goal
Positive view of self
Communication & problem solving skills
Ability to manage strong feelings and impulses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Types of mood disorders

A 
Adjustment disorder with depressed mood  
Major depressive disorder
 Bipolar disorder
 - Bipolar I  
 - Bipolar II
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Adjustment disorder with depressed mood ?

A

Change in mood and affect following a stressor
- “situational depression”

Symptoms begin within 3 months of stressor
Symptoms do not last beyond 6 months
Distress out of proportion to the stressor
- Causes impairment in functioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Adjustment Disorder with Depressed Mood:

Clinical Manifestations

A 
Sleep disturbances  
Feeling hopeless and sad  
Loss of self-esteem  
Irritability
Difficulty concentrating
Inability to feel pleasure (anhedonia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Adjustment Disorder with Depressed Mood:

Nursing Assessment

A 
Precipitating stressor  
Patient symptoms  
Depression risk factors  Resilience factors
Current coping strategies  SAFETY
Screening tool
 ** Ex: Beck Depression Inventory
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Adjustment Disorder with Depressed Mood:

Nursing Plan/Goal

A

Adequate sleep and rest Impulse control
Daily functioning
Self-esteem
Safety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Adjustment Disorder with Depressed Mood:

Nursing Interventions

A

Promote hope
Identify areas of control Encourage belief in themselves Assist in problem-solving process
Identify sources of support Encourage family functioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Adjustment Disorder with Depressed Mood:

Collaborative Interventions

A

Cognitive behavioral therapy (CBT)
Family therapy
Antidepressant medication Anti-anxiety medication
Exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Major Depressive Disorder?

Factors?

A

Single episode or recurrent
Change in emotional state and functioning
- 14 days or longer

Average age onset mid-20s Women more affected than men
Hereditary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Major Depressive Disorder:

Clinical Manifestations

A

** Significant decline in ability to function at work, school, or home

Depressed mood most of the day
Diminished interest or pleasure Weight loss or gain
Insomnia or hypersomnia
Fatigue
Feeling worthless
Diminished concentration Recurrent thoughts of death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Major Depressive Disorder:
Lifespan considerations
Children/adolescents

A

Usually assessed within context of home / school situation
Decreased school performance
Problems with parents or teachers
Irritability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Major Depressive Disorder:
Lifespan considerations
Older adults

A 
Memory problems  
Social withdrawal  
Sleep disturbances
Appetite
Delusions/ hallucinations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Major Depressive Disorder:

Nursing Assessment

A

Symptoms of depression Difficulty completing simple tasks
Tearfulness
Somatic complaints Withdrawal/ social isolation Differentiate from grief
Co-morbidities
Suicide Assessment

20
Q

Suicide assessment includes:

A 
S.I.
- Passive vs active
- Frequency 
Plan 
 - Realistic 
 - Available means
Intent
Past attempts 
Reasons to NOT complete
21
Q

Major Depressive Disorder: Suicide Precautions

A 
Nursing suicide assessment
Documentation
Patient transport considerations
Physical environment
Observation level  
 - 1:1
 - Q 15 minute   
Restriction
 - Supervised bathroom   Contraband
22
Q

Major Depressive Disorder: Nursing Plan/Goal

A

Remaining free from self-injury
Participation in recreational activities
Knowledge that feeling better follows engaging in activities
Adherence to treatment regimen

23
Q

Major Depressive Disorder:

Nursing Interventions

A 
Develop therapeutic relationship  
Provide distraction from self-focus  
Encourage activities
Recognize accomplishments
Set limits on time spent discussing failures  
Teach assertiveness
Assist in identifying strengths
Encourage patient to set goals
Explore various problem-solving strategies  
Help identify resources
24
Q

Major Depressive Disorder:

What should be avoided?

A

Avoid:
Being overly cheerful
Taking on patient’s feelings

25
Q

Major Depressive Disorder:

Collaborative Interventions

A 
Pharmacological
 - Antidepressants   Psychotherapy
 - CBT 
Non-pharmacological
 - ECT  
 - TMS
Complementary & Alternative
 - Exercise
 - Supplements  
 - Acupuncture
 - Animal companionship  
 - Music therapy
26
Q

Major Depressive Disorder:
Collaborative Interventions
Lab tests

A 
Thyroid  
Electrolytes  
Urinalysis  
Toxicology
Liver function tests  
Pregnancy test
27
Q

Major Depressive Disorder:

Pharmacological Interventions

A

SSRIs

  • increase available serotonin
  • First-line medication
  • fluoxetine, citalopram, sertraline, escitalopram

SNRIs

  • increase serotonin and norepinephrine
  • venlafaxine, duloxetine

TCAs & MAOIs
- Older with significant side effects

Atypical antipsychotics

  • Used with SSRI for severe depression
  • aripiprazole, risperidone
28
Q

Major Depressive Disorder:

Risk Factors with medication tx

A

Dysthymia prior to the episode Onset before age 20 or after age 50
Poor recovery between episodes
Family hx of depression
Current episode > 2 years Severe symptoms
- psychosis, suicidality

29
Q

MDD: Psychotherapy

A

Most effective when combined with medication
- Both effective when used independently

Cognitive behavior therapy (CBT)

  • Identifies negative thoughts and behaviors
  • Replaces disordered thought processes
  • Mindfulness training
30
Q

MDD: Non-pharmacological

ECT

A

Electroconvulsive Therapy (ECT)
- Electric current is passed through the brain to induce a seizure
- Given under anesthesia
NPO prior to tx
- Receive muscle relaxant
- Monitor EEG, EKG, Oxygen saturation, vital signs
- Short term memory loss expected (usually restored) - Typically 2-3 times per week for 12 treatments

31
Q

MDD: Non-pharmacological

TMS

A

Transcranial Magnetic Stimulation (TMS)

  • Magnetic field passes through skull
  • Causes cells in cerebral cortex to fire
  • FDA approved
  • Target area for depression is left prefrontal cortex **
  • Rapid onset of improved symptoms
  • 1-2 weeks
  • As effective for depression WITHOUT psychosis as ECT
32
Q

MDD: Inpatient therapeutic strategies

A

Many inpatient units use the Recovery Model

  • Healing is possible when health care team collaborates with patients
  • Focus on patient strengths
  • Identify realistic outcome criteria
  • Assist with developing measurable short term and long term goals
33
Q

MDD: Important strategies to remember

A
  • Recognize that patients with depression often reject support & encouragement
  • Recognize unrealistic expectations for self and patient
  • Identify feelings that originate with patient
  • Understand role of biology and genetics in maintenance of depressed mood
34
Q

What is bipolar disorder?

A

Mood alternates between extremes

  • Depression
  • Mania
  • Interspersed with neutral mood
35
Q

What is bipolar I?

A

≥ 1 manic episode and ≥ 1 major depressive episode

36
Q

What is bipolar II?

A

≥ 1 major depressive episode and at least 1 hypomanic episode

37
Q

What is a manic episode?

A

Abnormally expansive, elevated or irritable mood

38
Q

Manic episode includes >3 of the following:

A 
Inflated self esteem
Decreased need for sleep  
More talkative than usual  
Flight of ideas
Distractibility
Psychomotor agitation  Increased pleasurable activities
39
Q

Manic episode
Length?
Mood disturbance causes:

A

Symptoms last at least 1 week

Mood disturbance causes:

  • Marked impairment in functioning
  • Necessitates hospitalization
  • Psychotic features
40
Q

Hypomanic
Length?
Mood disturbance causes:

A

Symptoms last at least 4 days

Mood disturbance causes:

  • Change in functioning -
  • Uncharacteristic behaviors
  • Observable by others
  • NO hospitalization
41
Q

Rapid cycling

A

During a 12-month period
Four or more illness episodes
- Mania, hypomania, or depression

At least 2 months between each episode OR Alternating episodes
- Period of mania followed by depression

More likely:
- Female, earlier onset, treatment resistant

42
Q

Bipolar Disorder:

Nursing Assessment

A 
Changes in thought processes  Inflated self esteem
 -  Delusions
Ignoring fatigue, hunger, hygiene   
Distractibility
Hallucinations
Surprising sense of well being
Rapid loud pressured speech  Flight of ideas
Poor judgment/impulsivity
 - Shopping
 - Drugs  
 - Sex
Unusual appearance  
 - Dressing inappropriately
43
Q

Bipolar Disorder:

Nursing Plan/Goal

A 
Injury prevention
Focus
Making choices  
Appropriate behaviors  
Self-care
Sleep
44
Q

Bipolar Disorder: with Mania

Nursing Plan/Goal

A 
Encourage reality-based thinking
  - Acknowledge belief, but share that you see it differently  Enhance socialization
Set limits
Promote improved self-care
Enhance rest and sleep  Decrease stimuli
Remain calm and relaxed
Firm and matter-of fact demeanor
  - Especially with limit-setting  
Use role modeling behavior
  - Offers reassurance  
Build trusting relationship  Promote safety
45
Q

Bipolar Disorder:

Promote Safety

A

Remove smoking and contraband materials
Safety checks
Create structured program with rest periods
Redirect patients who are at doorways
- Elopement risk
Set and enforce limits on unsafe or inappropriate social
behaviors
Prevent escalation
- Patient self-identifies triggers/ calming strategies

46
Q

Bipolar Disorder:

Collaborative Interventions

A

Diagnostic studies
Pharmacological therapy
- Mood stabilizers
- Antipsychotics: aripiprazole, riperidone olanzapine
- Lithium
- Anticonvulsants: valproic acid, lamotrigine and carbamazepine
Psychotherapy
Case management
- Referral to community resources, NAMI

47
Q

Bipolar Disorder:

Relapse Prevention

A

Important to involve family and patient
- Creating relapse prevention strategies
Teach patient and family about:
- Course of illness
- Importance of adhering to medication regimen
- Early warning signs of relapse
- Community resources
- NAMI

Psych Exam 1 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions