Mood Disorders Flashcards
What are mood disorders?
Recurrent alterations or disturbances in mood caused by psychological distress and behavioral impairment.
ALTERATIONS IN MOOD NOT IN THOUGHT OR PERCEPTION.
Clinical features of depressive disorders
-Depressed mood
-Lack of interest in previously pleasurable activities, (Anhedonia)
-Significant wt loss or gain
-Insomnia/hypersomnia
Agitation or retardation of thinking
Fatigue/loss of energy
Impaired concentration
Thoughts of suicidal ideation
Description of mood/affect signs?
Flat- absent or nearly absent affective expression
Blunted- significantly reduced intensity of emotional expression.
Restricted/constricted- mild reduction in range and intensity of emotions.
Inappropriate-discordant affective expression accompanying speech content or ideation.
Labile-varied, rapid and abrupt shifts in affective expression
What are unipolar and bipolar depressive disorders? What are additional examples of depressive disorders?
Unipolar= Major depressive disorder
Mibipolar= Manic depressive disorder
Add. examples include: mood disorders caused by medications, substance induced mood disorder, PPD, seasonal affective disorder.
What is MDE?
A Major depressive episode is characterized by:
- unipolar depression
- depressed mood with loss of interest for minimum of 2 weeks
- feelings of hopelessness and discouragement
What is a dysthymic disorder?
It is a more mild version of MDD but tends to be more mild in nature.
It entails a depressed mood for >2 yrs with >2 symptoms.
What type of depression is considered the normal grief response?
Mild depression
Transient depression occurs when?
Everyday life
Moderate depression is classified as what type of depression? Severe depression?
Mod= dysthymic depression Severe= MDD
What is the prevalence of MDE in the population?
50% of people will experience one MDE in their lives.
Females are twice as affected a men during adolescence.
UNRELATED to race but culture can impact experience of communication of symptoms
Often co-occurs with substance and psychiatric disorders
What are the biological theories of onset for MDE?
Genetics: MDE more common amongst first degree relatives.
Neurobiologic: deficiencies or dysregulation of CNS concentrations of neurotransmitters
What are the psychological theories of onset for MDE?
Psychodynamic factors: early onset lack of love and connection with parents.
Behavioural factors:
Developmental factors: as in the Freudian thinking where childhood trauma may surface many years later.
What is the Brown and Harris Model of Depression
Certain vulnerability factors can interact with provoking agents to increase the risk of depression. Vulnerability factors include -maternal loss -greater than 3 children under age of 14 -lacking of confiding relationship -unemployment
What is the nurses role in Monitoring and Administration of antidepressant medication?
- Observe medication being taken
- Monitor lab results
- Diet restrictions if needed
- Teaching
- Physical assessments
What is bipolar mania?
Central features include:over-activity, elated/irritable mood, grandiosity.
based on the DSM-5 pt must have 4 of the following to be dx’d:
Increased sense of power, increased sense of worth, more energy/less sleep, talk more frequently, become distracted, set impossible goals, engage in risky behaviour, express delusions of grandeur.
What considerations need to be made with bipolar in a elderly population?
- More neurological abnormalities and cognitive disturbances
- Late onset BP is now being recognized
- Tend to be a poorer prognosis due to co-morbid medication conditions
What gender considerations need to be made with bipolar disorder?
No gender differences in type I BP however 5% increase in BPII for women.
Course, treatment and phenomenology may be different based on gender.
What is the general prevalence and onset for Bipolar disorder?
Less than 1% of population (0.2-0.6%)
Most dx’d between 21 and 30 yo
Often associated with many comorbidities including substance abuse.
What are example of mood stabilizers used in treating bipolar disorder?
Lithium carbonate- must monitor for toxicity as there is a narrow safe dose and it is impacted by salt and water intake.
Divalproex:
Carbamazepine
Mood stabilizers are usually anti-convulsant medications
Other than mood stabilizers what pharmaceutical interventions may be chosen for bipolar disorder?
Antidepressants: used during depressive phases but can trigger manic phases.
Anti psychotics: mania can at time progress to the point of psychosis. Also used if mood stabilizers are not tolerated.
Benzodiazepines: used for short term agitation.
