Mood Disorders Flashcards

1
Q

What are mood disorders?

A

Recurrent alterations or disturbances in mood caused by psychological distress and behavioral impairment.
ALTERATIONS IN MOOD NOT IN THOUGHT OR PERCEPTION.

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2
Q

Clinical features of depressive disorders

A

-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

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3
Q

Description of mood/affect signs?

A

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

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4
Q

What are unipolar and bipolar depressive disorders? What are additional examples of depressive disorders?

A

Unipolar= Major depressive disorder
Mibipolar= Manic depressive disorder
Add. examples include: mood disorders caused by medications, substance induced mood disorder, PPD, seasonal affective disorder.

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5
Q

What is MDE?

A

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
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6
Q

What is a dysthymic disorder?

A

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.

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7
Q

What type of depression is considered the normal grief response?

A

Mild depression

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8
Q

Transient depression occurs when?

A

Everyday life

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9
Q

Moderate depression is classified as what type of depression? Severe depression?

A
Mod= dysthymic depression
Severe= MDD
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10
Q

What is the prevalence of MDE in the population?

A

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

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11
Q

What are the biological theories of onset for MDE?

A

Genetics: MDE more common amongst first degree relatives.
Neurobiologic: deficiencies or dysregulation of CNS concentrations of neurotransmitters

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12
Q

What are the psychological theories of onset for MDE?

A

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.

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13
Q

What is the Brown and Harris Model of Depression

A
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
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14
Q

What is the nurses role in Monitoring and Administration of antidepressant medication?

A
  • Observe medication being taken
  • Monitor lab results
  • Diet restrictions if needed
  • Teaching
  • Physical assessments
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15
Q

What is bipolar mania?

A

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.

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16
Q

What considerations need to be made with bipolar in a elderly population?

A
  1. More neurological abnormalities and cognitive disturbances
  2. Late onset BP is now being recognized
  3. Tend to be a poorer prognosis due to co-morbid medication conditions
17
Q

What gender considerations need to be made with bipolar disorder?

A

No gender differences in type I BP however 5% increase in BPII for women.
Course, treatment and phenomenology may be different based on gender.

18
Q

What is the general prevalence and onset for Bipolar disorder?

A

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.

19
Q

What are example of mood stabilizers used in treating bipolar disorder?

A

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

20
Q

Other than mood stabilizers what pharmaceutical interventions may be chosen for bipolar disorder?

A

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.