Mood Disorders

Question 1

Major Depressive Disorder

Answer 1

Depressed for 2 wks
Impaired social/occupational functioning
No manic behavior hx
Not attributed to drugs or medical condition
5 or more diagnostics

Question 2

Depression Criteria

Answer 2

Depressed
Weight gain/loss
insomnia/hyperinsomnia
Psychomotor agitation/retardation
Fatigue
Worthless, guilt
Low concentration
Recurrent SI/death thoughts

Question 3

Depression Tools

Answer 3

MSE
Beck Depression Inventory
Patient Health Questionaire-9
Suicide Assessment

Question 4

Depression Biologic

Answer 4

NE and serotonin

Question 5

Caring for Depressed Patients

Answer 5

• patience and express belief
• avoid overaggressive or lighthearted actions
• step by step reminders
• time with (even in silence
• self care

Question 6

Kindling

Answer 6

Sensitization

• less stimuli to produce equal response
• more susceptible to recurrence

Question 7

Persistent Depressive Disorder

Answer 7

Milder than major depressive

-chronically depressed mood for most of days, for more days than not, for 2 yrs

Question 8

Premenstrual Dysphoric Disorder

Answer 8

5 symptoms 1 wk before menses

• improve within a few days after menses onset
• minimal/absent week postmenses

Question 9

Premenstrual Criteria

Answer 9

• mood swings
• irritability, anger, conflicts
• marked anxiety, tension
• anhedonia: can’t feel pleasure
• difficulty w/ concentration

Question 10

Premenstrual Criteria

Answer 10

• mood swings
• irritability, anger, conflicts
• marked anxiety, tension
• anhedonia: can’t feel pressure
• difficulty w/ concentration

Question 11

Seasonal Affective Disorder

Answer 11

• shortened daylight
• abnormal melatonin
• recurring
• lethargy, irritability, depressed, increased appetite

Question 12

Postpartum

Answer 12

• Blues: brief, 1-4 days, tx: reassurance/support
• depression: 2 wks-12 mos
• psychosis: 2-3 days

Question 13

Persistent Complex Bereavement Disorder

Answer 13

grief beyond 12 mos

Question 14

Disenfranchised Grief

Answer 14

“not congruent with socially recognized relationship”

Question 15

Grief

Answer 15

• insomnia, poor appetite, depressed

- gradually gets better

Question 16

Psychopharm Depression

Answer 16

• take 1-3 wks to work
• 3 mos to determine if effective
• stay on 6-9 mos

Question 17

Post Treatment in ECT

Answer 17

• recovery monitoring
• frequent reassurance/reorientation
• criteria for discharge

Question 18

ECT Potential SE

Answer 18

• headache
• muscle soreness
• nausea
• confusion, memory loss

Question 19

Light Therapy

Answer 19

decrease melatonin

For SAD

Question 20

St. John’s Wort

Answer 20

Homeopathic

-for mild depression

Question 21

Holistic Nursing Care

Answer 21

• Regulate: sleeping, eating, exercise, etc
• reframe: unhealthy beliefs
• health teaching/education
• spiritual
• family, comorbidity

Question 22

Bipolar

Answer 22

2 million americans

• RF: female, family hx
• mood swings
• may or may not have hallucinations/delusions

Question 23

Bipolar 1

Answer 23

1 or more episodes of major depression + 1 or more periods of mania

Question 24

Bipolar 2

Answer 24

1 or more periods of major depression + periods of hypomania

Question 25

Cyclothymia

Answer 25

chronic (at least 2 yrs) | -recurrent sx of hypomania alternating with dysthmic depression

Question 26

Bipolar DSM Criteria

Answer 26

4 days for hypomania 1 week for mania -hypomania: change in functioning -mania: impairment in functioning

Question 27

Mania DSM-IV Criteria

Answer 27

3 or more: - increased self-esteem - decreased need for sleep - increased, pressured speech - flight of ideas, racing thoughts - destractibility - increased activity, agitation

Question 28

Manic interventions

Answer 28

- risk for injury - need consistency, limit setting - remain neutral - high calorie fluids/foods frequently

Question 29

Suicide Assessment

Answer 29

- thoughts/attempts - feelings on failing - frequency/duration - controllability - deterrents, reasons

Question 30

Risk Factors for Suicide

Answer 30

Sex Age Depression ``` Previous attempts ETOH Rational thinking loss Social support lacking Organized plan No spouse Sickness ```

Question 31

HIPPA Suicide

Answer 31

HIPPA permits a clinician to make contact with friends, family, outpatient treatment providers without consent

Question 32

Suicide Safety Plan

Answer 32

1. List your specific warning signs: 2. Personal coping strategies to calm and comfort: 3. Reasons for living: 4. Activities for distraction: 5. Professional contacts with phone numbers: 6. Steps to make environment safe: 7. Where to go if still needing help