unit 5 Flashcards
What are protective factors that reduce the likelihood of self-harm behaviors?
Strong social support, effective coping skills, mental health treatment, positive relationships, and cultural or religious beliefs that discourage suicide.
What is meant by suicidal ideation?
Suicidal ideation refers to thoughts or plans about self-harm or suicide, ranging from fleeting thoughts to detailed planning.
What is the significance of having a plan and the means to enact the plan?
Having a specific plan and means increases the risk of suicide, indicating a higher likelihood of acting on suicidal thoughts.
What components of suicidal ideation would lead you to send someone to the hospital?
A clear plan, access to means, recent suicidal gestures, history of attempts, or significant psychosocial stressors.
How can peripartum depression develop?
It can occur abruptly or develop over time, sometimes preceded by subclinical or full depression during pregnancy.
Why is peripartum depression a concern?
It poses risks for both the woman and the fetus/infant.
what are stong risk factors for PPD?
depression or anxiety during pregnancy, stressful recent life events, poor social support, and a previous history of depression.
What are the potential impacts of maternal depression on child development?
It can affect the child’s emotional, cognitive, and social development.
what are moderate predictors of PPD?
are childcare stress, low self-esteem, maternal neuroticism, and difficult infant temperament.
what are small predictors of PPD?
obstetric and pregnancy complications, negative cognitive attributions, single marital status, poor relationship with partner, and lower socioeconomic status including income.
What is the primary goal of health promotion in relation to peripartum depression?
To reduce the risk of peripartum depression through supportive environments, increased self-efficacy, and stress reduction.
What additional strategies can help women in the postpartum period to reduce peripartum depression?
Facilitating parenting skills, enhancing self-efficacy, and providing ongoing support and guidance.
What depression screening tools are commonly used during pregnancy?
Typical depression screening tools can be used, with the Edinburgh Postnatal Depression Scale being most common in the postpartum period.
What successful strategies are employed in health promotion for peripartum depression?
Creating supportive environments, focusing on social determinants of health, improving health literacy, stabilizing relationships, and enhancing family support.
Up to how long after delivery can the Edinburgh Postnatal Depression Scale be used for screening?
up to 1 year after delivery
What EPDS score indicates a higher risk of postpartum depression?
a score of 10 or above
What is the CPS recommendation regarding the observation of babies with late-trimester SSRI exposure?
They should be observed in the hospital for neurobehavioral or respiratory symptoms for a minimum of 48 hours.
When do symptoms of post-partum psychosis typically onset?
Symptoms can begin from two to three days post-partum, up to three months after delivery (Schadewald & Friedrich, 2013).
What is the strongest risk factor for developing post-partum psychosis?
history of bipolar disorder (Schadewald & Friedrich, 2013).
What are the main presentations of post-partum psychosis?
Delusions, hallucinations, and disturbances in thought, mood, and behavior; depression is not always present.
What medications are used to treat post-partum psychosis?
Lithium, valproic acid, and carbamazepine; Electroconvulsive Therapy (ECT) may also be used.
Describe the tri-phasic pattern of post-partum psychosis.
1) Manic phase: racing thoughts, mood liability, hyperactivity.
2) Delirium: mental confusion, dissociative episodes, anxiety, agitation, hostility.
3) Psychotic depression: suicidal and homicidal ideation, psychomotor retardation.
What are the categories of symptoms for PMDD?
Affective symptoms (mood swings, irritability, depressed mood, anxiety) and physical/behavioral symptoms (lack of energy, appetite changes, sleep issues).
What are the DSM-5 criteria for PMDD?
Symptoms must occur in the luteal phase, include five specified symptoms, cause significant distress, and not be due to another disorder or substance abuse.
Which supplements are recommended for PMDD?
Vitamin B6, magnesium, calcium, vitamin D, L-tyrosine, vitamin C, and fish oils.
What lifestyle changes can help manage PMDD?
Good sleep hygiene, exercise, avoiding alcohol/caffeine, and relaxation techniques like yoga and mindfulness.
How effective are SSRIs for treating PMDD?
Up to 60% of women respond positively to SSRIs like citalopram and fluoxetine
What are the recommended hormonal treatments for PMDD?
Continuous oral contraceptives and supplementation with progesterone during the luteal phase.
What is the timing of symptoms for PMDD?
Symptoms occur in most menstrual cycles, typically in the week before menses, improve a few days after onset, and are minimal or absent in the week after menses.
What are the symptoms in Category B for PMDD?
Decreased interest in usual activities
Difficulty concentrating
Lack of energy
Marked change in appetite
Hypersomnia or insomnia
Feeling overwhelmed or out of control
Physical symptoms (e.g., breast tenderness, bloating)
What are the symptoms in Category A for PMDD?
Marked affective lability (mood swings, sensitivity)
Marked irritability or anger
Marked depressed mood (hopelessness, self-deprecation)
Marked anxiety or tension
What should PMDD not be attributed to?
It should not be due to substance abuse, withdrawal, or other physical conditions (e.g., hyperthyroidism).
What is the diagnostic timeline for PMDD?
he condition can be diagnosed after a minimum of two symptomatic cycles within one year.
what age group is at highest risk for intimate partner violence ?
Young women (aged 15-24) are at a higher risk of experiencing IPV.
hat are the five central characteristics of domestic violence?
Learned behavior
Repetitive nature
Responsibility lies with the abuser
Increased danger during separation
Victim behavior for survival
What traits identify a “domestic terrorist”?
Unpredictable outbursts, controlling behaviors, and sexual violence.
Why is context crucial in assessing risk for further violence?
It helps understand the individual’s behavior within the relationship dynamics.
At which time of the menstrual cycle do premenstrual dysphoric symptoms typically begin?
during the leuteal phase of the menstrual cycle
Which of the following are acceptable treatments for premenstrual dysphoric disorder?
oral contraceptives, anti-depressants, complmentary supplements
what is meant by a dual diagnosis ?
defined as having a mental health disorder plus another disorder that would affect or complicate the situation. Examples include: addiction and depression, mental impairment or disability plus an anxiety disorder, dementia and depression, ADHD and gambling, and so on.
What types of antidepressants are more effective for coexisting depression and substance abuse?
Tricyclics, SNRIs, and Bupropion respond better than SSRIs in treating coexisting depression and substance abuse.
What is Acamprosate used for?
Acamprosate reduces symptoms that persist from alcohol dependency after detoxification, such as sweating, anxiety, and sleep disorders.
What is the mechanism of action of Acamprosate?
It restores the normal balance of excitation and inhibition in the glutamate system, calming the nervous system.
What is the mechanism of action of Naltrexone?
It binds to opioid receptors and blocks the release of endorphins.
What is the standard dose of Acamprosate?
666 mg orally three times a day (TID).
In the context of alcohol abuse, what is the significance of comparing ALP to GGT?
A GGT/ALP ratio > 2.5 is highly suggestive of alcohol abuse.
What is the significance of AST and ALT in liver function tests?
Both are aminotransferases used to detect hepatocellular injury.
AST is also produced by skeletal muscles and other organs.
ALT is more liver-specific.
Why is GGT the most sensitive indicator for alcohol abuse?
GGT rises the most dramatically compared to other liver function tests in response to alcohol abuse.
GGT that is 3.5 times the upper limit of normal, suggests alcoholic hepatitis.
If the GGT/ALP ratio is > 2.5 it is highly suggestive of alcohol abuse.
What is the MOA of Campril?
Restores normal balance of excitation and inhibition in the glutamate system, thereby restoring calm within the nervous system. Acamprosate can “decrease alcohol craving, prolong abstinence and reduce the rate of relapse
What is the MOA of Antabuse?
Interferes with the metabolism of alcohol by inhibiting aldehyde dehydrogenase. leading to a build-up of acetaldehyde. Excess acetaldehyde in the body produces intense sweating, flushing, difficulty breathing, nausea and vomiting, headache, weakness, and hypotension.
