Workbook - Mood Disorders + Physical Health

Question 1

What is Aetiology?

Answer 1

the cause, set of causes, or manner of causation of a disease or condition.

Question 2

What is the biopsychosocial model?

Answer 2

The biopsychosocial model looks at the interconnection between biology, psychology, and socio-environmental factors. The model specifically examines how these aspects play a role in topics ranging from health and disease, to human development

Question 3

What comes under biology in the biopsychosocial model?

Answer 3

Physical health
Genetic vulnerability
Drug effects

Question 4

What comes under social in the biopsychosocial model?

Answer 4

Peers
Family circumstances
Family relationships

Question 5

What comes under psychological in the biopsychosocial model?

Answer 5

Coping skills 
Social skills
Family relationships 
Self-esteem
Mental health

Question 6

What are the key causative factors for depression?

Answer 6

Gene + gene environment interaction
Neuro chemicals, hormones, circadian rhythms + immune system
Sex differences

Question 7

What are the key causative factors for bipolar?

Answer 7

Neurochemicals
Hormone systems
Circadian rhythms

Question 8

Define affect.

Answer 8

The patients observable mood (Subjective)

Question 9

Define mood.

Answer 9

The patients sustained emotional makeup aka how the patient says they feel (Objective)

Question 10

Define egocentric.

Answer 10

The patients thoughts of themselves. Aka this may be the patients inability to understanding opinions different to their own

Question 11

Define Elation.

Answer 11

State of heightened joy, pride, and exhilaration

Question 12

Define Euthymic.

Answer 12

Typical mood. Mood that is neither happy nor sad.

Question 13

Define Dysthymic

Answer 13

Depressed mood most of the time for at least 2 years

Question 14

Define labile.

Answer 14

Rapidly changing emotional state

Question 15

Define impulsivity.

Answer 15

Acts based on feelings that lack forethought

Question 16

Define somatisation.

Answer 16

Manifestations of psychological distress in the form of physical symptoms

Question 17

Define pressure of speech.

Answer 17

Rapid or loud speech that can be difficult to interrupt

Question 18

Define Anhedonia

Answer 18

Loss of pleasurable feelings previously associated with favoured activities

Question 19

Define psycho-motor retardation.

Answer 19

The slowing of usually fluid physical movements

Question 20

Define depression.

Answer 20

Feelings of blue to very severe extraordinary sadness, dejection, and inability to take part in lifes activities

Question 21

What is the Criteria for Major depressive disorder in the DSM-5 where: Five (or more) of these symptoms have to have been present during the same two week period and represent a change from previous functioning. These symptoms include …..

(9)

Answer 21

1. Depressed mood
2. Loss of interest/pleasure
3. Changes in appetite
4. Trouble sleeping (to much/too little)
5. Loss of energy / inc fatigue
6. Psychomotor agitation OR retardation (pacing or slowed)
7. Feelings of worthlessness or guilty
8. Difficult thinking, concentrating, and making decisions
9. Thoughts of death/suicide

Question 22

What is the Criteria for a Manic disorder

Part A, Part B, Part C and Part D

Answer 22

Part A: Distinct period of abnormal + persistant and elevated mood (at least 1 week)

Part B: Increased energy / activity: Inflated self esteem, decreased need for sleep, talkative, flight of ideas, distractibility, goal directed activity, and excessive involvement in activities that have high potential for painful consequences.

Part C: This mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalisation to protect self/others

Part D: This episode is not due to substance or medical condition

Question 23

What should be incl in a risk analysis plan?

Answer 23

Catergory of risk, historical risk, health related factors, environmental factors, planned intent, staff allocation, strengths, barriers, and specific risk.

Question 24

What is a stable protective risk factor?

Answer 24

A factor which is stable such as: age, gender, marital stat, history, family history, childhood adversity, and employment.

Question 25

What is a dynamic protective risk factor?

Answer 25

Dynamic risk factors (DRF) are changeable features of individuals and their environments: Mental state, isolation, recent loss, recent experience of suicide with fam or friend, adversity and stress, access to means and unauthorised leave.

Question 26

What is a protective risk factor?

Answer 26

Protective factors are characteristics associated with a lower likelihood of negative outcomes or that reduce a risk factor’s impact. such as: help-seeking, strong + dependant social supports, positive engagement with services, stable employment and accomodation, and prolonged abstinence from substances.

Question 27

What are some questions that you would ask someone you suspect or know is experiencing suicidal ideation?

Answer 27

Have you experienced any suicidal ideation recently?
How often do you experience these type of thoughts?
If you were to act on these thoughts how would you do it?
If you had access to these means today, would you do it?

Question 28

What are some reasons given for poorer health outcomes for those with mental illness?

Answer 28

Most psychotic medications lead to poor side effects such as weight gain, sedation, dry mouth, and increased sexual problems.

Those with mental illness may also struggle with poorer health due to sedentary life-styles, increased fatigue, and low concentration/motivation which can be a barrier to living a balanced life therefore lead to illness and disease such as type 2 diabetes.

Question 29

What is diagnostic overshadowing and how does it contribute to poor health outcomes for people with mental illness?

Answer 29

Diagnostic overshadowing is the tendency to attribute all problems (symptoms) to one major, potentially un diagnosing a co-existing condition. Leading to potential inadequate or prolonged treatment for the patient leading to poorer health outcomes

Question 30

What is metabolic syndrome and what does metabolic screening involve?

Answer 30

Metabolic syndrome is a cluster of abnormal clinical and metabolic findings resulting in an increased risk of type-2 diabetes, Cardiovascular disease, and Cardiovascular disease mortality. Metabolic screening involves taking the waist circumference, Blood pressure, height, weight, and calculating the body mass index.

Question 31

What are some lifestyle interventions nurses may implement to assist with the management of cardiometabolic health?

Answer 31

Tobacco cessation, physical activity/nutrition, and looking into medication changes.

Question 32

What are some reasons given for people with mental illness having poorer diets?

Answer 32

1. Low fatigue = less likely to have the motivation to make healthy decisions
2. Medications increase extreme hunger and make it harder for patients to make healthy choices
3. Poor lifestyle, patients may not have the time, energy or money to put towards a healthy diet

Question 33

What are some nursing interventions for a poor diet related to mental illness?

Answer 33

Structured nutritional coaching, life coach (modifying lifestyle), and rationalising any polypharmacy

Question 34

What strategies have been identified to increase physical activity in people with mental illness?

Answer 34

Motivational interviewing, face to face group fitness sessions, structured exercise programs/prescriptions, and interventions that reflect individual variations in mood, motivation and access to facilities/resources.

Question 35

What factors must be considered when developing individualised exercise interventions?

Answer 35

Physical changes can seem overwhelming so it is best to add small changes slowly and base these around the individuals schedule. For example if a patient tends to sit down all day long, encourage multiple small (5min) walks throughout the day.

Question 36

What are some social and economic factors that influence an individuals oral health?

Answer 36

Social: Mental health, relation to the community, access to education, and culture

Economic: Cost (family income), Housing, and employment status

Question 37

What are some nursing strategies that you can use to change social/economic factors that influence an individuals poor oral health?

Answer 37

Use clinical interactions to promote oral health. Provide access to health promotion such as pamphlets, websites, seminars, workshops related to smoking, diet, alcohol use, + proper dental hygiene.

Question 38

Why is it important for nurses to complete physical observations on a regular basis (resp, BP, and temp)?

Answer 38

This is important because psychiatric patients are at a high risk of developing physical health complications which cannot be easily identified with only mental health assessments

Question 39

How would the mental health nurse use the EWS score in their assessment?

Answer 39

A raised EWS score would indicate a developing physical health complication. An example would be high temp, low or high BP, raised HR, and increased respirations related to neuroleptic malignant syndrome (NMS) which is caused by taking neuroleptic/antipsychotic drugs.

Question 40

Consider a condition and its side effects that highlights the importance of completing physical observations in nursing and not focusing purely on the mental illness.

Answer 40

An example would be with schizophrenia, due to the genetic dispositions and medications they are at a higher rate of developing metabolic syndrome. A physical health assessment would allow the nurse to identify this issue for example through noticing a higher blood pressure than usual.