Depression & Suicide Flashcards
What is the leading cause of disability in the US?
Depressive Disorder
What % of women suffer from depressive disorder
11%
What % of men suffer from depressive disorder
6%
What % of adolescents experience depressive disorder
18%
What % of children experience depressive disorder
6%
What % of elderly suffer depressive disorder
20%
DSM definition of Major Depressive Disorder
Change from previous functional level with five or more of the following symptoms present most of the day every day for at least two weeks
Diagnostic criteria for Major Depressive Disorder
Depressed mood* (sad, hopeless, empty, etc.)
Anhedonia*-inability to experience joy
Significant weight loss or gain
Insomnia-can’t sleep or hypersomnia-sleep all the time
Increased or decreased motor activity
Fatigue or loss of energy
Feelings of worthlessness or inappropriate guilt
Decreased concentration or indecisiveness
Recurrent thoughts of death or suicidal ideation
Important criteria for major depressive disorder
Causes significant distress or impairment in social, occupational, or other important areas of functioning
What is Melancholic presentation
Classic presentation…loss of appetite, weight & insomnia
What is catatonic presentation
completely checked out, non responsive
What is atypical presentation
increased appetite, weight & excessive sleep
Persistent depressive disorder
-Depressed mood for most of the day for more days than not for at least two years
-Two or more of the following symptoms:
Decreased or increased appetite
Insomnia or hypersomnia
Low energy or fatigue
Low self-esteem
Poor concentration or difficulty making decisions
Feelings of hopelessness
Other criteria possible for persistent depressive disorder
During the two years, symptoms never gone for more than two months
May include continuous MDD symptoms for two years
Absence of mania / hypomania / cyclothymia
Not better explained by psychotic disorder
Not due to substance or medical condition
Cause significant distress or impairment in functioning
Etiology of depression
Neurotransmitter imbalance or alteration
Primarily serotonin and norepinephrine with additional involvement of dopamine, acetylcholine, and GABA
Alterations secondary to medical disorder, substance use, etc. may produce similar S&S
Nursing care: Assessment
Standard scales such as Beck Depression Inventory and Hamilton Depression Scale-preliminary tool to identify risk, not diagnostic
Subjective findings persistent depressive disorder
Mood, feelings, self-esteem, changes in functioning, past history
Objective findings
Affect, weight, behaviors, thought precesses
What is the one thing to always assess for with all depression
Suicidal ideation
Possible Nursing diagnoses to use with depression
Risk for suicide Risk for self-mutilation Hopelessness Spiritual distress Risk for loneliness Ineffective coping Self-care deficit Disturbed sleep pattern Nutritional imbalance