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Psych > Chapter 4 pt 2 > Flashcards

Chapter 4 pt 2 Flashcards

1
Q

what is the Hamilton Depression Rating Scale

A

measures the severity of depression and is used in research to assess the effectiveness of therapies

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2
Q

what is the depression screening often used in primary care setting

A

PHQ-9

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3
Q

loss of parent before what age is associated with later development of MDD

A

11

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4
Q

what are the side effects of SSRIs

A

headache
GI
SEXUAL DYSFUCNTION
rebound anxiety

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5
Q

what are the side effects of TCAs

A 
lethal cardiac arrhythmia
sedation
weight gain
orthostatic hypotension
anticholinergic effects
QTc prolongation
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6
Q

what are the side effects of MAOIs

A

hypertensive crisis when used with sympathomimetics or tyramine
Serotonin Syndrome with SSRIs

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7
Q

what is seen in serotonin syndrome

A

autonomic instability
hyperthermia
hyperreflexia (myoclonus)
seizure

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8
Q

what period conveys an elevated risk of depression in women

A

postpartum

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9
Q

what medication is considered particularly useful for “atypical depression”

A

MAOIs

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10
Q

what psychotherapy is used in MDD

A

COGNITIVE-BEHAVIORAL THERAPY (CBT)

interpersonal

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11
Q

when is electroconvulsive therapy (ECT) indicated in MDD

A

pt is unresponsive to pharmacotherapy
if the patient cannot tolerate pharmacotherapy (pregnancy, etc)
rapid reduction of symptoms is desired (immediate suicide risk, refusal to drink/eat, catatonia)

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12
Q

primary risk of ECT is from what

A

anesthesia

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13
Q

what medication is typically used before ECT

A

ATROPINE
then anesthesia (methohexial)
and then muscle relaxant (succinylcholine)

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14
Q

how many ECT treatments are required for MDD

A

usually 6-12 (average of 7) over 2-3 week period

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15
Q

what are common side effects of ECT

A

retro and anterograde amnesia (resolved in 6 months usually)

headaceh, nausea, muscle soreness

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16
Q

what are melancholic features of a depressive disorder

A

present in approx 25-30% of MDE
more likely in severely ill inpatients, including those with psychotic features
ANHEDONIA, early morning awakenings, depressing WORSE IN MORNING, psychomotor disturbance, excessive GUILT, and ANOREXIA

17
Q

what are atypical features of a depressive disorder

A 
HYPERSOMINA
HYPERPHAGIA
REACTIVE mood
LEADEN PARALYSIS
hypersensitive to interpersonal rejection
18
Q

what are mixed features of a depressive disorder

A

manic.hypomanic symtoms present during the majority of days during MDE
elevated mood, grandiosity, talkativeness/pressured speech, flight of ideas/racing thoughts, increased energy/goal directed activity, excessive involvement in dangerous activities, decreased need for sleep

19
Q

what are cataonia features of a depressive disorder

A 
catalepsy (immobility)
purposeless motor activity
extreme negativism or mutism
bizarre postures
echolalia
especially responsive to ECT
20
Q

what are psychotic features of a depressive disorder

A

presence of delusions and/or hallucinations

24-53% of older, hospitalized patients with MDD

21
Q

what are anxious distress features of a depressive disorder

A 
feeling keyed up/tense
restless
difficulty concentrating
fears of something bad happening
feelings of loss of control
22
Q

what are PERIpartum onset features of a depressive disorder

A

onset of MDD symptoms occur during pregnancy or FOUR WEEKS following delivery

23
Q

what are seasonal pattern features of a depressive disorder

A

terminal relationship between onset of MDD and particular time of the year (most commonly the winter)
fall-onset responds really well to light therapy

24
Q

what is the triad for seasonal affective disorder

A

irritability
carbohydrate craving
hypersomnia

25
Q

what is bereavement

A

simple greif- reaction to a major loss, usually of a loved one (not a mental illness)
usually self-limited and only last for several months
if individual meets criteria for MDE he or she has MDD

Psych (35 decks)

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