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Mood and Affect Flashcards

1
Q

what is mood

A

the sustained emotional theme that influcences behaviors and perception
it is subjective

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2
Q

what is affect

A

outward expression of internal experience
what we observe

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3
Q

what is euthymia

A

normal healthy fluctuations in mood

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4
Q

what determines severity of mood spectrum disorder

A

degree of loss of functional status

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5
Q

what are unstable affective states

A

crying
rage
euphoria
screaming
blunting

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6
Q

what can happen in severe mania/severe melancholy

A

disabled
acute confusion
hallucinations/delusions

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7
Q

optimal fxn of mood regulatio requires….

A

coordination and balance of neurons, neurotransmiters, and several parts of the brain

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8
Q

dopamine, norepi, and serotonin regulate

A

Appetite
Sleep
Thought
Emotion
Learning
Mood
Memory
Motivation
Concentration

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9
Q

how many hours of sleep

A

6-8

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10
Q

mood regulation in infants

A

Emotion (smiles, frown, crying) is regulated by the degree of physical comfort and by cues from adults

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11
Q

mood regulation in toddlers

A

Able to recognize the emotions of others and mimic behaviors. Hugging others in attempt to sooth others in distress

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12
Q

mood regulation in preschool

A

Observing parents and caregivers, expectations
on how to behave

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13
Q

mood regulation of childhood

A

Express feelings of sadness or anger to parent more than peers. Understand different emotional states

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14
Q

mood regulation in adolescents

A

developed skills to regulated emtions (talking w/ parent/friend/coach, listening to music, journal etc)
aware of social circumstances r/t emotional regulation
ex not socially acceptable to throw a tantrum or outburst
more variability in mood state than adults (hormone imbalance or developing emotional regulation)

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15
Q

mood regulation in older adults

A

Mood regulation is overall consistent
Despite physical and cognitive decline, they report
higher levels of well being than younger adults
Use emotional regulation processes to
compensate for negative stimuli

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16
Q

mood regulation in elderly

A

Bereavement overload
Increased risk of suicides among elderly
Symptoms of depression often confused with symptoms of neurocognitive disorder (e.g., dementia vs pseudodementia)

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17
Q

what happens when mood cycle is below euthymic range

A

melancholy (depression)

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18
Q

which gender becomes more depressed

A

women

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19
Q

where are there higher rates of depression

A

older adults in nursing or assisted living facilities and those with acute and chronic conditions

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20
Q

etiology on mood and affect disorders

A

Genetics (twin and adoption studies)
Neurochemical dysfunction (deficiency of norepinephrine, serotonin, and dopamine
has been implicated & excessive cholinergic transmission may also be a factor)
Low birth weight
Early life adversity (ACEs)
Stressful life events
Social factors
Psychological factors (learned helplessness, object loss theory)
Physiological causes (electrolyte disturbances, hormonal disorders, nutritional
deficiencies)
Secondary depression from general medical disorders
Secondary depression from medications (anticholinergics, anticonvulsants,
antihypertensives, antiparkinsonian agents, etc.)

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21
Q

depressive symptoms

A

Depressed mood
Anhedonia
Change in appetite/weight (high or
low)
Sleep disturbance (high or low)
Fatigue or loss of energy
Neurocognitive dysfunction
Psychomotor agitation or retardation
Feelings of worthlessness or
excessive guilt
Suicidal ideation and/or behavior

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22
Q

what is anhedonia

A

Loss of pleasure in
interests or activities

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23
Q

neurocognitive dysfxn symptoms

A

Attention
Concentration
Cognitive flexibility
Executive function
Information processing
speed
Memory
Verbal fluency
Social cognition

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24
Q

what is PHQ-9

A

patient health questionaire

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25
what is transient depression
life's everyday disappointments
26
what is mild depression
normal grief response
27
what is moderate depression
dysthymia long lasting also called persistent depressive disorder feelings of sadness and emptiness, loss of interest in life
28
what is severe depression
major depressive disorder
29
how many symptoms to be diagnosed with depression
5 or more
30
MDD core symptoms
Sad, irritable or anxious mood Anhedonia Impaired concentration and decision making Worthlessness and inappropriate guilt Hopelessness Fatigue or loss of energy
31
what is the duration of MDD
>= 2 wks
32
what does MDD cause
impairment in social and/or occupational fxning
33
subtypes of MDD
melancholic depression, anxious depression, atypical depression, psychotic depression, seasonal depression
34
adolescent presentation of MDD
est clue that differentiates depression from normal adolescent behavior: a visible manifestation of behavioral change that lasts for several weeks* Anger, aggressiveness Running away Delinquency Social withdrawal Sexual acting out Substance abuse Restlessness, apathy
35
what is the 2nd leading cause of death in adolescents
suicide
36
if SI is present what do you ask
nature of the ideation, intent, plans, available means (e.g., firearms), and actions prior hx of suicide attempts, comorbid psychiatric and general medical illnesses, and family history of suicide
37
what is a saftey plan
therapeutic communication, use of soothing or distracting coping skills, and one-to-one monitoring
38
what are SSRIS
Selectively block reuptake of the neurotransmitter serotonin in the synaptic space, thereby intensifying the effects of serotonin first line for depression increase energy
38
side effects of ssris
n/v headache wt loss or gain sexual dysfunction
39
interactions which ssris
increased risk for bleeding with asprin, NSAIDS, warfarin
40
other SSRIs
citlopram esitalopram fluoxetine proxetine sertraline
41
what are SNRIs
selective norepi and serotonin reuptake inhibitors selectively block reuptake of norepinephrine and serotonin in the synaptic space, thereby intensifying the effects of both these NTs. Common agents for depression Adverse effects are usually mild and go away after the first few weeks of treatment. Take with food to avoid nausea
42
adverse effects of SNRIs
Nausea, sweating, insomnia, tremors, sexual dysfunction
43
SNRIs
desvenlafaxine duloxetine levomilnacipran venlafaxine
44
what are atypical antidepressants
change the levels of one or more neurotransmitters, dopamine, serotonin or norepinephrine Because atypicals work in different ways, each has their own characteristics and different possible side effects
45
ex of atypical antidepressants
bupropian mirtazapine nefazodnoe trazodone vilazodone vortioxetine
46
what is bupropion
Low risk of sexual side effects and weight gain, can increase anxiety, lowers seizure threshold, contraindicated with hx of head injury, seizure, or eating disorder
47
what is mirtazapine
Increases appetite, can be beneficial for elderly or those with poor intake, Adverse effects: weight gain, fatigue, elevated cholesterol
48
what is trazodone
Used in combination with SSRI to treat insomnia, side effects of sedation and rare priapism (prolonged erection of penis)
49
adverse effects of TCAs
Anticholinergic effects Orthostatic hypotension Sedation Cardiac arrhythmias, tachycardia Lethal toxicity in OD Excessive sweating Increased appetite/weight gain Sexual dysfunction
50
contraindications in TCAs
seizure disorder CAD, diabetes, urinary retention Highly toxic, assess OD risk, may increase suicide risk
51
examples of TCAS
Amitriptyline Amoxapine Desipramine (Norpramin) Doxepin Nortriptyline (Pamelor)
52
what are TCAs
Used to treat conditions other than depression, e.g. obsessive-compulsive disorder, anxiety disorders, nerve-related (neuropathic) pain Take at bedtime, causes sedation, amitriptyline, doxepin, imipramine, and trimipramine Cause weight gain, amitriptyline, doxepin, imipramine, and trimipramine Nortriptyline and desipramine are tolerated better than other TCAs
53
what are monoamine oxidase inhibitors
Increase norepinephrine, dopamine, and serotonin in brain Risk for hypertensive crisis; must avoid tyramine in diet Orthostatic hypotension Required 14-day “washout” period if switching meds
54
interactions with MAOIs
SSRIs TCAs OTC decongestants, etc. Antihypertensives Amphetamines, caffeine HF, CVD, renal disease, pheochromocytoma (tumor on adrenal gland, irregular secretion of epinephrine and norepinephrine – increases bp, palpitations, and HA)
55
examples of MAOis
isocarboxazid phenelzine selegiline tranylcypromine
56
what is serotonin syndrome
rare Most often occurs when 2 medication that raise the level of serotonin are combined Other antidepressants Some pain or headache medications Herbal supplement, St. John’s wort
57
s/s of serotonin syndrome
Anxiety Agitation High fever Sweating Confusion Tremors Restlessness Lack of coordination Major changes in BP Tachycardia Pupil Dilation
58
nonpharm treatments
Electroconvulsive therapy (ECT) Light therapy Tanscranial magnetic stimulation (TMS) Vagal nerve stimulation Deep brain stimulation Peer support Exercise Complementary medicine: St. John’s Wort -Not regulated by FDA -Photosensitivity -Risk for serotonin syndrome if taken with Rx agents
59
mechanism of action with ECT
Thought to increase levels of biogenic amines (i.e., neurotransmitters)
60
side effects of ECT
temp memory loss and confusion
61
risks of ECT
mortality permanent memory loss
62
post procedure ECT
monitor ABCs and vitals
63
recovery period of ECT
rest, quiet environment, falls prevention
64

NUR 210 (10 decks)

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