mood disorders Flashcards
(168 cards)
1
Q
a mood disorder that causes a persistent feeling of sadness and loss of interest
A
depression
2
Q
natural response to a loss
A
grief
3
Q
painful feelings come in waves often intermixed with positive memories associated with loss (there is little relief)
A
grief
4
Q
self esteem is maintained in this feeling
A
grief
5
Q
what is the similarity between grief and depression
A
intense sadness and withdrawal from usual activities
6
Q
this feeling causes decrease in interest or/and mood
A
depression
7
Q
feelings of worthlessness and self loathing are common in this feeling
A
depression
8
Q
what are other terms for major depressive disorder
A
clinical depression
major depression
unipolar depression
9
Q
what is the dsm-v diagnostic criteria for major depressive disorder
A
at least 2 weeks of depressive episode
or
at least 4 of the following:
- anhedonia
- appetite disturbance
- sleep disturbance
- psychomotor agitation or retardation
- fatigue (throughout the day)
- feelings of worthlessness
- recurrent suicidal thoughts
10
Q
what is the feeling of inability to experience pleasure
A
anhedonia
11
Q
what are the two types of sleep disturbance
A
hypersomnia
insomnia
12
Q
what do you call the type of sleep disturbance where th patient sleeps for long periods
A
hypersomnia
13
Q
what is another term for persistent depressive disorder
A
dysthymia
14
Q
how many weeks of depressive episode is it needed to diagnose major depressive disorder?
A
at least 2 weeks
15
Q
what are the dsm-v diagnostic criteria for persistent depressive disorder
A
depressed mood for at least 2 years
or
at least two of the following
- appetite disturbance
- sleep disturbance
- fatigue
- feelings of worthlessness
- feelings of hopelessness
- poor concentration or difficulty making decision
16
Q
what type of depression has
- anhedonia
A
major depressive disorder
17
Q
what type of depression has appetite disturbance
A
major depressive disorder and persistent depressive disorder
18
Q
what type of depression has sleep disturbance
A
major depressive disorder and persistent depressive disorder
19
Q
what type of depression has psychomotor agitation or retardation
A
major depressive disorder
20
Q
what type of depression has all day fatigue
A
major depressive disorder and persistent depressive disorder
21
Q
what type of depression has feelings of worthlessness
A
major depressive disorder and persistent
22
Q
what type of depression has feelings of worthlessness
A
major depressive disorder and persistent depressive disorder
23
Q
what depression has recurrent suicidal thoughts
A
major depressive disorder
24
Q
what depression has feelings of hopelessness
A
persistent depressive disorder
25
what depression has poor concentration or difficulty making decision
persistent depressive disorder
26
what is the exact cause of depression
unclear
27
what is the exact cause of depression
unclear
28
how many percentage of concordance rate do identical twins have when it comes to depressive disorder?
40-50%
29
what's the probability of first degree relatives of depressed individuals developing depression
3x more likely
30
can adopted children develop mood disorders simply because their biological parents had mood disorders
yes
31
what are the monoamine neurotransmitters
- serotonin
- norepinephrine
- dopamine
32
what monoamine neurotransmitter controls food intake
serotonin
33
what monoamine neurotransmitter controls sleep
serotonin
34
what neurotransmitter regulates emotions
serotonin
35
what neurotransmitter controls motivation
dopamine
36
what neurotransmitter controls cognition
dopamine
37
what neurotransmitter regulates emotional responses
dopamine
38
what neurotransmitter causes changes in attention
norepinephrine
39
what neurotransmitter causes changes in learning and memory
norepinephrine
40
what neurotransmitter causes changes in mood
norepinephrine
41
what neurotransmitter controls motivation, cognition; regulates emotional responses
dopamine
42
what neurotransmitter causes changes in attention, learning and memory, sleep and wakefulness, mood
norepinephrine
43
what are causes of dysregulation of neurotransmitters
- too few are released
- linger too briefly in synapses
- releasing presynaptic neurons reabsorb them too quickly
- conditions in the synapses do not support linkage with post synaptic receptors (monoamine oxidation)
- number of postsynaptic receptors have decreased
44
what medications cause depression
CNS depressants
antihypertensives
ant-acne
45
what CNS disorders cause depression
- cerebrovascular disorders
- temporal lobe tumors
- alzheimer's disease
- huntington's disease
- multiple sclerosis
46
what hormonal imbalances cause depression
adrenal dysfunction
- addison's and cushing's
estrogen - progesterone imbalance
47
what nutritional deficiencies cause depression
vitamin B complex deficiency
vitamin C deficiency
48
what are the b vitamins
b1 (thiamine)
b6 (pyridoxine)
b12 (cyanocobalamin)
49
what are CNS depressants
anxiolytics
antipsychotics
sedative-hypnotics
50
what is an example of antihypertensive that cause depression
propanolol
51
what anti-acne causes depression
isotretinoin
52
what feeling causes ambivalence
melancholia
53
what causes the formation of a weak ego and a punitive superego
melancholia
54
who created the concept of melancholia
sigmund freud
55
this imposes feeling of lack of control over life situation
learned helplessness
56
who created the idea of learned helplessness
seligman
57
this theory proposes that melancholia results to the formation of a weak ego and punitive superego, thus the development of depression
psychoanalytical theory by sigmund freud
58
this theory proposes that depressive illness is a result of having been abandoned by or otherwise separated from a significant other during the first 6 months of life
object loss theory
59
this theory proposes that the underlying cause of depressive affect is seen as cognitive distortions that result in negative, defeated attitudes
cognitive theory
60
what are the screening tests for depression
DASS - 21 (Depression, Anxiety and Stress Scale)
Hamilton Depression Rating Scale
61
this assesses for depression symptoms which will be used to determine severity of disease
hamilton depression rating scale
62
this is administered by a clinician
hamilton depression rating scale
63
this is a self-rating tool
DASS - 21
64
what are mHGAP protocol for management of depression
- provide psychoeducation to the person and their carer
- reduce stress and strengthen social supports
- promote functioning in daily activities and community life
- consider antidepressants
- if available, consider referral for brief psychosocial treatments
- do not manage the symptoms with ineffective treatments (i.e., vitamin injections)
65
t/f:
provide psychoeducation to the person only
false
provide psychoeducation to the person and their carer
66
t/f:
reduce stress and strengthen social supports
true
67
t/f:
promote functioning in daily activities and community life
true
68
t/f:
consider antipsychotics
false
consider antidepressants
69
t/f:
give vitamin injections as supportive care
false
do not manage symptoms with ineffective treatments
70
t/f:
if available, consider referral for brief psychosocial treatments
true
71
t/f:
depression is a rare condition
false
depression is a very common condition that can happen to anybody
72
t/f:
fatigue and avolition in a depressed person could be because they are just being weak and lazy
false
the occurrence of depression does not mean that the person is weak or lazy
73
t/f:
you should tell a depressed person to be more cheerful to keep the sadness away
false
depression cannot be controlled by sheer willpower
74
t/f:
the negative attitude of others may be due to the intangible nature of depression
true
75
t/f:
people with depression would have negative but real opinions about themselves, their life and their future
false
people with depression tend to have unrealistic negative opinions about themselves, their life and their future
76
t/f:
thoughts of self-harm or suicide are not that common but if they notice these thoughts, they should NOT act on them but instead tell a trusted person and seek help immediately
false
thoughts of self-harm and suicide are common
77
what are the action-oriented stress reduction strategies
- practicing assertiveness
- time management
- delegating
- managing expectations, commitments, and setting boundaries
- flexible or relaxed standards
- changing habits
78
what are the emotion-oriented stress reduction strategies
- positive self talk
- cognitive behavioral therapy
79
what are the acceptance-oriented stress reduction strategies
- diet and exercise
- meditation and physical relaxation
- avoiding social media sites which may exacerbate negative feelings
80
this stress reduction strategy confronts the problem causing stress
action-oriented
81
this stress reduction strategy changes our perspective about a stressful event; changes our response to stress
emotion-oriented
82
this stress reduction strategy acknowledges that stress co-exists with us and focus on how we can feel better as individuals
acceptance-oriented
83
t/f
starting previous social activities that the patient participated in before might trigger them to further sink into depression
false
starting social activities may potentially provide direct or indirect psychosocial support
84
t/f:
you should advise the patient to let their changes in appetite dictate their eating habits
false
- patients should try to eat regularly despite changes in appetite
85
t/f:
decision to start antidepressants shall be made both by the psychiatrist and the person
true
86
t/f:
antidepressants could be addictive
false
antidepressants are not addictive
87
t/f:
antidepressant medication is only taken during depressive episodes
false
regular intake of medication is important
88
t/f:
side effects should be immediately reported to the physician
false
some side effects may be experienced within the first few days but they usually resolve
89
t/f:
it may take several weeks before improvements in mood, interest or energy is noticed
true
90
medication usually needs to be continued for at least how many moths after resolution of symptoms
9-12 months
91
what is the time that it takes for the antidepressant to work
lag period
92
why do u have too continue antidepressant medication 9-12 months after the resolution?
to prevent relapse
93
what drugs are used for antidepressant therapy
SSRIs
TCAs
MAOIs
94
what is the mechanism of action of selective serotonin reuptake inhibitor
it blocks the reuptake of serotonin
95
why are selective serotonin reuptake inhibitors the first line of antidepressants
lower sedating, anticholinergic and cardiovascular side effects
96
what is the timeline of psychopharmacologic effect of antidepressant
reduced insomnia = 3-4 days
appetite normalize = 5-7 days
energy returns = 4-7 days
mood improves = 7-10 days
97
what SSRI is recommended for depression
fluoxetin (prozac)
98
what program recommends fluoxetine (prozac) as first line drug
MHGAP
99
what are side effects of SSRIs
- sedation
- insomnia
- headache
- dizziness
- GI disturbances
- changes in appetite
- sexual dysfunction
100
when do u give SSRIs at AM
when patient develops insomnia
101
why do u give SSRIs at pm
because of its sedative effect
102
what are the nursing interventions for people taking SSRIs
give in am if there is insomnia and pm if patient feels sedation
encourage drink adequate fluid report sexual difficulties
103
what are the most common ssris in the philippines
escitalopram
104
what are the side effects of escitalopram
- drowsiness
dizziness
wight gain
sexual dysfunction
restlessness
dry mouth
headache nausea
orthostatic hypotention
diarrhea
105
what are nursing responsibilities for escitalopram
check for orthostatic bp
assist client to rise slowly from sitting position
encourage use of sugar free beverages /hard candy
administer with food
106
this occurs when there is inadequate washout period between taking MAOIs & SSRIs/ when MAOIs are combined with meperidine
serotonin syndrome
107
what is a symptom of serotonin syndrome
changes in mental state
108
this primarily blocks reuptake of norepinephrine and to some degree serotonin too
tricyclic antidepressants
109
what is an example of tricyclic antidepressant
amitriptyline (elavil)
110
what are the side effects of amitriptyline (elavil)
- sedation
- orthostatic hypotension
- blurred vision
- dry mouth and sore throat
- difficulty urinating
- nausea
- weight gain
- sexual dysfunction
111
when do u administer amitriptyline (elavil)
hours of sleep
112
what drug interferes with enzyme metabolism (monoamine oxidase)
Monoamine oxidase inhibitor
113
how many weeks are the lag period of MAOIs
2-14 weeks
114
how many weeks is the washout period of MAOIs
5-6 weeks
115
what are the three monoamine oxidase inhibitors
tranylcypromine
phenelzine
isocarboxazid
116
what ar ethe brand names of the three monoamine oxidase inhibitors
parnate
nardil
marplan
117
what are the side effects of monoamine oxidase inhibitors
- drowsiness
- dry mouth
- overactivity
- insomnia
- nausea
- anorexia
- constipation
- orthostatic hypotension
118
what are the nursing interventions for MAOIs
- assist the client to rise from sitting
- administer at AM
- administer with food
- ensure adequate liquids
- educate importance of adhering to low tyramine diet
119
what is the adverse reaction caused by MAOIs
hypertensive crisis (cheese reaction)
120
this is a life threatening condition that can result when a client taking MAOIs ingests tyramine-containing foods
hypertensive crisi
121
this is a trace monoamine
tyramine
122
what are the clinical manifestations of hypertensive crisis
severe hypertension (BP> 180 mmHg systolic)
hyperpyrexia
tachycardia
diaphoresis
tremors
cardia dysrhythmias
123
when is the onset of hypertensive crisis
20-60 minutes after ingestion of tyramine containing foods
124
what is the drug of choice for hypertensive crisis caused by tyramine and MAOI ingestion
phentolamine
125
what drug class is phentolamine
adrenergic blocker
126
how do you prevent hypertensive crisis
adhere to low tyramine diet
127
what is a low tyramine diet
no processed foods
no canned goods
no aged cheese
128
this involves delivery of an electrical impulse to the brain to cause a seizure
electro convulsant therapy
129
what are the indications for ect
- unresponsive to antidepression
- patients who experience intolerable side effects at therapeutic levels
- pregnant women
- actively suicidal patients
130
what are the ect pre-procedure care
- facilitate signing of Informed consent
- NPO post midnight
- remove nail polish
- instruct to void before procedure
- start IV line
131
what are the ect preprocedure meds:
- atropine
- metohexital (brevital) IV
- succinylcholine (anectine) IV
132
what is atropine used for in ect
anticholinergic to reduce secretions
133
what is metohexital (brevital) IV used for in ect
for immediate anesthesia
134
what is succinylcholine (anectine) IV used for in ect
for neuromuscular blocking effect
135
why are muscle relaxants taken during ect
to prevent fractures caused by seizures
136
what are the criteria of a good, induced seizure in ECT
- monitor convulsions for at least 20 seconds
- increased HR for 30-50 seconds
- brain seizure as monitored by eeg for 30-50 secs
137
what are the side effects of ect
mild confusion/brief disorientation
fatigue
headache
short term memory loss
138
what are the post care for ect
- mechanically ventilate with 100% oxygen until patient can become unassisted
- monitor for respiratory problems
- reorient patient
- administer benzodiazepine IV when patient is agitated
139
this focuses on how a person thinks about self, others and future and interprets their experiences
cognitive therapy
140
this is the tendency to view everything in polar categories
absolute, dichotomous thinking
141
this is when the patient arrives at specific conclusion without sufficient evidence
arbitrary inference
142
this is when the patient focuses on a single detail while ignoring other bigger details
specific abstraction
143
this comes coming to a conclusion despite too little experience
overgeneralization
144
overestimating or underestimating the significance of something
magnification and minimalization
145
self references blame for external factors
personalization
146
what are the signs of manic bipolar disorder
- brightly colored clothing
- flamboyant
- sexually suggestive
- attention getting
- pressured speech: unrelentingly rapid
147
these are extreme mood swings from episodes of mania to episodes of depression
bipolar disorders
148
what are the phases of bipolar disorder
mania/hypomania
depression
euthymia
149
this is the bipolar disorder state of being in a natural mood
euthymia
150
this is characterized by hyper, expressive, irritable mood
mania
151
how many weeks does mania episode persists
1 week
152
what are the signs and symptoms of bipolar disorder manic phase
hyperactivity
elevated mood
distractibility
insomnia, irritability, increased interest in sex
grandiosity
flight of ideas
anger, anorexia
speech is loud and rapid; suicidal
talkative
153
this is the abnormal period where there is persistent elevated, expressive, irritable mood
hypomania
154
how many days is hypomania present
4 days
155
what are the signs and symptoms of hypomania
grandiosity
decreased need for sleep
subjective sense that thoughts are racing
distractibility
increase in goal-directed activity
excessive involvement in high risk fun activities
156
what are the types of bipolar disorder
bipolar type I
bipolar type II
cyclothymia
157
the patient experienced mood swings between manic and major depression
bipolar type 1
158
swings between major depression and hypomania
bipolar type II
159
patient experiences mood swings between hypomania and dysthymia but never at the extreme of the spectrum
cyclothymia
160
what is the criteria for cyclothymia
2 years no remission for 2 weeks
161
what is the probability of developing bipolar disorder in first degree relatives
2x
162
what is the probability of developing bipolar for patient offspring
50% chance
163
how much probability do identical twins have to develop bipolar
33% to 90%
164
what is a biochemical cause of bipolar disorder
catecholamine or increase in epinephrine and norepinephrine
165
what is the criteria of bipolar
at least 1 episode of mania
166
this etiology means that mania serves ad defense against the feelings of depression
psychodynamic
167
what is the defense mechanism of bipolar disorder
reaction formation
168
what are the environmental etiology for bipolar
external stressors
nature of work
increased exposure to sunlight
