Mood Disorders

Question 1

What is a mood disorder?

Answer 1

A disturbance in mood,

Question 2

What is the internal manifestation of a mood disorder?

Answer 2

The actual mood.

Question 3

What is the external manifestation of a mood disorder?

Answer 3

The affect.

Question 4

What is the #1 public health problem?

Answer 4

Depression.

Question 5

Why are women at a higher risk for mood disorders?

Answer 5

Hormones.

Question 6

What is the average age of onset of depression?

Answer 6

Mid-30’s but decreasing.

Question 7

What is the average age for manifesting bipolar disorder?

Answer 7

Mid to late 20’s

Question 8

What is the risk of suicide if depression is left untreated?

Answer 8

25-30%.

Question 9

What is the definition of major depression?

Answer 9

A state of intensely sad mood accompanied by other symptoms which exists nearly every day for at least two weeks.

Question 10

What are symptoms of depression?

Answer 10

Anhedonia, sleep disturbance, weight gain/loss, lack of energy, unable to concentrate, nihilism, psychomotor retardation, suicidal thoughts.

Question 11

What are risk factors of depression?

Answer 11

Past history of depression, Family history of depression, extreme stress, dysthymia

Question 12

What is anhedonia?

Answer 12

Inability to experience pleasure physically, mentally, or sexually.

Question 13

What is nihilism?

Answer 13

No motivation- “whats the use” attitude

Question 14

What are some early warning signs of depression?

Answer 14

Abnormal sleep patterns, trouble concentrating, lack of pleasure, isolating self, slipping grades, irritability, spending time alone

Question 15

What is hypersomnia?

Answer 15

Not able to sleep.

Question 16

What are subtypes of depression?

Answer 16

Single episode, recurrent, psychotic features, atypical features, seasonal, post-partum

Question 17

How is depression diagnosed?

Answer 17

Observing, self-report, Beck, Hamilton, Zung inventory, Dexamethasone Supression test

Question 18

What is self-report?

Answer 18

When the patient reports their symptoms and says they are depressed.

Question 19

What is a dexamethasone supression test?

Answer 19

A biological basis of adrenal gland over production that causes depression.

Question 20

What are Beck inventory concepts?

Answer 20

Sadness, pessimism, sad feelings.

Question 21

What are causative theories of depression?

Answer 21

Biological, genetic, psychoanalytic, cognitive, and behavioral.

Question 22

What is the biological theory of depression?

Answer 22

Imbalance of serotoninand norepinephrine and the circadian rhythm is disruption.

Question 23

What is the genetic theory of depression?

Answer 23

First degree relatives of individuals with major depression have twice the risk of developing it.

Question 24

What is the psychoanalytic theory of depression?

Answer 24

Hostility turned inward because of a major loss.

Question 25

What is the cognitive theory of depression?

Answer 25

The client is preoccupied with distorted, self deprecating thoughts.

Question 26

What is the behavioral theory of depression?

Answer 26

An early traumatic experience causes depression and the person has learned that there is nothing they can do.

Question 27

What percentage of clients respond to anti-depressant therapy?

Answer 27

70%

Question 28

What is "first break" therapy?

Answer 28

The first time the patient is treated, may be for 6 months to 5 years, then they are tried to be weaned off of meds to see if it is with chemical levels.

Question 29

What are the major categories of anti depressants?

Answer 29

Cyclic, Monoamine Oxidase Inhibitors, Selective serotonin reuptake inhibitors, and adjuntive therapies.

Question 30

What are cyclic anti depressants and an example?

Answer 30

The first type of antidepressants- often used for muscle pain. Ex: Elovil.

Question 31

What are monoamine oxidase inhibitors (MAO inhibitors)?

Answer 31

Can be dangerous, used for knowledgeable and functioning clients.

Question 32

What is selective serotonin reuptake inhibitors and an example?

Answer 32

The most popular treatment, effective with little side effects: EX: Paxil/Prozac

Question 33

What are some adjuntive therapies?

Answer 33

Anti-psychotics, lithium, and calcium channel blockers.

Question 34

What are some types of non-pharmalogical therapies for depression?

Answer 34

Light therapy, herbal therapy, ECT, cognitive therapy, behavioral therapy, and deep brain stimulation.

Question 35

What is electroconvulsive therapy?

Answer 35

A low energy electrical stimulation of the brain that causes a seizure of approx. 1 minute in duration. Usually given twice a week for 12-15 treatments.

Question 36

What does the seizure during the ECT do?

Answer 36

It alters the levels of neurotransmitters, basically resetting them.

Question 37

What are some nursing considerations for clients receiving ECT?

Answer 37

NPO after midnight (aspiration risk), given atropine for secretions, general anesthesia, muscle relaxant, continuous O2, Recovery room for several hours.

Question 38

What are some nursing actions for clients receiving ECT?

Answer 38

Talk to client before and educate, VS frequently, assess orientation and reorient, DO NOT LET CLIENT DRIVE HOME

Question 39

What is rigidity of thought with cognitive therapy?

Answer 39

Obessessed with a particular thought

Question 40

What is dichotomous thinking?

Answer 40

good/bad, everything is black and white.

Question 41

What is personalization?

Answer 41

feeling targeted.

Question 42

What is arbitrary inference?

Answer 42

Jumping to conclusions

Question 43

What is bipolar disorder?

Answer 43

Periods of depression that alternate with mania with periods of euthymia.

Question 44

What is euthymia?

Answer 44

Normal mood.

Question 45

What is the onset of bipolar disorder (usually)?

Answer 45

A trigger from a major psychosocial stressor or disruption in schedule.

Question 46

What are symptoms of bipolar disorder?

Answer 46

Grandiosity, decreased sleep, flight of ideas, racing thoughts, distracted, psychomotor agitation, libido increase, impulsive/violent acts.

Question 47

What is grandiosity?

Answer 47

exaggerated sense of self esteem- believe they have special pwoers.

Question 48

What are the subtypes of biopolar disorder?

Answer 48

I, II, and III

Question 49

What is Bipolar I?

Answer 49

alternating periods of depression and mania.

Question 50

What is Bipolar II?

Answer 50

Alternating periods of depression and hypomania- Not as high highs, not as low lows.

Question 51

What is Bipolar III or cyclothymia?

Answer 51

Hypomania alternating with dysthmia and euthymia- chance it will progress to I or II disorder.

Question 52

What may clients with Bipolar I exhibit?

Answer 52

Psychosis, paranoia, rapid cycling, recurrent schizophrenia, bizzarre behavior, substance abuse.

Question 53

What may clients exhibit with Bipolar II?

Answer 53

personality disturbance, depression in a seasonal pattern, often impulsive and insensitive. They have substance abuse issues.

Question 54

What is the Kindling theory of bipolar disorder?

Answer 54

Neurotransmission affected initially by stress which creats neurophysiologic sensitivity- brain chemistry has changed and it takes less and less to trigger another break.

Question 55

What enzymes are often high and low in bipolar clients?

Answer 55

High norepinephrine and low monoamine oxidase which degrages norepinephrine.

Question 56

What is the theory with circadian rhythms and bipolar disorder?

Answer 56

The internal chronometer is running faster than 24 hours.

Question 57

What is the genetic theory of bipolar disorder?

Answer 57

First degree relatives with bipolar disorder are 24x more likely to develop it.

Question 58

What is the prognosis of bipolar disorder?

Answer 58

Poorer prognosis with earlier onsets, family history, psychotic features