Quiz #2: Depression Flashcards
(48 cards)
Grief
-Subjective state that follows loss. -Grief is universal; however, the way in which it is expressed is culturally determined.
Depression
-Clinical disorder that is severe, maladaptive, and incapacitating.
-Extreme sadness, hopelessness, worthlessness and lack of motivation.
Mania
Elevated, expansive, or irritable mood, extreme sense of wellbeing with grandiosity.
How does culture affect depression?
Affects symptomatic expression, clinical presentation and effective treatment. (Most people now believe in a biological basis for this disorder)
Statistics for Depression
-Lifetime risk for MDD is 7 – 12% for men and 20 – 30% for women
-More than 50% of those who have one episode will eventually have another, and 25% of patients will have chronic, recurrent MDD
-1/3 of all people with MDD seek help, are accurately diagnosed, and obtain appropriate treatment
-High incidence of MDD is found among patients hospitalized for medical illness
MDD high prevalent in primary care settings
Who is important to screen for MDD?
Women of reproductive age. Especially those who have children or plan to become pregnant
Etiology of Depression
- Biological Theories
- Cognitive Theory
- Learned Helplessness
- Diathesis Stress Model
Etiology of Depression: Biological Theories
- No single biochemical model explains the causes of depression
- Dominant theory is the dysregulation hypothesis
Dysregulation Hypothesis
- Dysregulation in the amount or availability of 5-HT, the sensitivity of its receptors in relevant regions of the brain, and its balance with other neurotransmitters
- 5-HT has important brain functions such as aggression, mood, psychomotor activity, irritability, appetite, sexual activity, etc.
- 5-HT has an important role in the secretion of growth hormone, prolactin, and cortisol, all of which are found to be abnormal in people with depression
- Most effective antidepressant agents, such as ECT and medications, have been found to enhance neurotransmission of 5-HT
Depression Etiology: Diathesis-Stress Model
- Psychological / biological theory, and is basically the culmination of stress from life experiences (stress) and the vulnerability (diathesis) of a person, such as genetics, psychological, biological, or situational factors, that can lead to depression.
- Example: A child who has a family history of depression (vulnerability / diathesis) and who has been exposed to a particular stressor, such as exclusion or rejection by his peers (stress) would be more likely to develop depression than a child with a family history of depression that has an otherwise positive social network of peers.
Depression Etiology: Cognitive Theory
Depression is seen as a cognitive problem arising from a person’s negative view of self, the world, and the future.
Depression Etiology: Learned Helplessness
- Theory proposes that it is not trauma that produces depression but the belief that one has no control over important outcomes in life.
- It is a behavioral state and a personality trait of one who believes that control over reinforces in the environment has been lost.
- These negative expectations lead to hopelessness, passivity, and an inability to assert oneself.
Primary Risk Factors for Depression Include
- Female
- Unmarried
- Low socioeconomic class
- Early childhood trauma
- Presence of negative life event, especially loss and humiliation
- Family history
- Ineffective coping ability
- Postpartum time period
- Medical illness
- Absence of social support
- Alcohol or substance abuse
Depression DSM-5 Criteria
Add later
What is an affect?
Outward expression of emotion
Depression Affects include
- Sad
- Flat
- Blunted
Depression: Moods Include
- Anxious
- Sad
- Worthless
- Helpless
- Angry
- Hopeless
Depression: Physical Behavior and Appearance Include
- Psychomotor retardation
- Disheveled
- Insomnia
- Older than stated age
- Loss of libido
- Fixed gaze
Depression: Thought Processes Include
- Poor Judgement
- Indecisive
- Intrusive, negative thoughts
- Poor memory
- Poor Concentration
What is SIG-E-CAPS?
Rapid screening for depression
What does SIG-E-CAPS stand for?
- Sleep changes: increase during day or decreased sleep at night
- Interest (loss): of interest in activities that used to interest them
- Guilt (worthless): depressed elderly tend to devalue themselves
-Energy (lack): common presenting symptom (fatigue)
- Cognition/Concentration: reduced cognition &/or difficulty concentrating
- Appetite (wt. loss); usually declined, occasionally increased
- Psychomotor: agitation (anxiety) or retardations (lethargic)
- Suicide/death preoccupation
PHQ-9
-The most commonly used screening questionnaire for depression.
Expected outcomes for patients with depression
Patient will be emotionally responsive and return to pre-illness level of functioning
What actions by the nurse can be done to help the patient reach their expected outcomes?
- Allow patient to recognize feelings
- Analyze stressors and strengthen patient’s self-esteem
- Increase patient’s sense of control, awareness of choices, and responsibility for behavior
- Encourage healthy interpersonal ties with others
- Promote understanding of maladaptive emotions and to acquire adaptive coping responses to stressors
