affective mood
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| pervasive/sustained emotion that may have a major influence on perception (depression, elation, anger). | Mood (affect)-
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| alteration in mood or feelings(sadness, despair, pessimism). | Depression
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| alteration in mood or feelings (hyperactivity, agitation, hyperactivity, grandiose). | Mania
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| Major Depressive Disorder & Dysthymic Disorder are aka __________ | Depressive (Unipolar)
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| Mania is AKA _______ | (Bipolar)
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| depression is > in woman, young age,lower income,single,divorced,>spring,fall and > in whites but more sever in_____ | more severe in blacks- less likely to be treated.
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| Bipolar is = in both men and woman, 1st manic episode is at age ___ | 20
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| how does Pathological Depression occur | when ADAPTATION is ineffective.
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| *Features: delusions-include guilt/punishment, hallucinations are auditory, berating is known as | Psychotic ;Major Depressive Disorders Subtype
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| *Features (psychomotor retardation)is known as | Catatonic ;Major Depressive Disorders Subtype
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| *Features (severe form of depressive episode) worse in AM, suicidal ideation is known as | Melancholic ;Major Depressive Disorders Subtype
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| *Features dominant vegetative symptoms is known as | Atypical ;Major Depressive Disorders Subtype
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| features fall/winter months is known as | (SAD-seasonal affective disorder)Major Depressive Disorders Subtype
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| 4weeks postpartum( with psychotic features-infant at risk)is known as | PostPartum-onset;Major Depressive Disorders Subtype
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| Major Depression Proposed Subtypes are | Premenstrual dysphoric disorder- characterized by more severe symptoms than premenstrual syndrome.
Mixed anxiety/depression
Recurrent brief depression-(1day/1wk,1x per month over 12 months.*high risk of suicide.
Minor depression-chronic (self pity )
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| Change in previous function. Impaired social/occupational function existing for at least 2weeks. No history of Manic Behavior. Symptoms not attributed to medical conditions/substance abuse | Depressive Disorders Major Depressive Disorder MDD
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| 1. 5>symptoms presented in same 2 wks. Every day, most waking hours. 2. 1 of the symptoms is depressed mood (loss of interest/pleasure). 3. Clinically significant distress/impairment in social/occupational or other important Areas. | Major Depressive Disorder Diagnostic Criteria
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| Depressed (SAD) most of the day nearly every day.Child/Adolescent-irritable.Older adults- subsyndromal depression.Marked diminished interested in pleasure.Significant wgt. Loss/gain.Insomnia/Hypersomnia 5.Psychomotor agitation/retardation.Fatigue | Major Depressive Disorder Diagnostic Criteria r/t 1,2,3 named systems mentioned
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| Feelings of worthlessness/guilt (may be delusional). Decreased ability to think/concentrate/indecisive.Recent thoughts of death or SUICIDAL ideation. | Major Depressive Disorder Diagnostic Criteria r/t 1,2,3 named systems mentioned
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| B. Never a MANIC Episode. C. Clinically significant distress or impairment. D. Symptoms have no direct physiological cause. E. Symptoms longer than 2months,suicidal ideation, psychotic/psychomotor (not related to bereavement). | Major Depressive Disorder Diagnostic Criteria
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| Early onset (before 21yrs.) Childhood/ teens Late onset (21yrs>) early adulthood *MDD/DD-Main differences are duration and severity of symptoms.DD no psychotic symptoms | Dysthymic Disorders Classification
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| Feature –chronically depressed mood(2yrs>); most of the day, more days than not . irritable mood in child/adolescent(1yr>). No evidence of psychotic symptoms. Milder than major depression “down in the dumps”, able to function. | Depressive Disorders Dysthymic Disorder DD
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| What is the *Dominent Symptom in childhood depression | *Dominent Symptom:Irritability and disruptive behavior, sadness and hopelessness core issues
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| What is the common denominator in childhood DD | *Common denominator = LOSS
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| BEHAVIORAL changes lasting several weeks.Change in mood, thinking motivation. (sadness,loneliness,anxiety,delinquency,sexual acting out, substance abuse, anger,apathy are implications of | ADOLESCENTS DD
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| *Perception of Abandonment by parents or peers can precipitate what in childhood DD | SUICIDE .(3rd leading cause of death in 15-24yr olds)
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| What is the tx for DD in children and adolescents | TX:psychosocial interventions, antidepressant
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| Senescence- (Low self-esteem, helplessness, hopelessness).Symptoms of depression often confused with dementia. Bereavement Overload. Highest % of suicides among the _______ | Elderly -> TX: antidepressants, electroconvulsive therapy, psychotherapy (behavioral, group, cognitive, family).
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| Postpartum Depression-may last a week to several months. a. “blues”-50-85% (within 48hrs.) b. moderate-10-20% (start later-vary day to day) c. severe/psychotic-1to2 out of 1000 (risk of suicide/infanticide) what is the TX | TX.-antidepressents,psychosocial therapy,support.
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| Many older adults suffer from depression. They experience many but not all symptoms of Major Depression. Note: Depression is common in older adults but it is.... | NOT a normal result of aging.
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| what neurotransmitter deals with stress | norepinephrine
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| What neurotransmitter regulates psychobiological factors (irritability, poor impulse control,arousal | seritonin
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| What neurotransmitter exerts strong influence over mood/behavior | dopamine
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| What neurotransmitter is excessive in depression, inadequate in mania. | Acetylcholine
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| This theory states that depression results from the dynamic interplay of biology/environment. | *Diathesis –Stress model
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| This theory states that ”learned helplessness”. Repeated failure to control life leading to feelings of helplessness and dependence on others, a possible predisposition for depression. | *Learning theory
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| This theory states that negative cognitive distortion BECK’s TRAID (negative expectations of :envirorment, self, future). | *Cognitive theory
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| This belief is associated with lower rates of depression. | *Religious/Spiritual Belief-
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| This stage of Depression shows helpless, powerless,Behavioral-slow movement,limited communication, slumped, retarded thinking, difficulty concentrating anorexia or overeating, h/a, sleep disturbance. | Moderate-associated with Dysthymic Disorder.
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| What stage of depression shows Affective-total despair, worthlessness, flat affect.Behavioral- psychomotor retardation, no communications,fetal position.Cognitive- Delusional thinking,confusion, suicidal thought.Physiological- slow-down entire body | Severe- major depression or bipolar depression
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| ND for depression | Risk for violence (self-directed)
Powerlessness
Self care deficit
Low self esteem
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| Treatment Modalities Mood Disorders | Psychopharmacology;Depression (pp.261-269)
Mania (pp.290-296)
Psychotherapy
Group/Family
Cognitive- Behavioral Therapy (CBT)-change negative thought patterns and behavior.
Interpersonal Therapy (IET)-work through personal relations.
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| Electroconvulsive Therapy (ECT)Absolute contraindication | increased intracranial pressure. High risk: CVA,MI,Aneurysm,>BP,CHF.
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| At least 1 episode of mania alternates with depression.(Psychosis may accompany the manic episode) | Bipolar I (Mania)-
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| recurrent bouts of hypomania(euphoric) alternate with major depression (at risk for suicide). P.282 | Bipolar II (hypomania)-
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| *Psychosis not present in Bipolar ___ | II
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| hypomanic episodes alternate with minor depressive episodes (at least 2 years). They tend to have irritable hypomanic episodes. | Cyclothymia-
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| -(4>mood episodes in 12 month period) severe symptoms resistance to conventional tx. | Rapid Cycling
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| Bipolar Disorder Developmental Implications | *Suicide Risk: rage, aggression, self-injurious behavior
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| Child/Adolescent- Treatment Strategies Bipolar | . Psychopharmacology: Librium, Divalproex, Carbamazepine, Atypical antipsychotics.
*ADHD- most common comorbid condition.
ADHD Agents may >mania-only give after bipolar symptoms controlled.
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| What type of mainia *Does not require hospitalization usually | Hypomania
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| What type of mania *Usually requires hospitalization | Acute Mania
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| What type of mania * At risk for injury to self/others | Delirious Mania
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| Intervention (NIC) Mania(Safety) | Set limits on client’s behavior when needed.
Reminded the client to respect distance between self & others
Use short, simple sentences to communicate.Clarify the meaning of client’s communication. provide finger foods that are high in calories and prote
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| Suicide is a behavior, who has the highest rate of suicide | Elderly rate very high
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| What affiliation decreases suicide risk. | Religion-
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| What is a primary intervention for suicide | Activities that provide support, education, information to prevent suicide. (schools, conferences).
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| What is a secondary intervention for suicide | : Treatment of actual suicide crisis. (hot-lines, hospitals).
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| What is a tertiary intervention for suicide | Working with family/friends of suicide victim.
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| Nursing Intervention (NIC) Suicide | Ask client directly: do you want to harm yourself?, Do you have a plan?,Do you have the means (gun)?
Safe environment: eliminate harmful objects.
Contract not to harm self.
Close Observation.Possibly 1:1. Make rounds at frequent,irregular,intervals.
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