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Psychosocial Exam 2 M5
Terms in this set (30)
_________ is the leading cause of US disability in clients 15-44 years old
chronic, mild depression
depression is more prevalent in men/women?
women btwn the ages of 15-40
70% higher possibility
what are the neurotransmitters implicated in depression?
norepinephrine (NE), dopamine (DA), serotonin (5-HT)
What are the dominant features/diagnostic criteria for major depressive disorder?
-depressed mood/loss of interest in activities previously enjoyed, appear disheveled, downcast, tearful, avoids eye contact; however usually don't display odd or bizarre behavior
-diagnostic: symptoms present most of the day q day for @ least 2 weeks & cause significant distress or impairment
-can last several weeks to months, on average 4 months but may persist for 12 or more
What are the dominant features/diagnostic criteria for dysthymic disorder?
-poor appetite, low self-esteem, poor concentration, feelings of hopelessness
-diagnostic: depressed/irritable most of the day, occurring most days than not for @ least 2 years (1 year in children & adolescents)
-w/in this time client has no more than 2 months w/out symptoms & has not experienced a manic or depressive episode
What are the dominant features/diagnostic criteria for postpartum depression?
-postpartum blues to postpartum psychosis
-begin first 2-3 months up to 1st year after delivery
-postpartum psychosis is a severe psychiatric emergency-because they may harm infant or themselves
-begin 2-3 days up to first 2 weeks after delivery
-symptoms similar to manic or bipolar episodes, impulsive behaviors
____% of women experience hormonal fluctuations that result in transitory mood disturbances
what is electroconvulsive therapy (ECT) used for?
clients with refractory depression (recurs & doesn't respond to other efforts)
-side effects include: headache, muscle aches, nausea
-can cause memory loss-short term and recent memories
-teach patients and family, it is safe & that side effects are transitory
when taking an antidepressant, effects usually take up to ______ (time) to reduce signs and symptoms?
-long process to find the right antidepressant-provide encouragement and support
antidepressants can precipitate mania in clients with bipolar disorder. true or false?
-they can also activate latent psychosis in some clients
what will happen if an antidepressant is discontinued abruptly?
-can cause severe rebound symptoms & rapid return of original depression
what do selective serotonin re-uptake inhibitors (SSRI) do?
block serotonin reuptake on presynaptic neuron
-more serotonin available for longer helps mitigate depressive symptoms
-SE: GI & CNS
-risk for serotonin syndrome if taking other serotomimetic agents or St. John's wort (confusion, myoclonus, photosensitivity, rash)
what do tricyclic antidepressants (TCA) do?
block reuptake of norepinephrine & serotonin -decreases problems with mood and energy
-SE: cardiotoxic effect
-used when SSRIs & novel antidepressants ineffective
-don't give to suicidal patients because potentially lethal
Monoamine oxidase inhibitors
black activity of MAO -an enzyme that breaks down catecholamines especially norepinephrine
-treats atypical or depression not responsive to other drugs
-increases levels of tyramine-use caution w/food that contain tyramine-can lead to hypertensive crisis
which drug class is inappropriate in a depressed, acutely suicidal client?
which drug class typically is considered the 1st line treatment for depressive disorders?
what condition may result if a client taking MAOIs ingests food that contain tyramine?
what is learned helplessness
theory that proposed people susceptible to mood disorders believe, based on experience, they are ineffective and have no influence on factors that cause suffering
learned helplessness behaviors
passivity, negative expectations, feelings of helplessness, powerlessness, hopelessness
-also signs of major depression
important for nurses to view learned helplessness as relevant to the experiences of clients...
AFTER the development of a depressive disorder, rather than the cause
What risk factors are associated with the development of depressive disorders?
Genes, environment, individual life history, development, neurobiologic makeup
studies have shown risk for suicide increases/decreases w/in the first 2-3 weeks after starting antidepressants
Increases-convey information to client
What treatments are appropriate for different types of depressive disorders?
-individual, group, and family psychotherapies
thought disorders are mental illnesses characterized by disturbances in _______, _______ & ________.
what is schizophrenia?
disorder of the brain w/features like thought disturbances & preoccupation w/frightening inner experiences (hallucinations), affect disturbances (flat, inappropriate affect), and behavioral/social disturbances (isolation, bizarre behavior)
are schizophrenia and multiple personalities the same disorder?
No, schizophrenia is a "disconnected mind"-lack of coherence in mental functioning
-multiple personality is a dissociative disorder in which a pt displays more than one personality
is schizophrenia considered one disorder or a group of disorders?
group or collection of them-genetic, neurologic, metabolic, neuropsychological
what are the two most predictive factors of repeated admissions for clients with schizophrenia?
failure to follow medication regimens
_________ is the most common & severe psychotic disorder
-emerges during late adolescence & early adulthood
-affects 1% of population
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