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N330 Unit 2- Mood/Affect: Mood Disorders
Terms in this set (37)
What is the definition of mood?
A pervasive sustained emotional coloring of experience
Like anxiety, it can be a normal part of life, serving as an adaptive role in response to the life around the person
How is mood documented?
How is affect documented?
Mood is what the patient tells you and what we document
Affect is what we observe and document
What is the definition of a mood disorder?
A maladaptive response associated with disturbed psychological, physiological and social functioning, all characterized by many symptoms
When are mood fluctuations considered abnormal?
When it is beginning to impact many areas of functioning, how they feel in their body, how they feel as they get involved in their daily lives, and how they feel in work, school, or personal/family relationships
What is dysthymia a subcategory of?
What is cyclothymia a subcategory of?
Bipolar I & II Disorder
When does postpartum depression begin?
Starts within 3 months of delivery
What are some of the symptoms that accompany postpartum depression?
Psychosis, guilt, suicidal and homicidal thoughts
What is the definition of depression?
An abnormal emotional state characterized by exaggerated feelings of sadness, worthlessness, emptiness, and hopelessness that are inappropriate or out of proportion to reality
What is the DSM V diagnostic criteria for Depression?
*Last at least 2 weeks or longer
*Represent a change from previous functioning
*Cause some impairment in person's social or occupational functioning
*Five out of eight of the following symptoms during this time period (sleep disturbance, changes in appetite, anhedonia, feelings of hopelessness, suicidal thoughts, inability to make decisions, changes in physical activity, fatigue)
One of these MUST BE depressed mood or anhedonia
What is the definition of dysthymic disorder?
A mood disorder over a 2 year period
Characterized by more days than not of feeling down or sad
These feelings are less intense than major depression but still disrupts every-day life
What is the DSM V diagnostic criteria for dysthymic disorder?
At least 2 years of symptoms, including more days than not of depressed mood
While depressed at least two of the following (feelings of hopelessness, impairment in cognitive functioning, loss of appetite or overeating, low levels of energy or fatigue, low self-esteem, insomnia or hypersomnia)
At no time in the two years of symptoms has there been a symptom free period that lasted two or more months, of 1 and 2 above
At no time in the two years of symptoms, has there been a major depressive, manic, or mixed episode
The symptoms are not from another disorder or influence of a substance such as alcohol or drugs
Clinically significant distress from symptoms, impairment in work, social, or other areas of important functioning
What is the pathophysiology associated with depression?
Exact cause is unknown
Norepinephrine and serotonin are deficient
Deficiency in serotonin reuptake sites
Hypersecretion of cortisol
Hypothyroidism (especially women)
Circadian rhythm changes (evidenced by abnormal sleep patterns in these patients)
Defective gene on chromosome 4 (patients with this gene are 26x more likely to be hospitalized for severe depression/attempted suicide
What populations are at the greatest risk for developing major depressive disorder (MDD)?
Individuals in the second and sixth decades of life
What are some individual risk factors for developing major depressive disorder (MDD)?
Comorbid medical and psychiatric disorders
What is the memory aid used to remember the categories of symptoms of major depressive disorder (MDD)?
What is the acronym SIGECAPS used for and what does it stand for?
Memory aid for the categories of symptoms of MDD
S- suicidal ideation
I- interest (anhedonia)
E- energy decrease
C- concentration decrease
A- appetite changes (losing weight or overeating)
P- psychomotor activity increase or decrease
S- sleep issues (insomnia or hypersomnia)
What are some somatic complaints that may signal depression?
Decreased desire (anhedonia)
Problems with sexual functioning
There is usually multiple causes going on that attribute to these symptoms
What are some risk factors for post-partum depression?
History of depression
What might a new mother express during postpartum depression?
Mom expresses great concern over the ability to care for new baby
50% show signs of PPD prior to delivery
Can postpartum depression become major depression?
Can it have psychotic features?
PPD can become major depression if PPD continues for several weeks after baby is born
Major depression with psychotic features can develop, though it is not as common
In women who have PPD, how many are affected with major depression with psychotic features?
Affects 1 or 2 out of 1000 women
5% of women who have postpartum psychosis commit suicide
What percentage of children are affected by pediatric depression?
What occurs during pediatric depression?
Doesn't play with friends anymore
Doesn't have fun
Frequent c/o physical illness
What occurs during adolescent depression?
Includes same behaviors from pediatric depression, along with:
Fights at school
Morbid themes in written work
Insomnia or hypersomnia
Sees self as unloved, ugly, useless
Has death wishes
What is the 2nd leading cause of death in adolescents AFTER accidents?
What are nursing responsibilities when assessing children and adolescents for depression?
Need to monitor for signs of abuse and/or neglect
What occurs during elderly depression?
Under recognized, under treated
75% had visited PCP 1 month prior to suicide
Often presents with vague somatic complaints (often misdiagnosed with NCD, aka- pseudodementia)
What is pseudodementia?
When a HCP believes that a patient has dementia when they actually have underlying depression that is causing their signs and symptoms
What are the suicide rates in the elderly population?
12% of the population, account for 16% of completed suicides
Depression rates increase among those who require home health care or hospitalization
15-20% of nursing home residents are depressed
What race, gender, and age has the HIGHEST suicide rate?
White men over the age of 85 have the highest suicide rate (19%)
What is the role of the nurse in caring for patients with depression?
Assess coping behaviors
Collaborate with patient, family, and other team members
Develop a comprehensive plan of care for:
Crisis management and Safety
What are some nursing care interventions that should be used for patients with depression?
Suicide assessment- 1:1 supervision
Assess for command hallucinations in psychotic depression
Maintain a safe environment
Use confident, straight-forward approach (simple, clear directions)
Begin with brief interactions
Consider therapeutic use of touch
Verbal or written no suicide contract
1:1 counseling sessions to promote expression of feelings, validate client feelings
Monitor nutritional status and weight
What are command halluciations?
Hallucinations that tell the individual to do something such as telling them to harm themselves or others (typically telling them to hurt themselves) .
Promote self care (hygiene and ADLs)
Monitor sleep patterns
Limit environmental stimuli
Assess mood (using mood rating scale)
Strengthen support system
Eventually bring to group therapy and activities
Assess for and teach adaptive coping skills
Monitor for constipation and increase fluids
Why is it good to begin with brief interaction in patients with depression?
The patient may not be able to tolerate long interactions initially, may be too fatigued, or may not be able to concentrate
What are the medication classes used to treat depression?
Atypical Antidepressants (SNRIs, NDRIs, SARIs)
What are some important things to know about antidepressant medication therapy for depression?
Targets symptoms of depression
Effect is not immediate
There is a suicide risk
Sets with similar terms
chapter 13 depressive disorders
Mood Disorders - I
Chapter 28 Depression
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