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psych depression
mood disorders-depression,MDD,dysthymia,ECT,Bipolar
| Question | Answer |
|---|---|
| depression prevalence | 4th leading cause of disability in the U.S. symptoms of anxiety occur in 70% of cases of major depression. 2nd to medical condition |
| cause of depression | serotonin and norepinepherine are two major neurotransmitters involved. |
| serotonin job | important regulator of sleep, appetite,and libido. |
| serotonin dysfunction | poor impulse control, low sex drive, decreased appetite, and irritability |
| norepinepherine decrease | anergia, anhedonia, decreased concentration, diminished libido in depression |
| MDD | depressed mood,loss of interest, impaired social and occupational functions, sx last @ least 2wks-9mths, no hx of manic, can have hallucinations |
| MDD symptoms(need 5 or more over 2wk period) | depressed mood most of day, anhedonia, sig. wt loss, insomnia or hypersomnia, I/D motor activity, anergia, feeling worthlessness, D concentration, thoughts of death. NO HX MANIC |
| Dysthemic Disorder DD | same sx as MDD but milder, 2 years, chronic sad and depressed most of time, no psychotic features, children express by irritability |
| DD sx(2 or more are present) | D/I appetite, insomnia or hypersomnia, low energy, D self esteem, poor conc, difficult making decisions, feelings hopelessness |
| pt w/ DD | not normally severe enough for hospitalization, usually starts in childhood and teenage years to early adult, at risk for developing MDD as well as other psych disorders |
| difference between MDD and DD | main difference is the severity of symptoms, DD is much less severe than an episode of MDD |
| anhedonia | lack of enjoyment in life |
| meds for depression | TCAS, SSRIS, atypical antidepressants, MAOIS, SNRIS |
| TCAS | ELAVIL,ENDEP. sedation and wt gain common, dangerous for OD, if it does not get the heart it will get the liver. |
| SSRI | CELEXA,PROZAC,PAXIL,LUVOX,LEXAPRO, ZOLOFT. rare but serotonin syndrome can happy and is greatest when mixed w/ serotonin enhancing agent like MAOI |
| serotonin syndrome | overactivation of serotonin receptors, caused by high dose of drug interactions like MAOIS |
| serotonin syndrome S/S | abd pain, D, sweatring, fever, tachycardia, elevated BP, delirium, muscle spasms, I motor activity, irritability, hostility, and mood change |
| newer atypical antidepressants | WELLBUTRIN,ZYBAN,DYSEREL,AND SSRI (cymbalta,remeron,effexor) |
| MAOIS | NARDIL,PARNATE. used when no response to other meds, prevents breakdown of monoamine I levels and resulting in increased mood |
| MAOI problems | inhibit breakdown of tyramine in liver. I levels lead to high BP, HTN crisis, cerebrovascular accident and death. restrict foods high in tyramine |
| foods high in tyramine | avocados,figs,bananas,meat(fermented, smoked,aged),most cheeses, yeast extract, beers, most aged foods |
| Bipolar Disorder | labile mood-extreme euphoria to depression, periods of nl moods between, some happen at certain seasons, sx may become psychotic |
| criteria for bipolar | 4days hypomania,1wk mania. 3 or more sx including;high self-esteem, D sleep, more talkative, flight of ideas, distractibility, I goal directed activity, excessive pleasurable activites w/ painful consequences |
| mania | mood elevated, impairment of occupational and social functioning, excessive motor activity, may be harmful, may have psychotic features, often need hospitalization |
| hypomania | mood elevated but milder than mania, no hospitalization, no psychotic features |
| mixed episodes | rapidly alternate moods, mania and depression, causes severe occupationl and social dysfunction, usually requires hospitalization, may have psychotic features |
| predisposing factors of mood disorders | genetic, biochemical(D serotinin and dopamine), endocrine disorder (hypersecretion of cortisol, hypothyroidism) |
| psychiological factors of mood disorders | meds(steroids),neurological disorders (parkinsons), electrolye imbalance(I Na&Ca),nutritional deficiencies(B vit) |
| other causes of mood disorder | SLE, CHF, DM |
| psychosocial causes of mood disorder | loss, chronic anxiety |
| assess for | presence of suicidal thoughts, plan, means,any use of substances, previous attempts and what they were,contact for safety |
| tx | meds, therapy, electric shock therapy(electric convulsive therapy ECT) |
| meds for bipolar disorder | lithium carbonate,antiepileptic drugs(AED-depakote,tegretol, lamictal),anxiolytics(klonopin, ativan),antipsychotics(zyprexa, seroquel) |
Created by:
gudknecht
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