Week 4-7

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Week 4-7
2013-03-17 17:16:48
psychiatric nursing

psychopathology: depression, bipolar disorder, personality disorder, substance-related disorders,
Show Answers:

  1. What are the two major types of depression and what are the characteristics of each?
    1. Major depressive disorder: 1 or more major depressive episodes that are at least 2 weeks long. This is a disorder of severity.

    2. Dysthymic disorder: at least 2 years of depressed mood for more days than not. This is a disorder of chronicity
  2. What is the DSM-IV-TR criteria for Major depressive disorder?
    • Must have at least 5 of the criteria, one of which MUST be (1) or (2):
    • 1. Depressed mood
    • 2. Anhedonia (apathy)
    • 3. Significant change in weight
    • 4. Insomnia/hypersomnia
    • 5. Increased/decreased psychomotor 
    • 6. fatigue/energy loss
    • 7. feelings of worthlessness/guilt
    • 8. diminished concentration/indecisiveness
    • 9. recurrent death/suicidal thoughts
  3. What are the specifiers of MDD according to the DSM-IV-TR?
    Atypical, melancholic, catatonic, postpartum, psychotic, seasonal
  4. What is atypical depression?
    • - generally occurs in younger women
    • - characterized by increased appetite/weight gain, hypersomnia (10+hrs/day), leaded paralysis, extreme sensitivity to interpersonal rejection, and mood reactivity in which the mood brightens considerably with positive events.
  5. What is melancholic depression?
    • - most often occurs in older adults
    • - characterized by anhedonia/inability to be cheered up
    • - following symptoms: depression worse in the am, early am awakening, psychomotor retardation/agitation, significant anorexia/weight loss, excessive and inappropriate guilt.
  6. What are catatonic features of depression?
    Significant psychomotor alterations (immobility, excessive motor activity, mutism, echolaila [repetition of words], inappropriate posturing)
  7. What is psychotic depression?
    • - When a person has hallucinations and delusions with the mood disturbance.
    • - Tend to be mood-congruent
  8. What is the DSM-IV-TR criteria for dysthymic disorder?
    • A. Depressed mood for 2 years, with a depressed mood for most of the day, for more days than not
    • B. 2 or more of the following:
    • 1.poor appetite/overeating
    • 2. insomnia/hypesomnia
    • 3. low energy/fatigue
    • 4. low self-esteem
    • 5. poor concentration/difficulty making a decision
    • 6. feelings of hopelessness
  9. What are some of the causes of depression?
    • Neurochemical: norepinephrine, serotonin, dopamine, dysregulation of GABA. The cells that the monoamines activate have lost the ability to respond
    • Genetic
    • Endocrine: Hypothalamic-pituitary-adrenal (HPA), which mediates the stress response, malfunctions and creates cortisol, thyroid, and hormonal abnormalities
    • Circadian rhythm
    • changes in brain anatomy: atrophy of white matter in frontal lobes, cerebellum, and basal ganglia
    • psychological: Adverse early life experiences, intrapsychic conflicts, reactions to live events
  10. What is included in a suicide risk assessment?
    • 1. Plan: people with a plan are more serious about suicide and have a higher risk
    • 2. Method: Lethality-some methods are more lethal than others (some methods give person more time to think it through)
    • 3. Rescue: the person who will deceive possible rescuers as to where he/she is is higher risk
  11. What is bipolar I disorder?
    Characterized by a patient who swings between manic episodes and major depression
  12. What is bipolar II disorder?
    Person swings between a hypomanic episode and major depression
  13. What is cyclothymic disorder?
    Swing between hypomanic episode and dysthymia