Ati - Mh Chapters 12-14

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CHAPTER TWELVE

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(Ignore this card)

Front 2

MDD stands for what and how long do the S/S last?

Back 2

Major depressive disorder - five specific S/S lasting for a minimum of 2 weeks, occur at least every day for most of the day

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Describe MDD with atypical features

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S/S include chagnes in appetite or weight gain, excessive daytime sleepiness

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Describe MDD with postpartum onset

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episode begins within 4 weeks of childbirth

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Describe MDD with seasonal characteristics

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Seasonal affective disorder (SAD) which occurs during winter and may be treated with light therapy

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Describe MDD with chronic features

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a depressive episode that lasts over 2 years

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Describe the three phases of MDD

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(1) acute - severe symptoms of depression; (2) maintenance - increased ability to function; (3) continuation - remission of S/S

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Who are depressive disorders more common in?

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2x as common in females between the ages of 15 and 40 than in males

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Depression is very common in the elderly and is sometimes confused with dementia. What S/S of depression might be confused with dementia?

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memory loss, confusion, behavioral problems such as social isolation or agitation

Front 10

Serotonin deficiency is a risk factor for what?

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depression

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Anergia

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lack of energy

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Psychomotor retardation

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slowed physical movement, slumped posture

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Psychomotor agitation

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restlessness, pacing, finger tapping

Front 14

St. John's Wart is used to relieve what?

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S/S of mild depression

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What are adverse effects of St. John's Wart?

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photosensitivity, skin rash, rapid heart rate, GI distress, abdominal pain

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What can occur if St. John's Wart is taken with SSRIs?

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serotonin syndrome

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What is light therapy used for?

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it is the first-line Tx for SAD, inhibits nocturnal secretion of melatonin

Front 18

Describe light therapy?

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exposure of the face to 10,000-lux light box for 30 minutes a day, once or in 2 divided doses

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What is TMS?

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transcranial magnetic stimulation - a new therapy using electromagnetic stimulation of the brain; it may be helpful for depression that is resistant to other forms of Tx

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What is VNS

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Vagus nerve stimulation - an implanted device that stimulates the vagus nerve, it can be used for clients who have depression that is resistant to at least 4 antidepressant medications

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CHAPTER THIRTEEN

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(Ignore this card)

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When do bipolar disorders usually emerge?

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in late adolescence/early adulthood

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Children are not usually diagnosed with bipolar disorders until when?

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after the age of 7

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Describe the phases of bipolar disorder

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(1) acute - acute mania; (2) maintenance - increased ability to function; (3) continuation - remission of S/S

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Hypomania is a less severe episode of mania that lasts how long?

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at least 4 days

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What is a mixed episode of bipolar disorder?

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a manic episode and an episode of major depression experienced at the same time - marked impairment in functioning and may require admission to an acute care mental health facility to prevent self-harm or other-directed violence

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What is rapid cycling of bipolar disorder?

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four or more episodes of acute mania within 1 year

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Bipolar I disorder

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The client has at least one episode of mania alternating with major depression

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Bipolar II disorder

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The client has one or more hypomanic episodes alternating with major depressive episodes

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Cyclothymia

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The client has at least 2 years of repeated hypomanic episodes alternating with minor depressive episodes

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What may lead to a relapse episode of mania in bipolar disorder?

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use of substances (ETOH, drugs, caffeine)

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How much sleep does a client with mania require?

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a minimum of 4-6 hours

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CHAPTER FOURTEEN

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(Ignore this card)

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Paranoid schizophrenia

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characterised by suspicion toward others

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Disorganized schizophrenia

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characterized by withdrawal from society and very inappropriate behaivors (poor hygiene, muttering constantly); frequently seen among the homeless; S/S include loose associations, bizarre mannerisms, incoherent speech, hallucinations and delusions (much less organized that those in clients with paranoid type)

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Schizoaffective disorder

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the client's disorder meets both the criteria for schizophrenia and of the affective disorders (depression, mania, or a mixed disorder)

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Brief psychotic disorder

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the client has psychotic S/S that last between 1 day to 1 month in duration

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Schizophreniform disorder

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the client has S/S like those of schizophrenia, but the duration is from 1-6 months and social/occupational dysfunction may not be present

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Shard psychotic disorder

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AKA 'Folie a Deux'

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Secondary (induced) psychosis

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S/S of psychosis are brought on by a medical disorder or by use of chemical substances

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Positive S/S of schizophrenia

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These S/S are normal processes, but at abnormal levels - hallucinations, delusions, alterations in speech, bizarre behavior, such as walking backward constantly

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Negative S/S of schizophrenia

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These S/S refer to a lack of normala processes - flat affect, alogia, avolition, anhedonia, anergia

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ideas of reference

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misconstrues trivial events and attaches personal significance to them, such as believing that others are talking about him

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thought broadcasting

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believes that her thought are heard by others

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thought insertiion

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believes that others' thoughts are being inserted into his mind

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Thought withdrawal

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Believes that her thoughts have been removed from her mind by an outside agency

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Word salad

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words jumbled together with little meaning or significance to listener

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Clang association

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meaningless rhyming of words, often forceful

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Flight of ideas

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Associative looseness

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What are personal boundary difficulties and what are two types?

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disenfranchisement with one's own body, identity, and perceptions. Includes depersonalization and derealizataion

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Depersonalization

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nonspecific feeling that a person has lost her identity; self is different or unreal

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Derealization

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perception that environment has changed

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Wavy flexibility

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excessive maintenance of positoin

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Negativism

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doing the opposite of what is requested