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16 Cards in this Set
- Front
- Back
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Depressive disorders |
* adjustment disorder * complicated bereavement * post-partum depression * dysthymia * major depressive disorder * bipolar affective disorder-depressed * schizoaffective disorder-depressed |
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Symptoms of depression |
anxiety, hyper/insomnia, changes in appetite, decreased libido, irritability, suicidal ideations, alcohol/drug abuse, fatigue, hygiene, memory impairment, anhedonia, isolation/withdrawal, somatization, hallucinations, hopelessness, poor concentration, cry, delusions |
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Risk factors for depression |
female gender, married, low socioeconomic status, early childhood trauma, presence of negative life event (1st degree relatives), ineffective coping ability, postpartum time period, medical illness, absence of social support, alcohol of substance abuse |
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Beck's cognitive triad |
* a negative, self-deprecating view of self * a pessimistic view of the world * the belief that negative reinforcement will continue in the future |
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learned helplessness |
although anxiety is the initial response to a stressful situation, it is replaced by depression if the person feels no control over the outcome of the situation |
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Screening tools for depression |
* Beck Depression Inventory * Hamilton Depression Scale * Zung Depression Scale * Geriatric Depression Scale * Patient Health Questionnaire |
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Areas to Assess |
* Affect * Thought process * Mood * Feelings |
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Diagnosing Depression |
* risk for suicide * hopelessness * social isolation * spiritual isolation * spiritual distress * self-care deficit |
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Implementation of depression treatment |
* Acute phase (6-12 weeks) * Continuation phase (4-9 months) * Maintenance phase (1 year or more) |
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Acute phase |
* 6-12 weeks; directed at reduction of depression symptoms or restoration of psychosocial and work function * hospitalization may be required, and medication or other biological treatments may be initiated |
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Continuation phase |
* 4-9 months * directed at prevention of relapse through pharmacotherapy, education, and depression-specific psychotherapy |
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Maintenance phase |
* 1 year or more * directed at prevention of further episodes of depression * depending on the risk factors for relapse, medication may be phase out or continued |
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Selective Serotonin Reuptake Inhibitors (SSRIs) |
* rec'd as 1st line therapy for most types of depression * relatively low side-effects * low cardiotoxicity * common adverse reactions: agitation, anxiety, sleep disturbance, tremor, sexual dysfxn, tension HA * potential toxic SE: serotonin syndrome; greatest risk when taken w/ MAOI |
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Tricyclic antidepressants |
* inhibit uptake or norepi & serotonin * sedative effects are common d/t blockage of histamine receptors * full effects seen in 4-8 weeks * given at low doses, and gradually increase * common SE: dry mouth, blurred vision, tachycardia, constipation, urinary retention, esophageal reflux * potential toxic SE: cardiovascular (dysrhythmias, tachycardia, MI, heart block) * MAOIs, phenothiazine, barbiturates, antebuse, oral contraceptives, anticoags, some antihypertensives, bentos, and EtOH NOT given w/ tricyclics |
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MAOIs |
* risk of increase in neurotransmitters * cannot eat foods rich in tyramine * effective for unconventional depression (mood reactivity, oversleeping and overeating) * Common SE: orthostatic HTN, wt. gain, edema, change in cardiac rate/rhythm, constipation, urinary hesitance, sexual dysfxn, vertigo, overactivity, muscle twitching, hypomanic and manic behavior, insomnia, weakness, fatigue * potential toxic SE: increase in BP, possible dev. of intracranial hemorrhage, convulsions, coma, death |
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Electroconvulsive therapy |
* helpful for depression that isn't helped w/ medication * potential adverse reactions: confusion and disorientation for several hours afterwards, memory loss, might need multiple sessions to see results |
