Mood disorders

Question 1

What are types of mood disorders?

Answer 1

• Major depression
• Bipolar disorder
• Dysthymic disorder
• Cyclothymic disorder
• Seasonal affective disorder

Question 2

The incidence of depression is up to three times greater in first-degree relatives of people with diagnosed depression
indications of a genetic overlap between early-onset bipolar disorder and early-onsetalcoholism

Answer 2

genetic theories

Question 3

Serotonin, norepinephrine; possibly acetylcholine and dopamine

Answer 3

Neurochemical theories

Question 4

Postpartum hormone alterations precipitate mood disorders such as postpartum depression and psychosis.

Answer 4

Neuroendocrine influences: hormones

Question 5

blame the victim” and his or her family

Answer 5

Psychodynamic theories

Question 6

defense against underlying depression

Answer 6

mania

Question 7

Asians who are anxious or depressed are more likely to have

Answer 7

somatic complaints of headache, backache, or other symptoms

Question 8

Latin cultures complain of

Answer 8

“nerves” or headaches

Question 9

Middle Eastern cultures complain of

Answer 9

heart problems

Question 10

Present everyday for 2 weeks and

person experiences a depressed mood or loss of pleasure in nearly all activities

Answer 10

major depressive disorder

Question 11

Four of the following must be present:
changes in appetite or weight, sleep, or psychomotor activity; decreased energy; feelings of worthlessness or guilt; difficulty thinking, concentrating, or making decisions; or recurrent thoughts of death or suicidal ideation, plans, or attempts

Answer 11

major depressive disorder

Question 12

What are the s/s of major depressive disorder?

SAD IMAGES

Answer 12

Sad mood, Appetite change, Disturbed sleep, Inability to concentrate, Marked decrease in pleasurable activities (anhedonia), Apathy, (lack of interest in sex), Guilty feelings, Energy changes, Suicidal thoughts

Question 13

relieve symptoms of hopelessness, inappropriate guilt, suicidal ideation, and daily mood variations

Answer 13

Tricyclic antidepressants

Question 14

used when the client has an inadequate response to or side effects from SSRIs

Answer 14

Atypical antidepressants-

Question 15

There is a 2- to 4-week lag period before these antidepressants reach therapeutic levels. Because of the lag period, adequate washout periods of 5 to 6 weeks are recommended between the times that (blank) is discontinued and another class of antidepressant is started.

Answer 15

Monoamine oxidase inhibitors (MAOIs)-

Question 16

application of electrodes to the head of the client to deliver an electrical impulse to the brain; this causes a seizure

Answer 16

Electroconvulsive therapy (ECT)-

Question 17

focuses on difficulties in relationships, such as grief reactions, role disputes, and role transitions.

Answer 17

interpersonal therapy

Question 18

interactions-increase the frequency of the client’s positively reinforcing interactions with the environment and to decrease negative interactions

Answer 18

behavior therapy

Question 19

treatment for depression in which a pulse generator sends intermittent electrical impulses directed toward the brain via the vagus nerve

Answer 19

Vagus nerve stimulation-

Question 20

invasive procedure used to help manage the tremor caused by Parkinsonism and other neurologic conditions; also used to alter brain circuitry to relieve depression

Answer 20

Deep brain stimulation-

Question 21

(TMS) noninvasive method of stimulating the brain to treat depression by delivering short pulses of energy through an electromagnetic coil placed against the scalp near the forehead

Answer 21

Transcranial magnetic stimulation-

Question 22

What are the depression rating scales?

Answer 22

Self-rating scales: Zung, Beck

Clinician rating scale: Hamilton Rating Scale

Question 23

a mood disorder that has its onset during darker winter months and spontaneously disappears in the spring

Answer 23

Seasonal affective disorder (SAD)

Question 24

Prevalence: winter months only; states north of 40° to 50° of latitude
Primitive biologic response; triggered by photoperiods; melatonin

Answer 24

Seasonal affective disorder (SAD)

Question 25

Assessment Findings: bimodal depression; cycles with the seasons
Winter: sleepy, fatigued, lethargic; irritable, unable to concentrate; suicidal; increased craving for carbohydrates; poor social interaction

Answer 25

Seasonal affective disorder (SAD)

Question 26

What is the medical treatment for seasonal affective disorder?

Answer 26

Phototherapy: use of artificial light

Move to sunny location

Question 27

What is the nursing management for seasonal affective disorder?

Answer 27

Avoid the use of eyeglasses or contact lenses that are coated to shield ultraviolet radiation because the coating interferes with light transmission to the pineal gland.

Question 28

The several types of bipolar disorder all involve cycling among depressive, euthymic, and euphoric moods include?

Answer 28

• bipolar I
• bipolar II
• cyclothymic disorder
• mixed bipolar disorder
• rapid-cycling bipolar disorder
• ultrarapid-cycling bipolar disorder

Question 29

experience severely dysfunctional moods lasting several months; depressive phases tend to be longer than manic phases

Answer 29

bipolar I

Question 30

disorderhave severe depression alternating with hypomania.
Hypomania is a period of abnormally and persistently elevated, expansive, or irritable mood & some other milder s/s of mania.
there are no psychotic features (delusions and hallucinations)

Answer 30

bipolar II

Question 31

people have milder mood swings, don’t meet criteria for bipolar

Answer 31

cyclothymic disorder

Question 32

mania and depression occur simultaneously everyday for at least a week

Answer 32

mixed bipolar disorder

Question 33

experience at least four episodes of mania and depression per year

Answer 33

rapid-cycling bipolar disorder

Question 34

have alternating moods that may occur within a month or less

Answer 34

ultrarapid-cycling bipolar disorder

Question 35

diagnosis of a manic episode or mania requires at least 1 week of the following unusual and incessantly heightened, grandiose, or agitated mood in addition to three or more of the following symptoms:

Answer 35

bipolar I

Question 36

what are the symptoms of bipolar I?

Answer 36

exaggerated self-esteem
sleeplessness; pressured speech; flight of ideas
reduced ability to filter extraneous stimuli
distractibility; increased activities with increased energy
multiple, grandiose, high-risk activities involving poor judgment and severe consequences, such as spending sprees, sex with strangers, and impulsive investments

Question 37

Assessment findings for bipolar I disorder?

Answer 37

dress can be flamboyant, layered inappropriate to season, sexually suggestive
Exaggerated self importance
Mood: euphoric, dysphoric or labile
Rapid and or loud speech, maybe pressured
Disorganized thinking, tangential or circumstantial, flight of ides
Distractible limited concentration

Question 38

Medication management for bipolar disorder?

Answer 38

*anticonvulsants and lithium

Question 39

examples of anticonvulsants

Answer 39

carbamazepine and valproic acid derivatives

Question 40

used for Acute mania; decreases mood swings among rapid cyclers; risk for infection

Answer 40

Carbamazepine (Tegretol)

Question 41

Enhance GABA activity; used with lithium for long-term management
Unsafe during pregnancy; side effects—GI symptoms, sedation, and ataxia

Answer 41

Valproic acid derivatives: Depakote

Question 42

Antimanic, mood equalization; regulates activity between neurotransmitters and receptor sites

Answer 42

lithium

Question 43

Disadvantages: ineffective for some; time lag; narrow safety range; side effects
Periodic lab tests; lithium toxicity (see table 15.8)
Maintain adequate ingestion of salts

Answer 43

lithium