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Chapter 27 Mood Disorders Depression
Chapter 27 Mood Disorders Depression
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Concepts Of Psychiatric-Mental Health Nursing (Nova Southeastern University)
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Chapter 27- Mood Disorders-Depression
Introduction
Depression is the oldest and most frequently described
psychiatric illness.
Transient symptoms are normal, healthy responses to everyday
disappointments in life.
Pathological depression occurs when adaptation is ineffective.
Depression is an alteration in mood that is expressed by
feelings of sadness, despair, and pessimism.
There is a loss of interest in usual activities, and somatic
symptoms may be evident.
Changes in appetite and sleep patterns are common.
Examples of affect aka mood Depression, joy, elation,
anger and anxiety.
You need a dx for depression All related to sx & behavior
What person says or does, age and TIMEFRAMES are very
important.
Minimum of 2 weeks.
Can’t adapt effectively there’s a problem.
Depression is common in females
Inability to function-Pathological attachment
Epidemiology
Approximately 9.5 million persons reported a depressive
episode in 2008.
During their lifetime, about 21% of women and 13% of men will
become clinically depressed.
Gender prevalence
Depression is more prevalent in women than in men by
about 2 to 1.
Depression more common in young women than young men.
The gender difference is less pronounced between ages 44 and
65, but after age 65, women are again more likely to be
depressed than men
Social class: there is an inverse relationship between social
class and report of depressive symptoms
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Race and culture: no consistent relationship between race and
affective disorder has been reported; one recent survey
revealed
Depression is more prevalent in whites than blacks
Depression is more severe and disabling in blacks
Blacks are less likely to receive treatment than whites
Marital status: single and divorced people more likely to
experience depression than married persons or persons with a
close interpersonal relationship (differences occur in various
age groups)
Seasonality: affective disorders are more prevalent in the
spring and in the fall
Time of the year “seasonal affective disorder” SAD is a
disorder that’s generally due to a lack of natural light. People
in Seattle mostly or Alaska have this disorder High
Suicide Rate
Types of Depressive Disorders -MDPMS
Major depressive disorder
Dysthymic disorder
Premenstrual dysphoric disorder
Mood disorder due to a general medical condition
Substance-induced mood disorder
Distinguish these types! KNOW FOR TEST & KNOW
INTERVENTIONS
MAJOR—AXIS 1 DX
Hyperthyroid will look like a person is experiencing
depression! – mood disorder due to a general medical
condition
Substance-induced mood disorder – ex: cns stimulants,
alcohol, beta blockers (bp meds)
Major depressive disorder
Characterized by depressed mood
Loss of interest or pleasure in usual activities
Social and occupational functioning impaired for at least 2
weeks
No history of manic behavior
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Cannot be attributed to use of substances or a general medical
condition
Can be dx if it's a single/recurrent episode
Can be mild, moderate or severe
Noted as postpartum if sx appear 4 weeks after childbirth
S/s withdrawn, isolation from others, flat affect, apathy, loss
interest in activity, appetite disturbance, sleep disturbance,
crying & anhedonia!!
#1 LACK OF ABILITY TO CONCENTRATE OR FOCUS-
MINDLESS ACTIVITIES ARE MORE APPOPRIATE. Ex:
have them sort out the snacks or fold laundry. Things like
word puzzles wouldn't be good for the beginning of tx. Don’t
force these people to go to group therapy.
KEY THING: Improvement in mood, appetite improvement
would be a good thing
Depressed teenagers may express depression with
VIOLENCE/ANGER
TWO WEEKS OF DISFUNTION!
You can’t have any hx of manic behavior or mania, hyper
behavior or bi-polarism to be dx w/ depression nor can it be
related to any substance/medical condition
Dysthymic disorder
“Sad or down in the dumps”
No evidence of psychotic symptoms
Essential feature is a chronically depressed mood (or irritable
mood in children/adolescents) for
Most of the day
More days than not
For at least 2 years (1 year for children/adolescents)
Early onset (before 21) / late onset (occurring at 21, or older)
You can have agitation or psychotic depression with a major
depressive disorder.
Very blah most of the time out of a week at least 4 days at a
time they feel low.
Goes on for at least 2 years
Premenstrual dysphoric disorder
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