Term
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Definition
| a pt's inner, emotional tone - how someone perceives their own emotion. (affect is the external manifestation) |
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Term
| what characterizes symptoms of major depressive disorder (MDD)? |
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Definition
| sadness, depression, anhedonia, anergia, lack of motivation, anorexia, easy irritability, decreased libido, insomnia, hopelessness, difficulty concentrating/remembering, difficulty w/communication (limited and flat), physical somatic manifestations (h/a), and delusions (pts feel worthless, hear voices saying so). these symptoms are worse in the morning, get better through the day and are least strong at bedtime. this can affect pts at any age, it is common and dx is based on exam. |
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Term
| what is the relationship between MDD and suicide? |
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Definition
| about 60% of pts w/MDD think about suicide (have to ask pt about their plan) |
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Term
| what is major depressive disorder w/mood congruent delusions and hallucinations? |
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Definition
| pts feel depressed and have a belief system which reinforces it (aka psychotic depression). |
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Term
| what is bipolar disorder? |
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Definition
| this is diagnosed w/a pt shows an episode of mania or unregulated behavior (high on life, feeling of invincibility, disinhibited, pressured speech). |
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Term
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Definition
| mania which doesn't take the euphoric form, instead, it is a hostile energy. during a dysphoric manic episode pts may exhibit: pressured speech, echolalia (person responds w/the same words you used), echopraxia (mimics behaviors/movements you used), loosening of thought association (as seen in schizophrenia), hypersexuality and difficulty w/concentration. this is common in adolescents but can be treated and stabilized. |
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Term
| what season does mania more commonly present? |
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Definition
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Term
| what is the word for normal mood? |
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Definition
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Term
| can women normally get some insomnia premenstrually? |
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Definition
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Term
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Definition
| bipolar 2, or a less extreme form of bipolar (feeling good, but feet are touching the ground). these pts are less likely to need hospital tx (as w/bipolar 1). |
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Term
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Definition
| dementia-like signs(difficulty w/ memory, problem solving, concentrating) secondary to depression. tx the depression, the signs of dementia go away. |
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Term
| what other things could mimic mania? |
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Definition
| amphetamines, cocaine, endocrinopathies (thyroid disease, parathyroid disease, addison's, cushing's, carcinoid [serotonin secreting]) |
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Term
| what is dysthymic disorder (depressive personality disorder/charlie brown syndrome)? |
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Definition
| a chronic form of depression (at least 2 years), not as severe as MDD and more common in women than men where the pt wakes up every day feeling depressed (may be the only mood they can remember) but they can still be successful for the most part in their lives. this mainly affects interpersonal relationships b/c those they interact w/don't feel comfortable dealing w/it. MDD may be superimposed or follow an event in these pt's lives. |
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Term
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Definition
| a chronic condition where the pt fluctuates between being depressed (dysthymia) and feeling good (similar to bipolar). also affects interpersonal relationships b/c no one knows what to expect. |
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Term
| what are some of the theories behind mood disorders? |
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Definition
| mis-regulation of biogenic amines (DA, NE, serotonin), changes in neuroregulation (hormone activity: TSH, LH, testosterone, melatonin), sleep disorders, genetics (bipolar/MDD may be heritable), negative cognitions and loss. |
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Term
| what is tx for mood disorders? |
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Definition
| broad spectrum medication, including antidepressants (SSRIs, SNRIs, TCAs, MOAIs), mood stabilizers (mania), atypical antipsychotic agents, *psychotherapy, electroconvulsive therapy (creates grand-mal seizure), vagal nerve stimulation, and transcranial magnetic stimulation. |
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Term
| what characterizes the risk of suicide in depression pts? |
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Definition
| some people believe that meds cause thoughts of suicide but its more likely that they are able to get to the point of functioning w/medication to be able to actually kill themselves vs previously when they were completely overcome w/depression. the older TCAs were lethal at higher doses, but the newer SSRIs are much harder to reach a lethal dose with. |
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