unit 7 mood disorders online
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Mood Disorders
Major depressionDysthmyic disorderBipolar Type 1
mixed rapid cycling
Bipolar Type 2
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Etiology
Genetic factors ---current hypothesisCatecholamine hypothesisSerotonin hypothesis
weaker hypothesisHypothalamus-pituitary-adrenalsHypothalamus-pituitary-thyroidCircadian rhythms
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Psychosocial factors
Psychoanalytic theoryCognitive Behavioral
ReinforcementLearned helplessnessCognitive theory
negative cognitive triadself-world-future
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Major depression
Depressed moodMarkedly diminished interest in pleasureSignificant weight lossInsomnia or hypersomniaPsychomotor agitation or retardation
Depression
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Fatigue or loss of energyFeelings of worthlessnessDiminished concentrationRecurrent thoughts of death
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Vegetative Signs of Depression
Severe weight lossPsychomotor retardationSleep disturbance
early morning awakening (EMA)Decreased libido
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Dysthymia
Depressed moodPresence of at least 2 of the following:
poor or increased appetiteinsomnia or hypersomnialow energypoor concentrationfeelings of hopelessness for 1 year
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Nursing Assessment
Present complaintHx. of problemPast 4 hx.Social hx.Medical hx.Mental status exam
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Bipolar Disorders 1 and 2
Type 1RegularMixedRapid cycling
Type 2
Bipolar Disorder
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Mania
energy activities self-esteemflight of ideaseasy agitationpoor self controlhyperphagia or appetite need for sleep
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Mixed disorderboth sets of symptoms in a 24 hour period
Rapid cycleboth symptoms within one week
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Mental Status Exam
AppearanceDepression-poor hygieneMania-bizarre dress-frequent change of clothesSpeech
depressed-retarded & concretemania-flight of ideas-pressured speech-intrusive-expansive
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Thought contentDepression-worthlessness-hopelessness-
helplessness-guilt-somatic concernsMania-grandiosity-distractibility
AffectDepression-flat, dull, sad moodMania-labile
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PsychomotorDepression- retardationMania- hyperactive
DelusionsDepression-negative triadMania-grandeur, bizarre
Hallucinations
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Suicide potentialOrientationConcentration v distractibilityRecent memoryInsight Judgment
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Nursing Diagnosis
Risk for self-directed violenceSelf-esteem disturbanceSelf-care deficitSocial isolationAltered nutrition
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Nursing Intervention
Suicide preventionSocial interactionMaintain adequate nutritionMaintain fluid & electrolytesMaintain sleep wake cycleSupportive care re: judgmentElectroconvulsive therapy
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Sleep therapy
Cognitive behavioral therapydaily activitiestesting of depressive thoughts
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Anti-depressant medication
Tricyclic antidepressantsTofranilElavil
Monoamine oxidase inhibitorsParnateNardilMarplan
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Serotonin Selective Reuptake inhibitorsProzac ZoloftPaxilCelexa
OthersWellbutrinSerzone
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Anti-mania Medication
LithiumAnti-convulsants
Depakote Tegretol Lamictal