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Secondary Final: Depression
N/A
27
Nursing
Graduate
03/06/2012

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Cards

Term
Depression and anxiety affect how many American adults annually?
Definition
19 million
Term
Women or men more likely to be affected by depression?
Definition
Women twice as likely
Term
What percent of pop have anxiety?
Definition
13.3%
Term
What percent of pop have depression?
Definition
9.5%
Term
What percentage of depression cases missed in primary care?
Definition
50%
Term
How common is depression in primary care?
Definition
2nd most common after HTN. 74% will go to PCP rather than MH provider
Term
Rate of depression among medically ill
Definition
about 5-10%; up to 14% of hospitalized patients
Term
How many with heart disease have depression?
Definition
40-65% after MI
Term
how many with stroke have depression?
Definition
10-27% in first year; 15-40% experience some symptoms
Term
how many with cancer have depression?
Definition
1 in 4 patients
Term
how many with diabetes have depression?
Definition
25%; up to 70% with complications
Term
what is the order of severity of depressive syndromes?
Definition
adjustment disorder-->bereavement-->minor depression-->dysthymia-->major depression
Term
how do minor depression and major depression differ?
Definition
minor depression has <5 s/s and major is >5. also, major lasts longer than 2 weeks. minor: mood decreases, less interest, insomnia, fatigue, guilt, less concentration. major: significant distress, significant functional impairment, suicidal ideation
Term
what is dysthymia?
Definition
chronic, low grade depression present for > 2 years
Term
what is dysphoria and anhedonia?
Definition
dysphoria: feeling low

anhedonia: inability to take pleasure in things that are normally enjoyable

*for criteria for depression: at one of the s/s for diagnosis must be dysphoria or anhedonia
Term
causes of major depression
Definition
1. genetic (75% identical twins, 25% for fraternal twins)
2. biological (dysregulation of neurotransmitter systems)
3. medications (antihypertensives, steroids)
4. social (type D personality)

other factors:
5. role incongruence (esp in women)
6. stress
7. early disruption of attachment
8. sensitivity to relational problems
9. interaction of hormones (thyroid and estrogen)
Term
According to DSM, how many adults have depressive disorders?

how many with dysthymia?

how many with major depression?
Definition
18.8 million

dysthymia: 10.9 million

major depression: 9.9 million
Term
treatment of depression includes...
Definition
1. pharmocotherapy
-SSRIs, NDRIs, older drugs (tricyclics)
-therepeutic effects may not be seen for 6 weeks
-side effects: insomnia, weight gain, sexual dysfx, suicidality in children

2. psychotherapy
-cognitive behav therapy
-interpersonal therapy

3. combined thereapy (most effective)
-lower incidence of relapse compared to med alone

4. ECT (remains controversial)

5. Exercise
Term
how many >65 y/o have depression?
Definition
25%
Term
physical signs and symptoms of anxiety
Definition
1. anorexia
2. chest pain, palpitations, tachycardia
3. nausea, vomiting, diarrhea, urinary frequency
4. dizziness, faintness
5. dry mouth
6. dyspnea, hyperventilation
7. flushing
Term
According to DSM, how many have anxiety disorders?

how many have GAD?

how many have OCD?
Definition
anxiety disorders: 19.1 million

GAD: 4 million

OCD: 3.3 million
Term
3 types of panic attack:
Definition
1. unexpected
2. cued by situation
3. predisposed by situation
Term
treatment of panic disorder:
Definition
1. cognitive behavioral therapy
-graduated exposure
-cognitive restructuring

2. pharmacological treatment
-TCAs, MAOIs, high-potency benzodiazepines, SSRIs

3. combined therapy
4. patient education
5. factors in selecting treatment
-patient acceptance and tolerance
-urgency, history, comorbidity
Term
criteria for GAD:
Definition
1. lack of perceived control
2. lack of specific focus
3. not d/t physiological effects of substances or general medical condition
4. at least 3 of 6 cardinal s/s
5. s/s must cause:
-clinically sig distress
-functional impairment
Term
2 general definitions for anxiety:
Definition
1. state of fear, apprehension, dread, foreboding
2. symptoms assoc with autonomic activation: a) acute--"fight or flight" b) chronic: hyper-vigilance
Term
severity of anxiety syndromes
Definition
mild, moderate, severe, GAD, OCD, phobia, panic, PTSD
Term
GAD defined by
Definition
excessive anxiety and worry. it is an anxiety disorder d/t general med condition or it is a substance-induced anxiety disorder
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