Psychology of Mood Disorders

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Questions and Answers

What is the subtype of Seasonal Affective Disorder (SAD) that occurs from late spring or early summer until early fall?

Summer-pattern SAD

Spring-onset SAD (correct)

Winter-pattern SAD

Fall-onset SAD

What is the treatment for Seasonal Affective Disorder (SAD)?

Light therapy (correct)

Exercise regimen

Cognitive-behavioral therapy

Medication

What are the symptoms of Postpartum blues?

Delusions, hallucinations, and poor insight

Weight loss, poor appetite, and crying spells

Fatigue, sadness, and emotional lability

Labile mood, anxiety, and insomnia (correct)

What is the most common complication of pregnancy in developed countries?

Postpartum depression Signup and view all the answers

What is the onset of Postpartum psychosis?

Days following childbirth Signup and view all the answers

What is the risk factor for Postpartum relapse?

History of serious mental illness Signup and view all the answers

What is Premenstrual dysphoric disorder (PMDD)?

A severe form of premenstrual syndrome Signup and view all the answers

What is the duration of symptoms in Premenstrual dysphoric disorder (PMDD)?

The week before menses and resolving with menstruation Signup and view all the answers

What is a common characteristic of a client's thought process when experiencing depression?

Slow thinking processes Signup and view all the answers

What is a common behavior of clients with depression?

Making self-deprecating remarks Signup and view all the answers

What is rumination in the context of depression?

Repetitively going over the same thoughts Signup and view all the answers

What is a common symptom of severe depression?

No response to questions Signup and view all the answers

What is a common thought pattern in clients with depression?

Negative and pessimistic Signup and view all the answers

What is an important aspect of assessing suicidal ideation in clients with depression?

Asking about suicide directly Signup and view all the answers

What is a common feeling experienced by clients with depression?

Stuck, worthless, hopeless, and helpless Signup and view all the answers

What is a common suicidal thought pattern in clients with depression?

I wish I were dead and would never have to do anything again Signup and view all the answers

What is the primary purpose of assessing the client's history in clients with depression?

To determine the client's response to treatment Signup and view all the answers

Why does the nurse need to collect assessment data from multiple sources?

To ensure accuracy and completeness of the assessment data Signup and view all the answers

What is psychomotor retardation characterized by?

Slow body movements, slow cognitive processing, and slow verbal interaction Signup and view all the answers

Why does the nurse need to avoid rushing the client during the assessment?

To ensure the client is not overwhelmed Signup and view all the answers

What is a common characteristic of a client's responses to questions during the assessment?

Minimal responses with only one or two words Signup and view all the answers

What is the significance of latency of response in clients with depression?

It indicates the client is taking time to process the question Signup and view all the answers

What is a sign of psychomotor agitation in clients with depression?

Accelerated thinking and pacing Signup and view all the answers

What is a common observation of a client's general appearance during the assessment?

They appear sad and ill Signup and view all the answers

What is a common characteristic of clients with depression in terms of their orientation?

They experience difficulty with orientation, especially if they experience psychotic symptoms Signup and view all the answers

What is a challenge when assessing general knowledge of clients with depression?

They have a limited ability to respond to questions Signup and view all the answers

What is a common cognitive impairment in clients with depression?

Memory impairment Signup and view all the answers

What is a characteristic of clients with depression in terms of their judgment?

They have impaired judgment Signup and view all the answers

What is a common feeling of clients with depression in terms of their self-concept?

They feel guilty about not being able to function Signup and view all the answers

What is a challenge for clients with depression in terms of their roles and responsibilities?

They have difficulty fulfilling roles and responsibilities Signup and view all the answers

What is a common problem for clients with depression in terms of their daily activities?

They have difficulty going to work or school Signup and view all the answers

What is a common thought pattern of clients with depression in terms of their relationships?

They believe others would be better off without them Signup and view all the answers

What is the primary purpose of the Hamilton Rating Scale for Depression?

To evaluate the range of the client's depressive behaviors Signup and view all the answers

In the Hamilton Rating Scale for Depression, how is a score of 0 rated for Depressed Mood?

The patient's depressed mood is absent Signup and view all the answers

What is the rating for a patient who reports feeling guilty about past mistakes?

2: Ideas of guilt or rumination over past errors or sinful deeds Signup and view all the answers

How is a score of 4 rated for Suicide?

Attempts at suicide (any serious attempt rates 4) Signup and view all the answers

What is the rating for a patient who complains of occasional difficulty falling asleep?

1: Complains of occasional difficulty falling asleep Signup and view all the answers

What is the rating for a patient who wakes up in the early hours of the morning but goes back to sleep?

1: Wakes up in the early hours of the morning but goes back to sleep Signup and view all the answers

What is the primary focus of the Hamilton Rating Scale for Depression?

Evaluating the range of depressive symptoms Signup and view all the answers

How is a patient's sense of unreality about the self scored in the Hamilton Rating Scale for Depression?

Through the Depersonalization section Signup and view all the answers

Study Notes

Seasonal Affective Disorder (SAD)

SAD is a subtype of depression, with symptoms of insomnia, weight loss, and poor appetite lasting from late spring or early summer until early fall.
Light therapy is often used to treat SAD.

Postpartum or "Maternity" Blues

Postpartum or "maternity" blues is a mild, predictable mood disturbance occurring in the first several days after delivery of a baby.
Symptoms include labile mood and affect, crying spells, sadness, insomnia, and anxiety.
Symptoms subside without treatment, but mothers do benefit from the support and understanding of friends and family.

Postpartum Depression

Postpartum depression is the most common complication of pregnancy in developed countries.
Symptoms are consistent with those of depression, with onset within 4 weeks of delivery.

Postpartum Psychosis

Postpartum psychosis is a severe and debilitating psychiatric illness, with acute onset in the days following childbirth.
Symptoms begin with fatigue, sadness, emotional lability, poor memory, and confusion, and progress to delusions, hallucinations, poor insight and judgment, and loss of contact with reality.
This medical emergency requires immediate treatment.

Premenstrual Dysphoric Disorder (PMDD)

PMDD is a severe form of premenstrual syndrome, defined as recurrent, moderate psychological and physical symptoms that occur during the week before menses and resolve with menstruation.

Assessment of Depression

The nurse collects assessment data from the client, family, or significant others, and previous chart information.
Assessment may take several short periods to complete due to the client's exhaustion and overwhelm.
The nurse asks about behavioral changes, including when they started, what was happening when they began, their duration, and what the client has tried to do about them.
Assessing the history is important to determine any previous episodes of depression, treatment, and the client's response to treatment.

General Appearance and Motor Behavior

Clients with depression often look sad, with slouched posture, minimal eye contact, and slow body movements.
They may have psychomotor retardation, with slow cognitive processing and slow verbal interaction.
Responses to questions may be minimal, with only one or two words.
Latency of response is seen when clients take up to 30 seconds to respond to a question.

Thought Process and Content

Clients with depression experience slow thinking processes, with negative and pessimistic thoughts.
They may believe they will always feel this bad, things will never get any better, and nothing will help.
They tend to ruminate, repeatedly going over the same thoughts.

Suicide

It is important to assess suicidal ideation by asking about it directly.
Clients may have thoughts of dying or committing suicide, and it is essential to ask about suicidal thoughts.

Sensorium and Intellectual Processes

Clients with depression may have difficulty with orientation, especially if they experience psychotic symptoms or are withdrawn from the environment.
Memory impairment is common, and they may have extreme difficulty concentrating or paying attention.

Judgment and Insight

Clients with depression experience impaired judgment, unable to use their cognitive abilities to solve problems or make decisions.
Insight may be intact, especially if clients have been depressed previously.

Self-Concept

Sense of self-esteem is greatly reduced, with clients often viewing themselves as "good for nothing" or "just worthless".
They feel guilty about not being able to function and often personalize events or take responsibility for incidents over which they have no control.

Roles and Relationships

Clients with depression have difficulty fulfilling roles and responsibilities, including going to work or school, and caring for family responsibilities.
The more severe the depression, the greater the difficulty.

Hamilton Rating Scale for Depression

The scale rates the range of the client's behaviors, including depressed mood, guilt, suicide, and insomnia.
It also scores diurnal variations, depersonalization, paranoid symptoms, and obsessions.

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Description

Learn about Seasonal Affective Disorder (SAD) and postpartum or 'maternity' blues, including their symptoms and treatment options.