NR 547 QUESTIONS AND ANSWERS
Adjustment disorder with depressed mood - Adjustment Disorder with
Depressed Mood, also called Situational Depression, may sometimes feel nearly
as bleak as MDD, but a major difference is that it does not arise out of the blue.
Rather, situational depression occurs after there is a specific trauma-divorce,
accident, death of loved one, a major life change...
Antidepressant medications used to treat depressive symptoms - SSRI
SNRI
TCS
MAOI's
ASQ screening - The Ask Suicide-Screening Questions (ASQ) tool is a brief
validated tool for use among both youth and adults.
Assessing Depression in Patients with Dementia - Self-reporting scales, such as
the GDS, may be inappropriate.
Cornell Scale for Depression in Dementia can be used to screen not diagnose.
Bipolar I and II disorders - These mood disorders include mood swings that
range from highs (mania) to lows (depression). It's sometimes difficult to
distinguish between bipolar disorder and depression.
Cause of Depression - Though the exact cause is unknown, depression is
influenced by genetic and environmental factors.
Stressful life events, such as giving birth or experiencing emotional trauma, can
contribute to the development of depression.
Center for Epidemiologic Studies Depression Scale (CES-D) - Designed for use
in the general population and is now used as a screener for depression in
primary care settings.
It includes 20 self-report items, scored on a 4-point scale, which measure major
dimensions of depression experienced in the past week.
, The CES-D can be used for children as young as 6 and through older adulthood.
It has been tested across gender and cultural populations and maintains
consistent validity and reliability. The scale takes about 20 minutes to
administer, including scoring.
Children's Depression Inventory - can be used in both educational and clinical
settings to evaluate depressive symptoms in children and adolescents
(7-17 years old)
CDI 2 can aid in the early identification of depressive symptoms, the diagnosis
of depression and related disorders, as well as, the monitoring of treatment
effectiveness
Clinical pearls for adjusting and discontinuing pharmacotherapy for depression
in older adults - Dose changes:
start low, go slow
4-8 weeks for symptom relief
reassess
if partial improvement, consider adding second drug
if no improvement, consider changing to a new drug class
maintain pharmacotherapy for at least 1 year after remission to prevent relapse
discontinue therapy gradually to reduce withdrawal syndrome (dizziness,
anxiety, headache)
Cyclothymic Disorder (Cyclothymia) - Involves highs and lows that are milder
than those of bipolar disorder.
Depression Education: Older Adult - Emphasize that medications should be
taken as prescribed but that they may not "cure" depression; remission of
symptoms is the goal but changes to therapy may need to occur to achieve
remission.
Medications take 4-8 weeks to alleviate symptoms in older adults.
To best treat depression, concurrent nonpharmacologic interventions are
indicated.
Depression has a documented adverse effect of which medications? -
Corticosteroids
Interferon
Propranolol
Oral contraceptives
Adjustment disorder with depressed mood - Adjustment Disorder with
Depressed Mood, also called Situational Depression, may sometimes feel nearly
as bleak as MDD, but a major difference is that it does not arise out of the blue.
Rather, situational depression occurs after there is a specific trauma-divorce,
accident, death of loved one, a major life change...
Antidepressant medications used to treat depressive symptoms - SSRI
SNRI
TCS
MAOI's
ASQ screening - The Ask Suicide-Screening Questions (ASQ) tool is a brief
validated tool for use among both youth and adults.
Assessing Depression in Patients with Dementia - Self-reporting scales, such as
the GDS, may be inappropriate.
Cornell Scale for Depression in Dementia can be used to screen not diagnose.
Bipolar I and II disorders - These mood disorders include mood swings that
range from highs (mania) to lows (depression). It's sometimes difficult to
distinguish between bipolar disorder and depression.
Cause of Depression - Though the exact cause is unknown, depression is
influenced by genetic and environmental factors.
Stressful life events, such as giving birth or experiencing emotional trauma, can
contribute to the development of depression.
Center for Epidemiologic Studies Depression Scale (CES-D) - Designed for use
in the general population and is now used as a screener for depression in
primary care settings.
It includes 20 self-report items, scored on a 4-point scale, which measure major
dimensions of depression experienced in the past week.
, The CES-D can be used for children as young as 6 and through older adulthood.
It has been tested across gender and cultural populations and maintains
consistent validity and reliability. The scale takes about 20 minutes to
administer, including scoring.
Children's Depression Inventory - can be used in both educational and clinical
settings to evaluate depressive symptoms in children and adolescents
(7-17 years old)
CDI 2 can aid in the early identification of depressive symptoms, the diagnosis
of depression and related disorders, as well as, the monitoring of treatment
effectiveness
Clinical pearls for adjusting and discontinuing pharmacotherapy for depression
in older adults - Dose changes:
start low, go slow
4-8 weeks for symptom relief
reassess
if partial improvement, consider adding second drug
if no improvement, consider changing to a new drug class
maintain pharmacotherapy for at least 1 year after remission to prevent relapse
discontinue therapy gradually to reduce withdrawal syndrome (dizziness,
anxiety, headache)
Cyclothymic Disorder (Cyclothymia) - Involves highs and lows that are milder
than those of bipolar disorder.
Depression Education: Older Adult - Emphasize that medications should be
taken as prescribed but that they may not "cure" depression; remission of
symptoms is the goal but changes to therapy may need to occur to achieve
remission.
Medications take 4-8 weeks to alleviate symptoms in older adults.
To best treat depression, concurrent nonpharmacologic interventions are
indicated.
Depression has a documented adverse effect of which medications? -
Corticosteroids
Interferon
Propranolol
Oral contraceptives
