CMN 552 Module 1 Primary Study Guide University of South Alabama

CMN 552
Module 1
Primary Study Guide
University of South Alabama

, CMN 552
ModuleNM1NMPrimaryNMStudyNMGuideNM(Mo
odNMDisorders)

CarlatNMChapterNM23

AskingNMAboutNMtheNMSymptomsNMofNMDepression
>ANMrelatedNMdifficultyNMisNMdistinguishingNMtrue-positiveNMfromNMfalse-
positiveNMresponsesNMtoNMquestionsNMaboutNMsymptoms.NMMostN M peopleNMexperienceNMsomeNMof
NMtheNMsymptomsNMofNMmajorNMdepressionNMtoNMsomeNMdegreeNMatNMsomeNMtime.NMEstablishingN
MthatNMyourN M patientNMhasNMsymptomsNMsevereNMenoughNMtoNMmeetNMDSM-
5NMcriteriaNMtakesNMcreativity,NMpersistence,NMandNMexperience.

● EstablishNMthatNMtheNMsymptomNMisNMtrulyNMaNMchangeNMfromNMbaseline.
● EstablishNMthatNMtheNMsymptomNMhasNMoccurredNMalmostNMeveryNMdayNMforNM2NMweeks.
>It’sNMusefulNMtoNMremindNMpatientsNMthatNMyouNMareNMaskingNMaboutNMaNMspecificNMperiod.
>ThinkNMbackNMcarefully:NMHaveNMyouNMfeltNMdepressedNMprettyNMmuchNMeveryNMdayNMoverNMthe
NMpastNM2NMweeks?
● TryNMnotNMtoNMaskNMleadingNMquestions.NMAnNMexampleNMofNMaNMleadingNMquestionNMisNM―Ha
sNMyourNMdepressionNMmadeNMitNMhardNMforNMyouN M toNMconcentrate?‖NMThisNMimpliesNMthatNM
decreasedNMconcentrationNMwouldNMbeNMexpected,NMandNMaNMsuggestibleNMorNMmalingeringN M pa
tientNMmightNManswerNMwithNMaNMfalseNM―yes.‖NMAnNMexampleNMofNMaNMnonleadingNMquestionN
MwouldNMbeNM―DoNMyouNMthinkNMyourN M concentrationNMhasNMbeenNMbetterNMorNMworseNMthan
NMnormalNMoverNMtheNMpastNM2weeks?‖NMOfNMcourse,NMyouNMcanNMsubstituteNManyNMN M ofNM
theNMNVSsNMforNM―concentration‖NMinNMthisNMtemplate.

ScreeningNMQuestions

● AreNMyouNMdepressed?
● HowNMhasNMyourNMmoodNMbeenNMrecently?
● HaveNMyouNMeverNMfeltNMveryNMdownNMorNMdepressed,NMsoNMdepressedNMthatNMyourN
MwholeNMlifeNMwasNMaffectedNMbyNMitNMforNMatN M leastNM2NMweeks

SIGECAPSNMQuestions
SleepNMdisorderNM(eitherNMincreasedNMorNMdecreased)
InterestNMdeficitNM(anhedonia)
GuiltNM(worthlessness,NMhopelessness,NMregret)
EnergyNMdeficitN M Conce
ntrationNMdeficit
AppetiteNMdisorderNM(eitherNMdecreasedNMor
NMincreased)N M PsychomotorNMretardationN
MorNMagitationN M Suicidality

● ForNMdysthymicNMdisorder,NMtwoNMofNMtheNMsixNMstarredNMsymptomsNMmustNMbeNMpresent.
● RecommendedNMtime:NM1NMminuteNMifNMtheNMscreenNMisNMnegative;NM5NMminutesNMifNMthe
NMscreenNMisNMpositive.

SleepNMdisorder
HaveNMyouNMbeenNMsleepingNMnormally?NM(ANMgoodNMinitialNMscreeningNMquestionNMforNMaNMsleepNMpro
blem.)

,WhatNMhasNMyourNMsleepNMpatternNMbeenNMlikeNMlately?NM(DependingNMonNMtheNMadequacyNMofNMyour
NMpatient’sNMresponseNMtoNMthisNMquestion,N M youNMmayNMorNMmayNMnotNMneedNMtoNMfollowNMupNM
withNMtheNMfollowingNMquestions.)
WhatNMtimeNMdoNMyouNMlieNMdownNMtoNMfallNMasleep?NMWhatNMtimeNMdoNMyouNMactuallyNMfallNMasleep
?(ToNMdiagnoseNMdifficultyNMfallingNMasleep.)
DoNMyouNMsleepNMthroughNMtheNMnightNMorNMwakeNMupNMoftenNMduringNMtheNMnight?(ToNMdiagnoseNMfr
equentNMawakenings.)

, WhatNMtimeNMdoNMyouNMusuallyNMwakeNMupNMinNMtheNMmorning?NMDoNMyouNMgenerallyNMfeelNMrestedN
MwhenNMyouNMwakeNMup?
DoNMyouNMfeelNMmoreNMorNMlessNMdepressedNMwhenNMyouNMwakeNMup?NMHowNMdoesNMyourNMmoodN
MchangeNMasNMtheNMdayNMgoesNMon?
(ToNMdiagnoseNMearlyNMmorningNMawakeningNMandNMdiurnalNMvariationNMinNMmood.)
>InterestNMdeficitNM(anhedonia):NMAnhedoniaNMisNMaNMsurprisinglyNMdifficultNMsymptomNMtoNMasc
ertain.NMObviously,NMnoNMpatientN M willNMcomeNMrightNMoutNMandNMsay,NM―Doctor,NMI’veNMbeenNMreally
NManhedonicNMlately.‖NMYouNMwillNMmoreNMlikelyNMhearNMwordsNMlike,NM―I’mNMboredNMallN M theNMtime,
‖NM―INMhaveNMnoNMmotivation,‖NMorNM―INMdon’tNMcareNMaboutNManything.‖NMOneNMproblemNMisNMthatN
MpatientsNMmayNMnotNMunderstandNMwhatN M weNMmeanNMifNMweNMask,NM―CanNMyouNMdescribeNMyour
NMinterestNMlevel?‖NMorNM―HaveNMyouNMbeenNMtakingNMpleasureNMinNMthings?‖NMANMpatientNMmayN M
onlyNMassociateNMpleasureNMwithNMextraordinaryNMexperiences,NMsuchNMasNMgoingNMonNMvacation,NMorN
MsheNMmayNMsayNMsheNMhasNMbeenNMtakingN M anNMinterestNMinNMthingsNMwhen,NMinNMfact,NMherNMl
evelNMofNMinterestNMhasNMdecreasedNMmarkedlyNMsinceNMtheNMonsetNMofNMdepression.NMBecauseN M of
NMtheseNMpotentialNMpitfalls,NMit’sNMimportantNMtoNMbeNMspecificNMinNMyourNMquestioning.
>BeforeNMyouNMfeltNMreallyNMsad,NMwhatNMsortsNMofNMthingsNMwouldNMyouNMdoNMforNMfunNMorN
Mrelaxation?
WhatNMsortsNMofNMhobbiesNMdidNMyouNMhave?NMDidNMyouNMread?NMDidNMyouNMplayNMsportsNMorNMf
ollowNMtheNMsportsNMteams?NMDidNMyouNMgoNMoutNMtoN M theNMmovies?NMDidNMyouNMgoNMoutNMwit
hNMfriends?
ThisNMestablishesNMaNMbaselineNMagainstNMwhichNMtoNMcompareNMtheNMdepressedNMperiod.NMYouN
McanNMthenNMgoNMonNMtoNMaskNMabout
howNMtheNMdepressionNMhasNMaffectedNMtheNMpatient’sNMactivities:
SinceNMyouNMhaveNMfeltNMdepressed,NMhaveNMyouNMnoticedNMthatNMyou’veNMbeenNManyNMlessNMintereste
dNMinNMtheseNMpursuits?NMHaveNMyou
foundNMthatNMyou’veNMbeenNMableNMtoNMenjoyNMtheNMthings
NMyouNMusedNMtoNMenjoy?N M HaveNMyouNMgivenNMupNMdoin
gNManythingNMthatNMyouNMnormallyNMlikeNMtoNMdo?
*IfNMtheNMpersonNMyouNMareNMevaluatingNMisNMalreadyNMonNManNMantidepressant,NMparticularlyNMifNMthisN
MisNMaNMselectiveNMserotoninNMreuptakeN M inhibitorNM(SSRI),NMheNMmayNMseemNMtoNMhaveNManhedonia,
NMwhereasNMheNMmayNMactuallyNMhaveNM“apathyNMsyndrome”NMsecondaryNMtoN M theNMantidepressa
nt.NMThisNMoccursNMinNMupNMtoNM20%NMtoNM30%NMofNMpatientsNMonNMnewerNMantidepressantsNMand
NMmayNMbeNMcausedNMbyN M loweredNMlevelsNMofNMbrainNMdopamine.
>Guilt,NMworthlessness,NMhopelessness:NMHere,NMyouNMwantNMtoNMunderstandNMhowNMnegativelyNMtheNMpa
tientNMfeelsNMaboutNMhimself.
StartingNMwithNMquestionsNMthatNMassessNMtheNMpatient’sNMself-worthNMoftenNMworksNMwell:
HowNMhaveNMyouNMbeenNMfeelingNMaboutNMyourself,NMinNMtermsNMofNMself-
esteem,NMsinceNMyou’veNMbeenNMdepressed?
DoNMyouNMfeelNMthatNMyouNMareNMessentiallyNMaNMgoodNMperson,NMorNMdoNMyouNMhaveNMyourNMdou
bts?NMHaveNMyouNMfeltNMespeciallyNMcriticalNMofN M yourselfNMlately?NMTheseNMquestionsNMtouchNMspeci
ficallyNMonNMtheNMthemeNMofNMhopelessness:NMHowNMdoNMyouNMseeNMyourNMfuture?
DoNMyouNMhaveNMhopeNMthatNMthingsNMwillNMgetNMbetter,NMorNMdoesNMitNMlookNMprettyNMbleak?DoNMyo
uNMfeelNMhelplessNMtoNMchangeNMyourNMsituation?
*HaveNMyouNMfeltNMguiltyNMorNMregretfulNMaboutNMthingsNMyou’veNMdoneNMorNMhaven’tNMdone?NMLikeNMn
otNMbeingNMproductive,NMnotNMreachingNMyourN M potential,NMbeingNMaNMburden?
EnergyNMdeficit:NMBeginNMwithNMaNMscreeningNMquestion.
HowNMhasNMyourNMenergyNMlevelNMbeenNMoverNMtheNMpastNMcoupleNMofNMweeks?--
IfNMtheNMpatientNManswersNM―Lousy,‖NMmakeNMsureNMthatNMtheNMlowNMNMenergyNMcoincidesNMwithNMth
eNMonsetNMofNMtheNMdepressionNMratherNMthanNMbeingNMaNMconstantNMfeatureNMofNMherNMphysicalNMs
tate.
IsNMthisNMaNMchangeNMforNMyou?NMDidNMyouNMfeelNMsignificantlyNMmoreNMenergeticNMbeforeNMyourNMde