ANCC Certification PMHNP (2023/2024) Already Passed

ANCC Certification PMHNP (2023/2024) Already Passed Mood Disorders Most common psych illnesses Primary characteristic is persistent disturbance in mood Major Depressive Disorder Often occurs without precipitating event MDD Object loss theory Fairbairn, Winnicott & guntrip Aggression turned inward theory of MDD Freud Cognitive Theory Beck Learned Helplessness-Hopelessness Theory Seligman Genetic predisposition Strong genetic load for depression for child of depressed parent -having 3 fold increase in lifetime risk of MDD & 40% chance of depressive episode before age 18. Endocrine dysfunction Theory Probably related to etiology of MDD Sleep disturbances, appetite disturbances, libido disturbances, lethargy, anhedonia are neurovegitative symptoms that are related to functions of the Hypothalamus and pituitary gland secretions Endocrine dysfunction and pregnancy A high incidence of postpartum mood disturbances is suggested with this Hypothalamic-pituitary-adrenal axis (HPA) A theory of MDD, may be a result of an abnormal stress response related to dysregulation of this system HPA axis Controls the physiological response to stress and is composed of interconnective feedback pathways between the hypothalamus, pituitary gland, and adrenal gland. Hypothalamus releases corticotropin-releasing hormone (CRH) Adrenocorticotropin hormone (ACTH) Released by pituitary in response to CRH by hypothalamus Cortisol Released by adrenal glands in response to ACTH by pituitary gland Hyperactivity of the HPA axis Demonstrated to be present in individuals with MDD. May also have elevated cortisol levels Elevated cortisol levels Over time damages the CNS by altering neurotransmission and electrical signal conduction. Cortisol over time can cause changes in size and function of brain tissue Dexamethasone suppression test (DST) Not commonly used in clinical practice for screening of depression as it is too non specific. Hypovolemic