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NR 547 Differential Diagnosis in Psychiatric-Mental Health
across the Lifespan Practicum - Chamberlain



NR 547 Final Exam Study Guide

1. When do you consider Unipolar versus Bipolar depression: Unipolar major
depression (major depressive disorder) is characterized by a history of one or more
major depressive episodes (table 3) and no history of mania (table 1) or hypomania


2. Geriatric Depression Scale (GDS): Scoring Instructions. Score 1 point for each
bolded answer. A score of 5 or more suggests depression.


Self-reporting tool that may be used to diagnose and treat depression


3. Geriatric Depression Scale: The Geriatric Depression Scale (GDS) is a self-re-
port measure of depression in older adults. Users respond in a "Yes/No" format. The
GDS was originally developed as a 30-item instrument. Since this version proved
both time-consuming and difficult for some patients to complete, a 15-item version
was developed. The shortened form (GDS-S) is comprised of 15 items chosen from
the Geriatric Depression Scale-Long Form (GDS-L). These 15 items were chosen
because of their high correlation with depressive
symptoms in previous validation
studies

,5. Geriatric Depression Scale (GDS): Score: Pharmacologic, psychotherapeutic,
or combination treatment indicated of the 15 items, 10 indicated the presence of
depression when answered positively, while the rest (question numbers 1, 5, 7, 11,
13) indicated depression when answered negatively.


Scores of 0-4 are considered normal, depending on age, education, and complaints;
(No Treatment)


5-8 indicate mild depression; (Pharmacologic or psychotherapeutic treatment may
be indicated
Base treatment on duration of symptoms and functional impairment


9-11 indicate moderate depression; (Pharmacologic, psychotherapeutic, or combi-
nation treatment indicated)


12-15 indicate severe depression.(Pharmacologic, psychotherapeutic, or combina-
tion treatment indicated


6. Geriatric Depression Scale (GDS): Indication for Intervention: The presence
of depression warrants prompt intervention and treatment. The GDS may be used
to monitor depression over time in all clinical settings.
Any positive score above 5 on the GDS Short Form should prompt an in-depth
psychological assessment and evaluation for suicidality.


7. Patient Health Questionnaire [PHQ-9]: A brief 9-item self-report questionnaire
used as a screening tool to assess severity of depression; widely used by health care


providers, in validity is well established, particularly for identifying severe depression.

, The BDI takes approximately 10 minutes to complete. Validity and reliability of the
BDI has been tested across populations, worldwide.


9. 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.


10. EQ-5D: The EQ-5D is a standardized, non-disease specific instrument for de-
scribing and evaluating health-related quality of life. The instrument measures quality
of life in five dimensions: mobility, self-care, usual activities, pain/discomfort and
anxiety/depression.


11. Mood Disorders: Depression: Sadness, lethargy, inactivity and feelings of
helplessness and hopelessness
Genetic link
Behavioral changes: slower motor reactions
Cognitive changes: cognitive distortions


Physical changes: alters immune functioning

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