NR 547 Final Study Guide EXAM QUESTIONS AND ANSWERS

NR 547 Final Study Guide EXAM QUESTIONS AND ANSWERS 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 combination treatment indicated) 12-15 indicate severe depression.(Pharmacologic, psychotherapeutic, or combination treatment indicated Geriatric Depression Scale (GDS): Indication for Intervention - ANSWER 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. Patient Health Questionnaire [PHQ-9] - ANSWER 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 Beck Depression Inventory (BDI) - ANSWER Widely used to screen for depression and to measure behavioral manifestations and severity of depression. The BDI can be used for ages 13 to 80. The inventory contains 21 self-report items which individuals complete using multiple choice response formats. The BDI takes approximately 10 minutes to complete. Validity and reliability of the BDI has been tested across populations, worldwide. Center for Epidemiologic Studies Depression Scale (CES-D) - ANSWER 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. EQ-5D - ANSWER The EQ-5D is a standardized, non-disease specific instrument for describing 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. Hamilton Depression Rating Scale (HAM-D) - ANSWER Mood Disorders: Depression - ANSWER 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 PQ9 Scores - ANSWER Depression Severity 5 - 9Mild 10 - 14Moderate 15 - 19Moderately Severe 20 - 27Severe scores current depression severity and to follow up treatment response. Depression: Anxious distress Modifier - ANSWER Depression with unusual restlessness or worry about possible events or loss of control Depression: Mixed features - ANSWER Simultaneous depression and mania, which includes elevated self-esteem, talking too much and increased energy Depression: Melancholic features - ANSWER Severe depression with lack of response to something that used to bring pleasure and associated with early morning awakening, worsened mood in the morning, major changes in appetite, and feelings of guilt, agitation or sluggishness Depression: Atypical features - ANSWER Depression that includes the ability to temporarily be cheered by happy events, increased appetite, excessive need for sleep, sensitivity to rejection, and a heavy feeling in the arms or legs Depression: Psychotic Features - ANSWER Depression accompanied by delusions or hallucinations, which may involve personal inadequacy or other negative themes Depression: Catatonic Features - ANSWER Depression that includes motor activity that involves either uncontrollable and purposeless movement or fixed and inflexible posture Bipolar I and II disorders - ANSWER 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. Cyclothymic Disorder (Cyclothymia) - ANSWER Involves highs and lows that are milder than those of bipolar disorder. mood disorders - ANSWER Psychological disorders characterized by emotional extremes that occur across a spectrum from depression to mania. Disruptive Mood Dysregulation Disorder (DMDD) - ANSWER This mood disorder in children includes chronic and severe irritability and anger with frequent extreme temper outbursts. This disorder typically develops into depressive disorder or anxiety disorder during the teen years or adulthood. Persistent Depressive Disorder (Dysthymia) - ANSWER Less severe but more chronic form of depression. While it's usually not disabling, persistent depressive disorder can prevent you from functioning normally in your daily routine and from living life to its fullest. Depressed mood, for more days than not, for ≥2 years. Impairment compared with major depressive disorder may be less severe. During the 2 years, the patient has never been without symptoms for more than 2 months at a time. Premenstrual dysphoric disorder (PMDD) - ANSWER Depression symptoms associated with hormone changes that begin a week before and improve within a few days after the onset of your period, and are minimal or gone after completion of your period. Depression Prevalence in older adults - ANSWER Depression is the second leading cause of disability in older adults after cardiovascular disease and impacts around 7% of the geriatric population Biologic factors, including changes in brain structure and neurotransmitters after a cerebrovascular accident (CVA) or with a neurodegenerative disease such as Parkinson's or Alzheimer's disease, may increase the risk of depression. Examine the image below for additional risk factors.