ANCC CERTIFICATION PMHNP CHAPTER 7
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
, ANCC CERTIFICATION PMHNP CHAPTER 7
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 hippocampus and hypovolemic prefrontal cortex-limbic striatal regions - ✔
Abnormalities demonstrated by neuroimaging in individuals with chronic and severe
depression
Brain damage, including that from stroke and trauma - ✔Depression is a acommon
comorbidity in individuals who have experienced these events
What is the Chronobiological theory of MDD - ✔Desynchronization of the circadian
rhythms produces the symptom constellation collectively called MDD
Circadian rhythms control these biological processes that are frequent problems with
depressed individuals - ✔Sleep-rest cycle disturbances * Increased cortisol secretions *
REM abnormalities Increased emotional reactivity
Frequent waking
More intensified dreaming
Diurnal variations to circadian-related behaviors
Decreased arousal and energy levels
Decreased activity patterns *
Incidence of MDD - ✔5% of U.S. population ages 18 and older each year. About 9.9
million Americans
Most common psychiatric illness seen in primary care practices; only 50% of people
receive treatment - ✔MDD
25% women, 12% men - ✔Risk during reproductive years
Risk of MDD is ________ for both genders below puberty and after menopause - ✔
equal
MDD is (greater) or (lesser) source of morbidity for women than other illnesses. - ✔
Greater
Fifteen percent (15%) - ✔Of people with MDD will commit suicide
People with MDD - Four times greater risk of premature death - ✔Than normal control
population
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
, ANCC CERTIFICATION PMHNP CHAPTER 7
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 hippocampus and hypovolemic prefrontal cortex-limbic striatal regions - ✔
Abnormalities demonstrated by neuroimaging in individuals with chronic and severe
depression
Brain damage, including that from stroke and trauma - ✔Depression is a acommon
comorbidity in individuals who have experienced these events
What is the Chronobiological theory of MDD - ✔Desynchronization of the circadian
rhythms produces the symptom constellation collectively called MDD
Circadian rhythms control these biological processes that are frequent problems with
depressed individuals - ✔Sleep-rest cycle disturbances * Increased cortisol secretions *
REM abnormalities Increased emotional reactivity
Frequent waking
More intensified dreaming
Diurnal variations to circadian-related behaviors
Decreased arousal and energy levels
Decreased activity patterns *
Incidence of MDD - ✔5% of U.S. population ages 18 and older each year. About 9.9
million Americans
Most common psychiatric illness seen in primary care practices; only 50% of people
receive treatment - ✔MDD
25% women, 12% men - ✔Risk during reproductive years
Risk of MDD is ________ for both genders below puberty and after menopause - ✔
equal
MDD is (greater) or (lesser) source of morbidity for women than other illnesses. - ✔
Greater
Fifteen percent (15%) - ✔Of people with MDD will commit suicide
People with MDD - Four times greater risk of premature death - ✔Than normal control
population
