NR 547 Final Study Guide - PMHNP Study online at https://quizlet.com/_d27o84 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-report 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 4. Geriatric Depression Scale: Targeted Population he GDS may be used with healthy, medically ill and mild to moderately cognitively impaired older adults. It has been extensively used in community, acute care, and long-term care settings. 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 1 / 14 NR 547 Final Study Guide - PMHNP Study online at https://quizlet.com/_d27o84 impairment 9-11 indicate moderate depression; (Pharmacologic, psychotherapeutic, or combination treatment indicated) 12-15 indicate severe depression.(Pharmacologic, psychotherapeutic, or combination 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. 8. The Beck Depression Inventory (BDI) 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. 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. 2 / 14 NR 547 Final Study Guide - PMHNP Study online at https://quizlet.com/_d27o84 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 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. 11. Hamilton Depression Rating Scale (HAM-D) 12. 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 13. PQ9 Scores Depression Severity 5 - 9Mild 10 - 14Moderate 15 - 19Moderately Severe 20 - 27Severe scores current depression severity and to follow up treatment response. 14. Depression: Anxious distress Modifier Depression with unusual restlessness or worry about possible events or loss of control 15. Depression: Mixed features Simultaneous depression and mania, which includes elevated self-esteem, talking too much and increased energy 16. 3 / 14 NR 547 Final Study Guide - PMHNP Study online at https://quizlet.com/_d27o84 Depression: Melancholic features 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 17. Depression: Atypical features 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 18. Depression: Psychotic Features Depression accompanied by delusions or hallucinations, which may involve personal inadequacy or other negative themes 19. Depression: Catatonic Features Depression that includes motor activity that involves either uncontrollable and purposeless movement or fixed and inflexible posture 20. Bipolar I and II disorders 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. 21. Cyclothymic Disorder (Cyclothymia) Involves highs and lows that are milder than those of bipolar disorder. 22. mood disorders Psychological disorders characterized by emotional extremes that occur across a spectrum from depression to mania. 23. Disruptive Mood Dysregulation Disorder (DMDD) 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. 24. Less severe but more chronic form of depression. While it's usually not disabling, persistent depressive disorder can 4 / 14 NR 547 Final Study Guide - PMHNP Study online at https://quizlet.com/_d27o84 Persistent Depressive Disorder (Dysthymia) prevent you from functioning normally in your daily routine and from living life to its fullest.