NURS 600 MODULES 5–6 MENTAL HEALTH AND AUTOIMMUNE DISORDERS
COMPREHENSIVE LECTURE SUMMARY AND STUDY NOTES
1. Mild/Moderate depression Prevalence: 5-12% will experience at some point
can be as high as 40$
2. Depression Risk Factors: pre-existing mood disorder
3. Signs/Symptoms Depression: negative emotional experiences, sadness, disinterest (anhedonia),
self-hate, unexplaind fatigue, anger, anxiety, irritability, hyperactivity, altered sleep, appetite or sexual behaviour.
Motor slowness, stooped posture, minor cognitive impairment
4. Differential Dx for Depression: parkinsons, thyroid disorders, dementia, epilepsy, CVA and tumors
5. Work up for Depression: ask 2 questions: Have you felt down or hopeless in the past month?
Little interest in doing things for the last month?
PHQ-9 checklist of 9 symptoms over 2 week time.
Full physical assessment, medical history, neuro exam, UA, routine blood work including THYROID and ADRENAL
function.
any family HX of depression
6. Medications that can cause Depression: BP meds, sedatives, hyponotics, anti seizure, antipsy-
chotics, anti parkinsons, steroids, analgesics, antibacterials, antineoplastics.
7. Pharm management for depression:
8. Non-pharm management for Depression:
9. Major Depression Risk Factors: female, strong family history or suicide attempt, etoh abuse, hx of
migraines, back pain, recent MI, peptic ulcer dx, current chronic disease, insomnia, stress, poverty, < high school
education, recent trauma, parent or caregiver with behavior disorder, hypersecretion of cortisol and coexisting thyroid
disorder.
10. Sign/Symptoms Major Depression: severe negative changes in mood, thinking and behavior
sadness and apathy
slowed thinking
emotional numbness
substance abuse
social withdrawal
death and suicidal thoughts that persist regardless of circumstances
global thinking is distorted/ circular
loss of energy
anxious distress
diflcult thoughts about future
, NURS 600 MODULES 5–6 MENTAL HEALTH AND AUTOIMMUNE DISORDERS
COMPREHENSIVE LECTURE SUMMARY AND STUDY NOTES
melancholy
can have psychotic features with catatonic states.
11. Pharmacologic management of Major depression: simultaneous use of psycho therapy
and medications.
SSRI's, SNRI, NRI, TCA's and DA's
12. Non pharmacologic management of Major depression: CBT, home and reassurance,
Massage, relaxation therapy, exercise, good nutrition, self care.
establish a routine, focus on behaviors or activities rather than feelings.
13. PHSQ-9 scores: 0-4 : None
5-9: Mild
10-14: Moderate
15-19: Moderately Severe
20-27: Severe
14. General Anxiety Disorder: excessive worry over 6 month period of time about multiple concerns that
are diflcult to control
15. General Anxiety Disorder Prevelance:: 50-90% have co-morbid depression
Women > Men
5-6% of general population have GAD.
16. General Anxiety signs and symptoms: occurs more days than not associated with 3 or more
symptoms: easy fatigue, diflculty concentrating, muscle tension, sleep disturbance, feelings of restlessness or
hyperness. Hyperarousal and insomnia.
More disruptive than normal anxiety.
motor symptoms: shakiness, restlessness, headache, autonomic hyperactivity: sweating, palpitations, GI distress,
tachycardia, HA, SOB, cognitive villegence (irritability and quick to startle).
must cause significant impairment or distress.
17. Differential diagnosis for GAD: catteine intoxication
stimulant/ etoh abuse
sedative
anxiolytic and hypotic withdrawal
panic disoders
phobias
OCD
COMPREHENSIVE LECTURE SUMMARY AND STUDY NOTES
1. Mild/Moderate depression Prevalence: 5-12% will experience at some point
can be as high as 40$
2. Depression Risk Factors: pre-existing mood disorder
3. Signs/Symptoms Depression: negative emotional experiences, sadness, disinterest (anhedonia),
self-hate, unexplaind fatigue, anger, anxiety, irritability, hyperactivity, altered sleep, appetite or sexual behaviour.
Motor slowness, stooped posture, minor cognitive impairment
4. Differential Dx for Depression: parkinsons, thyroid disorders, dementia, epilepsy, CVA and tumors
5. Work up for Depression: ask 2 questions: Have you felt down or hopeless in the past month?
Little interest in doing things for the last month?
PHQ-9 checklist of 9 symptoms over 2 week time.
Full physical assessment, medical history, neuro exam, UA, routine blood work including THYROID and ADRENAL
function.
any family HX of depression
6. Medications that can cause Depression: BP meds, sedatives, hyponotics, anti seizure, antipsy-
chotics, anti parkinsons, steroids, analgesics, antibacterials, antineoplastics.
7. Pharm management for depression:
8. Non-pharm management for Depression:
9. Major Depression Risk Factors: female, strong family history or suicide attempt, etoh abuse, hx of
migraines, back pain, recent MI, peptic ulcer dx, current chronic disease, insomnia, stress, poverty, < high school
education, recent trauma, parent or caregiver with behavior disorder, hypersecretion of cortisol and coexisting thyroid
disorder.
10. Sign/Symptoms Major Depression: severe negative changes in mood, thinking and behavior
sadness and apathy
slowed thinking
emotional numbness
substance abuse
social withdrawal
death and suicidal thoughts that persist regardless of circumstances
global thinking is distorted/ circular
loss of energy
anxious distress
diflcult thoughts about future
, NURS 600 MODULES 5–6 MENTAL HEALTH AND AUTOIMMUNE DISORDERS
COMPREHENSIVE LECTURE SUMMARY AND STUDY NOTES
melancholy
can have psychotic features with catatonic states.
11. Pharmacologic management of Major depression: simultaneous use of psycho therapy
and medications.
SSRI's, SNRI, NRI, TCA's and DA's
12. Non pharmacologic management of Major depression: CBT, home and reassurance,
Massage, relaxation therapy, exercise, good nutrition, self care.
establish a routine, focus on behaviors or activities rather than feelings.
13. PHSQ-9 scores: 0-4 : None
5-9: Mild
10-14: Moderate
15-19: Moderately Severe
20-27: Severe
14. General Anxiety Disorder: excessive worry over 6 month period of time about multiple concerns that
are diflcult to control
15. General Anxiety Disorder Prevelance:: 50-90% have co-morbid depression
Women > Men
5-6% of general population have GAD.
16. General Anxiety signs and symptoms: occurs more days than not associated with 3 or more
symptoms: easy fatigue, diflculty concentrating, muscle tension, sleep disturbance, feelings of restlessness or
hyperness. Hyperarousal and insomnia.
More disruptive than normal anxiety.
motor symptoms: shakiness, restlessness, headache, autonomic hyperactivity: sweating, palpitations, GI distress,
tachycardia, HA, SOB, cognitive villegence (irritability and quick to startle).
must cause significant impairment or distress.
17. Differential diagnosis for GAD: catteine intoxication
stimulant/ etoh abuse
sedative
anxiolytic and hypotic withdrawal
panic disoders
phobias
OCD
