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DEPRESSION
MOOD DISORDERS :
Mood/affective Disorders
are characterised by a
disturbance of mood,
accompanied by a full or
partial man...
CLASSIFICATION
• F 30 : MANIC EPISODE
• F 31: BIPOLAR AFFECTIVE DISORDER
• F32 : DEPRESSIVE EPISODE
• F33 : RECURRENT DEPR...
DEFINITION
Oxford textbook of psychiatry (1997)
defines depressive disorders as
syndromes of depressed mood,
pessimistic t...
ICD-10 CLASSIFICATION
• F30-39- mood ( affective disorder)
• F 32 -Depressive episode
• F 32.0 -Mild depressive episode
• ...
EPIDEMIOLOGY
lifetime prevalence of about 15%
perhaps as high as 25% for women.
• Sex: more in women.
• Age: The mean age...
ETIOLOGY
• Biological Theories
– Genetics:
• twin studies,
• family studies and
• Adoption studies.
ETIOLOGY
• Biochemical influences (
NE,SERO.,DOP,A.CH)
• Neuroendocrine disturbances
– Hyperactivity of adrenal gland
– De...
ETIOLOGY
• Physiological influences
– Medication side effects: steroids,
hormones, sedatives, antineoplastics,
antibacteri...
ETIOLOGY
• PSYCHOSOCIAL THEORIES
– Psychoanalytic theory: loss of loved
object.
– Behavioral theory: conditioned by
repeat...
CLINICAL FEATURES
• DEPRESSED MOOD: Sadness of mood,
loss of interest and loss of pleasure in
almost all activities.
– Per...
CLINICAL FEATURES
• DEPRESSIVE COGNITIONS
– Hopelessness: no hope in future due to
pessimism.
– Helplessness: no help is p...
CLINICAL FEATURES
• SUICIDAL THOUGHTS:
• PSYCHOMOTOR ACTIVITY:
– Psychomotor retardation
– Thinks, walks and acts slowly
–...
CLINICAL FEATURES
• PSYCHOTIC FEATURES
– Delusions and hallucinations
CLINICAL FEATURES
• Somatic symptoms
– Significant decrease in appetite or weight
– Early morning awakening
– Pervasive la...
MAJOR DEPRESSIVE DISORDERS
• SINGLE EPISODE OR RECURRENT
• MILD/MODERATE/ SEVERE
• WITH PSYCHOTIC FEATURES
• WITH CATATONI...
DIAGNOSIS
• ICD 10 diagnostic criteria
• Psychological tests- Beck depression
inventory, Hamilton rating scale
• Dexametha...
TREATMENT
• Pharmacotherapy
PHARMACOTHERAPY
• antidepressants
PHYSICAL THERAPIES
• ELECTROCONVULSIVE THERAPY:
severe depression with suicidal risk .
• LIGHT THERAPY: seasonal depressio...
PSYCHOSOCIAL THERAPIES
• Cognitive therapy
• Psychoanalytic therapy
• Supportive psychotherapy
• Group therapy
• Family th...
NURSING MANAGEMENT
ASSESSMENT
NURSING DIAGNOSIS
• High risk for self directed violence
related to depressed mood, feelings of
worthlessness and anger tu...
• Powerlessness related to dysfunctional
grieving process as evidenced by feeling of
lack of control over life situations....
THANK YOU
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DEPRESSION NURSING

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Depression

  1. 1. DEPRESSION
  2. 2. MOOD DISORDERS : Mood/affective Disorders are characterised by a disturbance of mood, accompanied by a full or partial manic or depressive syndrome, which is not due to any other physical and mental disorder.
  3. 3. CLASSIFICATION • F 30 : MANIC EPISODE • F 31: BIPOLAR AFFECTIVE DISORDER • F32 : DEPRESSIVE EPISODE • F33 : RECURRENT DEPRESSIVE DISORDER • F34: PERSISTENT MOOD DISORDER • F38 : OTHER MOOD DISORDERS • F39 : UNSPECIFIED MOOD DISORDERS
  4. 4. DEFINITION Oxford textbook of psychiatry (1997) defines depressive disorders as syndromes of depressed mood, pessimistic thinking , lack of enjoyment, reduced energy and slowness.
  5. 5. ICD-10 CLASSIFICATION • F30-39- mood ( affective disorder) • F 32 -Depressive episode • F 32.0 -Mild depressive episode • F 32.1 - Moderate depressive episode • F 32.2 - Severe depressive episode without psychotic symptoms • F 32.3 - Severe depressive episode with psychotic symptoms • F 32.8 - Other depressive episode – atypical depression • F 32.9 - Depressive episode , unspecified • F 33 - Recurrent depressive disorder.
  6. 6. EPIDEMIOLOGY lifetime prevalence of about 15% perhaps as high as 25% for women. • Sex: more in women. • Age: The mean age of onset is about 40 years, 50% of all the patients have an onset between 20-50 years of age. • Marital status • Socioeconomic and cultural considerations: rural areas than in urban.
  7. 7. ETIOLOGY • Biological Theories – Genetics: • twin studies, • family studies and • Adoption studies.
  8. 8. ETIOLOGY • Biochemical influences ( NE,SERO.,DOP,A.CH) • Neuroendocrine disturbances – Hyperactivity of adrenal gland – Decreased level of thyroid hormone
  9. 9. ETIOLOGY • Physiological influences – Medication side effects: steroids, hormones, sedatives, antineoplastics, antibacterials – Neurological disorders: – Nutritional deficiencies:
  10. 10. ETIOLOGY • PSYCHOSOCIAL THEORIES – Psychoanalytic theory: loss of loved object. – Behavioral theory: conditioned by repeated losses in past. – Cognitive theory: depression is due to negative cognitions – Sociological theory: Stressful life events
  11. 11. CLINICAL FEATURES • DEPRESSED MOOD: Sadness of mood, loss of interest and loss of pleasure in almost all activities. – Pervasive and persistent pattern of sadness.
  12. 12. CLINICAL FEATURES • DEPRESSIVE COGNITIONS – Hopelessness: no hope in future due to pessimism. – Helplessness: no help is possible – Worthlessness: feeling of inadequacy and inferiority. – Unreasonable guilt – Self blame
  13. 13. CLINICAL FEATURES • SUICIDAL THOUGHTS: • PSYCHOMOTOR ACTIVITY: – Psychomotor retardation – Thinks, walks and acts slowly – Monotonous – Delay in answering questions
  14. 14. CLINICAL FEATURES • PSYCHOTIC FEATURES – Delusions and hallucinations
  15. 15. CLINICAL FEATURES • Somatic symptoms – Significant decrease in appetite or weight – Early morning awakening – Pervasive lack of interest and lack of reactivity to pleasurable stimuli – Posture is stooped – Reddened eyes from crying – Persons look 10 years older than their chronological age. – Constipation and anorexia – dry mouth, headache, sleep disturbance, fatigue and lowered libido
  16. 16. MAJOR DEPRESSIVE DISORDERS • SINGLE EPISODE OR RECURRENT • MILD/MODERATE/ SEVERE • WITH PSYCHOTIC FEATURES • WITH CATATONIC FEATURES • WITH MELANCHOLIC FEATURES • CHRONIC • WITH SEASONAL PATTERN • WITH POSTPARTUM ONSET • DYSTHYMIC DISORDER • PREMENSTRUAL DYSPHORIC DISORDER
  17. 17. DIAGNOSIS • ICD 10 diagnostic criteria • Psychological tests- Beck depression inventory, Hamilton rating scale • Dexamethazone suppression test • Based on signs and symptoms
  18. 18. TREATMENT • Pharmacotherapy
  19. 19. PHARMACOTHERAPY • antidepressants
  20. 20. PHYSICAL THERAPIES • ELECTROCONVULSIVE THERAPY: severe depression with suicidal risk . • LIGHT THERAPY: seasonal depression • REPETITIVE TRANS CRANIAL MAGNETIC STIMULATION.
  21. 21. PSYCHOSOCIAL THERAPIES • Cognitive therapy • Psychoanalytic therapy • Supportive psychotherapy • Group therapy • Family therapy • Behavioral therapy
  22. 22. NURSING MANAGEMENT
  23. 23. ASSESSMENT
  24. 24. NURSING DIAGNOSIS • High risk for self directed violence related to depressed mood, feelings of worthlessness and anger turned inward on the self • Dysfunctional grieving related to real or perceived loss as evidenced by denial of loss, inappropriate expression of anger.
  25. 25. • Powerlessness related to dysfunctional grieving process as evidenced by feeling of lack of control over life situations. • Self esteem disturbance related to learned helplessness , negative view of self as evidenced by expression of worthlessness and sensitivity to criticism • Altered sleep and rest related to depressed mood as evidenced by difficulty in falling asleep and early morning awakening.
  26. 26. THANK YOU
  • MahwashKamdaar

    Jul. 10, 2021
  • BindhuMaliyekkal

    Sep. 22, 2020
  • YADAVMUKESH1

    Oct. 2, 2019
  • RamyaPraveen4

    May. 2, 2019

DEPRESSION NURSING

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