NURS 3130 Lecture Notes - Lecture 23: Major Depressive Disorder, Suicidal Ideation, Psychomotor Agitation
Chapter 23: Depression
• Mood: pervasive and sustained emotion that influences one’s perception of the world
and how one functions
• Affect: outward emotional expression, related to the concept of mood
• Types of Affect:
o Blunted: significantly reduced intensity of emotional expression
o Bright: smiling, projection of a positive attitude
o Flat: absent or nearly absent affective expression
o Inappropriate: discordant affective expression accompanying the content of
speech or ideation
o Labile: varied, rapid, and abrupt shifts in affective expression
o Restricted/Constricted: mildly reduced in the range and intensity of emotional
expression
• Depression: primary mood of depressive disorders; significantly negative effect on
quality of life, and increase the risk of suicide. Common mental state marked by
sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed
appetite or sleep, low energy, poor concentration.
• Children with depression: more likely to show anxiety symptoms: fear of separation,
somatic symptoms, stomach ache, headaches, less interaction with their peers and
avoid play they previously enjoyed. Mood may be more irritable than sad.
• Depression in older adults is often assoc. with chronic illnesses, such as heart disease,
stroke, cancer, and symptoms of more somatic focus.
• Major Depressive Disorder: commonly a progressive, recurrent illness, initial onset may
occur in puberty
o DX: one or more moods which is either depressed mood or loss of interest in
nearly all activities for at least 2 weeks
o Four of Seven additional symptoms must be present:
▪ Disruption of sleep
▪ Appetite changes (weight gain/loss)
▪ Loss of concentration or energy
▪ Psychomotor agitation
▪ Excessive guilt or feelings of worthlessness
▪ Suicidal ideation
o Risk Factors:
▪ Prior episode of depression
▪ Family history
▪ Lack of social support
▪ Lack of coping abilities
▪ Presence of life and environmental stressors
▪ Current substance abuse
▪ Medical/mental illness comorbidity
o Onset is 30 years of age.
