wk 4 | NURS 321 - Mental Health

What are the two primary questions to ask when screening for depression?

• Have you felt down, depressed, blue, hopeless, or irritable in the past 2 weeks?

• Over the past 2 weeks, have you lost interest or pleasure in the things you normally enjoy doing?

• Follow up if pt endorses yes to either q

What is the standard questionnaire for assessing depression in adults?

PHQ-9: depression questionnaire

EtOH screening questionnaire technique

CAGE

• C cut down: do you feel like you consume to much EtOH —> feel need to cut down

• A annoyed: do you feel annoyed when someone confronts your drinking habits

• G guilt: do you feel guilty about drinking

• Eye opener: do you feel you need something in the morning

Symptoms vs diagnoses 

• 25% of US adults have diagnosable mental illness in their lifetime 

• DSM-V TR: diagnostic and statistical manual

why is depression a big deal

• leading cause of disability worldwide WHO

• it’s common

• it’s expensive

• it’s undertreated :(

Major Depression criteria

• 5 symptoms for 2 weeks straight 

• symptoms are present majority of the time

• Symptoms not attributed to recent bereavement, medication, medical condition

symptoms of major depression

• Dysphoria 

  • Irritability 

• Anhedonia 

• Change in sleep

• Change in appetite 

• Psychomotor retardation 

  • Moving, talking slowly 

• Feeling guilty/worthless across multiple topics 

• fatigue/lack of energy 

• Dec. concentration/indecisiveness 

• Suicidal thougths

GAD criteria

• at least 5 symptoms persistent and present for 6 months most days 

questionnaire for diagnosing GAD

GAD-7 – anxiety questionnaire

delirium vs dementia

Rapid onset  Short duration  Reversible

Insidious onset  Progressive  Irreversible

symptoms of delirium

• Attention deficit

• Disorganized thinking

• Confusion

• Disorientation

• Restlessness

• Incoherence

• Anxiety

symptoms of dementia

• Forgetfulness

• Short term memory loss

• Disorientation

• Wandering

• Agitation

• Aggression

• Obsessive compulsive

behavior

EtOH serving sizes - 40% alcohol content (hard)

• 1.5 oz 

EtOH serving sizes - 5% alcohol content (beer, cider)

• 12 oz 

EtOH serving sizes - 12% alcohol content (wine)

• 5 oz

way to interview pt in treating substance abuse

SBIRT

• screening

• brief intervention

• referral to treatment

harm reduction

• set of practical strategies & ideas aimed at reducing negative consequences with drug use

• also a movement for social justice for people who use drugs