Comprehensive exams for Mental Health Q 141
Mr. Cruz visits the physician’s office to seek treatment for depression, feelings of hopelessness, poor appetite, insomnia, fatigue, low self-esteem, poor concentration, and difficulty making decisions. The client states that these symptoms began at least 2 years ago. Based on this report, the nurse Tiffany suspects:
A. Cyclothymic disorder.
B. Atypical affective disorder.
C. Major depression.
D. Dysthymic disorder.
Correct Answer: D. Dysthymic disorder.
Dysthymic disorder is marked by feelings of depression lasting at least 2 years, accompanied by at least two of the following symptoms: sleep disturbance, appetite disturbance, low energy or fatigue, low self-esteem, poor concentration, difficulty making decisions, and hopelessness. These symptoms may be relatively continuous or separated by intervening periods of normal mood that last a few days to a few weeks.
Option A: Cyclothymic disorder is a chronic mood disturbance of at least 2 years’ duration marked by numerous periods of depression and hypomania. It is currently classified under the umbrella of bipolar mood disorders. It is a chronic disease that must be present for at least two years in order to be diagnosable in adults and over 1 year in children and adolescents. As with many other psychiatric disorders, it must lead to dysfunction and stress in order to be classified as a disorder and must not be concurrent or caused by another general medical condition or substance use disorder.
Option B: Atypical affective disorder is characterized by manic signs and symptoms. Affective disorders may include manic (elevated, expansive, or irritable mood with hyperactivity, pressured speech, and inflated self-esteem) or depressive (dejected mood with disinterest in life, sleep disturbance, agitation, and feelings of worthlessness or guilt) episodes, and often combinations of the two.
Option C: Major depression is a recurring, persistent sadness or loss of interest or pleasure in almost all activities, with signs and symptoms recurring for at least 2 weeks. The investigation into depressive symptoms begins with inquiries of the neurovegetative symptoms which include changes in sleeping patterns, appetite, and energy levels. Positive responses should elicit further questioning focused on evaluating for the presence of the symptoms which are diagnostic of major depression.