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    MSE Depression

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    Sam Raven Andres
    The most common symptom of depression is generalized psychomotor retardation, though some older patients may experience psychomotor agitation like hand wringing or hair pulling. Patients appear stooped with no spontaneous movement, downcast gazes, and decreased speech, movement, and responsiveness. Around 50% experience cognitive impairment resembling pseudodementia. While most severely depressed patients lack energy for impulsivity, 10-15% of depressed patients commit suicide, especially after initial improvement when energy returns. Prescribing large amounts of antidepressants, especially tricyclics, can paradoxically increase suicide risk.

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    MSE Depression

    Uploaded by

    Sam Raven Andres
    119 views3 pages
    The most common symptom of depression is generalized psychomotor retardation, though some older patients may experience psychomotor agitation like hand wringing or hair pulling. Patients appear stooped with no spontaneous movement, downcast gazes, and decreased speech, movement, and responsiveness. Around 50% experience cognitive impairment resembling pseudodementia. While most severely depressed patients lack energy for impulsivity, 10-15% of depressed patients commit suicide, especially after initial improvement when energy returns. Prescribing large amounts of antidepressants, especially tricyclics, can paradoxically increase suicide risk.

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    The most common symptom of depression is generalized psychomotor retardation, though some older patients may experience psychomotor agitation like hand wringing or hair pulling. Patients appear stooped with no spontaneous movement, downcast gazes, and decreased speech, movement, and responsiveness. Around 50% experience cognitive impairment resembling pseudodementia. While most severely depressed patients lack energy for impulsivity, 10-15% of depressed patients commit suicide, especially after initial improvement when energy returns. Prescribing large amounts of antidepressants, especially tricyclics, can paradoxically increase suicide risk.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    119 views3 pages

    MSE Depression

    Uploaded by

    Sam Raven Andres
    The most common symptom of depression is generalized psychomotor retardation, though some older patients may experience psychomotor agitation like hand wringing or hair pulling. Patients appear stooped with no spontaneous movement, downcast gazes, and decreased speech, movement, and responsiveness. Around 50% experience cognitive impairment resembling pseudodementia. While most severely depressed patients lack energy for impulsivity, 10-15% of depressed patients commit suicide, especially after initial improvement when energy returns. Prescribing large amounts of antidepressants, especially tricyclics, can paradoxically increase suicide risk.

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    - General description

    - most common symptom of depression:: generalized psychomotor retardation

    - psychomotor agitation is also sometimes seen in older px

    - most common symptom of agitation

    - hand wringing

    - hair pulling

    - posture:: stooped

    - no spontaneous movement

    - downcast , averted gaze

    - may appear gross symptoms of psychomotor retardation like those in catatonic schizophrenia

     Mood, Affect and Feelings


    o depression is the key symptom
     50% deny depressive feelings
    o family members bring the px because of social withdrawal and
    o decreased activity
     Speech
    o decrease rate and volume
    o respond to questions with single words
     delayed responses to question
    o may have to wait 2-3 min
     Perceptual Disturbance
    o with delusions or hallucinations are said to have:: major depressive episode with
    psychotic features
    o Psychotic depression or having catatonic features
     for grossly regressed px
     mute
     not bathing
     soiling
    o mood congruent if:: delusions and hallucinations are consistent with depressed
    mood
    o mood congruent delusions
     guilt
     sinfulness
     worthlessness
     poverty
     failure
     perscution
     terminal somatic illness
    o mood incongruent delusions or hallucinations is:: not consistent with a depressed
    mood
     might involve grandiose themes of
     exaggerated power
     knowledge
     worth
     when this occur consider:: schizophrenic disorder
     thought
    o have negative views of the world and of them selves
    o though content includes
     nondelusional rumination about
     loss
     guilt
     suicide
     death
    o 10 percent of px have
     though blocking
     profound poverty of content
     sensorium and cognition
    o orientation
     oriented to person, place and time
     some may not have sufficient energy to answer questions
    o memory
     50-70% have cognitive impairment
     aka as:: depressive pseudodimentia
     complain of
     impaired concentration
     forgetfulness

    - Impulse control

    - 10-15% of all depressed px commit suicide

    - 2/3 have suicidal ideation

    - px with psychotic features

    - consider killing other person

    - result of delusional systems

    - most severely depressed px:: lack motivation or the energy

    - to act in an impulsive or violent way

    - px with depressive disorder are at increased risk of suicide


    - as they begin to regain energy needed to plan and carry out a suicide

    - known as paradoxical suicide

    - unwise too give px a large prescription for a large number of antidepressants

    - especially tricyclic drugs

    - fluoxetine may be prescribed

    - so that energizing qualities are minimized

     Judgement and Insight


    o assessed by reviewing px actions in recent and passed and during interview
    o patients descriptions of their disorder is hyperbolic
     over emphasize their symptoms, their disorder, and life problems
    o difficult to convince px that improvement is possible
     reliability
    o over emphasize the bad and minimize the good
    o common clinical mistake:: ask and believe the px that their medications doesnt
    work
     such statements are false
     may require confirmation
    o do not view it as intentional fabrication
     admission of any hopeful information may be impossible
     for a person in depressed state of mind

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