DEPRESSION- ENDOGENOUS & EXOGENOUS

DEPRESSION- ENDOGENOUS & EXOGENOUS

 

1. Mr. chembe aged 30 years is brought to Chainama Hospital Ward X with history of profound sadness and suicidal ideations  for 2 weeks. On admission, the Doctor conducted a Mental State Examination and a diagnosis of Depresion is made

 a)  Define Depression                                                                                          5 marks                                                                             b) Explain five (5) causes/predisposing factors of Depression                             25 marks

c) outline  the differences between reactive and endogenous depression  20 marks

d) Discuss how you are going to nurse Mr. chembe during his stay in hospital                                                                                                                           50 marks  

 Patient Case: Mr. Chembe at Chainama Hospital Ward X

a) Define Depression (5 marks):

• Depression is a mood disorder characterized by persistent feelings of sadness, hopelessness, and loss of interest or pleasure in activities that were once enjoyable.
• It involves a range of emotional, cognitive, and physical symptoms, including changes in appetite, sleep disturbances, fatigue, difficulty concentrating, and thoughts of death or suicide.
• Depression significantly impacts daily functioning and quality of life, and it may vary in severity from mild to severe.

b) Causes/Predisposing Factors of Depression (25 marks):

1. Biological Factors: Genetic predisposition plays a significant role in depression, with individuals having a family history of the disorder being at higher risk. Neurochemical imbalances, particularly involving serotonin, dopamine, and norepinephrine, are implicated in depression.
2. Psychological Factors: Traumatic life events, such as loss of a loved one, abuse, or significant stressors, can trigger depression. Negative cognitive patterns, low self-esteem, and maladaptive coping strategies also contribute to the development of depression.
3. Social Factors: Social isolation, lack of social support, and dysfunctional interpersonal relationships can contribute to feelings of loneliness and exacerbate depressive symptoms. Socioeconomic factors, such as poverty or unemployment, may also increase the risk of depression.
4. Biopsychosocial Model: Depression often results from a complex interplay of biological, psychological, and social factors. Chronic illness, substance abuse, and hormonal changes (e.g., during pregnancy or menopause) can also predispose individuals to depression.
5. Neurobiological Factors: Alterations in brain structure and function, including reduced hippocampal volume and abnormal activity in the prefrontal cortex and limbic system, are associated with depression. Chronic stress and inflammation may contribute to these neurobiological changes.

c) Differences Between Reactive and Endogenous Depression (20 marks):

• Reactive Depression: Also known as situational depression, reactive depression is triggered by external stressors or life events, such as the loss of a job, relationship problems, or financial difficulties. The onset of symptoms is directly related to the triggering event, and the individual may experience a range of emotional reactions.
• Endogenous Depression: Endogenous depression refers to depression that arises from within the individual, independent of external stressors. It is often characterized by a more insidious onset and a lack of clear precipitating factors. Genetic predisposition and neurobiological factors play a prominent role in endogenous depression, and individuals may have a family history of mood disorders.

d) Nursing Care Plan for Mr. Chembe (50 marks):

• Assessment: Conduct a comprehensive assessment of Mr. Chembe's mental health status, including his thoughts of self-harm, previous psychiatric history, social support system, and coping mechanisms.
• Safety: Implement suicide precautions, including close observation, removal of potentially harmful objects, and regular monitoring of mood and suicidal ideation.
• Therapeutic Communication: Establish rapport with Mr. Chembe, providing a supportive and nonjudgmental environment for him to express his feelings and concerns.
• Medication Management: Administer prescribed antidepressant medications as ordered, monitoring for therapeutic response and side effects. Educate Mr. Chembe and his family about the importance of medication compliance.
• Psychosocial Support: Offer individual and group therapy sessions to help Mr. Chembe explore and address underlying issues contributing to his depression. Provide psychoeducation about depression, coping strategies, and relaxation techniques.
• Collaborative Care: Coordinate care with other members of the healthcare team, including psychiatrists, social workers, and occupational therapists, to ensure a multidisciplinary approach to Mr. Chembe's treatment and recovery.
• Discharge Planning: Develop a discharge plan in collaboration with Mr. Chembe and his support network, identifying community resources and follow-up care to promote continuity of care and prevent relapse.

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This plan outlines the definition and causes of depression, highlights the differences between reactive and endogenous depression, and provides a comprehensive nursing care plan for Mr. Chembe's stay in the hospital.