Symptom: Mood, Changes in

Initial Grading Reminder

CTCAE Grading of Mood Change:

Grade 1: Mild mood elevation/depression
Grade 2: Moderate mood elevation/depression affecting instrumental ADLs
Grade 3: Severe mood elevation/depression affecting self-care ADLs

Assessment and Grading

Characterize the symptom (onset, pace)

Ask the patient or caregiver:

Is this a new or worsening symptom? When did it start or get worse? Have/has you (or he/she) ever had rapid changes in your mood before? Has it developed gradually or suddenly?

Grade the symptom

Ask the patient or caregiver:

What has happened to your (or his/her) mood? How big of a change is it from your normal? Do you feel hyper or depressed? Is it affecting your ability to function? 

Patient Query Regarding Other Symptoms/Red Flags

Ask the patient:

Are you having any difficulty swallowing? Do you feel like your heart is going really slow or really fast?  Are you very tired? Do you think you may harm yourself or someone else?

Patient Factors to Consider That Affect the Approach to Intervention

Consider the following in individualizing the intervention: Is the patient a good or poor historian? Any language barriers or cognitive deficits? Is the patient reliable (able to carry out treatment recommendations)? Does this patient have alcohol/substance abuse issues? Does the patient have transportation? Is there sufficient caregiver support?

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    Suggested Intervention

    Patients who are affected by mood changes should be seen. Patients with any of the red-flag symptoms should be seen immediately.

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    Nursing Assessment of Potential Causes

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    Differential Diagnosis

    What do you suspect is the cause of the mood change?