5 - Paeds - Safeguarding - CAMHS - Depression

Question 1

Mostly affects who (kids) ? An important Hx point?

Answer 1

adolescents, often girls, but occasionally prepubertal children
take Hx without parents present

Question 2

What features are more seen in adults than in children

Answer 2

lost appetite/wt
lost libido
lost sleep
slowing of thought + movement
delusional ideas

Question 3

What features are more seen in children than in adults

Answer 3

apathy, boredom, anhedonia rather than depressed mood
social withdrawal
reappearance of separation anxiety
decline in school
hypochondriacal ideas and complaints of pain
irritable/antisocial behaviour

Question 4

MGMT of mild depression

Answer 4

primary care/other non-mental health service

watchful waiting 4wks

guided self help

no resolution by 2-3m -> CAMHS

Question 5

MGMT of mod/severe depression

-admit when?

Answer 5

> CAMHS
CBT, FT, Interpersonal therapy

address contributing factors eg bully

if insufficient after 6wks SSRI (fluoxetine)

admit if suicidal ideations