Adolescent Depression Flashcards

Describe the main features of depression Describe some important aetiological and maintaining factors Describe the outcome and interventions that may ameliorate the problem

1
Q

What percentage of adults diagnosed with a psychiatric disorder had a previous diagnosis before age 18? (Kim-Cohen et al, 2003)

A

75%

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2
Q

What is shy, fearful, and easily upset behaviour at age 3 predictive of?

A

Later depression, suicide attempts, and alcohol misuse

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3
Q

What is impulsive, restless, and distractible behaviour at age 3 predictive of?

A

Later conduct problems, depression, antisocial behaviour, suicide attempts, and alcohol misuse

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4
Q

What is the concordance rate of depression in monozygotic twins reared together and apart?

A

76% together, 67% apart

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5
Q

State some environmental risk factors for depression

A

Parental depression, family discord, maltreatment, peer victimisation, bereavement

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6
Q

Describe the change in depression incidence in males and females through puberty

A

Before puberty, incidence is the same in males and females. Between ages 11-13, incidence dramatically increases in females but only increases slightly in males. By 15, females are twice as likely to experience a major depressive episode

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7
Q

Give some potential explanations for the gender differences in depression incidence in adolescence

A

Hormones (testosterone affects social and affective information), rapid growth (change in body shape), circadian rhythm changes

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8
Q

Describe the changes in the prefrontal cortex during adolescence

A

Grey matter thinning, synaptic pruning, myelination

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9
Q

Describe the influence of the amygdala and prefrontal cortex on depression

A

Increased amygdala to prefrontal cortex connectivity is associated with an increase in adolescent suicidal ideation and attempts (Alarcon etal, 2019) - but positive parenting is protective, associated with decreased amygdala growth and increased cortical thinning (Whittle et al, 2013)

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10
Q

Describe the cognitive changes which occur during adolescence

A

Thoughts become more logical with more abstract reasoning
Greater consideration of consequences and ambiguity
Improved memory capacity, including autobiographical memory (sense of self across time)

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11
Q

Describe the emotional changes which occur during adolescence

A

Increased intensity of mood
Changes to self-regulation
Establishment of identity, including consideration of reputation amongst peers

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12
Q

Describe the social changes which occur during adolescence

A
Family shift towards autonomy and independence, questioning family rules and values
More importance attached to peer relationships
Romantic and sexual relationships
Increased experimentation (e.g. tobacco, alcohol, drugs)
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13
Q

How is adolescent depressive disorder differentiated from normal teenage angst?

A

It causes serious suffering and impairment, impacting on the individual, their family, their peers, and their education or work

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14
Q

What are the 3 main domains of depressive disorder?

A

Low mood and sadness, loss of enjoyment, and loss of energy

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15
Q

Give at least 3 differences between adolescent and adult major depressive disorder

A

1) Irritability instead of sadness or low mood (especially in boys)
2) Somatic complaints and social withdrawal more common
3) Psychotic symptoms rarer
4) Self-harm more common

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16
Q

Give 3 mental health disorders associated with adolescent depression

A

Anxiety disorder, eating disorders (especially in females), conduct disorders

17
Q

What percentage of cases of adolescent depression reoccur in adulthood?

A

40-70%

18
Q

What is the first-line treatment for adolescent depression?

A

Psychological therapy - either CBT, interpersonal psychotherapy, or psychodynamic psychotherapy

19
Q

What is the most commonly prescribed SSRI for adolescent depression?

A

Fluoxetine

20
Q

What percentage of deaths are due to suicide?

A

1%

21
Q

Give 3 directions of research for adolescent depression

A

Exercise as therapy, treatment for neuroinflammation, therapies for the gut microbiome, pharmacogenetics, internet-based therapies