Adolescent Depression and Suicide Flashcards
How many americans in 10 take antidepressants?
1 in 10 aged 12 and up
Which gender is more likely to take antidepressants?
females are 2.5 times more likely than males (nearly a quarter in the 40-59 range!)
Describe how antidepressant use is culturally bound?
white people are much more likely to take them than hispanics and blacks, regardless of SES
Over 80% of the psychiatric meds prescribe in MN are from what providers?
primary care
What is the prevalence of suicide in general in the US?
12 per 100,000 (the 2nd leading cause of death under age 18)
What group is most at risk for suicide?
white males over 85 (47 per 100,000)
In American Indian populations, what age group is most at risk?
youth - ages 15 to 24
What are the four major mood disorders described in the DSM?
major depressive disorder
persistent depressive disorder
bipolar 1 and 2
disruptive mood dysregulation disorder
What are the two main “bolded” signs of major depression?
- persistent sadnes or irritable mood in children
2. loss of interest in activities once enjoyed
THen what are the “non-bolded” signs of major depression?
- significant change in appetite or weight
- difficulty sleeping or oversleeping
- psychomotor retardation
- loss of energy
- feelings of worthlessness or inappropriate guilt
- difficulty concentrating
- recurrent thoughts of death/suicide
How long does the depressed mood have to last to be given a persistent depressive disorder (dysthymia) diagnosis?
at least 2 years (one year in adolescents and kids)
What is the difference between bipolar 1 and 2?
bipolar 1 - mania for 7 days
bipolar 2 - hypomania 4 days
Why was the new diagnosis of disruptive mood dysregulation disorder created?
in an effort to distinguish between kids who hav emood dysregulation and those who actually have bipolar disorder
What are the signs/characteristics of disruptive mood dysregulation disorder?
- severe recurrent tempter tantrums that are inconsistent with developmental age and occur 3+ times a week.
mood between outburts irritable or angery. criteria have to be present at least 1 year and in 2 settings (restricted to age 6-18 and onset has to be before 10)
What grade in high school has particular problems with depression?
9th
What are the pharmacology recommendations for depression in adolescents?
SSRIs should be reserved for moderate to severe depression and keep close contact during first few months
TCAs contraindicated
maintain treatment for at least 1 year
What are the three goals of CBT?
- challenge maladaptive beliefs
- enhance problem-solving abilities
- increase social competence
What are the common adverse side effects of SSRIs?
restlessness, dizziness, drowsiness, GI ditress, headache, tremor
What did the TADS student determine about treatment of depression in adolescents?
they found that CBT and fluoxetine alone had the same efficacy after a longer period of time, but using them in combo worked much faster
In addition to the faster efficacy, what is another benefit of combined CBT and drugs?
Having CBT also decreases the risk for suicide
What is the recommended length of treatment for combined therapy?
6-9 months
What are the 7 PREDISPOSING factors for adolescent suicide
- previous attempt
- psychiatric disorder
- sexual or physical abuse
- exposure to violent behavior
- fam hx of suicide or mood disorder
- male gender
- gay or lesbian
What are the 4 PRECIPITATING factors for adolescent suicide?
- substance abuse
- prior suicide attempt
- access to firearms
- social stress or emotional factors
In what group is postpartum depression practically the norm?
in adolescent mothers - 56% report moderate to severe PPD symptms that persist up to 4 years!
