Chapter 22: Depression in Children

Question 1

Major Depression

Answer 1

mood disorder

serious, time-limited

Question 2

Dysthymic Disorder

Answer 2

mood disorder

longer-term, less-intense depression

Question 3

Bipolar Disorder

Answer 3

mood disorder

consisting of mood swings between depression and mania

Question 4

Depression

Answer 4

-may be situational or related to environmental factors combined with genetic and biological factors
>persistent sad or irritable mood, worried, feeling empty
>loss of interest in activities once enjoyed
>change in eating and sleeping habits
>physical agitation or slowing
>loss of energy
>recurrent thoughts of death or suicide

Question 5

Signs + Symptoms

Answer 5

five key features must be present and persistent for most days during a period of 2 weeks for the diagnosis of major depressive disorder in children and adolescents

• persistent sad or irritable mood–reported feeling sad or empty or observed by others (e.g. appears tearful); this mood is different from the child’s baseline emotional and behavioral state and is unrelated to events that may cause temporary distress or sadness (e.g. getting a time-out)
• loss of interest in activities once enjoyed (anhedonia)—reported by child or observed by others
• significant change in appetite or body weight– difficulty sleeping or oversleeping
• fatigue or loss of energy
• feelings of worthlessness or excessive/inappropriate guilt
• decreased ability to think or concentrate or to make decisions; an example is a drop in grades and/or school performance
• recurrent thoughts of death or suicide with or without a suicide plan, and in younger children, consistent engagement in activities or play that involve themes of death and suicide

Question 6

Diagnosis

Answer 6

based on exhibited depressive symptoms

Question 7

Nursing Care

Answer 7

• ensure safety

- develop a trusting relationship with the child; ask about feelings or thoughts

Question 8

Education/Discharge

Answer 8

-talk with parents of a child about suspected depression and suggest referral to a counselor, pastor, chaplain, or spiritual director for evaluation and treatment

Question 9

Mania

Answer 9

• overly happy, irritable, silly, and elated
• overly inflated self-esteem; grandiosity
• increased energy, feels jumpy or “wired”
• decreased need for sleep; able to go with very little or no sleep for days without tiring
• increased talking; talks too much, too fast; changes topics too quickly; cannot be interrupted
• distractibility; attention moves constantly from one thing to the next
• hyper-sexuality; increased sexual thoughts, feelings, or behaviors; use of explicit sexual language
• increased goal-directed activity or physical agitation
• disregard of risk; excessive involvement in risky behaviors or activities
• impulsive behavior, such as spending sprees