Child psychiatry I

Question 1

what sign represents a common underlying condition of a mood disorder?

Answer 1

irritability

Question 2

what are the DSM IV criteria for major depressive disorder?

Answer 2

5 of the following symptoms for at least 2 weeks:

• one symptom must be depressed mood or loss of interest or pleasure
• pervasive depressed mood
• pervasive anhedonia
• significant change in weight
• sleep disturbance
• psychomotor agitation or retardation
• pervasive fatigue or loss of energy
• excessive guilt or feeling worthless
• difficulty concentrating
• recurrent thoughts of death or thoughts of suicide
• in children depressed mood may be substituted by irritable mood

Question 3

what is the average length of depressive episode?

Answer 3

7-9 months

Question 4

what is the remittance rate of childhood MDD?

Answer 4

90% by 1.5-2 years

Question 5

what is the 2 year recurrence rate by 2 years for childhood MDD? what about for 5 years?

Answer 5

• 40% by 2 years

- 60-70% by 5 years

Question 6

what is “double depression”? why is it important?

Answer 6

• dysthymia coupled with major depression
• severe and long episodes
• higher comorbidity
• increased suicidality
• worse social impact

Question 7

what are the factors that determine initiating psychotherapy vs medication?

Answer 7

• severity

- functioning

Question 8

what are the symptoms of serotonin syndrome?

Answer 8

• autonomic instability
• fever
• rigidity
• delirium
• psychosis (visual)
• myoclonic jerks