CPS Mental Health Flashcards
List 3 risk factors for post partum depression
- History of mood disorders
- Depression symptoms during pregnancy
- Family history of psychiatric disorders
List three adverse outcomes associated with depression during pregnancy
- Inadequate prenatal care
- Poor nutrition
- Higher preterm birth
- Low BW
- Pre-eclampsia
- Spontaneous abortion
- Substance abuse and general risk taking behaviour
List three trigger questions you can ask a new mother to assess for post partum depression
- How are you feeling about being a new mother?
- Are you enjoying your baby?
- Do you find your baby is easy or difficult to care for?
- How are things going in your family?
- Are you getting enough rest?
- How is your appetite?
- During the past month have you been bothered by feeling down, depressed or hopeless?
- During the past month have you been bothered by having little interest or pleasure in doing things?
List three effects of post partum depression on the infant of an affected mothe
- Insecure attachment
- Negative affect
- Dysregulated attention
Which is the SSRI associated with the highest chance of withdrawal symptoms?
Paroxetine (half life os 21 hours)
Which is the SSRI associated with the lowest chance of withdrawal symptoms?
Fluoxetine (half life of 96 hours)
Which SSRI is effective for depression in kids under the age of 12?
Fluoxetine only
Which two SSRIs are effective for depression in adolescents?
- Escitaolopram (cipralex)
- Citalopram (celexa)
List 5 side effects of SSRIs
- GI upset
- Restlessness
- Appetite changes
- Sleep changes: somnolence, insomnia
- Sexual dysfunction
- Headache
List 3 serious but rare side effects of SSRIs
- Increased risk of bleeding
- SIADH
- Serotonin syndrome
List one population in which citalopram is contraindicated
Associated with prolonged QT interval therefore kids with prolonged QT syndrome, congenital heart disease or lyte abnormalities it should not be used or used with extreme caution
Which SSRI has the most evidence for treating depression in kids and teens?
Fluoxetine
Who needs to be referred to psychiatry before starting an SSRI?
Patients with a personal or family history of bipolar depression or other psychiatric comorbidity
Which SSRI is best for anxiety disorders?
- Studies are inconclusive for showing evidence of benefit for one SSRI over another therefore treatment decisions should be based on family preferences and tolerability of SSRIs for the child
List 5 family risk factors for a child during divorce
- Ongoing conflict between parents
- Diminished capacity to parent or poor parenting
- Lack of monitoring children’s activities
- Multiple family transitions
- Parental mental health problems
- Chaotic, unstable relationships
- Impaired parent child relationships
- Economic decline
List 5 family protective factors for a child during divorce
- Protection from conflict between parents
- Cooperative parenting
- Healthy relationships between child and parents
- Parent’s psychological well being
- Quality, authoritative parenting
- Household structure and stability
- Supportive sibling relationships
- Economic stability
What are the three most significant factors impacting child’s well being during divorce?
- Quality of parenting
- Quality of parent child interaction
- Degree, frequency, intensity and duration of hostile conflict
What is the second most common cause of death among adolescents?
Suicide
Which types of structural heart disease are associated with sudden cardiac death?
- Tetralogy of Fallot
- D-transposition of the great arteries
Who needs to be assessed by cardiology before starting stimulant medications?
- Patients who answer yes to any cardiac screening questions during assessment or who have abnormal physical exam findings
- Patients with a history of congenital heart disease: appropriate to discuss ADHD treatment options before starting stimulant medications but ultimately stimulants do not really increase the risk of sudden death that much more than their baseline.
