Depression Suicide

Question 1

Depression in children has F= M in incidence T/F
Adolsecent depression rates F :M 2:1 T/F
5-10% of adolescents have sup dynoromal deression T/F

Answer 1

All True

Question 2

Criteria for depression

Answer 2

5 symptoms for at least 2 weeks
One of the symptoms has to be
1 low mood/ irritability/ anhedonia
Needs to be clinically significant distress/ impairment

Not due to a medical illness
Not associated with drug and alcohol
Not associated with another psychiatric diagnosis
No mania / no hypomia ( lots of energy/ loss of sleep)

Classical symptoms of depression seen in older children and with increasing severity
Children and adolescents DONT have loss of libedo/ EMW/ pscholmotor agitation

Question 3

Symptoms of MDD in children

Answer 3

Irritability / frustration / temper tantrums change in their normal behavior
Poor verbal is action of feelings

Question 4

Adolescents MDD

Answer 4

More sleep and appetite disturbance
More suicidal ideation / attempts
Impairment of functions (academic / and peer functioning is impaired)

Question 5

Co morbidities are common in MDD

Answer 5

40-90% associated co morbidites 
20-50% have multiple comorbidites 
Anxiety 30-80%
Disruptive  disorders ODD /CD
Substance abuse 
Social phobia

Question 6

Suicide

Answer 6

Major cause of death in the 15-24 year old age group (33%)
Males : Females 3:1

For every completed suicide there are unsuccessful S presentation to hospital high
40 females and 6 males for every 1 completed suicide

Question 7

Suicidal ideation is common in adolescents

Answer 7

12 % 12-14 yr old report had SI
24% 15-16Y olds report SI

5-7% 12-16 yr old self harm
Self harm is a means of communication of distress and way of getting rid of the stressed feelings
Suicide attempts different to SH

Question 8

Risk assessment 4 main areas to consider

Answer 8

Current Suicidal ideation
2 STressors
3. Risk factors
4 protective factors

Question 9

Risk factors for Suicide 6 things

Answer 9

Past suicide behavior
Mental illness 10x increased risk with one Mental illness 15x with 2
Substance abuse 
Social disadvantage 
Childhood adversity
Male

Question 10

Characteristics of suicide attempts

Answer 10

Lethality and intentionality big 2
Attempts to conceal suicide
5-15 % of MDD will commit Suicide
10% of patient with schizophrenia Suicide
50% of pt who commit suicide have substance on board

Question 11

Protective factors very important in making the suicide management plan

Answer 11

1 Skills that the young person has to deal with stress
2 support ( family/ community ( peers teachers others) sense of belong
3 self concept

Question 12

Treatment of depression

Answer 12

1 pschoeduction

2 medications SSRI Fluoxetine
3 talking therapies CBT
Combination of 2/3 has best outcome

Question 13

Safety plan

Answer 13

Develop a good relationship
Decrease access to self harm eg knives/ropes
If feeling unsafe who to they contact
Safety plan
What makes them feels good
Contact someone kids helpline, teachers peers
Remove from environment go somewhere they feel better eg GO office
If remain feeling terrible go to accident and emergency