depressive disorders in children and adolescents Flashcards
symptoms of depression
physical/somatic complains difficulty concentrating sleep problems weight changes apetite disturbances lack of energy, increased fatigue suicideal ideation negative thinking and low self-esteem hopelessness guilt, remorse, worthlessness
criteria for depression diagnosis
at least 1 core symptom
minimum if at least 5 symptoms( 1 has tp be core)
symptoms must cause impairment in interpersonal, social and scholastic functioning or carer distress
pervasiveness (symptoms present most of the day, everyday)
criteria of exclusion for depression diagnosis
symptoms should not be due to another mental disorder, effects of substance or another medical condition
core symptoms of depression
persistent and pervasive sadness or unhappiness
loss of enjoyment of everyday activities (anhedonia)
irritability
mild depressive episode
5 symptoms- 1 core
mild impairment in functioning
mild distress caused by the symptoms
moderate depressive episode
6/7 symptoms- at least 1 core
considerable difficulty in continuing with school work, social and family activities
severe depressive episode
more than 7 symptoms
hallucinations or delusions can be present
significant risk of suicide
severe impairment in most aspects of functioning
significant distress
risk factors of suicide
family history previous attempts comorbidities aggression impulsivity access to lethal means negative life events
dysthymia
chronic mild symptoms for at least one year (2 years for adults)
adjustment disorder
can be diagnosed if symptoms occur shortly after an identifiable stressor (within 3 months) do not outlast stressor by more than 6 months
co-morbidities for depression
Anxiety disorders Post Traumatic Stress Disorder Conduct problems Attention Deficit Hyperactivity Disorder Obsessive Compulsive Disorder Learning difficulties
criteria for depressed disorder due to another medical illness
prominent and persistent period of depressed mood or anhedonia
evidence from history, lab and exam that disturbance is the pathophysiological consequence of another medical condition
disturbance not better explained by another mental disorder
disturbance does not occur exclusively during the course of delirium
disturbance causes clinically significant distress or impairment in social, occupation or other important areas of functioning
rating scales for depression in children
CDRS
CDI
management for depression
SSRIs (fluoxetine)
olanzapine can be combined with fluoxetine
mood stabilizers such as lithium and sodium valproate can be combined with fluoxetine too
dangers of SSRIs in depression
increase the risk of self harm
can trigger mania
