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pediatric depression Flashcards

1
Q

case reports on childhood depression date to

A

the early 17th century

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2
Q

___ in children was first reported in the mid-19th century

A

melancholia

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3
Q

the existence of depression prior to ___ was seriously doubted because ____

A

1960
it was felt that children’s immature superego would not permit the development of depression

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4
Q

in the ___ increased the awareness and acceptance of childhood depression

A

1970’s

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5
Q

psychoanalytic perspective

A
  • depression results from an intrapsychic conflict between the ego and a persecutory superego
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6
Q

psychoanalysis held that the superego ___

A

was formalized only after resolution of the Oedipus Conflict, which occurred by late adolescence

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7
Q

Thus, psychoanalytic perspective believes that children could not ___

A

experience intrapsychic conflict and could not develop mood disorders

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8
Q

what is incidence

A

number of new cases in a give ntime period
a 5% incidence means that in a given year 5% of the population is affected

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9
Q

what is prevalence

A

total number of cases in a population at any given time
a 5% prevalence means that at any given time 5% of the population is affected

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10
Q

what is ACUTE

A

an illness with a high incidence and low prevalence
common cold

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11
Q

what is CHRONIC

A

an illness with a low incidence and a high prevalence

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12
Q

12 month prevalence in the us among youth is about __

A

7%

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13
Q

generally accepted 1-year incidence is
preschool age
school age
adolescent age

A

1%
2%
4-8%

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14
Q

sex ratio of __ in childhood and __ by adolescence

A

1:1
2:1

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15
Q

lifetime prevalence of MDD among adolescents is __

A

15-20%

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16
Q

prevalence increases during adolescence, possibly due to

A

biological factors
environmental factors
psychological and cognitive factors

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17
Q

biological factors

A

sexual maturation

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18
Q

environmental factors

A

increased social and academic expectations
more change of exposure to negative events

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19
Q

psychological and cognitive factors

A

increased autonomy and abstract thinking

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20
Q

psychodynamic theory of depression

A

anger turned inward; severe superego

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21
Q

attachment theory of depression

A

insecure early attachment

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22
Q

behavioral theory of depression

A

inability to obtain reinforcement

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23
Q

cognitive theory of depression

A

depressive mindset - negative cognitions

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24
Q

self-control theory of depression

A

deficits in self-monitoring, self-evaluation, and self-reinforcement

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25
interpersonal theory of depresison
characteristic to individual, roles and events
26
socioenvironmental theory of depression
stressful life circumstances exacerbate vulnerabilities
27
neurobiological theory of depression
neurochemical, endocrine, and receptor abnormalities
28
children with a parent who suffered from depression as a child are up to __ more likely than controls to become depressed prior to age __
14x 13
29
Children of parents with depression have about __ the risk of having depression
2-4x
30
The lifetime history of MDD in mothers of children with MDD is also high, about
50-75%
31
risk for anxiety disorders, major depression, and substance dependence were __ higher in the offspring of depressed parents
3x
32
the time of greatest incidence was ___ y/0
15-20
33
___ is associated with a reduction of anxiety, depressive, and disruptive disorders and symptoms in their offspring
effective treatment of mothers with MDD
34
paternal mental health problems are independently associated with a ___ increased risk
33-70
35
maternal mental health problems are associated with a ___ increased risk
50-350%
36
among those with pervasive suicidal thoughts and intent, levels of the ____ are ____ in the CSF
major serotonin metabolite lower
37
adults with one or two copies of the _____ gene have been shown to exhibit _____
short allele o the 5-HT transporter gene more depressive symptoms, diagnosable depression, and suicidality in relation to stressful life events
38
____ leads to reduced transcription of the 5-HT receptor and less serotonin uptake
short allele
39
cognitive disortions
such as overgeneralization, jumping to conclusions, should statements
40
biogenic amine hypothesis
too much neurotransmitter causes mania and too little causes depression
41
neuroendocrine markers
- 70% of depressed adults don't show normal suppression of cortisol secretion - alteration in stress response - blunting of normal growth hormone release - blunted production of thyroid stimulating hormone - depressed girls secrete more prolactin
42
brain volume
less cortical gray matter decreased cortical thickness
43
DSM-5 criteria do not differ ___
for children and adolescents
44
generally, children show ____ than adults
fewer neuro-vegetative signs
45
___ may substitute for depressed mood
irritability
46
diagnosis
1. 5 of 9 symptoms for the diagnosis 2. at least one symptom is either depressed mood or anhedonia 3. at least two straight weeks 4. not better accounted for by another illness
47
neuro-vegetative signs
1. decrease in appetite 2. insomnia or hypersomnia 3. fatigue or loss of energy 4. diminished ability to think or concentrate or indecisiveness these are generally the first to improve with medication treatment are also targets of CBT
48
developmetnal variants of MDD - children
1. more symptoms of anxiety and auditory hallucinations, somatic complaints 2. expressed as temper tantrums and behavior prob 3. fewer delusions and serious suicide attempts
49
developmental variants of MDD - adolescents
1. more cognitive components 2. guilt and hopelessness 3. more sleep and appetite disturbances, suicidal ideation and attempts 4. compared to adults, still more behavior problems and fewer neuro-vegetative difficulties
50
clinical variants of MDD
unipolar psychotic bipolar atypical seasonal affective disorder subclinical or subsyndromal depression treatment-resistant
51
relapse
an episode of MDD during a period of remission 40-60% of youth with MDD experience relapse after successful treatment of acute episode
52
predictors of relapse
natural course of MDD lack of compliance negative life events rapid decrease or discontinuation of therapeutic treatment
53
recurrence
is the emergence of MDD symptoms during a period of recovery - asymptomatic period of more than 2 months
54
predictors of recurrence
earlier age at onset increased number of prior episodes severity of initial episode psychosis psychosocial stressors dysthymia and other comorbidities treatment noncompliance
55
risk of bipolar disorder
20-40% of depressed children and adolescents develop bipolar disorder within 5 yrs of index episode of MDD
56
predictors of bipolar I disorder onset
early onset MDD psychomotor retardation psychotic features family history of bipolar disorder family history of psychotic depression heavy familial loading for mood disorders pharmacologically induced hypomania
57
suicide risk factors
prior history of suicide attempts or threats male sex for completion not attempts over 15 yrs of age being single or living alone having prominent feelings of hopelessness BPD LGBT younger age in particular
58
suicide crisis syndrome
75% of people don't express si in the month prior to an sa - frantic hoplessness and entrapment - affective dyscontrol - loss of congitive control - overarounsal
59
child suicide rates
suicide bef adolescence is very rare almost always more common among whites than other races in the US
60
implicit bias
10th leading cause of death in the US 2nd leading cause among adolescents

CAM 2 (4 decks)

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