Pediatric Depression and Suicide Flashcards
HEADSS based interview questions
home, education, activities, drugs, sexuality, suicide
DSM criteria for pediatric depression
at least 5 symptoms for 2 weeks and at least one symptom must be depressed mood or anhedonia
series of unintentional and purposeless motions that stem from mental tension and anxiety of an individual
psychomotor agitiation
What do the following have in common: somatic complaints, psychomotor agitation, hallucinations, school refusal, phobias
Depressive symptoms in children and pre-pubertal youth
What do the following have in common: Low self esteem, apathy, boredom, Substance use, Change in weight, sleep or grades. Aggression. Social withdrawal
Depressive symptoms in adolescents and post-pubertal youth
Used to carry out most suicides
firearms
What must all treatment plans for depressed patients include?
safety plan
Treatment options for pediatric patients
cognitive behavioral therapy, interpersonal psychotherapy, SSRIs
Based on the principle that one’s thoughts, feelings and behaviors affect one another. Goal of treatment is to modify the negative thoughts and behaviors.
cognitive behavior therapy
Based on the principle that depression occurs in an interpersonal context. Goal of treatment is to address the interpersonal problems that may be contributing to or resulting from the depression
Interpersonal Psychotherapy
SSRIs approved for kids and the corresponding age groups
fluoxetine (Prozac) 8 yrs and up. excitalopram (Lexapro) 12 yrs and up
First line SSRI treatment and it’s effective dose
Fluoxetine (Prozac) 20mg. Start at 10mg and taper up every 1-2 weeks.
How long should you wait out mild SSRI side effects like HA and GI upset?
one week then decrease med
Common SSRI side effects
HA, GI upset, insomnia, agitation, anxiety
present with more somatic symptoms and more likely to have psychomotor agitation
younger children
present with social withdrawal, substance use and psychomotor depression
teenagers
Other disorders you need to rule out for depression
mono, medication SE, hypothyroidism, anemia
3rd leading cause of death in adolescents
suicide
When does risk for suicide increase?
as the patient recovers some from depression and has more energy and motivation
Expressing self destructive thoughts, drawing morbid pictures, using death as a theme during play, listening to music that centers around death, or playing video games that have a self-destructive theme
Suicidal behaviors
Teens at high risk for suicide
Those with a family history of a first degree relative who committed suicide and have an organized plan
