Pediatric Depression and Suicide Flashcards
HEADSS Interview
Used to screen for depression
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Suicide/depression
DSM Criteria for Depression
Depressed/irritable mood
Diminished pleasure in activities
Sleep disturbances/insomnia
Decreased concentration/indecisiveness
Suicidal
Psychomotor agitation/retardation (slow to answer)
Fatigue
Worthlessness
Common presenting symptoms in:
Young children
Teens
Young Children: present more with somatic symptoms and psychomotor agitation
Teens: present with social withdrawal, substance use, psychomotor depression
SIG-E-CAPS
Sleep disturbances
Interest (decreased)
Guilt
Energy (decreased)
Concentration problems
Appetite changes
Pleasure (decreased)
Suicidal thoughts/actions
SAD PERSONS
Teens at high risk for suicide - also FHx 1st degree relative w/ successful suicide
Sex: males complete more*
Age >16*
Depression with comorbid disorder
Previous attempts*
ETOH/substance abuse
Rational thought lost
Social support lacking*
Organized plan**
No significant other
Sickness or stressors
Cognitive Behavioral Therapy goal and principle
Goal: modify negative thoughts and behaviors
Principle: thoughts, feelings, and behaviors affect one another
Interpersonal Psychotherapy goal and principles
Goal: address the interpersonal problems that may contribute to or result from depression
Principle: depression occurs in interpersonal context
SSRIs
Take 4-6 weeks for response
Long 1/2 life = less withdrawal sx w/ missed dose
Multiple successful medication trials in peds
Fluoxetine, Escitalopram
BBW: increase suicidal risk in pts <24 yo
Fluoxetine (Prozac)
1st line for Depression and OCD
Ages 8 and up
20 mg effective dose, 60 mg max
Taper up
Escitalopram (Lexapro)
Ages 12 and up
Start at 5 mg
10-20 mg effective, 20 mg max
Used to treat depression
