pedsdepression

Question 1

MDD preevalencein children?
adolescents?
ratio?

Answer 1

2%
4-*%
increases withage, remember adults its’s over 15%
female:male=2:1

Question 2

differ from adult depression by?

Answer 2

more somatic complaints
irritability and lability
less verbalization of feelings of depression
“more heterogeneous”
From other sources: more psychotic features, atypical features.

Question 3

RF for a depression turing into bipolar?

Answer 3

family history of bipolar or psychotic depression

Question 4

most frequent comorbidity?

what other CB?

Answer 4

anxiety DO #1 (b4 MDD)
SUD (after)
ADHD
disruptive DO (after MDD)}

Question 5

duration of untreated episode?

Answer 5

8 months

Question 6

risk of relapse in 5 yrs

Answer 6

70%

Question 7

percent of youth with MDD who have SI?

who attempt?

Answer 7

60%
30%
note: 1/3 os suicide victims had HI

Question 8

Tx of youth MDD
Mild
moderate
severe

Answer 8

1.psychoeducation
supportive management
family involvement
school involvement
This is sufficient for mild-mod episodes and may=CBT and IPT for this group

2. If above fails, and depression not severe try IPT or CBT
   other therapies like problem solving and attachment based did well too
3. If severe, try medications
4. Combine if above fails. It has the highest remission rates and may work faster

Question 9

What is TADS

What is TORDIA

Answer 9

Treatment of Adolescent depression study
CBT, sertraline, combo
higher remission with combination

Tx of resistant depression in adolescents
those who switched to 2nd SSRI +CBT did better tan those who switched to a 2nd SSRI

Question 10

what is the NNT for meds in youth with MDD

Answer 10

10 for SSRIs
RR=40-60% (but htis is close to placebo)
Prozac is FDA approved