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Pediatrics > Mental Health > Flashcards

Mental Health Flashcards

1
Q

The incidence of depression increases with ___, especially after the ______.

A

age, onset of puberty

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2
Q

Incidence of depression by gender among children

A

Equal

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3
Q

Incidence of depression by gender among youth

A

2:1 girls to boys

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4
Q

Symptoms of depression in children

A
  1. deny rather than admit
  2. vary with developmental age
    - chronic head/tummy ache, crying for no reason
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5
Q

Symptoms of depression in youth (>12)

A
  1. irritability
  2. loss of interest in favourite activities
  3. frequent complaints of physical illness
  4. oppositional behaviour
  5. poor performance in school
  6. recurrent suicidal ideation of behaviour
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6
Q

Considerations of symptoms of depression in youth?

A

■ Some are typical youth behaviors; not always obvious indicators
■ Parents are not always aware due to how subtle

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7
Q

Depression in children can lead to

A

Suicide - 95% of those who attempt/contemplate suffer

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8
Q

Major Depressive Disorder in Adolescents Symptoms

A
  1. Depressed mood MOST of the time
  2. Loss of interest in favourite activities
  3. significant weight loss/gain
  4. insomnia
  5. fatigue
  6. low self-esteem
  7. decreased ability to concentrate
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9
Q

Depression in children can be effectively treated with a combination of _______ and ________.

A

psychotherapy and antidepressants

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10
Q

Considerations of depression treatment

A

■ Consideration of insurance for therapy
■ Psychiatrists have big wait lists
■ Usually end up in ED with crisis

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11
Q

Mild depression can usually be treated with

A

psychotherapy alone

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12
Q

More serious depression requires an

A

antidepressant medication

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13
Q

What is the leading cause of death among Canadian youth aged 15-19?

A

Suicide

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14
Q

Incidence of suicide attempts peaks in

A

Adolescence

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15
Q

For every completed suicide there are as many as __ attempts

A

20 attempts

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16
Q

The rate of suicide among Indigenous People is __X compared to Non-Indigenous youth.

A

5

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17
Q

Suicide is leading cause of death among _______ youth.

A

indigenous

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18
Q

Of all age groups, Indigenous aged ______ years are at the highest risk of completing suicide

A

15-29

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19
Q

__________ of suicidal behaviour in 10-14 year age group-1.9/100,000

A

Increase

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20
Q

Suicidal ideation reports as young as ____

A

6-9

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21
Q

Rate of suicide by _____ has doubled

A

firearms

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22
Q

50% of suicide attempters fail to receive:

A

follow-up mental health care

23
Q

77%, of those who do receive follow-up, do not:

A

attend or fail to complete treatment

24
Q

What is the strongest risk factor for suicide?

A

Previous suicide attempt is strongest predictor. People who have attempted suicide are 40 times more at risk of suicide

25
Q

What gender is at greater risk for suicide?

A

Male gender: Males complete suicide 3X more than female.

Females more attempts.

26
Q

Other risk factors for suicide besides previous attempt and gender

A

family history of attempts

parental mental health problems

gay/bisexual

27
Q

4 social risk factors for suicide

A
  1. social isolation
  2. impaired parent/child relationship
  3. difficulties in school
  4. presence of stressful life event
28
Q

How does social isolation increase risk for suicide

A

The absence (or perceived absence) of supportive resources may increase the risk of suicide.

Personal resources can sustain a person on times of great trouble

29
Q

Personal Risk Factors for Suicide

A

Any history of mental illness

  • Depression
  • Bipolar disorder
  • Substance use
  • PTSD
  • Panic attacks
  • History of Anger management
30
Q

4 Traits of Adolescence at Low Risk for Suicide

A
  • responsive and intact family,
  • good peer relations and social support
  • hope for the future,
  • a desire to resolve conflicts
31
Q

4 Immediate Suicide Risk Factors

A
  1. agitation
  2. intoxication
  3. perception of recent stressful life event
  4. current plan
32
Q

6 Traits of Adolescents at High Risk for Suicide

A
  • have made previous attempts,
  • exhibit a high degree of intent to commit suicide,
  • show evidence of serious depression or other psychiatric illness,
  • are abusing alcohol or other drugs,
  • have low impulse control,
  • have families who are unwilling to commit to counseling
33
Q

4 Categories of Guiding Questions for Suicide Risk Assessment

A
  1. thoughts of suicide ideation
  2. intent
  3. plan
  4. resources
34
Q

What should you question regarding thoughts of suicide ideation in risk assessment

A

frequency, intensity, and quality of thoughts

35
Q

What should you question regarding intent in suicide risk assessment?

A

illicit reasons for living; how have they coped until this point

  • “Have you ever thought of acting on your thoughts?”
  • “Do you want to end your life?”
36
Q

What should you question regarding plan in suicide risk assessment?

A

do they have access to the means?

37
Q

What should you question regarding resources in suicide risk assessment?

A

clear instructions on the importance of communicating their thoughts with trusted adult

38
Q

Warning signs for family/nurse for suicide

A
  1. self-destructive behaviour
  2. signs of increased anxiety/panic
  3. new/more involuntary restlessness
  4. extreme degree of elation/energy - suddenly seem okay
39
Q

Nursing interventions for suicidal teen

A
  • Listen, reassure and help the person to remember the things that have kept them alive so far
  • Identify what and who needs to change
  • Evaluate the client’s way of thinking about problems and generating solutions
  • Suicide proof the environment
  • Document your contact with the suicidal person
  • Understand negative personal feelings
  • Identify positive traits
  • Reduce stressors
  • Strengthen coping abilities
  • Identify personal and community resources
40
Q

True or false: if a child is at risk for suicide but does not want to tell their family, you must put the therapeutic relationship first and keep their secret

A

False - lots of gray area though; use critical thinking

41
Q

True or false: a calorically focussed treatment plan is effective for treatment of eating disorders

A

False - psychological disorders not merely problems with food

42
Q

Eating disorder behaviors are initiated as _____ and expressed through a wide range of patterns focused on _____, _____ and ______

A

coping strategies

food, body and weight.

43
Q

body dissatisfaction and the desire to lose weight are the norm for ________ of young women.

A

70%

44
Q

Eating disorders are a unique reaction to

A

a variety of external and internal conflicts, such as stress, anxiety, unhappiness and feeling like life is out of control.

45
Q

The person suffering with Anorexia may be abnormally sensitive about:

A

being perceived as overweight.

46
Q

8 Symptoms of Anorexia

A

o Dramatic weight loss

o Dresses in layers to hide weight loss or stay warm

o Preoccupied with weight, food, calories, fat grams, and dieting

o Refuses to eat certain foods, progressing to restrictions against whole categories of food (e.g., no carbohydrates, etc.)

o Makes frequent comments about feeling “fat” or overweight despite weight loss

o Complains of constipation, abdominal pain, cold intolerance, lethargy, and/or excess energy

o Denies feeling hungry

o Develops food rituals

47
Q

Usually individuals suffering from bulimia often will have ______, ______ and ______

A

low self-esteem, feelings of helplessness, and a fear of becoming overweight.

48
Q

6 Symptoms of Bulimia

A

o Binge eating

o Recurrent inappropriate compensatory behavior to prevent weight gain (vomiting, use of laxatives)

o Excessive amount of tooth enamel erosion,

o A greater-than-normal number of filled cavities

o Calluses on the back of her hand.

o May not appear underweight

49
Q

Nursing interventions for eating disorders focus on

A

Holistic Health

50
Q

Why is treatment of an eating disorder difficult?

A

many of the clients with this problem believe there is nothing wrong with them.

51
Q

True or false: eating disorder recovery is about eliminating the disorder

A

False

not necessarily about eliminating the eating disorder.
It is about living life differently so that the behaviors diminish over time and may eventually disappear.

52
Q

What is the first step in eating disorder treatment?

A

acknowledging the difficulty of struggling day to day with the pain, secrecy, isolation and shame that are a big part of the disorder.

53
Q

3 Treatment steps for eating disorders

A
  1. counselling
  2. antidepressant
  3. support groups
54
Q

What is important to consider about the use of support groups for those with eating disorders

A

Can be counterproductive; sharing tricks in the trades – losing weight/hiding it better

Pediatrics (12 decks)

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