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Flashcards in Adolescent depression and suicide Deck (19):
1

Burden of Disease for suicide?

risen 60% in past 50 years
- in 2020 it will be the 2nd most prevalent medical condition in the world

2

Anti-depressant meds stats?

Females 2.5 times more likely to be on them
-except ages 12-17
- 23% of women 40-59 are on them
- non-hispanic white are more likely to be on them

3

Burden of suicide in US?

2nd leading cause of death of plp under 18
- 12/100,000 in US

4

Who is most at risk for suicide?

White males over the age of 85.
-most at risk American Indian group are youth

5

What are the 4 major DSM5 mood disorders for children and adolescents?

-MDD
-Persistent Depressive disorder
-Bipolar 1 and 2
-Disruptive mood deregulation disorder

6

What is a manic episode?

Abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently elevated activity or energy lasting at least 1 week.

7

What are the DX criteria for mania?

At least 3 of the following: (DIG FAST)
1. Distractibility
2. Irresponsibility (seeks pleasure without regard to consequences
3. Grandiosity- inflated self-esteem
4. Flight of ideas- racing thoughts
5. increased goal-directed Activity/psychomotor agitation
6. decreased need for SLEEP
7. Talkativeness or pressure speech

8

What is a hypomanic episode?

Like mania but mood disturbance is not severe enough to cause marked impairment in social and or occupational functioning or to be hospitalized.
- no psychotic features
- Lasts at least 4 consecutive days

9

What is bipolar 1 disorder?

Presence of 1 mani episode +/- hypomania or depressive episode

10

What is Bipolar 2 disorder?

presence of hypomania and a depressive episode.

11

What is cyclothymic disorder?

Milder form of bipolar disorder lasting at least 2 years, fluctuating between mild depressive and hypomanic symptoms

12

What is disruptive mood dysregulation disorder?

is the middle ground between mood dysregulation and childhood onset Bipolar disorder
- onset must be before 10
- A. Severe recurrent temper outbursts-verbal or physical–out of proportion to situation
B. Temper outbursts inconsistent with developmental age
C. Temper outbursts on average 3+ times week
D. Mood between outbursts persistently irritable or angry

13

What are some adolescent depression comobidities?

ADHD
CD
delinquency
Dr/ETOH
anxiety
eating disorder

14

What are some assessments to screen for adolescent depression?

-PHQ-9
-Beck Depression inventory
-Children's depression inventory
-Clinical interview

15

What pharmocologically can we give to adolescents for depression?

SSRI's
1. fluoxetine (Prozac)
2. citalopram (Celexa)
3. sertraline (Zoloft)
- TCA's are contraindicated
- keep on SSRI's for a year
- monitor pts on SSRI's and ADHD meds

16

What are the 3 main goals of CBT?

-Challenge maladaptive beliefs
- enhance problem solving abilities
- increase social competence

17

FDA findings on kids with antidepressants?

4% became suicidal compared to 2%
- most common after starting meds or after dose increase
- prozac lowest with Effexor highest risk

18

Adverse affects of SSRI's?

Restlessness
dizziness
drowsiness
GI distress
Headache
tremor
- SIAHD, anorgasmia and decreased libido)

19

What is SIAHD?

Syndrome of inappropriate Antidiuretic hormone secretion
- increased blood volume and hyponatremia