Flashcards in Adolescent depression and suicide Deck (19):
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
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
Burden of suicide in US?
2nd leading cause of death of plp under 18
- 12/100,000 in US
Who is most at risk for suicide?
White males over the age of 85.
-most at risk American Indian group are youth
What are the 4 major DSM5 mood disorders for children and adolescents?
-Persistent Depressive disorder
-Bipolar 1 and 2
-Disruptive mood deregulation disorder
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.
What are the DX criteria for mania?
At least 3 of the following: (DIG FAST)
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
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
What is bipolar 1 disorder?
Presence of 1 mani episode +/- hypomania or depressive episode
What is Bipolar 2 disorder?
presence of hypomania and a depressive episode.
What is cyclothymic disorder?
Milder form of bipolar disorder lasting at least 2 years, fluctuating between mild depressive and hypomanic symptoms
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
What are some adolescent depression comobidities?
What are some assessments to screen for adolescent depression?
-Beck Depression inventory
-Children's depression inventory
What pharmocologically can we give to adolescents for depression?
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
What are the 3 main goals of CBT?
-Challenge maladaptive beliefs
- enhance problem solving abilities
- increase social competence
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
Adverse affects of SSRI's?
- SIAHD, anorgasmia and decreased libido)