Lecture 7- Childhood Depression Flashcards
Are children with depression diagnosed according to the same criteria as adults?
-Children and adolescents are diagnosed by the same criteria as adults, with a few specified symptom differences.
-It is acknowledged in DSM-V that the symptoms of these disorders may be manifested differently in children and adolescents than in adults.
What is the DSM-V Criteria for MDE?
A. At least 5 of the following, including either (1) or (2), present during a 2-week period:
1. Depressed mood (children – can be irritable mood)
2. Diminished interest/pleasure
3. Weight/appetite change (children: can be failure to make expt weight gains)
4. Insomnia/hypersomnia
5. Psychomotor agitation/retardation
6. Fatigue/energy loss
7. Feelings of worthlessness/inappropriate guilt
8. Concentration difficulties/indecisiveness
9. Recurrent thoughts of death/suicidal ideation/suicide
attempt or plan
Are symptoms typically present for just 2 weeks when children are diagnosed with depression?
-This is the minimum requirement according to the DSM-5 however, it is unlikely the one would seek help after this short period
What disorders can look very similar to major depression?
ADHD, ODD, CD due to difficulties concentrating and indecisiveness
In depression are we looking for chronic or sudden change?
Sudden change, it’s all about a sharp difference from the norm
Is comorbidity with depression common in children? How does this compare to adults?
-Yes, “The rule rather than the exception” in childhood
-Comorbidity is more common in children and adolescents than in adults
What percentage of children with depression have other disorders?
-40-60% present with a comorbid disorder
-20-50% have two or more comorbid diagnoses.
What are some common disorders that depression occurs comorbidly with in children?
In children, depression commonly co-occurs with:
-Anxiety disorders
-Disruptive behaviour disorders
-Substance-use disorders
-Eating disorders
Where is substance use comorbidity with depression more common? What can be problematic about this?
-As children get older (progressing into teenage years)
-Often times people use it as a coping mechanism, to make them feel happy or even just to feel something
-However, important to remember that over time substances like alcohol are depressants and therefore, excessive use of them can maintain depression.
What is the chicken and egg situation when we think about comorbidity of eating disorders and depression among children/ young adults?
-How do you know what was the initial cause? Was it depression that caused the eating disorder. Or is it the eating disorder that then caused depression.
-Eating disorders cause a decrease in cognitive decline as essential nutrients are not being provided to the body and this can lead to depressive symptoms. This is part of the reason why when treating anorexia you have to tackle the physical side before the mental side.
Are there significant gender differences for MDD in young children? Does this differ once you get into adolescence?
-No significant gender differences for MDD in young children
-Beginning in adolescence, MDD occurs twice as frequently in girls than boys (paralleling adult ratio)
Why might it be that once adolescence is hit girls have higher rates for depression?
Hit puberty earlier
Do depressive disorders have just one pathway? What are the etiological contributors for depression in children?
-Depressive disorders have diverse pathways
-Etiological contributors for depression in children include:
o Biological models
o Cognitive models
o Behavioural/Interpersonal models
o Family models
o Life stress models
What is the theory behind cognition as an Etiological model for depression among children?
Individuals may interpret scenarios as more negative than a person not effected by the disorder.
Do we just focus on the individual in childhood depression?
No, look at the wider system.
