depression l.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Depression PowerPoint Presentation
Download Presentation
Depression

Loading in 2 Seconds...

play fullscreen
1 / 13

Depression - PowerPoint PPT Presentation


  • 245 Views
  • Uploaded on

Depression. Objectives. Background. Prevalence rates for depression: 1% to 2% of prepubertal children 3% to 8% of adolescents. Depression and bipolar disorder equally common in both sexes. Unipolar depressive disorders in teens more common in girls than in boys (ratio of 3:1)

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Depression' - tim


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
background
Background
  • Prevalence rates for depression:
    • 1% to 2% of prepubertal children
    • 3% to 8% of adolescents.
  • Depression and bipolar disorder equally common in both sexes.
  • Unipolar depressive disorders in teens more common in girls than in boys (ratio of 3:1)
  • Early onset of puberty in girls increases the risk for depression.
clinical features when to consider diagnosis
Clinical Features & When to Consider Diagnosis
  • Sad, irritable, or angry
    • may present with school or behavioral problems
  • Somatic complaints
    • headache, stomachache, muscle weakness, decreased or increased appetite, fatigue, insomnia, hypersomnia, or disturbed sleep-wake cycles
  • Self-injurious behaviors or suicidal ideation, plan, and intent
identifying risk factors environmental
Identifying Risk FactorsEnvironmental
  • Abuse or neglect
  • Parental substance abuse
  • Marital problems
  • Low socioeconomic status and education level
  • Loss of parent, sibling, or close friend
  • Stress related to adolescent developmental or issues of sexuality (eg, homosexuality)
identifying risk factors genetic
Identifying Risk FactorsGenetic
  • Depressed parent contributes both genetic vulnerability & emotional unavailability that can contribute
    • combination of adverse life events and the presence of the shorter allelic form of the serotonin transporter gene results in early-onset depression
  • Smaller prefrontal cortex and basal ganglia in depressed individuals
identifying risk factors
Identifying Risk Factors
  • Medications
    • glucocorticoids, immunosuppressives, isotretinoin, antiviral agents
  • Chronic illness
    • such as cystic fibrosis, juvenile diabetes
diagnosis the basic steps
DiagnosisThe Basic Steps
  • Are symptoms present?
  • Evaluate child’s current level of functioning relative to his or her baseline
  • Any potential for self-injurious behavior, suicidal ideation, or suicide attempt?
  • History taken from:
    • Patient
    • Parents
    • Others : teachers, counselors, or coaches.
diagnosis tools
DiagnosisTools
  • Children’s Depression Inventory (CDI)
    • assesses the severity of depression in prepubertal school-age children
  • Beck Depression Inventory (BDI) Reynolds Adolescent Depression Scale (RADS-2)
  • Mood and Feelings Questionnaire (MFQ)

Adolescents

diagnosis tools10
DiagnosisTools
  • The Guidelines for Adolescent Depression in Primary Care (GLAD-PC) Toolkit
    • Has child and parent report measures and scoring instructions on their web site http://www.thereachinstitute.org/files/documents/GLAD-PCToolkit.pdf
    • This user-friendly online resource also includes management flowcharts, scales, and educational materials in English and Spanish as well as tracking forms and information on billing
treatment pharmacological
TreatmentPharmacological
  • Currently, fluoxetine (Prozac)is the only antidepressant approved by the FDA in children and adolescents
    • research studies have demonstrated efficacy of other drugs such as citalopram, paroxetine, and sertraline
  • Dosing of Fluoxetine
    • Starting at 2.5 mg/day for prepubertal children
    • 10 mg/day for older adolescents
    • Most patients respond to fluoxetine at doses ranging from 20 to 80 mg/day
treatment pharmacological12
TreatmentPharmacological
  • 2006 FDA meta-analysis of children and adolescents taking SSRIs for depression
    • found an increased risk of suicidality in those patients treated with drugs versus those given placebo.
  • Subsequent meta-analysis including additional studies revealed that those who benefited from SSRI treatment outnumbered those who became suicidal during SSRI treatment by a ratio of 14:1.