Mood Disorders in Adolescents and Children

Mood Disorder

category of mental health problems

may also be called affective disorders

under diagnosed in children

Major Depressive Disorder

Low mood

loss of interest and pleasure in usual activities

experienced most days for at least 2 week period

interfere with all areas of a childs life including school and social

Other Symptoms - sleep disturbance, changes in appetite, highly unpredictably irritable, low frustration levels, guilt, low concentration,social withdrawal

Appearance

Younger children: more anxiety, (especially separation), somatic symptoms, temper tantrums, and behavioural problem

Middle/late: dysphoria, low self-esteem, guilt, hopelessness, "burden on family", social withdrawal

Adolescents: sleep and appetite changes, suicidality, irritability, explosive and conduct symptoms, "acting out" and substance abuse

Age Related Changes

Biological: sexual maturation and hormonal changes, differential ontogeny of neural pathways: serotonergic pathways mature earlier on, noradrenergic pathways continue development into young adulthood

Environmental: social and academic, expectations, increased exposure to adverse life experiences, stressors and loses. Increased autonomy and abstract thinking

Dysthymia: bad state of mind, ill feelins, abnormal feelings.

Symptoms -less severe than major depressive, but symptoms last longer, more than 2 years. But for children only 1 year- mood may be irritable rather than sad or depressed.

Appearance and Features:

.6 to 4.6% in children and 1.6 to 8% in adolescents, same ratio for boys and girls in child but higher for girls in adolescents

linked to long-term disabling consequences on social skill learning, psychosocial functioning, and consequent professional life, contributing to higher risk of relapse, or development of major depression, first major depression often 2-3 years after on set of dysthymia, suggesting it is a gateway

Bipolar: Bipolar I- severe mood episodes from mania to depression
Bipolar II - milder mood elevation, milder episodes of hypomania, that alternate with periods of severe depression

Appearance and Features

Manic and Hypomanic- elevated or irritable mood, grandiose self-image, little need for sleep, being overly talkative, flight of ideas, distractibility, overactivity, dangerous behaviour,

Difference in duration and severity - manic episode - symptoms for at least a week, marked impairment
-hypomanic - symptoms for 4 days or more, noticeable but no marked problems

depressive episode- the presence of 5 or more depressive symptoms during a week period - sig impairment

Disruptive Mood Dysregulation

Appearance

Chronic severe persistent irritability 2 clinical manifestion

  1. Frequent temper outburst
  1. Chronic, persistently angry mood that is present between out bursts

prevalance - 2-5%

diagnosed between 6-10

controversy - brat or sick

might be what a normal child experiences

might be better be described by bipolar but committing to a type of treatment when childhood is fluent

Mood order due to Medical Condition

Mood disorder substance induced

Etiology

genetics contributors

environmental factors- stresses, within a family, ordinal position, sex and temperament

attachment and parenting variables, generally play a role in a child's sense of security, and capacity, to manage feelings, and regulate behaviour.

Trauma

childhood abuse link to 42% chronic depression

greater number of symptoms

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:4 Pillars of Assessment

  1. Those who know the child
  1. different measures of assessment- observations, tests, history, discussions
  1. Characyeristics of child

Environment of the child - school, home, neighbourhood, activity, peers

Tools in diagnosing

see slides