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Mood Disorders in Adolescents and Children (Major Depressive Disorder (Low…
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
Frequent temper outburst
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
:4 Pillars of Assessment
Those who know the child
different measures of assessment- observations, tests, history, discussions
Characyeristics of child
Environment of the child - school, home, neighbourhood, activity, peers
Tools in diagnosing
see slides