Depression: A Brief Overview of the Disorder in Childhood

Depression: A Brief Overview of the Disorder in Childhood
By: James H. Johnson, Ph.D., ABPP
University of Florida

Case Examples
Childhood Depression:
History
Acceptance of Depression as a Child Disorder
Child Depression Lite
DSM IV CRITERIA: Major Depressive Episode
Major Depressive Episode
Major Depressive Disorder
Anxiety Versus Depression
Childhood Depression:
Prevalence
Comorbidity
Prognosis: Initial Recovery
Prognosis: Recurrence
Etiology: Conceptual Models of Depression
Psychoanalytic Views
The Role of Life Stress
Specific Life Stressors
Cognitive/Behavioral Views
Examples of Cognitive Distortions
Cognitive/Behavioral Views
Behavioral Views
Learned Helplessness and Depression
Learned Helplessness
Cognitive/Behavioral Views: Child Research Findings
Research Findings
Biological Perspectives
Genetic Factors
Other Biological Findings
Treatment of Childhood Depression
Interpersonal Therapy
Cognitive Behavior Therapy
Psychotropic Medications
Combination Therapies
Treatment: Final Comments

Depression: A Brief Overview of the Disorder in Childhood.ppt

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Mood Disorder

Mood Disorder
* Depressive disorders
Major depressive disorder (MDD)
Dysthymic disorder
* Biopolar Disorder
* Mood disorder due to a medical condition
* Substance-induced mood disorder

Psychopathology of Mood Disorders - Depression
* Not diagnosed or misdiagnosed - a lot
* Prevalence - 9-20% in general population
* Female - 10-20%; male - 5-12% (life time)
* Recurrence rate - 50% - 80%
* Seeking professional help - 16-23%
* Suicide rate

Assessment
* History of onset
* Comorbid substance - alcohol, med.
* Physical examination - senile, meta. dis.
* Non mood psychiatric disorders
* Stress level, coping & social support
* Presence and/or level of suicidal ideation
* Others - measurement scales, biological measures (cortisol, hormone, sleep pattern)

Measures of Depression (I)
Measures of Depression (II)
Diagnosis Criteria for Depression
Dysthymic Disorder
Diagnosis Criteria for Major Depression
Etiology of Depression
Genetic theory
Cultural, age, gender considerations
Depression in Children
Predisposing factors in Children and adolescents
Depression in Women
Depression in Men
Depression and the Elderly
Predictors for elderly suicide
Diagnostic Evaluation
Treatment of Depression
Nursing Diagnoses related to Mood Disorders
Assessment for Suicidal behavior
Suicide Prevention
Interventions
Interventions (II)
Monitor the side-effect of antidepressant
* Energy & motivation↑ -suicide tendency ↑
* Drug-drug & food-drug interactions
* Toxicity of the medications
* TCAs – drowsiness, agitation, tachycardia
* MAOIs – dizziness, fatigue, vertigo
* SSRIs – nausea, vomiting, tremor
* Lithium – diarrhea, muscle weakness, atxia; lag time 7-10 days
Biopolar Disorders
Young & Biopolar
Checklist for the Bioplar Child
Criteria for Bipolar Disorders - Manic episode
Manic Genius
Tendencies of Manic Patients
Etiology of Bipolar Disorders
Intervention - Bipolar Disorders
Interventions for suicidal pts
Self-help
Family and friends can help
Where to get help

Mood Disorder.ppt

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Bipolar Disorder in DSM-IV

Bipolar Disorder in DSM-IV
* Bipolar I disorder: manic episode(s)
or mixed episode(s) plus MDE(s)
* Bipolar II disorder: major depressive episode(s) plus hypomanic episode(s)
* Cyclothymia: hypomanic symptoms
plus depressive symptoms

Bipolar Disorders: DSM-IV Nosology
Criteria
Mania
Hypomania
Major depression
Mixed state
BPD I
BPD II
Manic Episode: Diagnostic Criteria
Manic Episode: Differential Diagnoses
Hypomanic episode
Mixed episode
History of treatment for depression
Differential diagnosis
* Physical
* Psychological
Mixed Episode: Diagnostic Criteria
Characteristics BPD I BPD II
Ethnic/racial differential
Gender differential M = F F›M (?)
Bipolar Disorders: Epidemiology
Characteristics BPD I BPD II
Bipolar Disorders: Epidemiology
Epidemiology
Diagnostic Dilemmas:
Unipolar Versus Bipolar
Unipolar
Etiology
Heritability
ADOPTION STUDIES
Cognitive Deficits
* Working memory
* Sustained attention
* Abstract reasoning
* Visuomotor skills
* Verbal memory
* Verbal fluency
* Cognitive flexibility
* General cognitive functioning
Potential Explanations for Cognitive Deficits
* Iatrogenic or Alcohol use
* Temporary functional changes
* Degenerative brain changes
* Permanent structural lesions
* Permanent functional alterations of neural networks underlying affect and cognition

Alcohol Use
Iatrogenic
Temporal Functional Deficits
Summary

Bipolar Disorder in DSM-IV.ppt

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