Depression Overview - Psychiatry - Lecture Slides, Slides of Psychiatry

Download Depression Overview - Psychiatry - Lecture Slides and more Slides Psychiatry in PDF only on Docsity! Depression Overview Docsity.com Depressive Disorders • Major Depressive Disorder • Dysthymic Disorder • Depressive Disorder Not Otherwise Specified (NOS) Docsity.com What type of depression?? • Tonya has come for an initial appointment to the SBHC. During the risk assessment, Tonya reports a number of depressive symptoms, including suicidal ideation. Tonya seems to display a lot of negative thinking and cognitive distortions. For example, she believes that “nobody” likes her and that she will “never” be successful in school. Her math teacher often compliments her work, but Tonya dismisses the teacher’s comments as him “just trying to be nice.” Tonya has good grades in all classes except for one, yet she only acknowledges her below average Chemistry grade. Tonya has felt extremely sad for about three weeks, which is a contrast from her usually happy disposition. Docsity.com Major Depressive Disorder • Major Depressive Episode: Five (or more) of the following symptoms have been present during the same two-week period and represent a change from previous functioning. At least one symptom is either (1) depressed mood or (2) loss of interest or pleasure. – Depressed mood most of the day, nearly every day, as indicated by subjective report or based on the observations of others. In children and adolescents, this is often presented as irritability. – Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day – Significant weight loss when not dieting or weight gain (change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day – Insomnia or hypersomnia nearly every day – Psychomotor agitation or retardation nearly every day (observable by others) – Fatigue or loss of energy nearly every day – Feelings of worthlessness or inappropriate guilt nearly every day – Diminished ability to think, concentrate, make a decision nearly every day – Recurrent thoughts of death, recurrent suicidal ideation with or without a specific plan, or an actual suicide attempt Docsity.com Major Depressive Disorder II. Symptoms cause clinically significant distress or impairment in social or academic functioning III. Symptoms are not due to the direct physiological effects of a substance (drugs or medication) or a general medical condition • Although there is a different diagnostic category for individuals who suffer from Bereavement, many of the symptoms are the same and counseling techniques may overlap. Docsity.com Depressive Disorder NOS • Disorders with depressive symptoms BUT do not meet criteria for: Major Depressive Disorder, Dysthymic Disorder, Adjustment Disorder with Depressed Mood, or Adjustment Disorder with Mixed Anxiety and Depressed Mood • Examples: premenstrual dysphoric disorder, minor depressive disorder (at least 2 weeks, but < 5 symptoms) • Also used in situations in which clinician has concluded that a depressive disorder is present, but is unable to determine whether it is primary, due to medical condition, or substance induced Docsity.com Depression Versus Normal Adolescent Development Docsity.com Adolescent Development Copyright 1996 Randy Glasbergen. www.glasbergen.com “At your age, Tommy, a boy’s body goes through changes that are not always easy to understand.” e) Docsity.com Suicide  Attempts- 3:1/F:M, Completions- 4:1/M:F  Most common means of completed suicide: FIREARMS  Most often associated with depressive disorder.  Risk factors: Age, sex, presence of psychiatric illness, family history, isolation from friends, substance abuse Docsity.com Adolescents and Suicide • In 1998, 4,153 young people, ages 15-24, committed suicide in the United States an average of 11.3 per day.1 • Suicide is the third leading cause of death in this age group following unintentional injury and homicide2 • Suicide accounts for 13.5% of all deaths in this age-group1 1 Murphy, SL, 1998 2 The Surgeon General’s Call to Action to Prevent Suicide, 1999 Docsity.com Mortality in Children Ages 1-19 years Suicide Homicide Accidents Cancer Congenital Other Source: CDC Wonder Mortality Statistics; Center for Disease Control and Prevention, 2001 Docsity.com What is Interpersonal Therapy (IPT)? • Short term, usually involves up to 20 sessions • Focuses on 1-2 key interpersonal issues most closely related to the depression. • Interpersonal events include: – interpersonal disputes / conflicts – interpersonal role transitions – complicated grief Docsity.com MH interventions with little or NO evidence of effectiveness for Depression: • Family Therapy* • Relaxation • Self-Control Training • Self-Modeling • Non-directive Supportive Therapy * note: Family Engagement in CBT and IPT, however, has been shown to be important! Docsity.com Practice Elements for Depression • Child Psychoeducation • Cognitive/Coping • Problem Solving • Activity Scheduling • Skill-building/Behavioral Rehearsal • Social Skills Training • Communication Skills • Parent Psychoeducation Docsity.com