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Mood Disorders in Children and Adolescents PowerPoint Presentation

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This medical PowerPoint presentation talks about Mood Disorders in Children and Adolescents.

Mood disorders, such as depression and bipolar disorder, can affect children and adolescents just as they can affect adults. These disorders can have a significant impact on a childs emotional, social, and academic development, as well as their overall quality of life.

Depression is one of the most common mood disorders in children and adolescents. Symptoms of depression may include sadness or irritability, loss of interest in activities, changes in appetite and sleep, fatigue or loss of energy, feelings of worthlessness or guilt, difficulty concentrating, and thoughts of death or suicide.

Bipolar disorder is another mood disorder that can affect children and adolescents. This disorder is characterized by episodes of extreme highs (mania or hypomania) and lows (depression). Symptoms of mania may include feeling euphoric or irritable, having increased energy, racing thoughts, decreased need for sleep, reckless behavior, and grandiose ideas. Symptoms of depression in bipolar disorder are similar to those of major depression.

It is important to note that mood disorders in children and adolescents can be difficult to diagnose, as the symptoms may be different from those in adults. In addition, other conditions such as anxiety disorders or attention-deficit/hyperactivity disorder (ADHD) may have similar symptoms.

Treatment for mood disorders in children and adolescents typically involves a combination of therapy and medication. Cognitive-behavioral therapy (CBT) is a common form of therapy that can help children and adolescents identify and change negative thought patterns and behaviors. Medications such as antidepressants and mood stabilizers may also be prescribed, depending on the specific diagnosis.

Early intervention is crucial in managing mood disorders in children and adolescents. If you suspect that your child may be experiencing symptoms of depression or bipolar disorder, it is important to seek professional help from a qualified mental health provider.

Tags : Mood Disorders in Children and Adolescents, depression, bipolar disorder, Pediatrics, Pediatrics PowerPoint presentation

Published on : Apr 03, 2023 | Views : 2118 | Downloads : 2

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Slide 1-

Mood Disorders in Children and Adolescents John Sargent, M.D.
Slide 2-

Learning Objectives: 1) Learn about the signs, symptoms and prevalence of depression and bipolar disorder in children and adolescents. 2) Learn about integrated care for youth with mood disorders.
Slide 3-

Depression affects 3% of children and 6 – 8% of adolescents 2 of 3 depressed teens are girls
Slide 4-

Depression represents a gene – environment interaction
Slide 5-

Family and contextual risk factors influence the occurrence Individual cognitive distortions, global and personal attribution styles and pessimism also increase its likelihood
Slide 6-

Family risk factors include Parental depression Family stressors such as moving, job loss, homelessness and poverty
Slide 7-

Persistent marital or post divorce conflict Persistent parent – child conflict or distrust
Slide 8-

Other factors inciting or exacerbating depression include Parental loss Chronic conflict with a step parent or paramour Family suicidality or family history of completed suicide
Slide 9-

Symptoms of Depression in Children and Adolescents Poor concentration Irritability Experience of boredom Quitting or decreased involvement in activities or relationships
Slide 10-

Further symptoms develop as depression persists Poor school performance Social isolation Family conflict Appetite and sleep changes
Slide 11-

Appetite disorders – substance abuse, eating disorder, cutting among adolescents Hopelessness Acute and chronic suicidal ideation Suicide attempts
Slide 12-

Depression associated with… Child neglect Parental depression or substance abuse
Slide 13-

Significant childhood difference (handicap, illness, learning disability) Domestic violence, marital conflict or persistent post separation parental conflict Other forms of child abuse
Slide 14-

Depression is often co-morbid with other problems Substance Abuse in Adolescents Anxiety and Post Traumatic Stress Disorder Unresolved grief ADHD School failure/learning disability Conduct problems
Slide 15-

Specific risk factors for suicide in depressed teens Obesity Teasing and bullying Previous suicide attempts
Slide 16-

History of childhood maltreatment Access to firearms Fluctuations in developmental maturity
Slide 17-

Concerns about sexual orientation Drug or alcohol intoxication Rejection, shaming failure or argument with important person (attachment figure) Impulsivity
Slide 18-

During the interview the examiner will often note that he/she feels sad while talking with the child
Slide 19-

History should always include… Family status Family stresses and transitions (moving, divorce, death of family member, economic distress/loss of job) History of abuse – physical, sexual, emotional
Slide 20-

Peer Relationships Legal difficulties and sexual activity (for children over age 11) Substance use/abuse School performance
Slide 21-

Previous Psychiatric treatment Family history of psychiatric disorder Suicidal ideation, intent, attempts
Slide 22-

Severity is indicated by… Presence of suicidality Child’s ability to respond to warmth of interviewer Child’s ability to identify strengths and enjoyable experiences The interviewer’s experience of hopelessness and helplessness
Slide 23-

Treatment Approaches Identify suicidality and develop a plan to limit suicidal behavior Build connections and competence
Slide 24-

Involve family in treatment and address family problems especially parental depression
Slide 25-

Identify problems caused by depression and develop methods of separating depression from the person
Slide 26-

Limit substance abuse, treat co-morbid problems and encourage academic success and pro social behaviors and peer relationships
Slide 27-

Use psychopharmacology when needed to facilitate treatment Assist patient and family in deciding on and monitoring psychopharmacology Monitor for switching to mania and for increased suicidal impulses
Slide 28-

It is essential to monitor and support return to normal development in school, with peers and in family during treatment
Slide 29-

Remember 10% of depressed children and adolescents will progress to develop Bipolar Disorder, often these teens have strong family history of Bipolar Disorder
Slide 30-

Be wary of suicidal behavior during treatment, especially at points of conflict and perceived isolation
Slide 31-

Build on unique skills, strengths and talents of both the child and his/her family
Slide 32-

Prepare family and adolescent for the possibility of relapse including identifying early signs warranting return to treatment
Slide 33-

Be aware of the influence of a culture of violence upon child or adolescent behavior
Slide 34-

Bipolar Disorder Alternating periods of depression and mania. Occurs in approximately 0.5-1% of population
Slide 35-

Mania Distinct period of time where child manifests symptoms of mania Grandiosity, expansive mood Pressured speech, flight of ideas Decreased need for sleep
Slide 36-

Engaging in potentially dangerous, risky behaviors, sexual promiscuity, excessive spending, engaging in dubious or risky projects (Impulsivity) Enhanced sense of well-being/perceived productivity
Slide 37-

May include irritability, law breaking, substance abuse, teen pregnancy/paternity and aggressiveness. These symptoms more likely in children with a history of maltreatment.
Slide 38-

Children are more likely to have rapid (hourly to daily) changes in mood. Older adolescents more likely to have classical (adult) mania
Slide 39-

Impulsivity, consequences of risky behavior, intoxication, incarceration and isolation are precursors of suicidal behavior in bipolar youth
Slide 40-

Treatment of bipolar disorders in children and adolescents often extremely challenging
Slide 41-

Family involvement and family stability are essential in effective treatment. Pay attention to the role of poverty, limited access to care and family chaos for child and family
Slide 42-

Family psychoeducation/decreasing family expressed emotion is extremely helpful
Slide 43-

Suicide prevention plan always part of treatment. This includes attention to firearms, planning for impulsivity and rejecting and shaming experiences
Slide 44-

Psychopharmacology may include mood stabilizers, atypical anti- psychotics and often both. Attention to side effects is essential
Slide 45-

Bipolar Disorder Treatment Antimanic psychopharmacology Depakote or Lithuim Atypical antipsychotics Abilify Risperdal 2 drug treatments Limited effectiveness of anticonvulsant drugs Trileptal Topomax Lamictal Neurontin
Slide 46-

Co morbid ADHD, academic and legal problems may complicate situation and must be addressed
Slide 47-

Building self – awareness, self assessment and self management are important
Slide 48-

Parenting Support Parental consistency Reducing negative expressed emotion DBSA – parental support Consistent longitudinal care/crisis plan
Slide 49-

Frequently family psychosocial circumstances complicate treatment and outcome (due to poverty, parental difficulties, single parenthood, lack of insurance and limited access to care)
Slide 50-

In some instances BPD may be comorbid with ADHD. In these cases treat BPD first, and then add ADHD treatment
Slide 51-

In some instances what looks like ADHD evolves into frank BPD. Families often find this diagnostic drift confusing
Slide 52-

These cases are always challenging and always require multidimensional, integrated treatment
Slide 53-

Course may be chronic with intermittent exacerbations and recurrent suicidality
Slide 54-

Development of long term treating relationships and long range treatment plan can be very helpful
Slide 55-

Remember not every child or adolescent who has emotional and behavioral dysregulation has Bipolar Disorder
Slide 56-

There is a group of children who present significant problems especially with affect regulation difficulties, impulse control problems, aggressiveness and poor response to frustration
Slide 57-

Some are experiencing sequellae of abuse and some have incipient personality disorders
Slide 58-

These children’s problems often include explosiveness, a lack of self – control that often requires police involvement and/or psychiatric hospitalization
Slide 59-

These children’s difficulties also often involve juvenile justice, multiple hospitalizations, school failure, expulsions and alternative school placement and polypharmacy
Slide 60-

Outbursts usually occur following frustration, perceived slights or disrespect, often within a context of emotional invalidation and disregard
Slide 61-

These patients require treatment of these problems in addition to psychopharmacology to limit arousal and manage periods of low mood
Slide 62-

A wide range of initial difficulties may lead to this clinical picture Previous significant abuse or maltreatment (may include domestic violence) CPS placement, placement transitions Mental retardation or significant brain injury Parental inconsistency Substance Abuse Marked Attachment Problems
Slide 63-

This is complicated by… Diagnostic confusion Lack of continuity of care Multiple placements
Slide 64-

Reinforcement of aggressive/explosive behavior Lack of effective family involvement Therapeutic inconsistency
Slide 65-

Defining Features Absence of expansive mood and decreased need for sleep Episodes are related to frustration, failure and/or criticism Episodes are generally discrete and goal directed, frequently viewed as defensive reactions
Slide 66-

A variety of diagnosis may be appropriate including PTSD Complex PTSD ODD Conduct Disorder Depression ADHD
Slide 67-

Common features of the children include Poor affect regulation Poor impulse control Poor attachment experiences Limited consideration of consequences of behavior Overall irritable mood
Slide 68-

Important considerations Role of negative coercive interactions Limited involvement in satisfying activities and prosocial peer groups
Slide 69-

Treatment Approaches Limit arousal (psychopharmacology) Improve mood or decrease anxiety with SSRI’s (if warranted) Promote attachment Develop a crisis plan Decrease negative expressed emotion
Slide 70-

Promote satisfying activities and relationships Chart episodes of high arousal, aggressiveness Enhance family relationships/functioning Teach tolerance for frustration
Slide 71-

Observe and alter provocation patterns Teach self – soothing and build social support