OT 501 Diagnostics (Major Depressive Disorder)

depressive disorder diagnostic criteria (9)

-depressed mood most of the day (this can look like irritability in children and adolescents because they can't identify depressed mood)

-anhedonia: marked diminished interest or pleasure in activity

-weight loss or gain

-insomnia or hypersomnia

-fatigue or loss of energy (child could be overactivity)

-feelings of worthlessness or guilt

-diminished ability to think/concentrate

- indecisiveness

-recurrent thoughts of suicide

common associated feature for depression in infants/toddlers

failure to thrive, developmental delays, feeding difficulties

common associated feature for depression in school age children

sudden schoolwork problems, aggression, separation anxiety, somatic complaints

common associated feature for depression in adolescents

reckless behavior and excessive emotional dependency

Rule outs for Major Depressive Disorder (4)

MONO/other basic medical conditions, anemia

not effects of substance

not learning problems

not environment problems (ex. spouse passes away)

what percentage of teens will experience a depressive episode?

15-20%

what are gender differences in MDD?

no gender differences before puberty

after puberty girls rate increases dramatically

MDD begins at what age?

any age (highest 25-44)

can MDD have a genetic compenent?

yes, more common in first degree biological relatives

what are causes of MDD?

decreased serotonin neurotransmitters

negative environmental conditions

destructive though pattern

what treatment is used for MDD?

SSRI medications (zoloft, paxil- may have significant side effects)

tricyclics- antidepressants, not very effective w/ kids (block norepinephrine reuptake)

MAO inhibitors- (MOST EFFECTIVE)

CBT (focuses on thoughts behind feelings)

behavioral interventions

MDD can coexist w/ (modifiers)

seasonal patterns...

CBT is best for treating

mild/moderate depression