Mood Disorders in Youth: Major Depressive, Dysthymic, and Bipolar Disorders, Slides of Public Health

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Mood Disorders

Mood Disorders

• Any disturbance in mood
• Extreme, persistent, or poorly regulated emotional states - Major Depressive Disorder - Dysthymic Disorder - Bipolar Disorder

Prior to 1970’s

• Before 1970's childhood depression was rarely discussed
• Children and depression?
• WHY?

Depression in Children

• One of the most disabling childhood disorders
• Prevalence is increasing and age of onset is decreasing
• Experience and expression changes with age
• Under age 7 tends  diffuse and less easily identified

Developmental Course of MDD

Figure 8.1 Adapted from “Development of Depression from Preadolescence to Young Adulthood: Emerging Gender Differences in a 10-year-Longitudinal Study,” by B. L. Hankin, L. Y. Abramson, T. E. Moffitt, P. A. Silva, R. McGee & K. E. Andell, 1998, Journal of Abnormal Psychology, 107, 128-140. Copyright (c) 1998 by the American Psychological Association. Reprinted by permission of the author. Docsity.com

DSM-IV Criteria A

• depressed mood/sadness most of the day, most days
• diminished interest or pleasure in activities
• changes in appetite or weight
• sleep disturbances
• psychomotor retardation or agitation
• fatigue or loss of energy
• feelings of worthlessness or inappropriate guilt
• difficulty thinking or concentrating
• thoughts of death or suicidal ideation

Criteria E

E. Symptoms are not accounted for by Bereavement; or the bereavement symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation

DSM-IV Criteria A

• depressed mood/sadness most of the day, most days
• diminished interest or pleasure in activities
• changes in appetite or weight
• sleep disturbances
• psychomotor retardation or agitation
• fatigue or loss of energy
• feelings of worthlessness or inappropriate guilt
• difficulty thinking or concentrating
• thoughts of death or suicidal ideation

Dysthymic Disorder

Dysthymic Disorder

• Features:
  • less severe than MDD
  • less anhedonia, social withdrawal, impaired concentration, death thoughts, and physical complaints
  • more constant sadness, self-depreciation, low self-esteem, anxiety, irritability, anger, and temper tantrums
  • “Double depression”

Prevalence & Comorbidity

• 1% of children and 5% of adolescents
• Most common comorbid disorder is MDD

Assessment

Interview

• Interviews
  • Parents, child interviewed separately
• With child, cover
  • General and specific self-reports
  • Discussion of mood and daily activities
  • Suicidal ideation, behavior

Challenges in Assessment

• Younger children cannot describe their emotional experiences
• Caregivers limited reports of younger children’s internal states
• May reflect problems of parent rather than child
• Lack of agreement between children, parents, and teachers on symptoms