Mood and Anxiety Disorders in Children and Adolescents
Mood and Anxiety Disorders in Children and Adolescents
Week 5: Mood and Anxiety Disorders in Children and Adolescents
School and going out with my friends used to be fun, but not anymore. Mom keeps telling me just to go out and have fun, but I don’t see the point of trying. All my friends are better than I am. I keep having these headaches and just feel worthless. I used to get As and Bs in school, but not anymore. I can’t concentrate at school. I would rather be at home sleeping. Mood and Anxiety Disorders in Children and Adolescents
—Madison, age 16
Mood and anxiety disorders can be particularly challenging to address in childhood and adolescence for many reasons. Children may not be able to fully express or understand their feelings and behaviors. Parents may misattribute or not recognize signs and symptoms. The symptoms of disorders also vary when present in children as opposed to adults. The PMHNP needs to know how to diagnose these conditions and must understand the importance of integrating medication management strategies with both individual and family therapy to optimize treatment outcomes.
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Learning Objectives
Students will:
- Explain signs and symptoms of mood and anxiety disorders in children and adolescents
- Explain the pathophysiology of mood and anxiety disorders in children and adolescents
- Explain diagnosis and treatment methods for mood and anxiety disorders in children and adolescents
- Develop patient education materials for mood and anxiety disorders in children and adolescents
Learning Resources
Required Readings (click to expand/reduce)
Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental health. American Psychiatric Association Publishing.
- Chapter 3, “Common Clinical Concerns”
- Chapter 7, “A Brief Version of DSM-5″
- Chapter 8, “A stepwise approach to Differential Diagnosis”
- Chapter 10, “Selected DSM-5 Assessment Measures”
- Chapter 11, “Rating Scales and Alternative Diagnostic Systems”
Shoemaker, S. J., Wolf, M. S., & Brach, C. (2014). The patient education materials assessment tool (PEMAT) and user’s guide. Agency for Healthcare Research and Quality. https://www.ahrq.gov/sites/default/files/publications/files/pemat_guide.pdf Mood and Anxiety Disorders in Children and Adolescents
Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.
- Chapter 60, “Anxiety Disorders”
- Chapter 61, “Obsessive Compulsive Disorder”
- Chapter 62, “Bipolar Disorder in Childhood”
- Chapter 63, “Depressive Disorders in Childhood and Adolescence”
Required Media (click to expand/reduce)
Center for Rural Health. (2020, May 18). Disruptive mood dysregulation disorder & childhood bipolar disorder [Video]. YouTube. https://youtu.be/tSfYXkst1vM
Mood Disorders Association of BC. (2014, November 20). Children in depression [Video]. YouTube. https://youtu.be/Qg-BBKB1nJc
Psych Hub Education. (2020, January 7). LGBTQ youth: Learning to listen. [Video]. YouTube. https://www.youtube.com/watch?v=Wn4AVjMMYX4
Medication Review
Review the FDA-approved use of the following medicines related to treating mood and anxiety disorders in children and adolescents.
| Bipolar depression | Bipolar disorder |
| lurasidone (age 10–17) olanzapine-fluoxetine combination (age 10–17) |
aripiprazole (age 10–17) asenapine (for mania or mixed episodes, age 10–17) lithium (for mania, age 12–17) olanzapine (age 13–17) |
| Generalized anxiety disorder | Depression |
| duloxetine (age 7–17) Mood and Anxiety Disorders in Children and Adolescents | escitalopram (age 12–17) fluoxetine (age 8–17) |
| Obsessive-compulsive disorder |
| clomipramine (age 10–17) fluoxetine (age 7–17) fluvoxamine (age 8–17) sertraline (age 6–17) |
Assignment: Patient Education for Children and Adolescents
Patient education is an effective tool in supporting compliance and treatment for a diagnosis. It is important to consider effective ways to educate patients and their families about a diagnosis—such as coaching, brochures, or videos—and to recognize that the efficacy of any materials may differ based on the needs and learning preferences of a particular patient. Because patients or their families may be overwhelmed with a new diagnosis, it is important that materials provided by the practitioner clearly outline the information that patients need to know.
Photo Credit: Getty Images
For this Assignment, you will pretend that you are a contributing writer to a health blog. You are tasked with explaining important information about an assigned mental health disorder in language appropriate for child/adolescent patients and/or their caregivers.
To Prepare
- By Day 1, your Instructor will assign a mood or anxiety disorder diagnosis for you to use for this Assignment.
- Research signs and symptoms for your diagnosis, pharmacological treatments, nonpharmacological treatments, and appropriate community resources and referrals.
The Assignment
In a 300- to 500-word blog post written for a patient and/or caregiver audience, explain signs and symptoms for your diagnosis, pharmacological treatments, nonpharmacological treatments, and appropriate community resources and referrals.
Although you are not required to respond to colleagues, collegial discussion is welcome. Mood and Anxiety Disorders in Children and Adolescents
Week 5: Mood and Anxiety Disorders in Children and Adolescents
School and going out with my friends used to be fun, but not anymore. Mom keeps telling me just to go out and have fun, but I don’t see the point of trying. All my friends are better than I am. I keep having these headaches and just feel worthless. I used to get As and Bs in school, but not anymore. I can’t concentrate at school. I would rather be at home sleeping.
—Madison, age 16
Mood and anxiety disorders can be particularly challenging to address in childhood and adolescence for many reasons. Children may not be able to fully express or understand their feelings and behaviors. Parents may misattribute or not recognize signs and symptoms. The symptoms of disorders also vary when present in children as opposed to adults. The PMHNP needs to know how to diagnose these conditions and must understand the importance of integrating medication management strategies with both individual and family therapy to optimize treatment outcomes.
Learning Objectives
Students will:
- Explain signs and symptoms of mood and anxiety disorders in children and adolescents
- Explain the pathophysiology of mood and anxiety disorders in children and adolescents
- Explain diagnosis and treatment methods for mood and anxiety disorders in children and adolescents
- Develop patient education materials for mood and anxiety disorders in children and adolescents. Mood and Anxiety Disorders in Children and Adolescents
Learning Resources
Required Readings (click to expand/reduce)
Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental health. American Psychiatric Association Publishing.
- Chapter 3, “Common Clinical Concerns”
- Chapter 7, “A Brief Version of DSM-5″
- Chapter 8, “A stepwise approach to Differential Diagnosis”
- Chapter 10, “Selected DSM-5 Assessment Measures”
- Chapter 11, “Rating Scales and Alternative Diagnostic Systems”
Shoemaker, S. J., Wolf, M. S., & Brach, C. (2014). The patient education materials assessment tool (PEMAT) and user’s guide. Agency for Healthcare Research and Quality. https://www.ahrq.gov/sites/default/files/publications/files/pemat_guide.pdf
Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.
- Chapter 60, “Anxiety Disorders”
- Chapter 61, “Obsessive Compulsive Disorder”
- Chapter 62, “Bipolar Disorder in Childhood”
- Chapter 63, “Depressive Disorders in Childhood and Adolescence”
Required Media (click to expand/reduce)
Center for Rural Health. (2020, May 18). Disruptive mood dysregulation disorder & childhood bipolar disorder [Video]. YouTube. https://youtu.be/tSfYXkst1vM
Mood Disorders Association of BC. (2014, November 20). Children in depression [Video]. YouTube. https://youtu.be/Qg-BBKB1nJc
Psych Hub Education. (2020, January 7). LGBTQ youth: Learning to listen. [Video]. YouTube. https://www.youtube.com/watch?v=Wn4AVjMMYX4 Mood and Anxiety Disorders in Children and Adolescents
Medication Review
Review the FDA-approved use of the following medicines related to treating mood and anxiety disorders in children and adolescents.
| Bipolar depression | Bipolar disorder |
| lurasidone (age 10–17) olanzapine-fluoxetine combination (age 10–17) |
aripiprazole (age 10–17) asenapine (for mania or mixed episodes, age 10–17) lithium (for mania, age 12–17) olanzapine (age 13–17) |
| Generalized anxiety disorder | Depression |
| duloxetine (age 7–17) | escitalopram (age 12–17) fluoxetine (age 8–17) |
| Obsessive-compulsive disorder |
| clomipramine (age 10–17) fluoxetine (age 7–17) fluvoxamine (age 8–17) sertraline (age 6–17) |
Assignment: Patient Education for Children and Adolescents
Patient education is an effective tool in supporting compliance and treatment for a diagnosis. It is important to consider effective ways to educate patients and their families about a diagnosis—such as coaching, brochures, or videos—and to recognize that the efficacy of any materials may differ based on the needs and learning preferences of a particular patient. Because patients or their families may be overwhelmed with a new diagnosis, it is important that materials provided by the practitioner clearly outline the information that patients need to know.
Photo Credit: Getty Images
For this Assignment, you will pretend that you are a contributing writer to a health blog. You are tasked with explaining important information about an assigned mental health disorder in language appropriate for child/adolescent patients and/or their caregivers. Mood and Anxiety Disorders in Children and Adolescents
ORDER A PLAGIARISM-FREE PAPER NOW
To Prepare
- By Day 1, your Instructor will assign a mood or anxiety disorder diagnosis for you to use for this Assignment.
- Research signs and symptoms for your diagnosis, pharmacological treatments, nonpharmacological treatments, and appropriate community resources and referrals.
The Assignment
In a 300- to 500-word blog post written for a patient and/or caregiver audience, explain signs and symptoms for your diagnosis, pharmacological treatments, nonpharmacological treatments, and appropriate community resources and referrals.
Although you are not required to respond to colleagues, collegial discussion is welcome.
A child or adolescent with persistent depressive disorder will experience a depressed or
irritable mood on most days for at least 1 year. The body, emotions, and thoughts of a
child are all affected by the depression. It’s not the same as being gloomy or down in
the dumps. It’s also not an indication of immaturity. It is not something that can be
hoped or commanded away. Children that are depressed are unable to pull themselves
together and improve on their own. Treatment is frequently required.
Symptoms may include the following:
Lasting feelings of sadness
Irritability and aggression
Despair
Helplessness
Low self-esteem
Sleep problems
Changes in appetite and weight
Low energy
Problems focusing
Suicidal thoughts or attempts
Running away or threats of running away from home
Disinterest in normal activities
CAUSES OF PERSISTENT DEPRESSIVE DISORDER:
There is no single cause for persistent depressive disorder. It frequently occurs in the
context of other mental health issues, such as substance misuse or anxiety. There are
unique risk factors for a chronic depressive disorder that include but are not limited to
genetics, epigenetics, prior mental illness, high anxiety states, trauma, life stresses, and
other social health indicators (Patel, & Rose, 2021).
Common risk factors for depression include the following:
Family history of depression
High level of stress
Abuse or neglect
Physical or emotional trauma
Other mental health problems
Loss of a parent, caregiver, or other loved one
Loss of a relationship
Other long-term health problems
Developmental or learning problems
DIAGNOSIS OF PERSISTENT DEPRESSIVE DISORDER IN A CHILDREN AND ADOLESCENTS
This disorder is frequently diagnosed by a mental health professional. A thorough
mental health examination will be performed. F amily members, instructors, and carers
may be consulted. Any psychiatric interview, especially one for diagnostic purposes,
requires a thorough history. The accurate diagnosis is determined by investigating
symptoms, severity, and sequential progression. Symptoms cannot be absent for
greater than 2 months. Mood and Anxiety Disorders in Children and Adolescents
In addition to depressed/irritable mood, at least 1 one of the following symptoms must
be present.
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Poor appetite or overeating
Insomnia or hypersomnia
Low energy/fatigue
Low self-esteem
Poor concentration/decision making
Hopelessness
The symptoms must cause significant distress and impairment in vital areas of
functioning for diagnosis.
TREATMENT OF PERSISTENT DEPRESSIVE DISORDER IN CHILDREN AND ADOLESCENTS
A combination of pharmacotherapy and psychotherapy is more effective than either
treatment independently (Das, Salam, Lassi, Khan, Mahmood, Patel, & Bhutta, 2016). If
antidepressant therapy is indicated, a selective serotonin reuptake inhibitor is the first
line typically given the overall efficacy and tolerability of the class. Cognitive behavioral
therapy and interpersonal therapy are most studied for the treatment of depression.
Treatment will depend on your child’s symptoms, age, and general health. It will also
depend on how severe the condition is. This disorder can be treated.
COMMUNITY RESOURCES FOR PERSISTENT DEPRESSIVE DISORDER IN CHILDREN AND
ADOLESCENTS
1. Your child/adolescent’s care team may include counselors, therapists, social
workers, psychologists, and psychiatrists, depending on their needs and
seriousness of their depression. Mood and Anxiety Disorders in Children and Adolescents
2. Pediatric clinicians may refer patients to outside resources for higher-acuity cases
or those who require more specialized care.
3. Care coordination is the process of organizing patient care activities, which is
often aided by information sharing among doctors participating in a patient’s
care. This ensures that services delivered across locations are well planned.
4. Music, dancing, singing, theater, and visual arts are examples of communitybased creative activities that have a good impact on behavioral changes, selfconfidence, self-esteem, knowledge, and physical exercise.
5. Children and adolescents with complicated and long-term mental health
difficulties benefit from mental health rehabilitation treatments. Inpatient
programs and community teams that provide clinical input to clients in
community-based settings (Dalton-Locke, Marston, McPherson, & Killaspy, 2021).
6. If your child’s depression makes it difficult to succeed in school, special
protections, and accommodations under the Americans with Disabilities Act
(ADA) or Section 504 of the Civil Rights Act may be provided. Discuss how to
obtain more information with your child’s teacher or school principal.
Seek help right away if your child:
Feels extreme depression, fear, anxiety, or anger toward himself or herself or
others
Feels out of control
Hears voices that others don’t hear
Sees things that others don’t see
Can’t sleep or eat for 3 days in a row
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Shows behavior that concerns friends, family, or teachers, and others express
concern about your child’s behavior and ask you to get help
Call 911 if your child has suicidal thoughts, a suicide plan, and the means to carry
out the plan. Mood and Anxiety Disorders in Children and Adolescents
