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.

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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” Mood and Anxiety Disorders in Children and Adolescents

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

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) quetiapine (age 10–17) risperidone (age 10–17)
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

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.

Week 5: Mood and Anxiety Disorders in Children and Adolescents