The Epilepsy Foundation is your unwavering ally on your journey with epilepsy and seizures. The Foundation is a communitybased, familyled organization dedicated to. Lower extremity injuries and fractures occur frequently in young children and adolescents. Nurses are often one of the first healthcare providers t. INTRODUCTION. The term autism spectrum disorders ASDs has been used to include the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text. I/5169JFn4EpL.jpg' alt='Differential Diagnosis For Physical Therapists 4Th Edition Pdf' title='Differential Diagnosis For Physical Therapists 4Th Edition Pdf' />Screening adolescents for depression Contemporary Pediatrics. Nec 2014 Pdf. Depressed adolescents experience emotional suffering, problems in daily living and functioning such as impairment in social and interpersonal relationships. Many parents ask their pediatrician about their adolescents moodiness as well as potential misuse of substances. Because depressed adolescents often present with physical complaints, providers are in an important position to help screen and identify depression so that adolescents receive proper assessment and appropriate care. In addition, because adolescents with chronic diseases are at increased risk for developing depressive disorders when compared with the general population, it is particularly important that providers be well informed and use appropriate screening tools for depression. It has been reported that as many as 5. In recognition of the fact that depression goes undetected in many adolescents, organizations such as the American Academy of Pediatrics and the US Preventive Services Task Force USPSTF recommend routine screening for depression in adolescents and having a system in place to handle positive screenings. This article reviews the criteria for adolescent depressive disorders, provides information on depression screening tools that can be used in everyday practice, and concludes with practical considerations in the implementation of screening. Differential diagnosis. Most screening tools focus on severity of depressive symptoms, yielding a continuous score with cutoff values for differentiating youth at risk from those not at risk, rather than on diagnostic criteria for depression. An understanding of the diagnostic criteria, however, can help pediatric primary care providers distinguish between different presentations of depression. Depressive disorders are classified under major depressive disorder, dysthymia, and adjustment disorder with depressed mood in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision DSM IV TR. Major depressive disorder requires the presence of a major depressive episode Table 1. It also includes significant impairment in functioning, which for adolescents includes interference with daily routines, school performance, and social relationships. Dysthymia is characterized by having depressed mood that is generally less severe but lasts longer in duration that is, at least 1 year Table 2. Lastly, although depressive disorders and adjustment disorders overlap in the presentation of depressed mood, adjustment disorders are related to external stressors with symptoms emerging within 3 months of the stressor onset but not persisting longer than 6 months after cessation of the stressor. Irritability has been identified as the most common symptom of depression among adolescents and may be an expression of depressed mood in adolescents. Prevalence. Transient depressive symptoms are common among typically developing adolescents, but adolescents with clinical depression, including major depressive disorder and dysthymia, experience a pervasive unhappy mood that is more severe than the occasional blues. The prevalence of depression increases with age. For example, the rates of major depression in preadolescent children are only 2, but the rates increase 2 to 3 fold by adolescence and into adulthood. Specifically, for adolescents aged 1. The average age for the first onset of depression is between the ages of 1. Many longitudinal studies indicate an extremely high rate of recurrence of depressive episodes, showing that as many as 6. Depressive episodes by age 1. Gender differences and comorbidities. As youth move through puberty and into adolescence the rate for depression increases for both boys and girls, but the rate of rise is more dramatic for girls, resulting in a 2 1 female to male prevalence. Family history of depression, family substance use disorders, and family conflict are important risk factors for youth depression. Depression in adolescence rarely occurs in isolation. Approximately two thirds of adolescents with depression have at least 1 comorbid psychiatric disorder and 1. The most common comorbid disorders in adolescents with major depressive disorder are anxiety disorders and specific phobias. Conduct disorder, dysthymia, attention deficithyperactivity disorder ADHD, and substance use disorders are also common in adolescents with depression. If adolescent depression co occurs with self harm or problematic substance use, providers should consider this a warning sign for increased self harm andor suicide risk. Screening for depression. Given that depression is a widely prevalent but treatable condition among adolescents that creates long term social, emotional, and economic burdens for the individual and the family, screening for depression is essential to ensure accurate diagnosis, follow up, and effective treatment planning. The American Medical Associations Guidelines for Adolescent Preventive Services GAPS and Bright Futures suggest that primary care providers in pediatric settings begin screening for depression at age 1. In addition the USPSTF now recommends depression screening in children and adolescents aged 1. Even seemingly asymptomatic adolescents should be screened because depression may go unrecognized. The most widely used and recommended screening approaches and tools are discussed herein. Physician interviews and forms. GAPS. GAPS provides templates and forms related to child and adolescent preventive services that can be utilized by all providers. Using these forms, providers are able to identify whether an adolescent is at risk for experiencing depression and also to inquire about suicidality. Age specific GAPS forms are available for younger adolescents, middleolder adolescents, and parents, and can be found for free through the main GAPS Web site http www. HEEADSSS. A thorough psychosocial evaluation can yield important information, including the opportunity to gather specific information about depressive symptoms. An example of an evaluative approach that can be used in a pediatric primary care setting is the Home, Education and employment, Eating, Activities with peers, Drugs, Sexual activity, Suicide and depression, and Safety HEEADSSS assessment. This acronym is used to prompt providers to ask adolescents about each of these areas of risk. The symptoms of depression can be subtle depression may be missed if providers do not explicitly ask about depression while under the assumption that adolescents appear to be doing well. Questions about suicidality naturally follow depression specific questions. Providers should keep in mind that a trustworthy relationship with the adolescent is essential for openness and honesty. When using either the GAPS guidelines or the HEEADSSS assessment, an adolescent might endorse having suicidal thoughts. Therefore providers should be ready to address suicidality directly, assess thoroughly for safety, and take action if needed. Questions that may be asked of the adolescent are Have you had thoughts of dying or death Have you harmed yourself and Do you have a plan Asking such questions is essential to clarify the adolescents risk for harm and will assist in developing a safety plan if needed. Questionnaires. There are a variety of options for structured questionnaires that screen for adolescent depressive symptoms, as well as many that screen for general adolescent mental health. I/41vp4kOOIjL.jpg' alt='Differential Diagnosis For Physical Therapists 4Th Edition Pdf' title='Differential Diagnosis For Physical Therapists 4Th Edition Pdf' />Books and Chapters by Myopain Seminars Faculty Books Coedited by Jan Dommerholt Manual Therapy for Musculoskeletal Pain Syndromes. To Touch Or Not To Touch Exploring Touch and Ethics In Psychotherapy And Counseling. Schizoid personality disorder SPD is a personality disorder characterized by a lack of interest in social relationships, a tendency towards a solitary or sheltered. We would like to show you a description here but the site wont allow us. DSM5 What you need to know about the new psychiatric diagnostic criteria. The recent release of the American Psychiatric Associations 5th edition of its. The recent literature on carers burden in mental disorders is reviewed. Families bear the major responsibility for such care. Carers face mental ill health as a.