PATIENT EDUCATION FOR CHILDREN AND ADOLESCENTS NRNP 6665 WEEK 5

PATIENT EDUCATION FOR CHILDREN AND ADOLESCENTS NRNP 6665 WEEK 5

PATIENT EDUCATION FOR CHILDREN AND ADOLESCENTS NRNP 6665 WEEK 5

WEEK 5: AT A GLANCE

MOOD AND ANXIETY DISORDERS IN CHILDREN AND ADOLESCENTS



INTRODUCTION

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

Also Read:

Neurodevelopment Disorders Study Guide NRNP6665 Week 8

Please choose one of these disorders below for week 5 Assignment depending on last name

Group 1. Last name starting with letter A through L

Anxiety Disorder
Disruptive Mood Dysregulation Disorder

Group 2. Last name starting with letter M through Z

Major Depressive Disorder
Bipolar Disorder
Disruptive Mood Dysregulation Disorder
Remember you have to research treatments for children/adolescents with these disorders. In regard to the community resources and referrals, do not just name them, but describe the services they provide.

Points to keep in mind:

You need a title page and a reference page. All assignments should follow APA guidelines. Please refer to your APA manual or the writing center at the university. Points will be deducted automatically for late submissions, unless received prior approval from the professor. Read your Turnitin report and revise your work if needed. Read the assignment instructions and the rubric carefully and ensure you all questions were answered before submitting.

Do not worry if you have more than 500 words.

LEARNING RESOURCES

  • Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental healthLinks to an external site.. 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”Links to an external site.
  • Shoemaker, S. J., Wolf, M. S., & Brach, C. (2014). The patient education materials assessment tool (PEMAT) and user’s guideLinks to an external site.. Agency for Healthcare Research and Quality. https://www.ahrq.gov/sites/default/files/publications/files/pemat_guide.pdfLinks to an external site.
  • 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”

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)

Depression in Children and Adolescents Sample Paper

Depression in children is multifactorial in origin. It results from interactions between both environmental factors and biological vulnerabilities. Heritability is the leading risk factor for mental illness.  The interaction between genes and environmental factors further contributes to this risk. Genes-environmental interaction increases the susceptibility to environmental stress.

Psychosocial factors can also increase the risk of developing depression, such as in the case of stressful life events which precede depressive symptoms in children and adolescents (Bremner et al., 2020). Cognitive factors can also contribute to the development of depression. Depressed children and adolescents have memory and attentional bias. These children tend to recall more negative words.

Also, children who underestimate their competence are more likely to have depressive symptoms. Children who have had depression before are also likely to underestimate their competence. Other factors that may contribute to the development of depression include substance and alcohol abuse, other mental illnesses, and comorbidities such as diabetes, epilepsy, and obesity.

The signs and symptoms of depression in children include pessimism and hopelessness about the future, a lack of interest in activities they previously enjoyed, feeling sad and irritable, criticism of themselves, difficulties in concentration in school, lack of energy, and problems with sleeping. Children may also experience symptoms such as stomach aches and headaches. There can be an increase or decrease in appetite. Weight changes can also be noticed, such as a remarkable weight gain or weight loss when not dieting. As Charles and Fazeli (2017) note, morbid thoughts may progress to suicidal ideations or suicide attempts.

Diagnosis of depression is made with the presence of at least five of the above symptoms with a change in function within 2 weeks. These symptoms should be accompanied by a depressed mood and should not be explained by another medical condition (Forman-Hoffman & Viswanathan, 2018).

Treatment of depression in children and adolescents targets recovery and returning to the premorbid level of functioning. Treatment involves the use of both pharmacological and nonpharmacological methods (Leichsenring et al., 2021).

Pharmacological methods involve the use of antidepressant medications. The most commonly used antidepressants are selective serotonin reuptake inhibitors (SSRIs). These drugs are fluoxetine, citalopram, sertraline, and escitalopram. Fluoxetine and escitalopram are FDA approved for the treatment of depression in children and adolescents (Leichsenring et al., 2021). Children on antidepressants should, however, be monitored for risk of suicide. This is one of the major side effects of antidepressants.

Nonpharmacological methods include the use of psychosocial interventions which involve both the children and the parents. Psychosocial interventions are used in the case of mild to moderate depression. It entails using psychoeducation, including education about illness, nutrition, and the importance of good sleep.

Patients should be encouraged to exercise for at least 30 minutes daily. Cognitive-behavioral therapy is also used to help patients identify cognitive distortions, learn problem-solving skills, and modify behaviors predisposing them to depressive symptoms (Oar et al., 2017). Interpersonal therapy is used to help individuals learn interpersonal problem-solving skills.

Parents should contact a healthcare provider if they observe changes in mood and functioning of the child. Mental health nurses and pediatricians should ensure they promote mental health and increase awareness to decrease the stigma associated with mental illness. Depression in children and adolescents is a treatable condition.

Treatment in an outpatient setting is recommended. Treatment should involve an interprofessional team comprising a mental health nurse, a pediatrician, a psychiatrist, a case manager, and a psychotherapist. In severe cases of depression, the management of patients in an inpatient setting is recommended (Leichsenring et al., 2021).

PATIENT EDUCATION FOR CHILDREN AND ADOLESCENTS NRNP 6665 WEEK 5 References

Bremner, J. D., Moazzami, K., Wittbrodt, M. T., Nye, J. A., Lima, B. B., Gillespie, C. F., Rapaport, M. H., Pearce, B. D., Shah, A. J., & Vaccarino, V. (2020). Diet, Stress and Mental Health. Nutrients, 12(8), 2428. https://doi.org/10.3390/nu12082428

Charles, J., & Fazeli, M. (2017). Depression in children. Australian Family Physician, 46(12), 901–907.

Forman-Hoffman, V. L., & Viswanathan, M. (2018). Screening for Depression in Pediatric Primary Care. Current Psychiatry Reports, 20(8), 62. https://doi.org/10.1007/s11920-018-0926-7

Leichsenring, F., Luyten, P., Abbass, A., Rabung, S., & Steinert, C. (2021). Treatment of depression in children and adolescents. The Lancet. Psychiatry, 8(2), 96–97. https://doi.org/10.1016/S2215-0366(20)30492-2

Oar, E. L., Johnco, C., & Ollendick, T. H. (2017). Cognitive Behavioral Therapy for Anxiety and Depression in Children and Adolescents. The Psychiatric Clinics of North America, 40(4), 661–674. https://doi.org/10.1016/j.psc.2017.08.002

PATIENT EDUCATION FOR CHILDREN AND ADOLESCENTS NRNP 6665 WEEK 5

PATIENT EDUCATION FOR CHILDREN AND ADOLESCENTS NRNP 6665 WEEK 5 Rubric

NRNP_6665_Week5_Assignment_Rubric
NRNP_6665_Week5_Assignment_Rubric
Criteria Ratings Pts

In a 300- to 500-word blog post written for a patient and/or caregiver audience: • Explain signs and symptoms for the assigned diagnosis in children and adolescents.

 
 
 

30 to >26.0 pts

Excellent
The response accurately and concisely explains signs and symptoms of the assigned diagnosis in language and tone that are engaging and appropriate for a patient/ caregiver audience.
 

26 to >23.0 pts

Good
The response accurately explains signs and symptoms of the assigned diagnosis in language and tone appropriate for a patient/ caregiver audience.
 

23 to >20.0 pts

Fair
The response somewhat vaguely or inaccurately explains signs and symptoms of the assigned diagnosis. Language and tone are mostly appropriate for a patient/ caregiver audience.
 

20 to >0 pts

Poor
The response vaguely or inaccurately explains signs and symptoms of the assigned diagnosis. Language and tone are not appropriate for a patient/ caregiver audience. Or the response is missing.
30 pts

· Explain pharmacological and nonpharmacological treatments for children and adolescents with the diagnosis.

 
 
 

30 to >26.0 pts

Excellent
The response accurately and concisely explains pharmacological and nonpharmacological treatments in language and tone that are engaging and appropriate for a patient/ caregiver audience.
 

26 to >23.0 pts

Good
The response accurately explains pharmacological and nonpharmacological treatments in language and tone that are appropriate for a patient/ caregiver audience.
 

23 to >20.0 pts

Fair
The response somewhat vaguely or inaccurately explains pharmacological and nonpharmacological treatments. Language and tone are mostly appropriate for a patient/caregiver audience.
 

20 to >0 pts

Poor
The response vaguely or inaccurately explains pharmacological and non pharmacological treatments. Language and tone are not appropriate for a patient/ caregiver audience. Or the response is missing.
30 pts

· Explain appropriate community resources and referrals for the assigned diagnosis.

 
 
 

25 to >22.0 pts

Excellent
The response accurately and concisely explains appropriate community resources and referrals for the assigned diagnosis in language and tone that are engaging and appropriate for a patient/ caregiver audience.
 

22 to >19.0 pts

Good
The response accurately explains appropriate community resources and referrals for the assigned diagnosis in language and tone that are appropriate for a patient/ caregiver audience.
 

19 to >17.0 pts

Fair
The response somewhat vaguely or inaccurately explains community resources and referrals for the assigned diagnosis. Language and tone are mostly appropriate for a patient/ caregiver audience.
 

17 to >0 pts

Poor
The response vaguely or inaccurately explains community resources and referrals for the assigned diagnosis. Language and tone are not appropriate for a patient/ caregiver audience. Or the response is missing.
25 pts

Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.

 
 
 

5 to >4.0 pts

Excellent
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.
 

4 to >3.5 pts

Good
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive.
 

3.5 to >3.0 pts

Fair
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic.
 

3 to >0 pts

Poor
Paragraphs and sentences follow writing standards for flow, continuity, and clarity <60% of the time. No purpose statement, introduction, or conclusion were provided.
5 pts

Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation

 
 
 

5 to >4.0 pts

Excellent
Uses correct grammar, spelling, and punctuation with no errors
 

4 to >3.5 pts

Good
Contains one or two grammar, spelling, and punctuation errors
 

3.5 to >3.0 pts

Fair
Contains several (three or four) grammar, spelling, and punctuation errors
 

3 to >0 pts

Poor
Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/narrative in-text citations, and reference list.

 
 
 

5 to >4.0 pts

Excellent
Uses correct APA format with no errors
 

4 to >3.5 pts

Good
Contains one or two APA format errors
 

3.5 to >3.0 pts

Fair
Contains several (three or four) APA format errors
 

3 to >0 pts

Poor
Contains many (five or more) APA format errors
5 pts
Total Points: 100
 

Major Depressive Disorder in Children and Adolescents

Major depressive disorder (MDD) is a significant mental illness that affects millions of individuals globally, including children and adolescents (World Health Organization, 2023).

Patients and caregivers need to identify the telltale signs and symptoms of MDD, comprehend the many treatment choices, and be aware of the support systems in their local communities. With the guidance of this post, you should be able to understand MDD and direction to the assistance you require.

Signs and Symptoms

Major Depressive Disorder (MDD) symptoms and signs include persistent sadness, emptiness, and hopelessness (Bains & Abdijadid, 2022). Typical warning signs and symptoms include:

  • A depressed mood is usually characterized by persistent sadness and melancholy for most of the day; in children and adolescents, there is often an aspect of irritability.
  • Loss of interest or pleasure: the individual loses delight in once-enjoyed activities.
  • You may notice significant weight loss or increased changes in hunger and appetite. Children fail to gain weight as expected of their age group.
  • You may notice disturbances in sleep patterns, including difficulty falling asleep or excessive sleeping.
  • Fatigue and lack of energy: Constantly tired and low energy levels.
  • Self-doubt or guilt: Constantly thinking negatively of oneself, they think of themselves as worthless and guilty.
  • Poor concentration and having trouble focusing or making decisions: the adolescent finds it challenging to make even straightforward decisions.
  • You are frequently having thoughts of suicide or death.
  • Psychomotor agitation and retardation: the individual speech gets slowed, their movement decreases, and they have cognitive function that is impaired (Halverson, 2019).

Pharmacological and Nonpharmacological Treatment

MDD is managed through various modalities, from drugs to interventional, psychotherapeutic, and lifestyle modifications. Combination therapy of medications and psychotherapy has been found to work better than the treatments alone. The severe forms of the disorder are best handled using electroconvulsive therapy. The use of medications is crucial in the management of MDD. Commonly prescribed antidepressants include selective serotonin reuptake inhibitors (SSRIs) like fluoxetine and serotonin-norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine (Dwyer & Bloch, 2019). These drugs assist in balancing brain chemistry to lessen depressive symptoms.

Speaking with a healthcare professional is critical to choose the drug and dose that will work best for you. Nonpharmacological therapies can help manage MDD in addition to medication. Psychotherapy, like Cognitive Behavioural treatment (CBT), can help one recognize damaging thought patterns and create coping mechanisms. Regular exercise, such as yoga, walking, or other physical activity, can improve mood and lessen depression symptoms. Building a network of supportive relationships is essential, as is looking for emotional support from friends, family, or support groups.

Community Resources and Referrals

For controlling MDD, having access to comprehensive care and support is essential. Think about the following neighborhood resources:

  • Local mental health organizations offer information, counseling, and support groups for MDD.
  • Support groups: Participating in support groups enables you to interact with people who have gone through similar things, providing mutual understanding and support.
  • Consulting mental health specialists enables individualized care and direction. Examples of such specialists are psychiatrists, psychologists, and counselors.
  • Crisis helplines are available for urgent support during emergencies.

It is essential to be knowledgeable about the presentation of Major Depressive Disorder, understands available treatment options, and be aware of community services. You do not have to deal with MDD alone; asking for expert help and support is a show of might.

References

Bains, N., & Abdijadid, S. (2022). Major depressive disorder. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559078/

Dwyer, J. B., & Bloch, M. H. (2019). Antidepressants for pediatric patients. Current Psychiatry, 18(9), 26–42F. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6738970/

Halverson, J. (2019, March 28). Depression clinical presentation: History, physical examination, major depressive disorder. Medscape.com. https://emedicine.medscape.com/article/286759-clinical

World Health Organization. (2023). Depressive disorder (depression). World Health Organisation. https://www.who.int/news-room/fact-sheets/detail/depression

Also Read: Child and Adolescent Assessment NRNP 6665