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CHYS 2P35 - October 24

6 Pages

Child and Youth Studies
Course Code
Ayda Tekok- Kilic

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CHYS 2P35 MOOD DISORDERS CHAPTER 7 October 24, 2013 Major Depressive Disorder Current statistics Merikangas et al (2010) National Comorbidity Study-Adolescent Supplement (NCS-A): 10,123 adolescents ages 13-18, face to face interviews. Prevalence and demographics and risk factors Diagnosed - Major depressive disorder o Children: 0.4-2.5% o Adolescents: 0.4-8.5% - Dysthymic disorder o Children o Adolescents Sub threshold - 3.7 % - 28% lifetime Risk Factors - female - severity - medical conditions - anxiety - family history Comorbidities - anxiety - disruptive behavioural disorders - eating disorders - substance abuse - ¾ of depressed youth have a history of at least one anxiety disorder - 42% of youth with a first diagnosis of an anxiety disorder developed a second diagnosis of MDD by the one year follow-up Gender - In females o Higher prevalence o Longer episodes o Not related to recurrence - Males and females have different trajectories - May not see the effect of gender in young children SES & Ethnicity - Low SES is a risk factor (not specific for depression) - Epidemiological studies: Anderson and Mayes (2010) - Some main findings: a) High prevalence rate of depression in youth with different ethnic background (US), b) African-American, Asian-American, Latina- American and Native- American c) Gender X Ethnicity d) Differences in groups - Symptom expression - Parenting factors - Genetic make up e) Protective factors - Preservation of ethnic identity and strong social ties - Perceived family and peer support (#1 protective factor in preventing mood disorders) Issues with this type of research - Sampling bias - Participation bias - Use of ethnicity as a categorical variable - Heterogeneity among ethic groups - Studies fail to consider sex X ethnicity - Low SES - Standard research tools Symptoms of Major Depressive Disorder - Depressed mood most of the day - Significant weight loss or gain - Sleep problems psychomotor agitation/retardation - Fatigue, loss of energy - Feelings of worthlessness, guilt - Diminished ability to concentrate - Recurrent thoughts of death, suicidal ideation Dysthmic disorder - Persistent, long-term change in mood - Less intense but more chronic than MDD - Interferes more in a person’s life - Earlier onset than MDD - Can be intermittent - Can lead to psychosocial impairment - Very pessimistic outlook of life - Can predict MDD - Double-depression: both MDD and dysthymia - Depression in childhood and adolescent - Childhood depression has only been consider since 1980s - Concept of “masked depression” o Too ambiguous - Lack of clear diagnostic criteria - Children and youth express their symptoms in a very different way o Still using adult criteria o Developmental differences o Trajectories and sex differences – different trajectories are found in females than in males Symptom expression and development - Are essential symptoms isomorphic across development? (expression is different) - Within individual continuity - Continuity of form - Anhedonia (lack of interest in age appropriate activities): o Children - lack of interest in playing with toys, o Teens – pervasive sense of boredom, o Adults – lack of interest in social intervention Infancy - Lack of interaction with others - Lack of responsiveness - Sad facial expression - Irritability - Feeding and sleep problems - Difficult to make an operational definition - The extreme infant’s dependence on context calls to question whether an intrinsic infant disorder can exist independently of a disordered parent-child relationship - Attachment disorders in infants Childhood/Adolescent - Can be chronic/recurrent - By late adolesc
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