Assessment of Mood Disorders in Children 7
Running Head: Assessment of Mood Disorders in Children 1
Assessment of Mood Disorders in Children
Author
Date
Assessment of Mood Disorders in Children
Last Name: W Name: J Patient#: W-004523 Date: 10/10/2020 Sex: Male () Female (YES) Allergies: NKA
Accident Related: No Worker Compensation: None Phone No: 765-877-XXX
Vita Sign: Time: 10.00 AM Temp: 97F0 B/P: 110/69mmHg HR: 75 RR: 13 Weight: 160lbs Height: 156cm
Subjective Assessment
Chief Complaint: The child had sleeping issues, impulsiveness, and temper tantrums. The parent revealed that the child is always picking fights at school, and there are times when she would just keep to herself without speaking.
HPI: W.J, who is a thirteen-year-old African-American female child, was brought to the clinic by her parents with several concerns. The parents revealed that she is impulsive and has temper tantrums that have landed her in problems at school. She gets irritated easily and frequently involved in fights with her classmates. They also reported she has low moments where she wants to be left alone, and any company is likely to irritate her. They also discovered her sleeping patterns are disrupted. She exhibits inappropriate behavior and poor judgment.
Past Medical History: The child suffered from anxiety and panic attacks while she was five years. The two conditions were treated through psychotherapy and counseling. The child also experiences occasional migraines, which are treated using ibuprofen.
Family Medical History: The mother reported that she suffered from a persistent depressive disorder. The father has not suffered from any psychological or mood disorders. The parents revealed they have limited knowledge about the medical history of other family members.
Objective Assessment
Skin: the skin was moisturized and supple. There were no rashes, lesions, or cracks observed on the skin
Head: The scalp was clean, and there was even distribution of hair. She refutes having any lumps or deformities on the scalp
Neck: Refutes having swollen lymph nodes. No soreness or itching around the neck.
Resp: Refutes having rhinitis and dyspnea. No coughs, wheezing, or shortness of breath
Cardiovascular: Absence of edema in the lower extremities. No palpitation or chest pains. Denies having edema
Gastrointestinal: No rectal bleeding or pains. She refutes having heartburn, constipation, diarrhea, nausea, dysphagia, and abdominal pains.
Genital/Urinary: No problems at the beginning of urination. No hematuria and dysuria. Refutes having abdominal pains
Musculoskeletal: Denies myalgias and fractures. No pain or tenderness in the neck, shoulders, joints, and the back. Refutes general body weakness. No problem of ambulating
Neurological: No numbness or tingling of extremities. No seizure. She has unusual migraines. Denies having memory loss or paralysis
Diagnosis: Depression
Differential Diagnosis
Bipolar Disorder: It is characterized by unstable moods and frequent mood swings that range from periods of depression and mania (Grunze, 2015). People have low moments that may resemble depression. The patients may feel elated and highly irritable during the manic period. The change in the moods of the patient made the disorder a possibility.
Intermittent explosive disorder: It is a disorder that is characterized by episodes of extreme and unwarranted anger (Kulper et al., 2015). The patients often have outbursts that are unnecessary. The impulsiveness in the child and the frequent unwarranted fights with other pupils could have been a sign of an intermittent explosive disorder.
Insomnia: It is a sleep disorder characterized by problems falling asleep and remaining asleep for a long period (Qaseem et al., 2016). The unpredictable sleeping patterns of the child would have been a sign of insomnia.
Rationale: Depression is common among teenagers with an incidence of 3-5% (Findling et al., 2009). Depression among adolescents is related to poor social relations, decreased performance in school, and increased suicidal thoughts and behavior. Major depressive disorder (MDD) is among the most prevalent psychiatric disorders, with a prevalence of 16.2% in the USA (Fried & Nesse, 2015). Globally, it is a major cause of disability, and it among the top three causes of disease burden in the world (Fried & Nesse, 2015). 20-30% of teenagers with MDD suffer from the abuse of at least one drug (Findling et al., 2009). The symptoms of depression include changes in sleeping and feeding habits, extreme feelings of helplessness, irritability or impulsiveness, poor judgment, problems in concentration, and reckless behavior such as drug abuse, fighting, and gambling.
Plan
List and evaluate the main symptoms exhibited by the patient and rule out any possible mood disorders that do not meet the full diagnosis. Ensure proper and complete diagnosis of the patient to avoid under-diagnosis.
Engage the patient in counseling sessions that will help her to have a better understanding of the condition. It will help the practitioner to identify the causes or triggers of the condition.
Address issues that may be contributing to depression and how to cope with them
Enroll the patient for individual or family therapy to reduce the isolation or stigma issues related to depression. Individual therapy will help the patient to learn coping skills and help her resolve or sort out her feelings and emotions. Family therapy will increase parents’ knowledge about depression and help them learn how to support or encourage the child.
Address the feeling of irritability, anger, and helplessness that the patient may be experiencing. The strategy aims to ensure that the progress of the patient is monitored.
If the moods of the patient do not improve, the practitioners can decide to combine cognitive behavioral therapy with pharmacology to improve the health outcomes.
The patient will be educated on the adverse effects that may arise from the use of various antipsychotics. The parents will also be informed on the various treatment options available for their child;
The practitioner will liaise with the parents and the child to select the best intervention for the child.
If possible, the child may be advised to take some break from school as the practitioners monitor her response to medications and progress.
The parents will be advised to bring the child back after four weeks for further monitoring.
Non-Pharmacologic Treatment
Education on the potential causes of depression
Individual therapy to help the patient acquire coping skills
Cognitive behavioral therapy
Pharmacologic Treatment
Medications
Zoloft: 25mg taken orally daily
Fluoxetine: 20mg daily oral dose
Referrals: Psychotherapist for further guidance and monitoring
Side Effects Explained: ( )Continues Same Medication: ( ) Education: ( ) Verbal () Written Health Education: ( ) Yes ( ) No
Nutrition: Diet: Regular ( ) Diabetic ( ) Calories: ______ Low Fat ( ) Low Cholesterol ( ) Low Salt ( ) Ulcer ( ) Other:______________
Next Appointment: Days: __________ Weeks: __________ Months: __________ PRN__________
Provider: Provider Signature:
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