1. Diagnostic criteria and match it to case study
2. Possible differential diagnosis
3. Developmental considerations (a developmental theory in
children-teens that explains or is interrupted by the disorder)
eg) attachment style, eriksons development
4. Aetiology/Causes: Use the 4Ps (Predisposing, Precipitating,
Perpetuating, and Protective) or the Biopsychosocial model
to case study aetiology/causes of disorder
5. Treatment approach best suited for the case and the disorder,
and take into consideration the SA context, and try to
substantiate your answer.
These are notes from the Child Psychopathology
Textbook by Mash et al. and includes:
Overview of Mood Disorders . . . . 363
Major Depressive Disorder (MDD) . . . 367 (Prevalence Comorbidity
Onset, Course, and Outcome Causes Treatment)
10.4 Persistent Depressive Disorder [P-DD] (Dysthymia) . . . . . . . . .
.375
10.5 Disruptive Mood Dysregulation Disorder
(DMDD) . . . . . . . . . . .377
10.6 Associated Characteristics of Depressive
Disorders . . . . . . .378
10.7 Theories of Depression . . . . . . . . 385
10.8 Causes of Depression . . . . . . . . . 389
10. 9 Treatment of Depression . . . . . .398
10.10 Bipolar Disorder (BP) . . . . . . . . 406 (Prevalence Comorbidity
Onset, Course, and Outcome Causes Treatment)
, 10.3 Major Depressive (12 pages for exam)
Disorder (MDD)
MDD in Children and Adolescents
Five (or more) of the following symptoms have been present during the same 2-
week period and represent a change from previous functioning; at least one of
the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
Emoji Diagnostic Criteria for Major Depressive Disorder
1.1️. Depressed mood MOTD, NED, as indicated by subjective report (e.g., feels sad, empty, hopeless) or
😢
by others (e.g., appears tearful). Note: In children/adolescents, can be irritable mood.
😕 2. Diminished interest/pleasure in all, or almost all, activities MOTD, NED, as indicated by SA/OO
3. Significant weight loss (when not dieting) or weight gain, or change in appetite NED. Note: In children,
⚖️🍽️
consider failure to make expected weight gains.
🛌 4. Insomnia or hypersomnia NED.
🏃♂️ 5. Psychomotor agitation or retardation NED, observable by others (not merely Subjective feelings of
⏳ restlessness or being slowed down).
💤 6. Fatigue or loss of energy NED.
7. Feelings of Worthlessness or excessive/inappropriate Guilt (which may be delusional) NED (not
😔❗
merley self-reproach or guilt about being sick).
🤔 8. Diminished ability to Think/Concentrate or Indecisiveness NED, either by SA/OO
9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan,
💭💔
or a suicide attempt/specific plan for committing suicide.
🚫 (B) Symptoms cause clinically significant distress or impairment in S-O-OTHER-F
💊🩺 (C) Episode is not attributable P-E-S-OR-AMC
🧠❌ (D) Episode is not better explained by schizoaffective disorder, schizophrenia, or other psychotic disorders.
🌀 (E) No history of a manic or hypomanic episode (unless they are substance-induced/medical condition).
Specify if:
Mild: Two symptoms. Moderate: Three symptoms. Moderate-severe: Four or
five symptoms. Severe: Four or five symptoms and with motor agitation.
With anxious distress - With mixed features - With melancholic features-With
atypical features - With catatonia - With seasonal pattern (applies to pattern
of recurrent major depressive episodes) (p. 214
Category Key Points
Prevalence - Annual incidence: 2%-8% of youths (4-18 years) experience MDD.
- Preschool and school-age: 1%-3%
- Adolescence: Prevalence increases 2-3 fold.
- Lifetime prevalence: 11%-20% of youths. (USA) 9.8% South Africa
Developmental Factors - Preschool to elementary: Modest increase in depression due to self-awareness, cognitive
growth, and social pressures.
- Adolescence: Significant rise due to increased performance and social pressures.
Comorbidity - Up to 90% of youths with MDD have at least one other disorder, and 50% have two or
more.
- Common co-occurring disorders: anxiety, (P-DD), conduct problems, ADHD, and SUD.
- Conduct problems (ODD, CD) often linked with irritable mood in MDD.
Onset, Course, and - Onset: Most first depressive episodes occur between ages 13-15.
Outcome - Duration: Average episode lasts 8 months; shorter in community samples (4 months in
childhood, 2 months in adolescence).
- Recurrence: 25% within 1 year, 40% within 2 years, 70% within 5 years.
- Bipolar switch: About one-third of adolescents develop bipolar disorder.