NU-664C-02-23PCS3 FamilyPsychiatric Ment.Hlth I
- My courses
- Week 10: Depression and Somatization Disorders
- Week 10: Group-Facilitated Discussion 1 – Group 1
Week 10: Group-Facilitated Discussion 1 – Group 1
Done: Make forum posts: 1
Value: 100 points
Due: Facilitating group to post by Day 1; all other students post to facilitating group discussion prompt by Day 4 and reply to at least two other peer posts by Day 7
Grading Category: Group Facilitated Discussions
Initial Post: Created by Facilitating Group
This is a student-led discussion.
- Please review the Week 7 Get Started: Group-Facilitated Communication Board and Instructions for assignment guidelines for this discussion to ensure that you have met all the criteria.
- The facilitating group should choose one member from their group who will be responsible for the initial post.
- On Day 1 of this week, the chosen group member will create an initial post that is to include the group’s discussion prompts, resources, and the ins tructions for what your classmates are to do with the resources.
- During this week, each member of your group is to participate in the facilitation of the discussion. This means making certain that everyone is engaged, questions from students are being answered, and the discussion is expanding.
- It is the expectation that the facilitating group will address all initial peer response posts by Day 7.
Reply Posts: Non-Facilitating Students
- If you are not a member of the facilitating group, you are to post a discussion prompt response according to the facilitating group’s instructions by Day 4. Your reply posts should include substantive reflection directed to the presenters.
- You are also expected to respond to at least two other peers’ initial discussion prompt posts.
- Pick out an idea from your peersâ€™ initial post that you find most interesting and tell how you use this information in practice.
Please refer to the Grading Rubric for details on how this activity will be graded. The described expectations meet the passing level of 80%. Students are directed to review the Discussion Grading Rubric for criteria which exceed expectations.
Re: Week 10: Group-Facilitated Discussion 1 – Group 1
by Bhagyshree Brahmbhatt – Tuesday, 4 July 2023, 6:59 PM
1. What are some pharmacological and non-pharmacological evidence-based treatment options for a child or adolescent diagnosed with a depressive disorder?
When it comes to treating children or adolescents with depression, treatment options include psychotherapy and pharmacotherapy. Before choosing the treatment, it is important to assess for â€œthe presence of agitation, psychosis, suicidal and homicidal ideation and behavior, comorbidities, the patientâ€™s age and functioning, the number of previous depressive episodes, response to and adherence with prior treatment and patient and family preferenceâ€, (Bonin & Moreland, 2023). If they have mild depression, they can usually be treated with psychotherapy alone and if symptoms are not improving with six to eight weeks, pharmacotherapy, such as, antidepressant medication can be recommended as an add-on (Moreland & Bonin, 2023). For children and adolescents with moderate to severe depression, a combination treatment of psychotherapy and pharmacotherapy is suggested as an initial treatment. Itâ€™s also known that combination therapy works better than pharmacotherapy and psychotherapy alone (Bonin & Moreland, 2023). In terms of pharmacotherapy, fluoxetine, which is an SSRI, is used as it is the most studied medication in adolescents (Bonin & Moreland, 2023). Sertraline and escitalopram are other alternatives, which can be used as well. For psychotherapy, cognitive behavioral therapy is used (Bonin & Moreland, 2023).
2. What is the FDA black-box warning on antidepressant medications? Does this warning automatically disqualify children and adolescents from being prescribed these medications for depression? Are there any FDA approved medications for depression for the child/adolescent population?
The FDA black-box warning on antidepressant medications is the increased risk of suicide in children and adolescents (Spielmans et al., 2020). The black-box warning has caused much criticism as it has resulted in fewer antidepressant prescriptions for young patients, leading to increased rates of events such as suicide or suicide attempts due to lack of treatment (Spielmans et al., 2020). There are only to medications which the FDA has approved for acute treatment of major depressive disorder in children and adolescents, which are fluoxetine and escitalopram (Wagner, 2022).
3. How does somatization disorder differ from other medical conditions and why is it often challenging to diagnose?
With somatic aymptom disorder, the physical pain and symptoms the individual feels are related to psychological factors and leads them to having excessive thoughts, feelings and behaviors that interferes with their ability to function or maintain relationships (Jones, 2023). These symptoms canâ€™t be traced to a specific physical cause (Jones, 2023). In people who have a somatic symptom and related disorders, medical test results are either normal or donâ€™t explain the personâ€™s symptoms (Jones, 2023). People who have this disorder may have several medical evaluations and tests to be sure that they donâ€™t have another illness (Jones, 2023). They often become very worried about their health because they donâ€™t know whatâ€™s causing their health problems (Jones, 2023). Their symptoms are similar to the symptoms of other illnesses and may last for several years (Jones, 2023).
4. What are some common misconceptions or stigma surrounding somatization disorder and how can providers work to overcome them?
The patients and their families can often arouse negative responses in medical providers and this can make them feel frustrated and angry (Agarwal et al., 2019). There can be beliefs that these patients and families are abusing healthcare resources, wasting the professionalsâ€™ time, and that no intervention will help (Agarwal et al., 2019). There is a fear between the patients and the medical providers dealing with somatic symptom disorder is that they have gotten it wrong and may have missed something. Or providers have them believe or patients assume itâ€™s all in their head when they are not making it up. Experienced clinicians reassure their patients that even though the tests run so far have been normal, it doesnâ€™t necessarily mean that what the patient is experiencing isnâ€™t happening. Itâ€™s important to reassure the patient. This can be done by performing labs to show nothing is going on or show them the number of diagnoses being ruled out. As a healthcare provider, it is important to support and continue to work with the patient to improve functionality and monitor symptoms for any change in quality or quantity warranting further investigation. Medical providers should also express empathy with the shared fear and confusion that inevitably occur with these disorders.
Agarwal, V., Srivastava, C., & Sitholey, P. (2019). Clinical practice guidelines for the management of somatoform disorders in children and adolescents. Indian Journal of Psychiatry, 61(8), 241. https://doi.org/10.4103/psychiatry.indianjpsychiatry_494_18
Bonin, L., & Moreland, C. S. (2023). Overview of prevention and treatment for pediatric depression. UpToDate. https://www.uptodate.com/contents/overview-of-prevention-and-treatment-for-pediatric-depression?search=depression%20treatment%20children&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
Jones, K. B. (2023). Somatic symptom and related disorders. Familydoctor.org. https://familydoctor.org/condition/somatic-symptom-and-related-disorders/
Moreland, C. S., & Bonin, L. (2023). Patient education: Depression treatment options for children and adolescents (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/depression-treatment-options-for-children-and-adolescents-beyond-the-basics
Spielmans, G. I., Spence-Sing, T., & Parry, P. (2020). Duty to warn: antidepressant black box suicidality warning is empirically justified. Frontiers in Psychiatry, 11(18). https://doi.org/10.3389/fpsyt.2020.00018
Wagner, K. D. (2022). Update on depression treatments for youth. Psychiatric Times. https://www.psychiatrictimes.com/view/update-on-depression-treatments-for-youth