Therapy for Pediatric Clients with Mood Disorders An African American Child Suffering From Depression

African American Child

BACKGROUND INFORMATION

The client is an 8-year-old African American male who arrives at the ER with his mother. He is exhibiting signs of depression.

· Client complained of feeling “sad”

· Mother reports that teacher said child is withdrawn from peers in class

· Mother notes decreased appetite and occasional periods of irritation

· Client reached all developmental landmarks at appropriate ages

· Physical exam unremarkable

· Laboratory studies WNL

· Child referred to psychiatry for evaluation

MENTAL STATUS EXAM

Alert & oriented X 3, speech clear, coherent, goal directed, spontaneous. Self-reported mood is “sad”. Affect somewhat blunted, but child smiled appropriately at various points throughout the clinical interview. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. Judgment and insight appear to be age-appropriate. He is not endorsing active suicidal ideation, but does admit that he often thinks about himself being dead and what it would be like to be dead.

You administer the Children’s Depression Rating Scale, obtaining a score of 30 (indicating significant depression)

RESOURCES

§ Poznanski, E., & Mokros, H. (1996). Child Depression Rating Scale–Revised. Los Angeles, CA: Western Psychological Services.

Decision Point One

Select what you should do:

Begin Zoloft 25 mg orally dailyhttp://cdnfiles.laureate.net/2dett4d/Walden/NURS/6521/05/mm/decision_trees/week_02/img/pill-red.pngBegin Zoloft 25 mg orally daily

RESULTS OF DECISION POINT ONE

· Client returns to clinic in four weeks

· No change in depressive symptoms at all

Begin Zoloft 25 mg orally daily

Decision Point Two

Select what you should do next:

http://cdnfiles.laureate.net/2dett4d/Walden/NURS/6521/05/mm/decision_trees/week_02/img/pill-red.pngIncrease dose to 37.5 mg orally daily

· Client returns to clinic in four weeks

· Depressive symptoms decrease by 20%. Client reports feeling a little bit better