NURS 6660 Week 8 Assignment Paper

NURS 6660 Week 8 Assignment Paper

NURS 6660 Week 8 Assignment Paper

Diagnosing Pediatric Bipolar Depression Disorder

Among the major presenting symptoms of Bipolar disease, the most common is mood alteration between elation and depressions. Depending on the level of mood elation, this mood can be described as mania or hypomania. The controversy comes in clinically ascertaining the lows of mood, or depression, in children. In all types of bipolar disorders, there are variations in irritability, energization, and education in activity levels. The diagnostic and statistical manual, fifth edition, (DSM-5) requires that a patient have an alteration of mania and depression in the ratio of at least four days and 2 weeks respectively (Goldstein et al., 2020 NURS 6660 Week 8 Assignment Paper). The depressive episode should be characterized by five or more symptoms of mood depression, lack of pressure and interest, significant weight or appetite loss, purposeless movements, loss of energy, worthless feeling, and lack of concentration.

NURS 6660 Week 8 Assignment Paper

Available Literature, Epidemiological Data, and Diagnosis

According to the National Institute of Mental Health (NIMH), the overall prevalence of bipolar disorders is negligible in children and up to three percent in adolescents (Goldstein et al., 2019 NURS 6660 Week 8 Assignment Paper). The NIMH states that bipolar disease usually starts in adolescence and early stages of adulthood. The occurrence of bipolar disorder in preadolescence is implied but the relevant research data is negligible. Therefore, I think this makes the diagnosis of childhood bipolar depression inappropriate. Even though the bipolar disease has a genetic component and can run in some families, I support the idea that diagnosing bipolar depression inappropriate and can lead to overdiagnosis and misleading data.

Goldstein, Post, & Birmaher (2019 NURS 6660 Week 8 Assignment Paper) argue the denial of the presence of bipolar disease in children based on the absence of diagnostically agreed criteria leads to underdiagnosis and prolongation of treatment initiation. In contrary to their opinion, think that overdiagnosis of bipolar depression can happen due to other conditions that mimic depression symptoms in children would lead to overtreatment and subjecting the children to various ‘unnecessary’ medical management associated with antidepressants and bipolar disease medications (Goldstein et al., 2020). In the absence of proper and agreeable diagnostic criteria, the epidemiological data cannot be ascertained. 

Children Mood and Emotional Health and Development

During early childhood, children can understand the causes of emotions and respond to them appropriately. At the preadolescent stage, children can understand and respond appropriately to the emotions of others through empathy. However, there exist temperamental differences regarding responses to emotions and moods in children (Sadock, Sadock, & Ruiz, 2014). Diagnosis of bipolar disease and bipolar depression requires proper psychiatric history and pertinent mental state evaluation. The aforementioned diagnostic criteria for adults include some features that cannot be ascertained in children. For example, evaluation of concentration in younger children requires on-point observation skills. Lack of concentration can be a feature of attention deficit and hyperactivity disorder (ADHD) that is very common in children than adults. Including this feature to judge if the children are candidates of major depressive episodes requires proper elimination of other possibilities.

Children who can respond to external mood stimulus such as bereavement may be labeled as depressed when the external stimulus is not taken into consideration. However, distinguishing between normal bereavement and excess mood depression in children has not been established. The misdiagnosis of depression in ADHD on medication patients can also happen (Sadock et al., 2014 NURS 6660 Week 8 Assignment Paper). Other similar disorders such as Disruptive Mood Dysregulation Disorder (DMDD) may be present in a similar way in children (Cichoń et al., 2020). Alterations in appetite, energy, and interest in children can be results of underlying episodic organic illnesses that cannot be established yet in them. Despite the available set structured diagnostic interview guides for MSE (Sadock, Sadock, & Ruiz, 2014)., implying bipolar depression in a child should be last after elimination of other causes of depression.

At What Stage Should Bipolar Depression be Diagnosed in Children?

The mental growth and development rates vary in children as a result of other external influences including nutritional states, race, and socioeconomic status. This implies that diagnosis of bipolar depression in children can be made difficult by patient characteristics. Children and adolescents have difficulties expressing their emotions verbally. Therefore, it is upon the examiner to interpret the subjective data for diagnosis purposes. Poor interpretation skills may lead to overdiagnosis of bipolar depression by clinicians and overtreatment as mentioned earlier.

Children and adolescents present with emotional lability before the age of ten years. therefore, the DSM-5 only recommended diagnosis of bipolar depression after the age of 10 years. Therefore, bipolar depression can only be implied in the patients who are adolescents who most of the time may not understand their emotions and report subjective data to the clinicians. Relying on the parent’s subjective data about their child for diagnosis also presents a nightmare in the diagnosis process. This is because the parents’ interpretation of the symptoms and behavior of the child may not be based on scientific and psychological knowledge and the frequencies of the symptom’s occurrence may not be accurate.

Conclusion

 The controversial discussion surrounding a conventional diagnosis of bipolar depression in children still hang in the balance. Bipolar disease presentation among adults is straight forwards from the adult’s expressions. However, children’s presentation and biological constitution present a dilemma in the diagnosis of bipolar depression. The basic reasons are that the presentation of labile mood is common in children who are necessarily sick, the developmental stages in the children may limit their capabilities to express their emotions and mood accurately making misdiagnosis possible, and other diseases such as ADHD, Disruptive Mood Dysregulation Disorder (DMDD), and organic illnesses present similarly in children. Therefore, the diagnosis of bipolar depression in children is inappropriate and other possibilities should be considered. NURS 6660 Week 8 Assignment Paper

NURS 6660 Week 8 Assignment Paper References

NURS 6660 Week 8 Assignment Paper Instructions

WEEK 8
THIS IS A DEBATE. I have to argue against it ,Each of you will argue a position against\”
against the issue of diagnosing pediatric bipolar depression disorder. Write “against” in the subject line of your Discussion post.
Based on the position you were assigned, justify whether or not pediatric bipolar depression disorder should be diagnosed• “Bipolar and Related Disorders”
• “Depressive Disorders”
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
• Chapter 31, “Child Psychiatry” (pp. 1226–1253) NURS 6660 Week 8 Assignment PaperStahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.Note: All Stahl resources can be accessed through the Walden Library using the link. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear.

To access information on the following medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.

Zeanah, C. H., Chesher, T., & Boris, N. W. (2016). Practice parameter for the assessment and treatment of children and adolescents with reactive attachment disorder and disinhibited social engagement disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 55(11), 990–103. Retrieved from http://www.jaacap.com/article/S0890-8567(16)31183-2/pdf

Review the following medications: NURS 6660 Week 8 Assignment Paper

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