1
Assessing and Treating Vulnerable Populations for Depressive Disorders
Name
Institution
Course
Date
2
Introduction
Depressive disorders are mental health problems often characterized by consistently depressed
mood and the frequent loss of interest in normal day-to-day activities. A depressed mood often
leads to persistent sadness among patients, and different disorders affect patients. For this patient
medication guide, I aim to explore depressive disorders among children. This condition affects
children's behavior at home, with peers, and in school (Poznanski & Mokros, 1996).
Causes and Symptoms
The following factors often cause depressive disorders among children; first, stressful events
such as changes at home such as parent divorce often increase the risk of children developing
depressive disorders. The environment also plays a critical role in contributing to depressive
disorders among children, as a chaotic and stressful home can put much pressure on a child
(Watanabe et al., 2007). Due to family history, children with family members with a history of
depressive disorders also tend to develop depressive disorders. Finally, children's physical health
is important, as children with severe chronic conditions are more likely to develop depressive
disorders. The symptoms of depressive disorders among children include; Sadness, Crying, Low
energy, Communication problems, Suicidal thoughts, Guilt feeling, and Feelings of hopelessness
(Ghandour et al., 2019).
Diagnosis of depression among children
The first step of diagnosing depressive disorders among children is by conducting a medical
examination to evaluate cognitive processes (American Psychiatric Association, 2013). Lab tests
may also be conducted to assist in ruling out certain disorders. The child's history and
developmental history will be explored to assist in reviewing the kind of environment the child
3
resides in. furthermore, direct conversation with children can include open-ended questions to
analyze their responses. Finally, children's relations with their parents or guardian will also be
explored (Howland, 2008b). Children are considered a vulnerable population due to their high
dependence on adults for basic needs. Therefore, denial of basic needs or abuse from adults could
lead to depression among children. Therefore, most of the time, children would experience
depressive disorders as a result of the actions of an adult, such as a parent or guardian (Howland,
2008a).
Medication Treatment Option
The approved medication for treating children with MDD include; Clomipramine, Fluoxetine,
Sertraline, Escitalopram, and Fluvoxamine (Fava & Papakostas, 2016). The main side effect of
these medications on children is that it increases suicidal thoughts among children. Parents and
guardians are encouraged to closely monitor children taking these medications and seek immediate
assistance from a healthcare professional if they feel the side effects are getting out of hand. The
Food and Drug Administration is responsible for protecting the public by ensuring the safety of
foods and drugs. Fluoxetine, also known as Prozac, is the only antidepressant approved by the
FDA to treat depressive disorders among children (U.S. Food & Drug Administration, n.d.).
Medication Consideration
While diagnosing depressive disorders among children, Lab tests are essential, and healthcare
professionals often monitor elements such as the complete blood count, cholesterol, and calcium
and magnesium levels. Blood tests are vital as doctors use them to check for anemia, calcium, and
vitamin D levels. Other disorders have similar symptoms as depressive disorders; doctors use lab
tests to rule out these disorders. Monitoring lab tests is important because it offers an initial
4
assessment of depressive disorder among children and thus assists in determining possible
treatment. Doctors will therefore monitor lab tests for depressive disorders among children to assist
in gaining an overview of the extent of the disorder and thus understand what treatment would be
recommended.
Special Consideration
a) Legal Consideration
The main legal consideration for medication and treatment of depressive disorders among
children is informed consent. Before administering medication such as Fluoxetine to children
diagnosed with depressive disorders, a healthcare professional must first obtain informed consent
from the legal guardians of the patients. The informed consent should also include a patient
appraisal of the risk/benefit ratio. For instance, even though medications such as Fluoxetine have
side effects, their benefits outweigh the risk. This is why it is FDA approved as a medication for
children with depressive disorders (Lorberg et al., 2019).
b) Ethical Consideration
The ethical consideration in medication for depressive disorders includes voluntary
participation, as children who undergo medication must participate voluntarily. Apart from
informed consent, patients must participate voluntarily, ensuring they are not under duress or
forced to do something they haven't approved. Another ethical consideration for medication for
depressive disorders among children is confidentiality. There is a need to keep medication
information private and only share it with legal guardians and parents. Confidentiality is essential
because it assists in building trust between patients and healthcare professionals. Therefore,
children suffering from depressive disorders can share more valuable and vital information by
5
ensuring confidentiality. Another ethical consideration on medication for depressive disorders is
autonomy. Autonomy allows healthcare providers to educate patients or guardians but is prohibited
from making decisions for the patient (Yasuda et al., 2008).
c) Social determinants of health
The social determinants are factors that people are accustomed to, including the physical
environment, education, and neighborhood. However, children with depressive disorders are
affected by poverty, inadequate access to healthcare, and poor environmental conditions. These
are factors that can lead to depressive disorders among children. Therefore, by maintaining a good
environmental condition, ensuring access to healthcare, and eradicating poverty, children may
begin to overcome depression (Psych Hub, 2020).
Follow up Location
The local healthcare institution is the main place to conduct a follow-up in my community for
further information. Therefore, whenever parents of a child diagnosed with depressive disorder
have inquiries, they can visit the local hospital or book an appointment with the available
healthcare professionals to seek further information (Mullen, 2018).
Prescription writing Examples
A prescription is an instruction written by healthcare professionals that offers a patient
treatment plan. Different types of prescriptions exist, and each offers a different approach while
writing a prescription for a patient (Magellan Health, 2013).
6
a) Simple Prescription
These prescriptions have a single component or products and thus do not require admixture
by a pharmacist. This prescription can be written by first including the patient's name, followed by
the medication and the medication amount prescribed. The simple prescription offers the most
basic format of writing a prescription.
Fig 1. Simple prescription.
b) Complex Prescription
Complex prescriptions are those written for more than one component. The following
information is therefore included when writing a complex prescription; patient name, date of birth,
patient phone number, active drug name, dosage, and direction of usage.
c) In-patient Prescription
This is a medication order used majorly in the hospital setting. These can be drug-specific
forms for patients relocating from one department to another. Writing these prescriptions involves
including a patient's name and medication, as other information is readily available in the hospital
database.
7
Conclusion
Depressive disorders are common among children just as they are in adults. The causes and
symptoms are similar because children are exposed to stressful events such as divorcing parents
or poor living conditions. However, children's environment also plays a critical role in influencing
depressive disorders. For instance, if the child is being bullied in school, they will be depressed.
The diagnosis process for children with depressive disorders primarily includes doctor-patient
interaction, and the healthcare professional might conduct lab tests to rule out certain diagnoses.
The main medication offered to children suffering from depressive disorders is Fluoxetine, an
FDA-approved medication. However, parents and legal guardians have to be aware of the side
effects, and this information must be provided through informed consent, and healthcare
professionals also have to guarantee voluntary participation and autonomy. While offering
medication to patients, healthcare professionals are encouraged to use prescriptions that offer
detailed information on how patients must utilize their medication (Baek et al., 2016).
8
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders
(5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Baek, J. H., Nierenberg, A. A., & Fava, M. (2016). Pharmacological approaches to treatmentresistant depression. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.),
Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 44–47).
Elsevier.
Fava, M., & Papakostas, G. I. (2016). Antidepressants. In T. A. Stern, M. Favo, T. E. Wilens, &
J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and
neurotherapeutics (pp. 27–43). Elsevier.
Ghandour, R. M., Sherman, L. J., Vladutiu, C. J., Ali, M. M., Lynch, S. E., Bitsko, R. H., &
Blumberg, S. J. (2019). Prevalence and treatment of depression, anxiety, and conduct
problems in U.S. children. The Journal of pediatrics, 206, 256–267.
Howland, R. H. (2008a). Sequenced Treatment Alternatives to Relieve Depression (STAR*D).
Part 1: Study design. Journal of Psychosocial Nursing and Mental Health Services, 46(9),
21–24. https://doi.org/10.3928/02793695-20080901-06
Howland, R. H. (2008b). Sequenced Treatment Alternatives to Relieve Depression (STAR*D).
Part 2: Study outcomes. Journal of Psychosocial Nursing and Mental Health Services,
46(10), 21–24. https://doi.org/10.3928/02793695-20081001-05
Lorberg, B., Davico, C., Martsenkovskyi, D., & Vitiello, B. (2019). Principles in using
psychotropic medication in children and adolescents. In J. M. Rey & A. Martin (Eds.),
9
IACAPAP e-textbook of child and adolescent mental health.
https://iacapap.org/_Resources/Persistent/a97650fb538f47bb697c47
873b0e58d493684a07/A.7-Psychopharmacology-2019.1.pdf
Magellan Health. (2013). appropriate use of psychotropic drugs in children and adolescents: A
clinical monograph.
http://www.magellanhealth.com/media/445492/magellanpsychotropicdrugs-0203141.pdf
Mullen, S. (2018). Major depressive disorder in children and adolescents. Mental Health
Clinician, 8(6), 275–283.
Poznanski, E. O., & Mokros, H. B. (1996). Child depression rating scale—Revised. Western
Psychological Services. Rao, U. (2013). Biomarkers in pediatric depression. Depression
& Anxiety, 30(9), 787–791. https://doi.org/10.1002/da.22171
Psych Hub. (2020). Social determinants of health [Video]. YouTube.
https://www.youtube.com/watch?v=17jeXGbKlTQ
U.S. Food & Drug Administration. (n.d.). Fluoxetine (marketed as Prozac) Information.
https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-andproviders/fluoxetine-marketed-prozac-information
Watanabe, N., Hunot, V., Omori, I. M., Churchill, R., & Furukawa, T. A. (2007). Psychotherapy
for depression among children and adolescents: a systematic review. Acta Psychiatrica
Scandinavica, 116(2), 84–95.
Yasuda, S. U., Zhang, L. & Huang, S.-M. (2008). the role of ethnicity in variability in response
to drugs: Focus on clinical pharmacology studies. Clinical Pharmacology & Therapeutics,
10
84(3), 417–423. https://web.archive.org/web/20170809004704/https://www.fda.gov/do
wnloads/Drugs/ScienceResearch/.../UCM085502.pdf
Purchase answer to see full
attachment