资源描述：
《een Depression in Primary Care Practical Strategies an：青少年抑郁症的初级保健实践策略》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。
1、TeenDepressioninPrimaryCare: PracticalStrategiesandSolutionsKarenSoren,MD,FAAP,FSAHMDirector,AdolescentMedicine AssociateClinicalProfessorofPediatrics&PublicHealth ColumbiaUniversityMedicalCenterMoiraRynn,MDAssociateProfessorofClinicalPsychiatry DeputyDirectorofResearch NewYorkStatePsychiatricIns
2、titute/ColumbiaUniversity July18,2011Overview–AdolescentDepressionEpidemiologyMorbidityManifestationsinprimarycareDiagnosisofdepressionScreeningfordepressionBarrierstoscreeningandhowprimarycarephysicianscanovercomethesebarriersCase115yearoldgirlpresentsforyearlyphysicalShec/ofatigue,difficultyge
3、ttingupinmorningRecentbreak-upwithboyfriend-thinksaboutitallthetimeStaysaloneinroomwhennotinschoolMotherwantsherincounselingassheis“lazyanddoesnothelparoundthehouse”16yearoldboysentinwithheadachesofincreasingseverity-momwantsCTscanSchoolstressful,gradesslipping,truantRecentlyirritable,hashadalter
4、cationwithteacheratschoolAdmitstodrinkingandmarijuanauseCase2EpidemiologyofAdolescentDepressionPointprevalence2%-8%(maybehigher)Byage18,upto20%ofteenshavehadadepressiveepisodePrevalenceincreasedinteengirlsvsboysIncidenceincreaseswithageMooddisordersaccountformajorityofadolescentsuicides(3rdleadin
5、gcauseofdeathinadolescents)Whydoesdepressionpresentinadolescence?GeneticriskHormonalchangesofpubertySleepdisturbancesDevelopmentalchangesPsychosocialpressures(identity,sexuality,schoolachievementissues)Emotionaland/orphysicaltraumaSubstanceuse/abuseConsequencesofDepressioninAdolescentsSchoolunder
6、achievementandfailurePeerandfamilyrelationshipproblemsLong-termeducationalandsocialdifficultiesSubstanceabuse,antisocialbehavior,high-risksexualbehaviorSubsequentmoodepisodes(20-40%)Suicideattempts,completedsuicide,accidentaldeathsSuicideSuicidalideationcommonamongadolescentsAttemptslesscommonbut
7、significantSelf-harm,cutting-commonbutnotnecessarilyrelatedtosuicidalityCompletedsuicidesrarebutsignificanteventsManifestationsofDepressionInAdolescents(typical)Mood/behavioralchangessuchassadnessandtearfulnessHopeless
