Feb 23, 2024 NURS 6630 Assessing and Treating Vulnerable Populations for Depressive Disorders
NURS 6630 ASSESSING AND TREATING VULNERABLE POPULATIONS FOR DEPRESSIVE DISORDERS
A Sample Answer For the Assignment: NURS 6630 Assessing and Treating Vulnerable Populations for Depressive Disorders
Major Depressive Disorder is a mental health condition that affects millions of people worldwide. Depression can range from mild to severe, and its symptoms can be both acute and chronic. It can affect people of all ages, genders, and backgrounds and can have a significant impact on individuals, families, and society as a whole.
Depression is one of the leading causes of disability worldwide and can increase the risk of other health problems, such as heart disease, diabetes, and substance abuse. Fortunately, depression is a treatable condition, and various therapies, including medication, psychotherapy, and lifestyle changes, can help manage its symptoms.
Depressive Disorder Causes and Symptoms
Depressive disorder, also known as major depressive disorder, is a common mental health condition that is characterized by feelings of sadness, hopelessness, and a loss of interest in activities that were once enjoyable.
There is no single cause of depressive disorder, but it is believed to be a combination of biological, genetic, environmental, and psychological factors (Kakhramonovich, 2022). Some of the biological factors that can contribute to depressive disorder include an imbalance of chemicals in the brain, such as serotonin, norepinephrine, and dopamine.
Struggling to Meet Your Deadline?
Get your assignment on NURS 6630 Assessing and Treating Vulnerable Populations for Depressive Disorders done on time by medical experts. Don’t wait – ORDER NOW!
Meet my deadline
The symptoms of depressive disorder can vary from person to person, but typically include feelings of sadness, hopelessness, and a lack of interest in activities that were once enjoyable. Other common symptoms include fatigue, changes in appetite or sleep patterns, difficulty concentrating, feelings of worthlessness or guilt, and thoughts of suicide or self-harm (Kakhramonovich, 2022). These symptoms can have a significant impact on an individual’s daily life, affecting their ability to work, socialize, and maintain relationships.
Depression in Adolescents
Adolescents are considered a vulnerable population when it comes to the diagnosis of depression because they are in a stage of development where they are undergoing significant changes, physically, emotionally, and mentally. Depression can be difficult to diagnose in adolescents because they may not be able to express their feelings in a way that is easily understood by others.
Additionally, adolescents may not recognize that what they are feeling is depression or may feel embarrassed or ashamed to seek help (Daly, 2022). To diagnose depression in adolescents, mental health professionals typically conduct a thorough assessment that includes a review of the adolescent’s medical history, a physical exam, and a psychological evaluation.
NURS 6630 ASSESSING AND TREATING VULNERABLE POPULATIONS FOR DEPRESSIVE DISORDERS
During the psychological evaluation, the clinician may use various assessment tools, such as self-report questionnaires, interviews, and observation, to evaluate the adolescent’s symptoms and assess the severity of their depression.
The criteria for diagnosing depression in adolescents are similar to those for adults and include a persistent feeling of sadness or emptiness, loss of interest or pleasure in activities, changes in appetite or weight, difficulty sleeping or oversleeping, fatigue, difficulty concentrating, feelings of worthlessness or guilt, and thoughts of death or suicide (Daly, 2022). To be diagnosed with depression, these symptoms must be present for at least two weeks and must significantly impair the adolescent’s ability to function in daily life.
Medication Treatment Options
When it comes to treating depression in adolescents, medication is an option that can be considered after a thorough assessment by a mental health professional. Medications used to treat depression are known as antidepressants and work by changing the levels of certain chemicals in the brain that are responsible for mood regulation.
Antidepressants that have been approved by the FDA for use in adolescents include selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac), sertraline (Zoloft), and escitalopram (Lexapro), as well as serotonin-norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine (Effexor XR) (Park & Zarate, 2019). These medications have been found to be effective in reducing depressive symptoms in adolescents, although they do come with some risks and potential side effects.
One potential risk associated with the use of antidepressants in adolescents is the increased risk of suicidal thoughts and behaviors, particularly during the early stages of treatment. Therefore, it is crucial that adolescents taking antidepressants are closely monitored by their mental health professional and caregivers. Other potential side effects of antidepressants can include weight gain, sleep disturbances, sexual dysfunction, and gastrointestinal problems.
Therapy, lifestyle changes, and support from family and friends should also be a part of the treatment plan. The decision to use medication should be made on a case-by-case basis, weighing the potential benefits against the risks and side effects (Park & Zarate, 2019). Additionally, it is important to involve the adolescent and their family in the decision-making process and to ensure that they have a good understanding of the risks and benefits of medication treatment.
Medication Considerations
When prescribing medication for depression in adolescents, there are several aspects that should be taken into account. These include the severity of the symptoms, the potential benefits and risks of the medication, the patient’s medical history and current medications, and the patient’s personal preferences and beliefs (Park & Zarate, 2019).
Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac), sertraline (Zoloft), and escitalopram (Lexapro) are commonly prescribed antidepressants for adolescents. These medications work by increasing the levels of serotonin in the brain, which can help to regulate mood.
When writing a prescription for an antidepressant medication, it is important to include the following information:
The name of the medication: For example, “Fluoxetine 20 mg tablets.”
The dosage and instructions for use: For example, “Take one tablet by mouth every morning with food.”
The duration of the prescription: For example, “Dispense 30 tablets with one refill, to be taken daily for four weeks.”
Here are three examples of how to write a proper prescription for an antidepressant medication:
Fluoxetine 20 mg tablets: Take one tablet by mouth every morning with food, dispense 30 tablets with one refill, to be taken daily for four weeks
Sertraline 50 mg tablets: Take one tablet by mouth every day, preferably in the morning, dispense 30 tablets with two refills, to be taken daily for six weeks
Escitalopram 10 mg tablets: Take one tablet by mouth every day, with or without food, dispense 30 tablets with one refill, to be taken daily for eight weeks
Importance of Lab Tests
When prescribing medication for depression in adolescents, it is important to monitor their labs and any comorbid medical issues they may have. This is important for several reasons. One reason is that some antidepressant medications can cause liver damage. Therefore, it is important to monitor liver function with regular blood tests.
This is especially important for adolescents who are taking other medications that can also affect the liver. If liver function is impaired, the dosage of the antidepressant may need to be adjusted or the medication may need to be switched to a different one (Oh et al., 2019). Another important lab to monitor is the complete blood count (CBC).
Some antidepressant medications can cause changes in blood cell counts, such as a decrease in white blood cells or platelets. This can increase the risk of infection or bleeding, respectively. Regular CBC monitoring can help catch these changes early and allow for appropriate management.
Special Considerations
Legal considerations refer to the laws and regulations that govern the prescribing of medication for minors. In many cases, parents or legal guardians must provide informed consent before a medication can be prescribed for a minor. It is important to ensure that this consent is fully informed and that the parents or guardians understand the potential risks and benefits of the medication.
Additionally, it is important to be aware of any state or federal laws that govern the prescribing of certain medications to minors (Evans & Erickson, 2019). It is important to consider issues such as autonomy, beneficence, non-maleficence, and justice. Healthcare professionals must ensure that they are acting in the best interests of the adolescent while respecting their autonomy and rights as a patient. Additionally, healthcare professionals must ensure that they are not causing harm to the adolescent and that the medication is being prescribed in a just and equitable manner.
Before prescribing medication in healthcare, it is important to consider their cultural background and beliefs. For example, some cultures may view mental illness differently than others, and may have different beliefs about the effectiveness of medication. Healthcare professionals should work to understand and respect these cultural beliefs, and tailor their treatment approach accordingly.
Adolescents from marginalized communities may face additional barriers to accessing mental health care, including lack of insurance, transportation, and language barriers (Evans & Erickson, 2019). It is important to consider these social determinants of health when prescribing medication for adolescents with depression, and to work to address these barriers in order to ensure that all adolescents have access to appropriate care.
Follow-up
One potential resource is my local community health center. These facilities often provide mental health services for adolescents and may have healthcare professionals on staff who can provide more information about the legal, ethical, cultural, and social considerations involved in prescribing medication for this population (Park & Zarate, 2019).
One may also want to reach out to local mental health advocacy organizations, such as the National Alliance on Mental Illness (NAMI) or Mental Health America. These organizations can provide information and resources related to mental health, including medication options for adolescents with depression.
Conclusion
Prescribing medication for patients with depression necessitates considerations of the legal, ethical, cultural, and social factors that can impact treatment outcomes. By taking these special considerations into account, healthcare professionals can ensure that they are providing the best possible care for their patients.
It is also important to remember that there are resources available in the local community, such as community health centers, mental health advocacy organizations, schools, and healthcare providers, that can provide further information and support related to medication treatment for adolescents with depression. By working together and building a network of support, we can improve outcomes for adolescents with depression and promote mental health and wellbeing for all.
References
Evans, C. R., & Erickson, N. (2019). Intersectionality and depression in adolescence and early adulthood: A MAIHDA analysis of the national longitudinal study of adolescent to adult health, 1995–2008. Social Science & Medicine, 220, 1-11. https://doi.org/10.1016/j.socscimed.2018.10.019
Daly, M. (2022). Prevalence of depression among adolescents in the U.S. from 2009 to 2019: Analysis of trends by sex, race/Ethnicity, and income. Journal of Adolescent Health, 70(3), 496-499. https://doi.org/10.1016/j.jadohealth.2021.08.026
Kakhramonovich, T. P. (2022). Epidemiology of Pysichiatric Disorders. Texas Journal of Medical Science, 12, 102-105. https://doi.org/10.15863/tas.2021.10.102.61
Oh, J., Yun, K., Maoz, U., Kim, T., & Chae, J. (2019). Identifying depression in the national health and nutrition examination survey data using a deep learning algorithm. Journal of Affective Disorders, 257, 623-631. https://doi.org/10.1016/j.jad.2019.06.034
Park, L. T., & Zarate, C. A. (2019). Depression in the primary care setting. New England Journal of Medicine, 380(6), 559-568. https://doi.org/10.1056/nejmcp1712493
Depressive disorders are usually familial recurrent mental conditions associated with increased mortality and morbidity. Timely diagnosis and appropriate treatment have been reported to reduce the impact of the disorder on vulnerable populations with reduced risks of substance abuse, suicide, and persistent depressive disorder later in life (Mullen, 2018).
Evidence-based treatment interventions have been developed comprising both the use of medication and psychotherapy to guide clinicians to improve the outcome of the given population. The purpose of this paper is to provide a patient medication guide for the assessment and management of depressive disorder among the pediatric population.
Causes and Symptoms
Depression can be described as a mood disorder characterized by feelings of sadness, hopelessness, or irritability (Tsehay et al., 2020). Most children develop depressive disorders due to a combination of several factors.
The risk factors are not able to account for depressive disorder independently but contribute to its development. Such risk factors include chronic or severe medical conditions, stressful events at school, at home, or with a friend, growing up in a chaotic or stressful environment, family history, and biochemical imbalances.
Childhood depression is more similar to adult depression in terms of clinical presentation. However, different patients may present different symptoms depending on the level of development of the mood disorder, comorbidities, course of treatment, and outcome (Hetrick et al., 2021).
Despite pediatric patients being unable to verbalize their feeling of depression, some of the common symptoms will include irritability, crankiness, social withdrawal, continuous feeling of hopelessness and sadness, changes in appetite, changes in sleep, concentrating difficulties, fatigue and low energy levels, feeling of worthlessness, and suicidal ideation.
Diagnosis of Depression in Children
Depression is one of the most common mental problems affecting children with approximately 3% of children in the United States dealing with a mood disorder (Tsehay et al., 2020). Children consequently lack the right to autonomous decision making which has made studies on the most effective diagnostic tools limited, for timely diagnosis of this vulnerable population. The diagnosis of childhood depression is thus based on the findings of a comprehensive psychiatric evaluation of the patient conducted by a psychiatrist among other mental health professionals (Vadukapuram et al., 2022).
The comprehensive psychiatric evaluation will also assess the risks or presence of any comorbidities such as anxiety and conduct disorder. Consequently, contextual factors like school problems, family environment, and interpersonal difficulties must also be assessed the role of contributing factors. The administration of questionnaires and interviews with the child’s parents and teacher is crucial for the development of the contextual factors mentioned above. Common screening tools for childhood depression include the Beck Depression Inventory and Patient Health Questionnaire for Children and Adolescents.
Medication Treatment Options
The management of depression in children can be done by either both pharmacotherapy or psychotherapy. The determination of which treatment approach to adopt depends on the diagnostic findings of the mood disorder, as either mild, moderate, or severe. Psychotherapy alone is recommended by most clinical guidelines for the management of the mild depressive disorder in children for at least 1 to 4 weeks (Vadukapuram et al., 2022). The most common psychotherapeutic approaches recommended for children include cognitive behavioral therapy (CBT), interpersonal therapy, dialectical behaviour therapy, and family therapy.
For children with mild to severe depression, the use of psychotherapy together with medication is usually recommended. The choice of which medication to prescribe usually depend on the available evidence, patient characteristics, the severity of depression, comorbidities, and response to reamendment among other factors.
Due to the limited evidence, only a few drugs under selective serotonin reuptake inhibitors (SSRIs) have been approved by the FDA for the management of depression in children including Fluoxetine, Escitalopram, Sertraline, and Fluvoxamine, depending on the pediatric patient’s age group (Lorberg et al., 2019). However, clinicians are advised to ensure that the benefits outweigh the risks of the drug for positive outcomes, given the high risks of suicidality among children on SSRIs. The following table provides the available evidence on antidepressants recommended for children:
Table 1: Antidepressants for Children with Depression
Selective Serotonin Reuptake Inhibitors (SSRIs) Level of EvidenceFDA ApprobationSide EffectsFluoxetineA+ApprovedGI disturbances, insomnia, and headacheEscitalopramAApprovedGI disturbances, nausea, insomnia, and headacheSertralineAApprovedGI disturbances, insomnia, dizziness, and headacheFluvoxamineAApprovedGI disturbances, insomnia, nausea, and headache
Medication Considerations
Due to the high risk of side effects with the use of SSRIs in children, a low starting dose is usually recommended, with an increment of the dose or a change of the drug regimen done only after 4 weeks of treatment (Lorberg et al., 2019). The dose should only be increased with the minimal improvement of the patient’s symptoms.
In case of a lack of response or intolerable side effects, the treatment regimen should be changed. For consideration with the use of specific drugs, fluoxetine is associated with reduced weight gain, while escitalopram and fluvoxamine are discouraged for use by children less than 12 years due to side effects of weight loss and reduced appetite. Sertraline on the other hand should be observed for risks of suicidal ideation.
Medication Monitoring
Therapeutic drug monitoring for children on SSRIs is very crucial to avoid incidences of toxic reactions and adverse events. The FDA recommends clinical monitoring of children on SSRIs at least weekly after initiation of treatment for the first four weeks, then after every two weeks for the following four weeks, then at 12 weeks, then as indicated clinically henceforth (Hetrick et al., 2021).
Monitoring parameters are based on the possible side effects and response to the medication including the risk of suicidal ideation and weight loss among others. The serum concentration of the drug and pulse rate should be closely monitored for patients with comorbid medical conditions like kidney disease.
Special Considerations
The FDA has outlined several special considerations with the use of SSRIs among pediatric patients due to the increased risks of suicidality (Zhou et al., 2020). Legal considerations are associated with the off-label use of SSRIs among patients below the age of 18 years, given their lack of right to consent which has been delegated to their parents or caregivers.
Ethical considerations are associated with the patient’s right to information regarding their short-term and long-term risks and side effects. Since certain cultural factors can also impact the significance of using SSRIs with pediatric patients, genetic testing is necessary for patients who display poor outcomes with the medication. Finally, considering the patient’s social determinants of health such as socioeconomic status is also crucial for prescribing affordable drugs to promote patient compliance.
Follow-up
Pediatric patients on antidepressants are usually required to report back to the clinic after four weeks for follow-up evaluation and adjustment of the treatment regimen. However, to help with the management of childhood depression at home, parents are advised to seek further information from local community resources like mental health hospitals and psychiatric centers (Mullen, 2018).
Additional community resources can be accessed online at home including the National Alliance on Mental Illness, National Suicide Prevention Lifeline, AACAP Resource Centre for Depression and Depression in Children and Adolescents – Facts for Families.
Prescription Writing
Writing a proper prescription for patients with mental disorders is crucial to avoid incidences of medication errors. For instance, the prescriber must countercheck and confirm that all the information in the prescription is accurate including date, name of patient and address, patients age, name of clinician, address and DEA number, drug name strength dosage form, and quantity prescribed, direction for use, refill number and prescriber’s signature (Zhou et al., 2020).
The second way of writing a proper prescription involves the use of computerized provider order entry to reduce the risks of medical errors. The last approach is by avoiding the use of abbreviations which might lead to confusion during administration by the patient or dispensing by the pharmacist.
Examples of Prescriptions
Pediatric Health Centre
Address
Date:6/12/2022
Patients Name: Jack Zadnick
Address:
DOB: Jan 27, 2012
Allergies: NKDA
RX: Fluoxetine 10mg orally every morning for two weeks.
Dispense 14 tabs
Refills: 2 weeks
Prescribers initials and Signature:
Pediatric Health Centre
Address
Date: 8/12/2022
Patients Name: Sharon Mat
Address:
DOB: March 23, 2014
Allergies: NKDA
RX: Sertraline 25 mg orally once every day for 14 days
Dispense 14 tabs
Refills: biweekly
Prescribers initials and Signature.
Assessing and Treating Vulnerable Populations for Depressive Disorders
Major depression is a mental disorder among most of the American population. Depression affects health, wellbeing and quality of life of the patients and their families. Psychiatric practitioners should be competent in the assessment, diagnosis, treatment, monitoring, and evaluation of depression.
They should be able to select evidence-based treatments for vulnerable populations for their recovery and health. Therefore, this essay examines depression among the elderly populations. It focuses on topics such as causes and symptoms, diagnosis, medication treatment options, monitoring and special considerations.
Causes and Symptoms of Depression
Depression among the elderly is attributed to several causes. One of the causes is genetics. An elderly patient born to a family with a history of major depression is at a risk of developing the disorder because of the role of genetics. Chronic illnesses also contribute to the development of major depression. For example, the experiences with health issues such as cancer or chronic obstructive pulmonary disease predispose patients to major depression.
The use of alcohol and other drugs can also cause depression. Substance use and abuse may produce side effects, which include major depression. Traumatic experiences in life also cause major depression. Patients with histories such as loss of a significant other, job, or undergoing challenges such as a divorce also increases the risk of developing major depression.
Imbalances in the neurotransmitters and hormones in the brain also cause major depression. Imbalances in hormones such as acetylcholine and dopamine predispose individuals to major depression (Trenoweth, 2022). Similarly, any disruption in the levels of neurotransmitters such as serotonin and norepinephrine also cause major depression.
The elderly patients suffering from major depression experience several symptoms. One of them is feeling sad in most of the days, nearly every day. They also raise a significant decline in their interest or pleasure nearly every day. The patients also report weight gain from increased appetite or loss because of decline in appetite. They also experience slowed thought processes, fatigue, and feel worthless or guilty almost every day.
The depressed mood makes it hard for them to concentrate or make decisions. In some cases, patients report recurrent suicidal thoughts, attempts, with or without a plan. A comprehensive history taking reveals that the symptoms are not because of a medical condition, medication use or substance abuse (Trenoweth, 2022). In addition, the symptoms affect the normal functioning of the patients in their environments.
Diagnosis
The diagnosis of major depression in the elderly patients require a detailed history taking and physical assessment. History taking provides subjective information about the disorder to the practitioner. The psychiatric nurse asks questions that quantify the existence and severity of a health problem. History taking provides insights into potential causes of major depression such as
Order a similar assignment, and have writers from our team of experts write it for you, guaranteeing you an A
