ABSTRACT
Depressive disorders among children and adolescents impact the practice of many providers, in many specialties. These disorders contribute to illness and disability throughout the world, and they are a significant risk factor for suicide. Depression in these age groups can differ from those in adults, and early recognition along with proper treatment can lead to improved outcomes. It is important for clinicians to differentiate depression from other possible diagnoses such as anxiety disorders, attention deficit hyperactivity disorder (ADHD), and other mood disorders. Once the diagnosis of depression is established, the severity should be assessed to determine the most appropriate level of treatment. Outpatient treatment often starts with therapy, and if medications are indicated, the use of selectiveserotonin reuptake inhibitors (SSRIs) tend to be first-line.
Subject(s)
Depressive Disorder , Humans , Adolescent , Child , Depressive Disorder/diagnosis , Depressive Disorder/drug therapy , Depressive Disorder/therapy , Antidepressive Agents/therapeutic use , Selective Serotonin Reuptake Inhibitors/therapeutic useABSTRACT
Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in childhood. Children and adolescents with ADHD are at increased risk for behavioral issues, academic issues, substance abuse issues, and legal problems. Approximately 50% of cases of childhood ADHD will persist into adulthood where it can impact employment, organizational skills, and frustration tolerance. Use of amphetamine and methylphenidate stimulant medications have shown to have the best outcomes, and are considered first line treatments. It is important to monitor stimulant use closely in individuals with substance abuse concerns, however, studies in adolescents with both substance abuse histories and ADHD tend to support their use and benefits. It is important to identify other co-morbid conditions that a patient with ADHD may be struggling with and treat those accordingly. Providers should re-evaluate the symptoms and clinical presentation of patients that show minimal or no improvement with treatment to ensure a proper diagnosis has been made.
Subject(s)
Attention Deficit Disorder with Hyperactivity , Methylphenidate , Humans , Adolescent , Child , Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/drug therapy , Amphetamine , Methylphenidate/therapeutic use , Employment , AttentionABSTRACT
OBJECTIVES: To assess qualitative aspects of long-term care facility (LTCF) preparedness programs and to test the utility of a LTCF pandemic preparedness Tool. DESIGN: A Tool was developed and weighted with input from various subject matter experts. SETTING: LTCFs. PARTICIPANTS: LTCF preparedness programs. INTERVENTIONS: A 61-question Tool was used in facilities. MAIN OUTCOME MEASURES: Prevalence of pandemic preparedness elements was assessed, and total Tool scores were calculated and graphed. RESULTS: The Tool results were used to assess overall preparedness and specific preparedness measures in LTCFs. Results suggested that LTCFs that are engaged in planning are addressing many but not all key plan details. LTCFs scored better on plan elements rated as most important (eg, does the LTCF designate an individual in charge during a disaster?) than on all pooled plan elements. The LTCF preparedness Tool score correlated positively with both facility size and whether the facilities had exercised their plan. CONCLUSIONS: Most LTCFs had developed a number of aspects of a preparedness program, but additional preparedness measures remain to be implemented. The LTCF should focus on the identified key plan elements and exercise their plan before a disaster occurs.