Wednesday, April 26, 2023

Pediatric mood disorder

Disorders of mood, also called affective disorders, are common among the general population. Children and adolescents are frequently referred to psychiatric consultation due to mood complaints. Longitudinal studies clearly indicate mood disorders begin early in life, with the majority of first episodes occurring before adulthood (Arch Gen Psychiatry. 2003;60:709-17).

The most common mood disorders in children and adolescents include:
~Major depression.
~Persistent depressive disorder (dysthymia
~Bipolar disorder.
~Disruptive mood dysregulation disorder.
~Premenstrual dysmorphic disorder.
~Mood disorder due to a general medical condition.
~Substance-induced mood disorder.

Mood disorders in children consist of some of the most debilitating categories of emotional and behavioral disturbances in youth, resulting in academic, social, and interpersonal relationship difficulties.

Children show symptoms differently, according to their age and biological makeup. Symptoms also vary according to the type of mood disorder. In preschool children the most common symptoms are as follows: somatic complaints such as headaches and abdominal pains, facial hypomimia, hair-trigger crying, irritability, aggression outbreaks, reduced or increased motor activity, and inappropriate behavior intended to attract the attention of parents or teachers.

When children act out persistently so that it causes serious problems at home, in school, or with peers, they may be diagnosed with Oppositional Defiant Disorder (ODD). ODD usually starts before 8 years of age, but no later than by about 12 years of age.

In elementary school-aged children, the most common symptoms are inattention or lack of concentration, lack of interest in activities previously considered enjoyable, spontaneous manifestations of worry or despair about life, worsening academic performance and provocative or challenging behavior including auto or hetero-aggression.

One diagnosis that presents only in children aged 7-18 is called Disruptive Mood Dysregulation Disorder (DMDD). DMDD is a condition in which a child experiences chronic, severe irritability and anger. Primary symptoms include an irritable mood and temper outbursts. They have had a hard time self-soothing, and trouble adapting to changes without getting upset or losing their temper. As toddlers, they have been strong-willed and difficult to manage. And by grade school age, they are still having tantrums that are no longer developmentally appropriate.

In adolescents, the symptoms just described can be accompanied by apathy, withdrawal, anger, despair, lack of interest, anxiety, low self-esteem, fear of the future and, in the most severe cases, suicidal behavior.
Pediatric mood disorder

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