By Q. Arokkh. Wilberforce University.
Following are a few signs which may indicate that a child and adolescent psychiatric evaluation will be useful buy accutane 20 mg mastercard. Hyperactivity buy 40mg accutane with amex; fidgeting; constant movement beyond regular playing. Persistent disobedience or aggression (longer than 6 months) and provocative opposition to authority figures. Inability to cope with problems and daily activities. Depression shown by sustained, prolonged negative mood and attitude, often accompanied by poor appetite, difficulty sleeping or thoughts of death. Intense fear of becoming obese with no relationship to actual body weight, purging food or restricting eating. Aggressive or non-aggressive consistent violation of rights of others; opposition to authority, truancy, thefts, or vandalism. Strange thoughts, beliefs, feelings, or unusual behaviors. American Academy of Child & Adolescent PsychiatryWe have 2468 guests and 4 members onlineDetailed information on teen depression - signs, causes, treatment of teenage depression and how to help a depressed teen. Many parents miss the symptoms of teen depression in their own children. Teens who are depressed may seem irritable more than down, which can cause parents to simply write off the symptoms as "normal" adolescent growing pains. As a concerned parent, there are many things you can do to help a depressed teen. There are as many misconceptions about teen depression as there are about teenagers in general. Yes, the teen years are tough, but most teens balance the requisite angst with good friendships, success in school or outside activities, and the development of a strong sense of self. Occasional bad moods or acting out is to be expected, but depression is something different. And although depression is highly treatable, experts say only 20% of depressed teens ever receive help. Unlike adults, who have the ability to seek assistance on their own, teenagers usually must rely on parents, teachers, or other caregivers to recognize their suffering and get them the treatment they need. Teenagers face a host of pressures, from the changes of puberty to questions about who they are and where they fit in. The natural transition from child to adult can also bring parental conflict as teens start to assert their independence. Making things even more complicated, teens with depression do not necessarily appear sad and weepy. As the American Academy of Child and Adolescent Psychiatry notes, "Though depression is more often associated with withdrawal than aggression, its symptoms can include irritability and rage. While some "growing pains" are to be expected as teenagers grapple with the challenges of growing up, dramatic, long-lasting changes in personality, mood, or behavior are red flags of a deeper problem. SIGNS AND SYMPTOMS OF DEPRESSION IN TEENSSadness or hopelessnessIrritability, anger, or hostilityTearfulness or frequent cryingLoss of interest or enjoyment in activitiesChanges in eating and sleeping habitsRestlessness and agitationFeelings of worthlessness and guiltLack of enthusiasm and motivationFatigue or lack of energyDifficulty concentrating and making decisionsDepression in teens can look very different from depression in adults. The following symptoms of depression are more common in teenagers than in their adult counterparts:Irritable or angry mood - As noted above, irritability, rather than sadness, is often the predominant mood in depressed teens. A depressed teenager may be grumpy, hostile, easily frustrated, or prone to angry outbursts.
The conditions and duration of treatment with ziprasidone included open-label and double-blind studies 40mg accutane visa, inpatient and outpatient studies 10 mg accutane otc, and short-term and longer-term exposure. The premarketing development program for intramuscular ziprasidone included 570 patients and/or normal subjects who received one or more injections of ziprasidone. Over 325 of these subjects participated in trials involving the administration of multiple doses. Adverse events during exposure were obtained by collecting voluntarily reported adverse experiences, as well as results of physical examinations, vital signs, weights, laboratory analyses, ECGs, and results of ophthalmologic examinations. Adverse experiences were recorded by clinical investigators using terminology of their own choosing. Consequently, it is not possible to provide a meaningful estimate of the proportion of individuals experiencing adverse events without first grouping similar types of events into a smaller number of standardized event categories. In the tables and tabulations that follow, standard COSTART dictionary terminology has been used to classify reported adverse events. The stated frequencies of adverse events represent the proportion of individuals who experienced, at least once, a treatment-emergent adverse event of the type listed. An event was considered treatment emergent if it occurred for the first time or worsened while receiving therapy following baseline evaluation. The prescriber should be aware that these figures cannot be used to predict the incidence of side effects in the course of usual medical practice where patient characteristics and other factors differ from those which prevailed in the clinical trials. Similarly, the cited frequencies cannot be compared with figures obtained from other clinical investigations involving different treatments, uses, and investigators. The cited figures, however, do provide the prescribing physician with some basis for estimating the relative contribution of drug and non-drug factors to the side effect incidence rate in the population studied. Adverse Findings Observed in Short-Term, Placebo-Controlled Trials with Oral ZiprasidoneThe following findings are based on the short-term placebo-controlled premarketing trials for schizophrenia (a pool of two 6-week, and two 4-week fixed-dose trials) and bipolar mania (a pool of two 3-week flexible-dose trials) in which ziprasidone was administered in doses ranging from 10 to 200 mg/day. Adverse Events Associated with Discontinuation of Treatment in Short-Term, Placebo- Controlled Trials of Oral ZiprasidoneSchizophrenia--Approximately 4. The most common event associated with dropout was rash, including 7 dropouts for rash among ziprasidone patients (1%) compared to no placebo patients (see PRECAUTIONS ). The most common events associated with dropout in the ziprasidone-treated patients were akathisia, anxiety, depression, dizziness, dystonia, rash and vomiting, with 2 dropouts for each of these events among ziprasidone patients (1%) compared to one placebo patient each for dystonia and rash (1%) and no placebo patients for the remaining adverse events. Commonly Observed Adverse Events in Short-Term, Placebo-Controlled Trials--The most commonly observed adverse events associated with the use of ziprasidone (incidence of 5% or greater) and not observed at an equivalent incidence among placebo-treated patients (ziprasidone incidence at least twice that for placebo) are shown in Tables 1 and 2. Table 1: Common Treatment-Emergent Adverse Events Associated with the Use of Ziprasidone in 4- and 6-Week Trials - SCHIZOPHRENIARespiratory Tract InfectionTable 2: Common Treatment-Emergent Adverse Events Associated with the Use of Ziprasidone in 3-Week Trials - BIPOLAR MANIAExtrapyramidal Symptoms*Adverse Events Occurring at an Incidence of 2% or More Among Ziprasidone-Treated Patients in Short-Term, Oral, Placebo-Controlled Trials Table 3 enumerates the incidence, rounded to the nearest percent, of treatment-emergent adverse events that occurred during acute therapy (up to 6 weeks) in predominantly patients with schizophrenia, including only those events that occurred in 2% or more of patients treated with ziprasidone and for which the incidence in patients treated with ziprasidone was greater than the incidence in placebotreated patients. Treatment-Emergent Adverse Event Incidencein Short-Term Placebo-Controlled Trials Body System/Adverse EventExtrapyramidal Syndrome*Table 4 enumerates the incidence, rounded to the nearest percent, of treatment-emergent adverse events that occurred during acute therapy (up to 3 weeks) in patients with bipolar mania, including only those events that occurred in 2% or more of patients treated with ziprasidone and for which the incidence in patients treated with ziprasidone was greater than the incidence in placebo-treated patients. Treatment-Emergent Adverse Event Incidence In Short-Term Oral Placebo-Controlled Trials-BIPOLAR MANIA Explorations for interactions on the basis of gender did not reveal any clinically meaningful differences in the adverse event occurrence on the basis of this demographic factor. Dose Dependency of Adverse Events in Short-Term, Fixed-Dose, Placebo-Controlled TrialsAn analysis for dose response in the schizophrenia 4-study pool revealed an apparent relation of adverse event to dose for the following events: asthenia, postural hypotension, anorexia, dry mouth, increased salivation, arthralgia, anxiety, dizziness, dystonia, hypertonia, somnolence, tremor, rhinitis, rash, and abnormal vision. Extrapyramidal Symptoms (EPS) - The incidence of reported EPS (which included the adverse event terms extrapyramidal syndrome, hypertonia, dystonia, dyskinesia, hypokinesia, tremor, paralysis and twitching) for ziprasidone-treated patients in the short-term, placebo-controlled schizophrenia trials was 14% vs. Objectively collected data from those trials on the Simpson-Angus Rating Scale (for EPS) and the Barnes Akathisia Scale (for akathisia) did not generally show a difference between ziprasidone and placebo. Vital Sign Changes - Ziprasidone is associated with orthostatic hypotension (see PRECAUTIONS ). Weight Gain - The proportions of patients meeting a weight gain criterion of ?-U7% of body weight were compared in a pool of four 4- and 6- week placebo-controlled schizophrenia clinical trials, revealing a statistically significantly greater incidence of weight gain for ziprasidone (10%) compared to placebo (4%). In this set of clinical trials, weight gain was reported as an adverse event in 0.
Psychological abuse of a child is often divided into nine categories:1 quality 40mg accutane. Rejection: to reject a child proven 40 mg accutane, to push him away, to make him feel that he is useless or worthless, to undermine the value of his ideas or feelings, to refuse to help him. Scorn: to demean the child, to ridicule him, to humiliate him, to cause him to be ashamed, to criticize the child, to insult him. Isolation: to physically or socially isolate a child, to limit his opportunities to socialize with others. Corruption or exploitation: to tolerate or encourage inappropriate or deviant behavior, to expose the child to antisocial role-models, to consider the child as a servant, to encourage him or coerce him to participate in sexual activities. The absence of emotional response: to show oneself as inattentive or indifferent towards the child, to ignore his emotional needs, to avoid visual contact, kisses or verbal communication with him, to never congratulate him. Neglect: to ignore the health or educational needs of the child, to refuse or to neglect to apply the required treatment. Exposure to domestic violence: to expose a child to violent words and acts between his parents. A child is sensitive to the feeling, opinions, and actions of his or her parents. Ignoring the child when he or she is in need of comfort. Emotionally abusive parents say things or convey feelings that can hurt a child deeply. Common examples include:Making the child feel unwanted, perhaps by stating or implying that life would be easier without the child. For example, a parent may tell a child, "I wish you were never born. Symptoms of psychological abuse of a child may include:Vague physical complaintsWhile decades ago child sexual abuse was rarely recognized, we now realize as a society that sexual abuse is a huge problem affecting our population. It is estimated that up to one-in-three females and one-in-six men are sexually abused in childhood. In its simplest form, child sexual abuse is any sexual encounter that occurs between a child and an older person (as children cannot legally consent to sexual acts). This abuse may involve contact, like touching or penetration. It also includes non-contact cases, like "flashing" or child pornography. However, in practice there are actually two working definitions of child sexual abuse. One definition of childhood sexual abuse is used by legal professionals while the other is used by clinical professionals, like therapists. In the realm of legal definitions, both civil (child protection) and criminal definitions exist for child sexual abuse. Federally, the definition of child sexual abuse is contained within the Child Abuse Prevention and Treatment Act. Sexual abuse is defined to include: "(A) the employment, use, persuasion, inducement, enticement, or coercion of any child to engage in, or assist any other person to engage in, any sexually explicit conduct or simulation of such conduct for the purpose of producing a visual depiction of such conduct; or(B) the rape, molestation, prostitution, or other form of sexual exploitation of children, or incest with children;... Clinicians, like psychiatrists and psychologists, though judge childhood sexual abuse more on the effect it has on the child and less on a cut-and-dried definition.
Eating disorder specialists see many patients like this and an important part of eating disorders treatment is working on denial and building a relationship in which the patient feels comfortable with talking about the problem cheap 20mg accutane. David: We all hear about the worst cases of anorexia or bulimia purchase 5 mg accutane amex. As far as treatment goes, what should a parent do to help their child? How do you determine if your child just needs weekly therapy, outpatient treatment or inpatient eating disorders treatment? Weltzin: This really depends on the severity of the eating disorder symptoms. Often times, this advice will come from a specialist who has done a referral. The majority of patients can improve in an outpatient setting, especially if they are not severely underweight or if they are not severely depressed or unable to control their eating at all. Patients with anorexia, in general, need inpatient and residential treatment as they tend to be unable to correct their eating without specialized help during meals. Patients with bulimia, or those who binge and purge and are at a normal weight, typically fail at outpatient treatment before a more intense treatment like residential is needed. If there are medical problems, which can be life threatening, then inpatient should be done immediately. David: One of the scariest things for parents, I think, is the idea that their child will either die from an eating disorder or suffer with it for the rest of their lives. Weltzin: It is important to emphasize that the mortality rate for anorexia remains about 10%. People do die from these illness and the majority are not in treatment or have left a treatment program. It is also important that the treatment team includes a physician with some experience in eating disorders, especially their medical complications, a dietitian and therapist. As to the prognosis for eating disorders, only about 1/3 of anorexic patients recover in general. With intensive treatment this percentage can be increased to over 60%. Therefore, treatment can have a great impact on outcome. As for bulimia, often times patients do have relapses, but with treatment these tend to be time limited and do not lead to a severe loss of function. Over 50% of patients with bulimia will have a significant improvement and often recover with treatment. David: When you use the word "recover," can you define that? Weltzin: Recovery, at its best, means healthy nutrition. This can be defined as healthy meal patterns, such as three meals a day, and maintaining a normal weight. What is a normal weight can vary depending on who you are talking to, but generally this is a weight in which there are no physical problems, including a loss of menstrual function, decreased energy, or feeling run down. More important to recovery, however, is the psychological aspects including body image, self acceptance, improved mood, healthy relationship, and function in school and work. If patients are at a healthy weight and able to junction in their lives, this is recovery, even if there may be brief episodes of abnormal eating or distorted thoughts. My daughter is 20 years old and went to Toronto General Hospital Eating Disorders program, but we live 3 hours away and no doctor here seems to understand how serious this can get. Weltzin: Unfortunately, services for these problems cannot be provided in smaller communities.
You can print out this shopping addiction quiz and share the results with your doctor or other mental health professional cheap accutane 10 mg with mastercard. Getting a psychological evaluation is a good first step cheap accutane 20mg line. For treatment of a shopping addiction, therapists use cognitive-behavioral therapy to help the person recognize and change their behaviors. Some compulsive shoppers may learn to limit their shopping and for the most severe patients, the therapist may recommend that someone else control their finances altogether. Antidepressant medication may be considered as a treatment. There are also 12-step programs for support, like Debtors Anonymous and Shopaholics Anonymous. And many compulsive spenders run up of tens of thousands of dollars in bills, so credit counseling is also helpful. In discussing shopping addiction treatment, psychiatrist, Dr. Develop other ways to handle emotionsLearn to ride through urges and preoccupationsDevelop habits in storesAnd keep in mind that while behavior change is clearly crucial to treatment and recovery from a shopping addiction, so is reaching out for help. Robinson, a leading researcher on workaholism, describes some of the differences between simply "working too much" or being a hard worker and workaholic in his book:Hard workers experience their work as a necessary and, at times, fulfilling obligation. Workaholics see their work as a place of safety from the unpredictableness of life and distance from unwanted feelings and/or commitments. Hard workers know when to set limits on their work in order to be fully available and present for their family, friends, and to be able to participate in play. Workaholics allow their work to take top billing over all other areas of their life. Commitments to family, friends, and their children are often made and then broken to meet work demands. Workaholics get an adrenalin rush from meeting impossible demands. The mind of the workaholic continues to grind away about work issues/problems to be fixed. Research shows that the seeds of workaholism are often planted in childhood, resulting in low self-esteem that carries into adulthood. According to Robinson, many workaholics are the children of alcoholics or come from some other type of dysfunctional family, and work addiction is an attempt to control a situation that is not controllable. These children grow up thinking that nothing is ever good enough. Saul, PhD, a psychotherapist in Columbus, Ohio, who frequently counsels workaholics. Chained to the Desk by Bryan Robinson, Family Therapy Networker, July/Aug. Written by Martha Keys Barker, LCSW-CSigns that work holds too much importance for you. When individuals describe themselves as " workaholics," they usually mean that they work hard. Frequently the description is given as a matter of pride. Since our society encourages and rewards workaholic behavior, identifying work addiction is difficult. However, several factors or symptoms help us to distinguish between the hard worker and the workaholic:The workaholic not only works hard but also sets impossibly high standards and is beset by a sense of never being good enough.