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of Contents Co-Occurring Disorders need Co-Occurring Treatment Nationally-known
expert, Dr. Kenneth Minkoff, brought his vision of optimum treatment
for people with dual disorders-mental illness and substance abuse-to
the Glens Falls region. Based on extensive research, his treatment
model is filled with common-sense, integrated approaches to a
complex problem. Dr. Minkoff's presentation was a second in a
series funded by the Office of Mental Health and Community Services.
Participants included representatives from substance abuse, mental
health, social services, probation, education, consumer and family
groups. What happens when a kid's depressed? According to guidelines published by the Journal of American Academy of Child and Adolescent Psychiatry, early diagnosis and treatment can improve the prognosis of depressive disorders in children and adolescents. Since 1950, depression has become more common and is now recognized at increasingly younger ages. Data show that depression is found among 2% to 8 % of adolescents and among 2% of younger children; teenage girls fall within the highest risk. As the rate of depression rises, so does the teen suicide rate. Depressive illness includes a cluster of symptoms over a period of time-changes in weight, sleep patterns, activities, fatigue, scattered concentration, irritability, vague physical complaints. The characteristics of child and adolescent depression vary, but most have additional disorders such as behavioral disorder or substance abuse problems. Depressed youth often have problems at home and, in many cases, the parents are depressed. Episodes of major depression last an average of seven to nine months although as many as 10% may last two years or longer. And, even with effective treatment, depression often returns in about 50% of the patients. Clinicians favor treatment in a "least restrictive setting". Antidepressant SSRI drugs (selective serotonin reuptake inhibitors) are often used in conjunction with therapy. Depression has a wide-ranging impact on a child's social, emotional, intellectual, and interpersonal development and some type of psychotherapy is needed to deal with its effects. One option is cognitive-behavioral therapy, which helps to correct distorted ideas which inhibit growth. Because the risk of recurrent depression remains high even when a child seems better, treatment should continue beyond the signs of improvement. For major depression, Child and Adolescent Psychiatrists recommend continued therapy to help patients and families consolidate the skills they have learned in dealing with the illness. Specific subtypes of depression must be recognized and treated. For example, patients with psychotic or bipolar depression need additional drug therapy. Those whose depression occurs in wintertime only, may benefit from bright-light therapy. For adolescents with milder forms of depression, supportive psychotherapy may be all the treatment that is needed. One study showed that some patients receiving psychotherapy, which consisted largely of support and "active listening" rapidly responded to this therapy. The results suggest that depressed teens with a rapid response to treatment tend to be less depressed to begin with, do better in the long run and have a lower rate of recurrent depression than later responders. Late responders appear to require more extensive treatment. Source: American Association of Child and Adolescent Psychiatry. The guidelines also include posttraumatic stress disorder, obsessive-compulsive disorder, and language and learning disorders. For further information contact the AACAP at www.aacap.org.
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