The client in our case study is an eight-year-old African-American male who was brought
to the emergency room by his mother due to exhibiting signs of depression. The client
confirmed this by stating he feels “sad”. The mother reports him having a decreased appetite and
being occasional irritated. Also, the mother reports the client’s teacher said he is withdrawn from
other peers his class. The child has reached all developmental landmarks at the appropriate ages.
Physical exam was completed and unremarkable as well as laboratory studies done have been
normal. The client has been referred for a psychiatric eval.
Children and adolescents may find successful treatment using therapy-based approaches
versus medications. Children diagnosed with mild depression may find success with family
support, symptom monitoring, and therapy, while those with moderate-to-severe depression may
be treated with psychotherapy and/or antidepressants (Cheung, Kozloff and Sacks, 2013). As the
provider, we must determine if client has been treated for depression prior to this ER visit. As an
initial step, behavior therapy may be an effective option before pharmacological interventions are
considered. Depending on the severity and treatment history, we may find the best action to be a
combination of therapy and antidepressants. By combining these two options as a treatment
approach, this may be more beneficial for long-term success.
Several studies have shown that long-term treatment can be effective in maintaining
improvement and preventing symptom recurrence in children suffering from depression (Lorberg
et al, 2019). There are some specific patient factors the PMHNP must consider before deciding
to treat the client with antidepressants. Such factors include cultural considerations or beliefs,
economic status, geographical location, family and friend support systems, and ethnicity. The
client’s ethnicity is an important factor that may account for differences in both pharmacokinetic
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