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Chapter 1. Mood Disorders and Suicidal Behavior

Elizabeth B. Weller, M.D.; Roomana M. Sheikh, M.D.; Seth D. Laracy, B.A.; Ronald A. Weller, M.D.
DOI: 10.1176/appi.books.9781585622986.250000

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Excerpt

Treatment of mood disorders and suicidal behavior is complex. It requires knowledge of the proper diagnostic assessment of the disorders and familiarity with the changing concepts and evolving treatment strategies for these conditions. Accurate diagnosis is the key to successful treatment and requires a comprehensive psychiatric diagnostic evaluation, which includes interviews with the child, parents, and collateral informants (e.g., teachers, social services personnel). The psychiatric assessment of depressed and manic children and adolescents is difficult and must be performed by a clinician who pays attention to developmental, environmental, and cultural factors that may affect the patient's clinical presentation.

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Figure 1–1. Texas Children's Medication Algorithm Project (CMAP) algorithm for treatment of children with major depressive disorder.Note. SSRI = selective serotonin reuptake inhibitor; MAOI = monoamine oxidase inhibitor; ECT = electroconvulsive therapy.Source. Adapted from Hughes CW, Emslie GJ, Crismon ML, et al.: "The Texas Children's Medication Algorithm Project: Report of the Texas Consensus Conference Panel on Medication Treatment of Childhood Major Depressive Disorder." Journal of the American Academy of Child and Adolescent Psychiatry 38:1442–1454, 1999. Used with permission.

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