From the Clinical Knowledge Center

Adolescent Major Depressive Disorder, Deliberate Self-Harm, and Suicide

Among the myriad of adolescent psychiatric issues, major depressive disorder (MDD) and suicide have captured the headlines. In the United States approximately 14% of 15- to 18-year-olds have at least one MDD episode, and depression is the “cardinal risk factor” for suicide in children and adolescents. Deliberate self-harm (DSH) is another issue in this population, and in a recent paper, Madge et al comment: “…in the UK, it [DSH] is one of the top five reasons for acute medical admissions"...

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Compass Questions™

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Responses from Last Compass Questions™

In the 08.12.08 issue of Clinical Compass™, we asked two questions.

Question #1 was "How often do you ask your patients about sleep problems, including insomnia?" and the neuroscienceCME learning community responded:
63% - Very often
24% - Often
12% - Seldom
01% - Never

Question #2 was "How would you rate your knowledge of circadian rhythm sleep disorders?" and the neuroscienceCME learning community responded:
07% - Excellent
31% - Good
43% - Average
19% - Poor

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Follow-Up Sleep News

In the Clinical Compass™ article Insomnia in the News (8.12.08), we mentioned a study by Vgontzas and colleagues that investigated the relationship between low sleep efficiency and high blood pressure.(1) Recently, Susan Redline, MD, MPH, Professor of Medicine and Pediatrics and Director of University Hospitals Sleep Center at Case Western Reserve University in Cleveland, Ohio, investigated a similar link. In a cross-sectional analysis of 238 healthy 13- to 16-year-olds (123 boys and 115 girls), they found that poor sleep quality and a shorter time spent asleep were linked to a higher risk of elevated blood pressure. The odds of elevated blood pressure increased 3.5 times for those teenagers with low sleep efficiency (26% of participants) and 2.5 times for those who slept less than 6.5 hours (11% of participants).(2)

References

1. Vgontzas A, Bixler E, Liao D, et al. Chronic insomnia with objective low sleep efficiency is associated with a high risk for hypertension. Presented at Sleep 2008, The 22nd Annual Meeting of the Associated Professional Sleep Societies, LLC. Baltimore, MD; June 7-12, 2008. Abstract 0685.
2. Javaheri S, Storfer-Isser A, Rosen CL, Redline S. Sleep Quality and Elevated Blood Pressure in Adolescents. Circulation 2008;published online before print August 18. Available at: http://www.ncbi.nlm.nih.gov/pubmed

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New Depression Webcast/Podcast Coming Soon!

Depression as a Mind-Body Disorder in Minority Populations: Special Challenges in Diagnosis and Treatment

Premiere Date: Monday, September 22, 2008
Credit Expiration Date: Tuesday, September 22, 2009

Activity Goal
To enable healthcare providers to gain insight into the specific needs of minorities when they are treated for depression, including such items as diagnosis, screening, compliance,
and stigma.

Learning Objectives
At the end of this CE activity, participants should be able to:

• Identify manifestations of depression in minorities.
• Apply culturally sensitive approaches to involve minority patients in the diagnosis and treatment of depression.
• Create goal-directed therapy plans to treat depression in minority patients.

Credit Information
This CME/CE activity can be used toward mandatory Cultural Competence requirements in states where applicable.

This activity offers CE credit for:

• Physicians (ACCME/AMA PRA Category 1)
• Nurses (CNE)
• Pharmacists (ACPE)
• Psychologists (APA)
• Social Workers (NASW)
• Certified Case Managers (CCMC)

All other clinicians will either receive a CME Attendance Certificate or may choose any of the types of CE credit being offered.

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