WK5 NRNP 6665 ASSIGN

Week 5: Patient Education for Children and Adolescents

College of Nursing-PMHNP, Walden University

NRNP 6665: PMHNP Care Across the Lifespan 1

July 4, 2021

Introduction

Mood disorders in children is one of the most under-diagnosed health or mental

health problems in the U.S and the world at large. Mood disorders that go undiagnosed can put

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kids at risk for other conditions, like disruptive behavior and substance use disorders, that remain

after the mood disorder is treated. Children and teens with a mood disorder don’t always show

the same symptoms as adults. As a result, it might be difficult for parents to notice a problem in

their child, particularly if he or she is unable to verbalize his or her feelings or thoughts.

Disruptive mood dysregulation disorder (DMDD) usually starts in childhood disorder marked by

excessive or severe irritation, anger, and frequent, violent outbursts of temper. For treatment of

DMDD if counseling and parent management training aren't enough to treat DMDD symptoms,

medication may be administered.

Signs and Symptoms of Disruptive Mood Dysregulation Disorder

Disruptive Mood Dysregulation Disorder can lead to persons acting irrationally or

aggressively toward other people, animals, or property. It can include frequent, unexpected

episodes of impulsive or aggressive behavior, as well as verbal outbursts in which the patient

overreacts (Yackey & Stanley, 2019). Disruptive mood dysregulation disorder (DMDD) usually

starts in childhood disorder marked by excessive or severe irritation, anger, and frequent, violent

outbursts of temper. This acute irritation manifests itself in two ways: frequent temper outbursts

and a chronic, irritable mood that is present more or less continuously in between these

outbursts. According to American Psychiatric Association, (2013) a kid must display the

following symptoms to be diagnosed with DMDD:

Temper tantrums that are severe and recurrent: These might be verbal (yelling or screaming)

or behavioral (physical aggression).

Temper outbursts that are out of character for the child's age: Tantrums in children with

DMDD are not as frequent or as severe as you might assume based on their developmental level.

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For example, while it's common for toddlers to kick and scream on the floor, you wouldn't expect

to see this from an 11-year-old.

Outbursts are common: on average, you should expect to observe at least three outbursts per

week.

Parents, family members, instructors, or peers may notice a continuously irritable or angry mood

in between outbursts (Gore et al., 2017).

Pharmacological treatments for Disruptive Mood Dysregulation Disorder

If counseling and parent management training aren't enough to treat DMDD symptoms,

medication may be administered. When medicine appears to be essential, the initial step is

usually to employ stimulants, which can help children manage their impulses, or an

antidepressant with mild side effects, such as SSRIs. Stimulants, antidepressants, and

antipsychotics are the three most prevalent types of medication used to treat DMDD. Stimulants

- Methylphenidate (Ritalin), dextroamphetamine (Dexedrine), and Risperidone are common

stimulant drugs. Prozac, and Clonidine can also be used (Sadock, et al., 2015).

Treatment for a Disruptive Mood Irritability, Temper tantrums, ADHD symptoms, and

Oppositional defiant disorder are all indications of dysregulation disorder, which can be

addressed with therapy, medication, or a combination of both (ODD)

Nonpharmacological Treatments for Disruptive Mood Dysregulation Disorder

Psychotherapy and Behavioral Interventions

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CBT, a sort of psychotherapy, is widely used to teach children how to deal with thoughts and

feelings that make them feel depressed, worried, or irritated. The therapy also teaches strategies

to identify and re-label the mistaken perceptions that contribute to outbursts, as well as coping

skills for moderating anger. Another approach is dialectical behavioral therapy for children

(DBT-C), which teaches children mindfulness, emotional regulation, and how to endure

frustration. Rather than ignoring a kid's emotions, the therapist suppoo0rts them in DBT-C in

order to assist the child acquire skills to regulate them. Parents are taught particular tactics to

utilize while responding to a kid's outbursts in order to prevent reinforcing undesired behavior,

soothe the child, and reinforce positive behavior in parent management training. When a

youngster does not follow instructions, the training emphasizes the necessity of predictability

and the implementation of consistent consequences (American Psychiatric Association, 2013).

Community Resources and Referrals

In your area, reach out to The National Alliance on Mental Illness, the National Federation of

Families for Children's Mental Health, Mental Health America, and other groups may be able to

provide resources and encouragement to parents and caregivers.

There are two phone lines supplied to the patient: 911 for immediate assistance and the Client's

Crisis Line. For mutual and collaborative understanding, medical and therapist reports were

evaluated.

Consult your PCP if necessary, or if you have any questions or concerns concerning the start of

any undesirable or unexpected side effects.

Learn everything you can about the condition. Speak with your child's doctor or a mental health

professional. Inquire about the dangers, benefits, and treatment options available. On the NIMH's

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health issue page regarding DMDD, you can get more information (including the latest news,

videos, and clinical trial information).

Life Help Mental Health Center: The National Helpline for SAMHSA is 1-800-662-HELP (4357) Denton County | Mobile Crisis Outreach Team 800-762-0157

North Texas Crisis Line (includes Mobile Crisis Outreach Team) 866-260-8000 National

Alliance on Mental Illness (NAMI) HelpLine 800-950-NAMI (6264)

Conclusion

Mood disorders in children is one of the most under-diagnosed health or mental

health problems in the U.S and the world at large. Children and teens with a mood disorder don’t

always show the same symptoms as adults. As a result, it might be difficult for parents to notice a

problem in their child, particularly if he or she is unable to verbalize his or her feelings or

thoughts. Disruptive mood dysregulation disorder (DMDD) usually starts in childhood disorder

marked by excessive or severe irritation, anger, and frequent, violent outbursts of temper. For

treatment of DMDD if counseling and parent management training aren't enough to treat DMDD

symptoms, medication may be administered.

Reference

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American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental

Disorders, fifth edition DSM-5 American Psychiatric Association, 2013.

Gore, R., K Chugh, P., D Tripathi, C., Lhamo, Y., & Gautam, S. (2017). Pediatric off-label and

unlicensed drug use and its implications. Current clinical pharmacology, 12(1), 18-25.

Sadock, B.J., Sadock, V.A., & Ruiz, P. (2014). Kaplan and Sadock’s synopsis of psychiatry:

Behavioral sciences/clinical psychiatry (11 th ed.). Philadelphia, PA: Wolters Kluwer.

Yackey, K., & Stanley, R. (2019). Off-Label Prescribing in Children Remains High: A Call for

Prioritized Research. Pediatrics.

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