Choose a public health/population health issue that involves child and adolescent health

Answer

Abstract

The rate at which cases of children and adolescents suffering from depressive disorders are being reported is alarming. The causes of the depressions are not accurately known. However, some include; family disagreements, bad memories, and a negative environment. The effects are low academic performances, drug abuse at a tender age, and even death. Despite the enormous number of children suffering from the disorders, very few of them are treated for the disorder. As such, there is a need for the framing of a plan that sensitizes parents on the symptoms of the depressive disorders and the various therapeutic techniques that are can be used to help combat this runaway epidemic. This program includes the incorporation of all the people interested in the well-being of children including; the parents, families, the government, and other key stakeholders. This paper seeks to review the available literature using a meta-synthesis method of the literature review. After the discussion, the various opinions of different scholars will be synthesized with an aim of coming up with a better plan that can be deployed to save the future generation from this unrelenting disorder. The results of the review will be reported and a discussion conducted based on the results. Finally, recommendations will be made on the best method of preventing depressive disorders from affecting children and adolescents.

Depressive Disorders among Children and Adolescents

Introduction

The rate of depression among children and adolescents have been on the rise. However, despite the increasing rates of depressive disorders, the rate of recognition by parents and public healthcare practitioners has been very minimal (1). Specifically, in the view of Merikangas (2), depressive disorders of whatever level and nature affect 2% of the prepubertal children and a 5-8 % of adolescents (3). The clinical spectrum of the depressive disorders has been experienced at different levels. In this regard, the disorders range from the pure sadness’ that is displayed in the faces of those children and adolescents to the major depressive or the bipolar disorders. This topic was selected due to the lack of knowledge from parents on what ails their children and adolescents. This lack of understanding from parents of the symptoms of depressive disorders affecting their children is disadvantageous as the children are not given the necessary therapy that would otherwise control the diseases. The ultimate effect is the low performance in schools, loneliness, and detachment from the other family members, and increased cases of suicide (11). Additionally, according to (15), the causes of the disorders are unknown to most parents, and they cannot, therefore, control them. The following are major types of depressive disorders.

Figure 1: Types of depression.

One in every five children and teens suffers from the effects of mental health problems, and this number keeps growing every single day. According to the estimates of the World Health Organization (WHO), by the year 2020, the neuropsychiatric disorders will increase by a whopping 50 percent compared to other health related diseases (12). This will make the depressive disorders one of the leading five causes of illnesses in children and teens as well as disability and eventually death arising from the suicide cases. The World Health Organization further reports that the causes of the increasing numbers are not well known. However, it is the view of experts that increased stress in children that arises from the nature of their surroundings, and their family histories are the primary cause. Moreover, the effects of the depressive disorders have been reported as drug and substance abuse, failure in academics, involvement in criminal activities, and suicidal cases (14). Surprisingly, despite those alarming figures being reported, less than half of those children and teens undergoing the problems receive treatment (7). Therefore, there is a need for awareness about the symptoms and signs of the depressive disorders and the measures that parents should take in case they notice such signs.

To address this issue of increasing cases of depressive disorders in children, it is critical that an awareness plan be devised with an aim of sensitizing parents, teachers and all community members on the causes, symptoms and effects of the disorders and the methods which they can use to ensure that the lives of the young people ate not jeopardized (16). There is a need for a universal recognition that the issue of mental illnesses is an epidemic that requires the collective efforts of all the members of the community. Specifically, acceding to (19), there is a need for a coordinated plan that puts on board the needs of the children, various agencies, the government, involvement of the local communities and the direct working with their parents and families in general. The framing of a holistic public health plan that provides services and support to all the affected children will help the children live successfully and free of this epidemic that is threatening to compromise the brightness of the future generation (11).

This paper seeks to provide parents and healthcare practitioners with the leading causes of depressive disorders and how they can be prevented. This will be done through a review of the relevant scholarly articles that has been written by various known psychologists and other public care practitioners.  Specifically, it will explore how the disorders such as depression and bipolar develop, how parents can detect them, and the ways of preventing them. Moreover, the signs and symptoms of the disorder will be discussed in detail.  This review of literature will start from an international look at the prevalence of the depressive disorders and the internationally evidence-based causes of the disorders. Then it will narrow down to the United States with an aim of establishing the local causes and effects of the disorders.

Methodology

The review of literature will be done via the use of a Meta-synthesis of the various qualitative data that is relevant to depressive disorders, the causes, effects, and the ways of treating the diseases. A meta-synthesis is a non-statistical technique that involves the integration, evaluation, and interpretation of findings of multiple qualitative research studies. In this regard, it identifies the core elements and themes that are found in almost all the pieces of literature reviewed. Additionally, this method of a literature review may also use the findings from the phenomenological theory of the studies in ethnography and the identification of the themes and key elements, their analysis, and synthesis. The rationale of this analysis and synthesis in this research will be to transform the individual findings from every piece of literature reviewed into new concepts and interpretations that will help solve the existing problem of depressive disorders in children and adolescents.

The choice of a meta-synthesis method of the literature review was informed by the fact that there are a variety of scholarly articles that have addressed the issue of depressive disorders in children and adolescents, US Preventive Services Task Force (17). However, most of these items propose different ways in which the increasing rate of mental illnesses in children and teenagers can be treated and managed. Additionally, others are concerned with the causes and symptoms of the disorders and do not state ways in which the depressive disorders can be treated (10). Therefore, a meta-synthesis will integrate those various methods that have been and advanced by those different authors with the aim of coming up with a common plan that borrows from most of those scholarly articles. This plan would incorporate the ideas as that will be collected from the review of the relevant literature.

The collection of data via the use of the meta-synthesis method is very easy depending on the aim that a researcher has in the compilation of the information. In this regard, the researcher used various search engines such as google and google scholar. Additionally, the researcher visited several websites on health that provided information on depressive disorders. There are several keywords that were used in the search. These include depression, disorders, bipolar, psychotherapy, etc. After the search of the individual words the researcher made a phrase that was entitled “depressive disorders”. After that, the search was narrowed down to depressive disorders in children and adolescents. Afterward, there were several scholarly articles that popped out and those who offered valuable information on this topic. However, some of them were not relevant and were thereby discarded. All critical documents and reports were looked at in a very keen manner to establish what they were talking about and the relevance or otherwise of their contents.

As mentioned in the outgoing paragraph, the search brought about articles that were both relevant and irrelevant to the subject matter of this study, therefore, it was critical for the researcher to sieve and only concentrate on those articles that could succinctly address the causes, effects and preventive measures of depressive disorders in children and adolescents. In this regard, after the search and finding of the article, the abstract was critically evaluated with an aim of establishing the summary of the whole content of the book. The quality of the information was also assessed by checking on whether the article was peer-reviewed or not. Additionally, the number of times that the article was quoted by other scholars was also another method that was deployed in the process of ascertaining their quality.

A meta-synthesis technique of the review of the literature has various advantages that are brought about by the use of it. Specifically, the method is advantageous as it first appreciates the efforts that have been made by the previous authors in a particular area of study. This is done through the analysis of the relevant literature that has been written in this area. This is necessary for the study as it shows that the researcher has made steps to ensure most of the articles written on the subject matter are reviewed and critically discussed. The second advantage lies in the ability of the literature review method to synthesize all the information that is collected through the various articles that have been looked at in detail. This synthesis produces a masterpiece as it is a collective view of all the opinions that have been adduced by different authors in different times of their history. However, it also contains a disadvantage. Specifically, it is focused on critiquing the available literature and not necessarily appreciating other authors.

Results

From the search of the various words and phrases in the various search engines, several results were obtained. In this regard, it was found that depressive disorders in children are prevalent, though, they are not adequately treated. The World over, in the view of Wijlaars (19), the rate at which children and adolescents have various depressive disorders is increasing at an alarming rate. Currently, WHO reports that one in every five children has a depressive disorder either inform of sadness or bipolar which is at an advanced stage. Additionally, by the end of 2020, it is predicted that the number of these children and teens that will have a form of depressive disorder will have increased by 50 percent which will be an epidemic (6). Moreover, depressive disorders will be among the top five leading causes of illnesses, disability, and even death. In other words, children are increasingly suffering from depressive disorders ranging from the ordinary depression to advance bipolar.

According to Cox et al. (8), the causes of depressive disorders are not well known. They can range from a variety of factors. It was also established that the causes of depressive disorder among children and adolescents are biological, psychological or environmental. The reasons are biological when they relate to the history of the family having had cases of the disorders. Therefore, it could be the case that the depressive disorder was genetically transferred to the child. Causes of depressive disorder are psychological when they result from the remembrance of life events- these include the event such as death, loss of a loved one, and other bad memories. It is detrimental when the environment in which the children and adolescents live in is not mentally conducive and. Therefore, they feel that they are being tortured psychologically (11). These thoughts that arise out of the surroundings can lead to the disorder. However, it was difficult to discern whether the disorder was caused by one factor and not the other.

The main area that most scholars were concerned with are the symptoms of depressive disorders. In this regard, depressive disorders can be detected by a range of signs and symptoms which include; suicidal thoughts, feelings of worthlessness, drop in academic performances, abrupt loss of energy, hopelessness, lack or reduction of interest in the normal daily activities, irritability without any reason, problems in falling asleep, self-loathing, loss of appetite and feelings of guilt (5). These symptoms can appear one at a time or in multiple manners. However, not all symptoms alluded to signify depressive disorders. Others can result from other aspects and could, therefore, be a depiction of other disorders (12).

The effects of the depressive disorders have been established as death, mental incapacitation, drop in the level of school performance, and drug abuse (14, 16. 19). Death as an effect is caused by the contemplation of suicide and actual trials of suicides by the children and adolescents. Specifically, due to the thoughts that the children have in their minds, they conclude that the only option remaining is to take away their lives so that they can get away from the thoughts (10). The drop in the level of academic performance is caused by the negative thoughts in their minds which translate into the low grades. The abuse of drugs stems from the fact that they need to stop thinking about a particular event and, therefore, indulge in drug addiction to give them some reprieve.

Figure 2: the effects of depression.

About the treatment of depression, addressing the medical condition that might have worsened the condition is one of those methods that can be used (13). Additionally, the use of psychotherapy by experienced psychologists can also be an excellent method of treating depressive disorders. In cases of moderate to severe depression, medication can serve to stabilize the children and adolescents. However, the most successful method used in the treatment of severe depression in children and adolescents is the use of interpersonal therapy (IPT) and cognitive behavioral therapy (CBT) (15). However, in the view of (10, 13, 14), about 60% of children suffering from depressive disorders who take antidepressant medication are seen to improve. Indeed, this is not the case in adults.

Discussion

The gravity of the effects of moderate to severe depressive disorders is enormous, but the challenge lies with the failure of parents to take measures at the earliest stage of the disorders (5). In this regard, the depressive disorders are realized when they have already become bipolar. In most cases, parents rarely understand when their children and adolescents go through the disorder (7, 8). This has led to the prevalence of the condition. From the findings that have been made out of the review of the literature, there is a lack of information on the symptoms that families should check so as to seek medical intervention when one of the members has a mental disorder. Therefore, the cases of children dropping out of school and others getting low marks have been on the rise.  Additionally, from the review, it is evident that the principal causes of the disorder are the remembrance of undesirable memories and the existence of an adverse environment (9). The effects have been strictly seen to be drug abuse, suicidal attempts, and misuse of narcotics. Therefore, any measures devised to address the problem should be centered on this cause.

The methods that are used to treat these disorders have been described as medication, psychotherapy, and personal interventions. These methods exist to help treat the disorder at whatever stage. In this regard, the methods are curative as opposed to preventive. Additionally, they are only concerned with reducing the symptoms other than rooting out the whole depressive disorders issue. In every child and adolescent who has the disorder, there must have been a cause that can be deeply looked into and the necessary measures taken to ensure that the child does not suffer from the disorder. Instead of the scholars proposing a method that brings on board all persons who have an interest in the wellbeing of children, they provide measures that are meant to help the children in isolation of the causes of the disorder. It is due to this issue that their methods of preventing and treating the depressive disorders are counterproductive.

This research recommends that an integrated plan be devised with the aim of ensuring that the causes of depression are eliminated instead of curing the effects of the disease. This plan should bring together the children, their parents and families, the government, the healthcare providers, and all other stakeholders that can help stop this menace. Notably, the rate at which children are falling victim of the disorder is alarming. Consultation among those stakeholders will contribute to put together a mechanism that will save the lives of these children and the future generation. In this regard, various mechanisms of detecting any slight changes in the behavior of children and adolescents need to be devised so that the disorders are identified at an early stage.  Additionally, the various family disagreements that are responsible for the disorders should be minimized. Moreover, parents should be sensitized on how to detect such disorders and report them to their family psychotherapists. This integrated plan would most certainly help reduce this alarming trend.