Case Study: Adolescent Depression
Kari, age 16, has had what her parents call a “very normal childhood and adolescence” so
far. She is a good student, has had lots of friends, is involved in many school activities,
has been a class officer, and has never been in serious trouble. She began dating in groups
last year, and she developed a relationship with a classmate named Sean. She and Sean
began dating, and, as Kari’s mother explains, “Kari changed. She isn’t open to her father
and me as she once was. She spends hours on the phone talking to Sean. She has let her
studies go, and her grades are dropping. We have tried limiting her time with Sean, but
she finds ways to be with him or talk to him. We can’t just lock her in the basement! We
don’t know what to do!”
On this night, Kari’s parents are called by the emergency department of the local
regional hospital. Kari has been brought here by the Emergency Medical Service after her
friends found her in her car with an empty bottle of acetaminophen. Kari’s physical
condition has been stabilized, and the psychiatric admitting team has been called to make
an assessment. Kari explained that she had had a date with Sean that evening, and instead
of going to the movies as they had planned, Sean told her he wanted to talk to her. They
parked their car at a local teenage hangout, and Sean began to tell her that he had found
someone whom he wanted to date and wanted to break off their “permanent” relationship.
He suggested they date other people. Kari broke down and cried and begged Sean not to
break up with her. She said she told him she didn’t want to date anyone else. She said she
told him that if he broke up with her, she would kill herself. But he told her that he had
made up his mind. She also said he told her he was “disgusted” by her childish behavior.
He got out of her car, and she went to a local convenience store, purchased the
acetaminophen and bottle of water, sat in the parking lot, and swallowed the pills. Her
friends went looking for her when they later talked to Sean and he related to them about
their breakup. Kari has been admitted to the adolescent psychiatric unit with a diagnosis
of Adjustment Disorder with Depressed Mood. She has been placed on Suicide
Precautions. Answer the following questions:
1. Explain the etiology of Adjustment Disorder with Depressed Mood.
2. Provide clinical manifestations of this condition. What are the criteria of this
condition according to the DSM-V?
3. Develop a nursing care plan for this patient (Assessment, Nursing Diagnosis,
Plan, and Intervention).
4. What do you know about anti-depressants for adolescents? Which psychotropic
medication(s) is FDA approved for adolescents with major depressive disorder?