This document discusses the use of SSRIs compared to CBT for treating mood disorders in adolescents over 3 months. It notes that mood disorders affect 5% of adolescents but only 30% receive treatment. Most new adolescent patients are seen following hospitalization for suicide attempts. The document outlines the population, interventions, outcomes, and timeline of a proposed study comparing SSRIs and CBT. It also lists strengths, weaknesses, opportunities, threats, expenses, and roles of staff needed for the study.

1. Suja George RN, PMHNP-BC

2. • How does SSRI compared to CBT affect
mood disorders signs and symptoms 3
months after initiation of treatment in
Adolescents?

3. • Population identified
Children under 18 yrs. old
• Intervention
Use of Selective Serotonin Reuptake Inhibitors ( SSRIs)
• Comparator
Cognitive Behavior Therapy (CBT)
• Outcome
Improvement in level of depression or anxiety can be
measured by scales including Spence Children’s Anxiety Scale
(SCAS) or Beck Depression Inventory (BDI-11).
• Time
3 months after the initiation of treatment.

4. • “Mood disorders including depression affect
approximately 5% of adolescents. Of these, a mere
30% receive any sort of intervention or treatment”
(Adolescent Depression Awareness Program, 2010).
• Most of our new adolescents patients are post –
hospital admission follow ups due to suicidal
attempts
• Most of the adolescents with mood disorders do not
seek early help due to lack of knowledge about
treatment options ((DeSocio, Stember, & Schrinsky,
2006)

5. • Suicide caused by mood disorders is one of the
leading causes of death among adolescents today.
• Schools are a cost-effective way to reach youth
• Lack of clear evidence for an effective prevention
program (Katz, Bolton, Katz, Isaak, Tilston-Jones, & Sareen,
2013).
• Missing early identification and lack of necessary care
for adolescents cause high risks for mood
disorders(Whitney, Renner, Pate, & Jacobs, 2011).
• Care for adolescent depression is minimal
• “Care could be improved through the development of
quality interventions” (Lewandowski et al., 2013)

6. Strengths Weaknesses
• Support from the staffs for the
processing of the innovation
• Possible fund available from the
partial hospital organization.
• Lack of knowledge of the staffs
regarding the process of innovation
• limited generalizability of the study
by including only the adolescents
Opportunities Threats
• Possibility of opportunity for
further research study
• Make community aware about the
mood disorders and the treatment
options
• The innovation can be cost
effective by reducing the
complicated mental illness .
• Language barrier between staffs and
patients
• Lack of sufficient fund in completing
the study project
• Noncompliance with medications

7. • Salary for Nurse Practitioner-$400
• Salary for Clerical staff- $50
• Salary for Billing staff- $ 75
• Salary for Counselor-$320
• Supplies- $ 500
• Training of staffs- $1000
• Total estimated expense=$ 2345 for 4hr/
day
(The revenue is based on the available fund)

8. • I am a psychiatric mental Health Nurse
Practitioner.
• I am licensed to educate about mental
disorders and treatments.
• I have been working with adolescents and
children for the last 3 years.
• I am the one who usually does the initial
evaluation and assessment of the new
patients at our clinic.
• From my experience I can share with others
the importance of seeking help.

9. • Psychiatric and mental health nurse
practitioner
• Counselor
• Billing staff
• Clerical staff
• School nurse

10. • Adolescent Depression Awareness Program (2010). Psychiatry and
behavioral sciences, Retrieved from
https://www.hopkinsmedicine.org/psychiatry/specialty
areas/moods/.../index.html
• DeSocio, J., Stember, L., & Schrinsky, J. (2006). Teaching children about
mental health and illness: a school nurse health education program. Journal
of School Nursing (Allen Press Publishing Services Inc.), 22(2), 81-86.
doi:10.1177/105984050602200204
• Katz, C., Bolton, S., Katz, L. Y., Isaak, C., Tilston-Jones, T., & Sareen, J.
(2013). A systematic review of school-based suicide prevention programs.
Depression & Anxiety (1091-4269), 30(10), 1030-1045.
doi:10.1002/da.22114

11. • Lewandowski, R. E., Acri, M. C., Hoagwood, K. E., Olfson, M., Clarke,
G., Gardner, W., … Horwitz, S. M. (2013). Evidence for the Management
of Adolescent Depression. Pediatrics, 132(4), e996–e1009.
http://doi.org/10.1542/peds.2013-0600
• Reavy, K. (2016). Inquiry and leadership: A resource for the DNP project.
Philadelphia, PA: F.A. Davis Company.
• Whitney, S. D., Renner, L. M., Pate, C. M., & Jacobs, K. A. (2011).
Principals' perceptions of benefits and barriers to school-based suicide
prevention programs. Children & Youth Services Review, 33(6), 869-877.
doi:10.1016/j.childyouth.2010.12.015