CLIENT DESCRIPTIONDemographicsThe patient, KRC, is a 13-year-old Caucasian female who was brought to the MedStar Franklin Square Medical Center psychiatric emergency department on March 14, 2014 by her mother for suicidal ideation with a plan vague. She was admitted to the Pediatric and Psychiatric Services (CAPS) unit on March 15, 2014 where she was diagnosed with Depressive Disorder Not Otherwise Specified (DD-NOS). According to the admission assessment, the patient was self-harming with several superficial cuts on the right thigh and left arm caused by a razor on the morning of 03/14/2014. Her mother was unaware of the severity and frequency of the patient's self-injurious behavior until the day of admission. The patient's parents have been divorced since she was 2 years old and have shared custody. He alternates living with his mother and father on a weekly basis. The patient is single and attends middle school in Aberdeen, Maryland. She is on her father's HMO insurance, is not religious, and has no known allergies. The patient has a full resuscitation order. Chief Complaint and History of Present Illness Patient denies medical and surgical history and her medical record confirms this. She has no previous psychiatric hospitalizations and has never been admitted to hospital. However, she says she has felt depressed for four years now and has been cutting since she was 11. His father only noticed the cut last month and his mother noticed it late last year. Ms. K says she cuts her schedule almost every other day because she feels lonely, rejected or worthless. She has been bullied since elementary school because of her weight. The patient's mother took her to counseling therapy which ...... middle of paper ... life and it is something she finds difficult to change about herself because she has been having negative thoughts even before she started cutting herself . As part of her treatment plan, Ms. K was prescribed sertraline (Zoloft), which is a selective serotonin reuptake inhibitor (SSRI). SSRIs are associated with suicidal ideation (SI) in adolescents as they are thought to cause irritation, agitation, and impulsivity (Stuart 699). The only SSRI approved for adolescents with depression is fluoxetine; signs of SI should still be monitored as antidepressants in general may increase the risk of SI. Because the patient was hospitalized for SI, she is at particular risk for this side effect. Mrs K's sertraline treatment was stopped and she was given bupropion which inhibits the reuptake of the neurotransmitter dopamine. This antidepressant drug does not cause SI in adolescents.