10.2. Child and Adolescent Psychiatry - Assessment / Management of Common Presentations Flashcards
What Factors have to be Considered when Formulating Management in Child / Adolescent Psychiatry?
- Biological Aspects
- Psychological Aspects
- Social Aspects
- Identify Predisposing / Precipitating / Maintaining / Protective Factors
What Biopsychosocial Factors need to be considered when Formulating Management in Child / Adolescent Psychiatry?
- Biological - Genetic Predisposision / Neuro-developmental Insults / Illness …
- Psychological - Temperament / Attachment Style / Psychological Attributes (Impulsivity / Perfectionism …)
- Social - Family Relationships / Peer Relationships / Hobbies / Religious Faith / Neighbourhood / School…
What are Characteristics of Conduct Disorders?
Repetitive and Persistent Patterns of Antisocial / Aggressive / Defiant Behaviours, which Violate Age-Appropriate Societal Norms
What is the Course of Conduct Disorders?
It is a Persistent Disorder with Increase Risk of:
- Early Death - Often by Sudden / Violent Means
- Social Exclusion
- Poor School Achievement
- Long-Term Unemployment
- Criminal Activity
- Adult Mental Health Problems
- Poor Interpersonal Relationships - including their kids
What is the Management of Conduct Disorders?
Will be based on Biopsychosocial Assessment:
- Parent Training Programme
- Modify School Environment - Behavioural Support
- Functional Family Therapy
- Multi-Systemic Therapy
- Child Interventions - Social Skills / Problem Solving / Anger Management / Confidence Building
- Treat Comorbidity
- Address Child Protection Concerns
What are the Characteristics of Hyperkinetic Disorders?
Core Features of: 1. Developmentally Abnormal Inattention 2. Hyperactivity 3. Impulsivity Present Across Time and Situations
What are the Symptoms of Hyperkinetic Disorders?
- Learning Disability
- Autism Spectrum Disorders
- Conduct Disorder
- Tics
- Motor-Coordination Problems
- Substance Misuse
- Anxiety / Depression
Note - Majority are Symptomatic into Adulthood
What is the Management of Hyperkinetic Disorders?
- Psychoeducation
- Medications - Atomoxetine / Guanfacine / Stimulants (Methylphenidate)
- Behavioural Interventions
- Parent Training - PinC / School Interventions
- Treat Comorbidity
- Volunteer Organisations / Benefits
What Factors increase the Risk of Suicide in Child / Adolescent Psychiatry?
- Persistent Suicidal Ideas / High Intent / High Motivation
- Past Suicidal Behaviours / High Lethality of Method
- Ongiong Precipitating Stresses
- Mental Disorder / Poor Physical Health
- Parental Psychopathology / Suicidal Behaviour
- Physical / Sexual / Emotional Abuse
- Disconnection from Support Systems
What is the Management of Self-Harm in Child / Adolescent Psychiatry?
- Usually Admit to Age-Appropriate Medical Ward
- Mental Health Risk Assessment - Specifically Trained Staff
- Further Referral to Agencies as Appropriate