105. Anxiety/Mood Disorders in Children Flashcards
What is selective mutism?
Young children with ability to speak, but not speaking in social situations and not part of another disorder
Mild variant (single words/soft spoken) - may develop language/social skills delay and get ASD dx
What is the key specific sign of OCD in children?
Prominent obsession/compulsion regarding cleanliness/dirt
How does a parent describe their child’s anxiety?
How do they specifically describe SeAD, GAD, SoAD?
All anxiety: fear, apprehension, worry, “stressed out”
GAD: worry wort, dread
SeAD: Homesick
SoAD: shy/self-conscious
What is the course and signs of anxiety in adolescence and young adulthood?
What is the epidemiology of childhood anxiety?
How is childhood anxiety “contagious”?
Adolescence: “burn out”, overwhelmed by typical life, may evolve to depression, increased school drop-out
Young Adult: failure in major roles (work inhibition, fail to leave home or stay in college), evolves to panic disorder, recurrent depression, BPD, substance abuse
E: 8-10% kids - under-dx and under-tx - MOST COMMON CHILDHOOD DISORDER
Contagion: parental attention to anxious child, parental support for avoidance, catastrophic rxns shape relationships
What is the most effective tx for anxiety in children?
Combo of meds and CBT
SSRI: Duloxetine (for non-OCD anxiety) - start low dose and increase to MAXIMUM SAFE LEVEL
CBT: address triad of anxious thoughts/feelings/behavior
How has childhood depression rates changed over time? What is the epidemiology?
Higher rates of depression, lower age of onset, higher rates in teens/young adults and all ages
W>M 2-3:1
+FamHx (First degree relatives): 2-3x risk
What is the tx for childhood depression?
How does tx influence prognosis?
- CBT, Interpersonal Therapy
- Meds: SSRIs, Atypical Antidepressants, TCAs, MAOis
Combo of SSRI + CBT is best (SSRI > CBT)
Tx lowers risk of suicides
Earlier the response to tx = BETTER OUTCOME
