47. Common Child Psychiatric Disorders Flashcards
Describe the following childhood psychiatric disorders, including risk factors for b and c:
a) Pre-school behaviour problems
b) Conduct disorders
c) Emotional disorders
a) Habit problems, failure to develop routines, temper tantrums, attachment difficulties, autism/social communication problems, hyperkinetic disorder (ADHD), anxiety (incl. separation anxiety), abuse (emotional, behavioural conseqeunces of physical, sexual or emotional abuse).
b) Disorder of behaviour characterised by repetitive and persistent pattern of dissocial, aggressive or defiant conduct. Presents >6m. Important to manage as can cause wide-ranging negative outcomes. Risks: boys>girls, inner cities>rural areas, socio-economic disadvantage, family conflict and poor communication, difficult temperament, reading disability.
c) Disturbances of mood, persistent and not in response to a single identified stressor, disabling, anxiety and fearfulness, depression. Symptoms: fears (separation anxiety, phobias), lack of pleasure/interest/hopelessness, physical symptoms (abdo pain, headaches), fall off in school perfomances, truancy. Risks: boys=girls, no association with socio-economic status, family factors (over protection, parental anxiety), quiet compliant temperament, no educational problems.
Describe the following childhood psychiatric disorders, and risk factors for b:
a) Adjustment disorders
b) Disorders of activity and attention (ADHD)
c) Failures of normal development: specific and pervasive (autistic spectrum)
a) Distress and emotional disturbance arising in a period of adaptation to a significant life change or to the consequence of a stressful life event (bereavement, divorce, physical illness).
b) Combination of hyperactivity (restless, fidgety), inattention (careless mistakes, doesn’t listen properly) and impulsivity. Early onset, pervasive and persistent. Risk: boys>girls, genetic factors, neuro-developmental abnormalities, maternal depression, smoking during pregnancy.
c) Specific: speech and language, reading (dyslexia), spelling, arithmetic, motor function (dyspraxia), enuresis/encopresis. Pervasive: autistic spectrum disorders (need 3 main things to diagnose: can’t read emotions, impaired communication, restricted and repetitive behaviours).
Describe the following childhood psychiatric disorders, and risk factors for b:
a) Attachment disorders and abuse
b) Adult-type disorders
a) Attachment: marked distress and social impairement as a result of extremely abnormal pattern of attachment, typically due to repeated changes of care-giver in early childhood. Reactive and disinhibited attachment disorders.
Abuse: physical, emotional, sexual, neglect, Munchausen syndrome by proxy/factitious induced illness.
b) Psychoses (schizophrenia, bipolar), PTSD, OCD, eating disorders, self-harm.
What are the main areas to cover in assessment of child psychiatric disorders?
What treatment approaches are there in child psychiatry?
Description and history of main problems, child’s peri-natal, developmental, medical, educational and social history, family history, mental state of child, family communications and relationships, interventions so far.
Talking therapies (CBT, family therapies, psychodynamic therapy), Psycho-education (explanation), Parent training/advice, Pharmacotherapy (stimulants, anxiety and depression antipsychotics).
