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Psychiatry > Adolescent mental health > Flashcards

Adolescent mental health Flashcards

1
Q

What is CAMHS

A

Child and Adolescent Mental Health Service

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2
Q

How many tiers of CAMHS are there?

A

4

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3
Q

What is CAMHS tier 1

A

Universal service consisting of all primary care agencies including GP, school nurses, health visitors and the schools themselves

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4
Q

What is CAMHS tier 2

A

A combination of some specialist CAMH services and some community-based services including primary mental health workers

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5
Q

What is CAMHS tier 3

A

Specialise MDT outpatient CAMHS team

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6
Q

What is CAMHS tier 4

A

High specialised inpatient CAMH units and intensive community treatment services

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7
Q

What are some genetic factors of anxiety disorders in children?

A
  • Biological vulnerability to a fearful disposition
  • Abnormal function of 5-HT, NA, dopamine and GABA
  • Irritable, shy, cautious and quiet temperament
  • Overactive limbic system
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8
Q

What are some behavioural factors of anxiety disorders in children?

A
  • Acquisition of fear through classical conditioning
  • Maintenance of fear through operant conditioning
    • Negative reinforcement is manifested by avoidance and escape learning
  • Observational learning
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9
Q

What are some cognitive factors for anxiety disorders in children?

A
  • Attentional biases
  • Selective attention
  • Distortion of risk judgement
  • Negative spin on non-threatening situations
  • Select evoidant solutions
  • Selective memory processing
  • Tendency to remember anxiety-provoking cues
  • Perfectionistic beliefs
  • Inflated sense of responsibility
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10
Q

How is mild anxiety disorder treated in adolescence?

A

CBT

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11
Q

How is unresponsive or moderate-severe anxiety disorder managed in adolescence

A
  • SSRIs
  • Up to 12 weeks to affect
  • Continue for 1 year
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12
Q

How common is depression in adolescents?

A

4-8 of 100 young people suffer from depression at any point in time

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13
Q

What are some vulnerable groups for depression in adolescence?

A
  • Young offenders - 10%
  • Looked after children - 23%
  • LGBT - 44% have considered suicide
  • Ethnic minorities
  • Disabilities
  • Homeless youth
  • Young people in gangs
  • Unemployed young people
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14
Q

What are some predisposing factors for depression in adolescence?

A
  • Conflict between parents
  • Depression or stress in parents
  • Separation of parents
  • Conflict with friends
  • Social disadvantage
  • School stress
  • Bullying
  • Loss of someone important
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15
Q

How is mild depression in adolescent managed?

A
  • Watchful waiting for 2 weeks
  • Group IPT/CBT, digital CBT for 2-3 months
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16
Q

How is unresponsive or moderate-severe depression managed in adolescence?

A
  • Individual CBT, IPT, family therapy, psychodynamic therapry for 4-6 sessions
  • Then Fluoxetine
  • Then sertraline or citalopram
17
Q

How common is self-harming behaviour in adolescence?

A

7% in 14-16 year olds at school

13% in 11-16 years old in the community

1 in every 12-15 young people deliberately self-harm

18
Q

What are some functions of self-harm?

A
  • Coping with intense emotions
  • Communicating distress
  • Re-connecting with self and others
  • Suicidal attempt
19
Q

What is the biological basis of self-harm?

A

Self harm promotes the release of endorphins, so brings temporary distress reduction and so through negative reinforcement (Removal of negative stimulus), it tends to be repeated

20
Q

What are some features of non-suicidal self-injury in adolescence?

A
  • Periods of optimism and some sense of control
  • Successful decrease in discomfort
  • Frequent chronic and repetetive
  • Intent to relief from unpleasant emotions
  • Uncomfortable but intermittent psychological pain
21
Q

What are some features of suicidal self harm in adolescence?

A
  • Hopeless and helplessness is central
  • No release of discomfort after self-injury
  • Generally not chronic or repetitive
  • Intent to escape pain or end consciousness
  • Unendurable, persistent psychological pain
  • Tunnel vision (Only 1 way out)
22
Q

How is self-harm in adolescence managed?

A
  • Educate about signs of distress in themselves and others
  • Use of positive coping skills
  • Learn about the difference between self-inury and suicide and normalise the experience
  • Some people will just want to be heard
  • Refer to specialist mental health professional for risk assessment
23
Q
A

Psychiatry (29 decks)

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