Adolescent Psych

Question 1

It’s important to get multiple sources of info before diagnosing a child with something, where could you get it?

Answer 1

• Them
• Family (as many members as possible)
• School
• Social Work

Question 2

Important to build a bio-psycho-social formulation of the child’s case. what sort of things fall under these categories?

Answer 2

Bio - FH, perinatal problems, drugs, psych history

Psychological - attachment, self-esteem/efficacy & motivation

Social - Relationships, peers, sports/clubs/groups, schooling

Question 3

This includes

Answer 3

Conduct Disorders
ADHD
School Avoidance
Suicide

Question 4

What is a conduct disorder?

Answer 4

A repetitive and persistant pattern of Antisocial, Aggressive & Defiant to authority behaviours that violate age-appropriate societal norms

Question 5

Conduct disorders can cause problems with socializing, education, employment, mental health & criminal activity. How do we manage it?

Answer 5

Parent Training
Modifying school environment
Therapy incl Family therapy, social skills training & anger management

Question 6

What are the features of ADHD?

Answer 6

Abnormal INNATENTION, HYPERACTIVITY & IMPULSIVITY present across time & situations

Question 7

How do we treat ADHD?

Answer 7

Psychoeducation
Parent Training
School interventions
Meds 1st = Methylphenidate (Ritalin)
Meds 2nd = Atomoxetine (Noradrenalin reuptake inhibitor)

Question 8

We should always look out for comorbidities in ADHD, how come?

Answer 8

Its super common, like 50%+ cases have another mental health disorder incl LD, ASD, CD, anxiety, depression or substance misuse

Question 9

A teen comes in having attempted suicide, what risk factors are there for further attempts?

Answer 9

• Persistant suicidal ideas
• Previous suicidal behaviour
• High lethality of method
• High intent & motivation
• Ongoing precipitating factors
• Mental disorders
• Poor physical health
• Impulsivity
• Parental mental health or suicidal behaviour
• Abuse
• Poor support network

Question 10

How do we manage a suicidal child?

Answer 10

Admit temporarily for treatment and assessment

Mental health & risk assessment including psychiatric opinion

Refer to CAMHs, social work, child protection as needed

Question 11

The major cause for kids avoiding school is anxiety, what are the two categories it’s important to distinguish?

Answer 11

Seperation anxiety - Problem leaving parents/home

Social Phobia - Problems arriving at school and with groups

Question 12

What are the features of anxiety?

Answer 12

• Anxious thoughts
• Autonomic symptoms
• Avoidance

Question 13

How do we treat anxiety in kids?

Answer 13

CBT
Psychoeducation
SSRI
Return to school ASAP (to avoid fear growing with avoidance)