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7. Child and adolescent psychiatry > Anxiety disorders > Flashcards

Anxiety disorders Flashcards

1
Q

Prevalence of anxiety disorders in young people

A

5-15%

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2
Q

Male:female ratio of anxiety disorders in young people

A

Equal before adolescence
1:2 after adolescence

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3
Q

Prevalence of separation anxiety in children

A

3-5%

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4
Q

Prevalence of separation anxiety in adolescents

A

0.8%

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5
Q

Prevalence of GAD in adolescents

A

4%

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6
Q

Presence of phobia in young people

A

10%

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7
Q

Presence of social phobia in children

A

1%

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8
Q

Presence of social phobia in adolescents

A

5-15%

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9
Q

Presence of panic disorder in adolescents

A

3-6%

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10
Q

Most common symptoms of anxiety in preschool children

A

Tearfulness
Clingy behaviour

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11
Q

Most common symptoms of anxiety in school aged children

A

Somatic complaints
Hypochondriasis
Irritability
Aggressive behaviour

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12
Q

Length of time symptoms need to be present for a diagnosis of separation anxiety

A

4 weeks

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13
Q

Age at which separation anxiety is expected to develop

A

6-18

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14
Q

Most common symptoms of separation anxiety leading to families seeking help

A

School refusal
Somatic complaints

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15
Q

Four types of childhood attachment

A

Secure
Insecure avoidant
Insecure ambivalent
Disorganised

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16
Q

Percentage of children who show secure attachment

A

60%

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17
Q

Percentage of children who show insecure avoidant attachment

A

15%

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18
Q

Percentage of children who show insecure ambivalent attachment

A

10%

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19
Q

Percentage of children who show disorganised attachment

A

15%

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20
Q

Symptoms of secure attachment

A

Child uses carer as a secure base
Child explores but comes back to their carer

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21
Q

Symptoms of insecure avoidant attachment

A

Child appears uninterested in carer
Child does not show distress at separation from carer

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22
Q

Symptoms of insecure ambivalent attachment

A

Child shows significant distress at separation from carer but resists comforting and takes a long time to settle

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23
Q

Symptoms of disorganised attachment

A

Child shows contradictory behaviour patterns
Child sometimes appears frozen and confused

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24
Q

Figure who studied child attachment and developed the Strange Situation procedure to identify attachment types in children

A

Mary Ainsworth

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25
Q

Percentage of children who had significant disturbances aged 6 in the Romanian Adoptees study

A

20%

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26
Q

Cause of reactive attachment disorder

A

Severe parental neglect, abuse and mishandling

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27
Q

Features of reactive attachment disorder

A

Fearfulness
Hypervigilance
Poor social interactions
Aggression towards self and others

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28
Q

Age at which reactive attachment disorder is diagnosed

A

<5

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29
Q

Features of disinhibited attachment disorder

A

Clinging behaviour
Attention seeking
Indiscriminately friendly behaviour

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30
Q

Timing of onset of sibling rivalry disorder

A

Within 6 months of the birth of the sibling

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31
Q

Time symptoms need to last for a diagnosis of sibling rivalry disorder

A

4 weeks

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32
Q

Three peaks of age for school refusal

A

5-7
11
14

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33
Q

Possible cause of school refusal in children aged 5-6

A

Separation anxiety

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34
Q

Possible cause of school refusal in children aged 11

A

Triggered by the transition to high school

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35
Q

Possible causes of school refusal in children aged 14

A

Bullying
First presentation of mood/anxiety disorders
Exam stresses

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36
Q

Percentage of young people with school refusal who will successfully reintegrate into school

A

70%

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37
Q

Age at which selective mutism normally starts

A

3-5

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38
Q

Main treatments for anxiety disorders in young people

A

CBT
SSRIs

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39
Q

Percentage of people aged 11-15 diagnosed with PTSD

A

0.4%

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40
Q

Trigger type in type 1 PTSD in young people

A

Single, acute, traumatic event

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41
Q

Trigger type in type 2 PTSD in young people

A

Longstanding or repeated exposure to traumatic events

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42
Q

Symptoms in type 1 PTSD in young people

A

Detailed memories of the event
Misperceptions

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43
Q

Symptoms in type 2 PTSD in young people

A

Denial
Numbing
Depersonalisation and dissociation
Self harm
Extreme passivity

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44
Q

Main treatment for PTSD in young people

A

Trauma focused CBT

45
Q

Prevalence of OCD in young people

A

0.5%

46
Q

Average age of onset of OCD in young people

A

10

47
Q

SSRIs licensed for treatment of OCD in young people

A

Fluvoxamine
Sertraline

48
Q

Main treatments for OCD in young people

A

SSRIs
CBT

49
Q

Disease characterised by OCD and/or tic symptoms following a beta haemolytic streptococcal infection

A

PANDAS

50
Q

Minimum age to diagnosis eneuresis

A

5

51
Q

Percentage of children dry at night by age 2

A

50%

52
Q

Percentage of children dry at night by age 3

A

75%

53
Q

Percentage of children who have daytime wetting age 5

A

1%

54
Q

Percentage of boys who have night time wetting age 5

A

15-22%

55
Q

Percentage of girls who have night time wetting age 5

A

7-15%

56
Q

Most important predictor of night time eneuresis

A

Family history

57
Q

First line treatments for eneuresis

A

Rule out physical issues e.g. UTI
Behavioural interventions e.g. alarm, bell and pad

58
Q

Medication which has been approved for childhood eneuresis

A

Imipramine

59
Q

Alternative medication for childhood eneuresis which has shown positive results in trails

A

Desmopressin

60
Q

Definition of encopresis

A

Voluntary or involuntary soiling of normally formed stools in inappropriate places by a child aged 4 or over (and developmentally aged >4) without organic cause, occurring at least once a month for 3 months

61
Q

Male:female ratio of encopresis

A

6:1

62
Q

Percentage of children with soiling aged 5

A

5%

63
Q

First line treatments for encopresis

A

Rule out physical causes
Treat constipation and evacuate the stool
Behavioural therapies
Family support/therapy

64
Q

Definition of pica

A

Eating of non-nutritive substances at the age of >1, at least twice a week for over a month

65
Q

Age at which pica usually starts

A

2-3

66
Q

Most common substances eaten with pica

A

Dirt
Stones
Plastic
Hair
Faeces
Wood
Paper

67
Q

Condition pica is associated with

A

Learning disability/developmental delay

68
Q

Common comorbidities of PANDAS

A

Anxiety
Emotional lability/depression
Irritability
Aggression
Behavioural regression
Deterioration in school performance
Somatic symptoms

69
Q

Percentage of children who are dry at night by age 5

A

90%

70
Q

Features seen in truants rather than school refusers

A

Antisocial behaviour
Poor academic record
Large families more likely

71
Q

Features seen in school refusers rather than truants

A

Family history of neurotic disorders
Satisfactory academic record
Over-protective parenting
Small families more likely

72
Q

Sex distribution of school refusal

A

Equal

73
Q

Disorder comorbid in the majority of children with selective mutism

A

Social anxiety

74
Q

Most effective treatment for OCD in children and young people

A

Combination of SSRI and CBT

75
Q

Most common age of presentation of school refusal

A

11

76
Q

Chief medical problem to be excluded in children with encopresis

A

Hirschsprung’s disease

77
Q

Element of sleep which improves with melatonin

A

Sleep onset latency

78
Q

Position in family associated with school refusal

A

Being the youngest child

79
Q

Male:female ratio for childhood bulimia nervosa

A

1:10

80
Q

Medication which has been used for eneuresis which can be given as an intranasal spray

A

Desmopressin

81
Q

First line treatment for PTSD in children and young people if symptoms have been present for at least a month

A

Trauma focused CBT

82
Q

First line treatments for PTSD in children and young people if symptoms have been present for under a month

A

Active monitoring
Trauma focused CBT

83
Q

Role of drugs for treatment of PTSD in people aged <18

A

Should not be used

84
Q

Circumstances where EMDR may be considered for children and young people with PTSD

A

Aged 7-17
Precipitating event more than 3 months ago
They have not responded to trauma focused CBT

85
Q

Percentage of 7 year olds who have night time wetting

A

7%

86
Q

Percentage of 10 year olds who have night time wetting

A

5%

87
Q

Percentage of children with nocturnal eneuresis who have a first degree relative who had the same

A

75%

88
Q

Percentage of children with faecal incontinence who are constipated

A

80%

89
Q

First line medication for childhood insomnia

A

Melatonin

90
Q

Age at which fear of strangers usually develops

A

End of first year

91
Q

Age at which fear of being alone usually develops

A

3-4

92
Q

Age at which separation anxiety usually develops

A

End of first year

93
Q

Age at which fear of the dark usually develops

A

3-4

94
Q

Age at which fear of animals usually develops

A

3-4

95
Q

Age at which fear of bodily injury usually develops

A

4-12

96
Q

Age at which fear of illness usually develops

A

4-12

97
Q

Age at which fear of social situations usually develops

A

4-12

98
Q

Age at which fear of supernatural things usually develops

A

4-12

99
Q

Age at which fear of criticism usually develops

A

4-12

100
Q

Most common symptom in children with bodily distress disorder

A

Abdominal pain

101
Q

Percentage of encopresis thought to be functional

A

90%

102
Q

Percentage of 10 year olds who experience nocturnal eneuresis at any one time

A

5%

103
Q

Factors associated with nocturnal eneuresis in children

A

Stressful life events
UTI
Constipation
Low socioeconomic background
Large family size
Overcrowded home conditions

104
Q

Most important intervention for children with reactive attachment disorder

A

Providing an emotionally available attachment figure

105
Q

First line medication for body dysmorphic disorder in children

A

Fluoxetine

106
Q

Percentage of 4 year olds affected by encopresis

A

3%

107
Q

Treatments compared in the POTS study looking at OCD treatments in children

A

SSRIs
CBT

108
Q

Findings of the POTS study looking at OCD treatments in children

A

Treatment should be either CBT alone or CBT + SSRI

109
Q

Youngest age reactive attachment disorder can be diagnosed

A

1 year

7. Child and adolescent psychiatry (9 decks)

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