CAMHS Flashcards
what age is schizophrenia likely to present
20s
what age does depression usually occur
20s
what age does BAD typically occur
20s, very rare in CAMHS units
what age can personality disorders be diagnosed
> 18
if <18 can be listed as likely when symptoms are clear, persistent and impair functioning
typical onset is abour 14
what are disruptive/behavioural disorders in CAMHS referred to as
Conduct disorder in >12
<12 is oppositional defiant disorder
what is the most important management form to managing disruptive or behavioural disorders
early intervention
what gender is ASD more common in
males
overall management of ADHD
parenting and educational intervention
medication in moderate to severe cases
what features would a child with trauma/attachment disorders possibly have
PTSD like symptoms oppositional behaviour irritability and anxiety quasi psychiatric symptokms other mental illness
some primary presentations that are not always related to mental illness?
developmentally appropriate anxiety hyperactivity/short attention span grandiose ideas imaginary friends intense interest non-impairing tics
some secondary presentations that are not always related to mental illness?
mood swings sullen, withdrawn, anxious sleep change peer pressure influence OCD type behaviour intrusive thoughts and pseudohallucination
what is puerperal psychosis
acute onset psychotic or manic symptoms
psychiatric emergency
risk factors for puerperal psychosis
bipolar disorder previous thyroid disease FHx unmarries 1st pregnancy C/s perinatal death
onset of postnatal depression
1-4 weeks post delivery
risk factors for postnatal depression
FHx of Hx depression complicated delivery traumatic birth relationship issues trauma or abuse lack of support financial issues
risk factors for late onset old age depression
genes
life events
financial hardship
poor health
what is pseudodementia
older people affected by predominant cognitive symptoms flux loss memory good insight into memory loss slow movement depressed mood responds to meds and or ECT
cause of anxiety in adolescents - genetic and behavioural
inherited
classical and operant conditioning leading to fear
cognitive factors leading to anxiety in adolescents
attention bias selective attention negative spin on situations tendency to remember anxiety provoking cues perfectionistic beliefs inflated sense of responsibility
managing adolescent anxiety
mild CBT
unresponsive to CBT or mod/severe - fluoxetine/sertraline
BZD short term but look out for paradoxical agitation
DO NOT GIVE PROPRANOLOL
predisposing factors to adolescent depression
FHx psychological conflict divorce school stress bereavement
managing adolescent depression
watchful waiting
CBT or supportive therapy
unresponsive, moderate/severe - CBT, fluoxetine, consider sertraline or citalopram
consider low dose antipsychotic if failure of >2 SSRI
venlafaxine, mirtazapine
causes of DSH
cope with intense emotion
distress
attempt to end life
attempt to save life
biological reason for self harm
promotes endorphin release so leads to temp distress reduction
tends to be repeated
features of non-suicidal DSH
optimism decrease discomfort chronic intent to relieve emotion uncomfortable with intermittent psychological pain
features of suicidal DSH
hopeless helpless no release of discomfort following injury persistent psychological pain "no other way out"
managing self harm
educate on signs distress
positive coping skills
refer for risk assessment
