CAMHS Flashcards
Genetic risk ADHD
Population risk - 5% children, 2.5% adults
Siblings - 2-3x baseline risk
Prevalence of nocturnal eneuresis
15% of 5 year olds
7% of 7 year olds
5% of 10 year olds
2% of 15 year olds
CAMHS ADHD (history)
Clarify HPC (onset, duration, location)
Hyperactivity (sit still, climbing)
Inattention (teacher reports, concentration at home, not finishing tasks, forgetful, losing things)
Impulsiveness (shouting out, interrupting, risky situations)
Comorbidities (FHx, tics, language, social development, Police, mood)
CAMHS ADHD (management)
Explain diagnosis
Clarify symptoms
Explain medication (mechanism, side-effects, monitoring)
Alternative treatments (environmental change, OT, parenting and teaching strategies)
Sibling risk of ADHD
Twice the risk (baseline risk is 3-5%, so sibling risk is 6-10%)
Methylphenidate - side-effects and monitoring
Baseline ECG, HR, BP, height and weight
3 monthly HR/BP, 6 monthly weight/height
Common: appetite suppression, GI upset, insomnia, headache, tics, BP
Severe: liver impairment, sudden cardiac death, leucopenia.
Conduct disorder (history)
Clarify HPC (onset, duration)
Behaviour towards adults (arguments, defy rules, deceitful)
Behaviour towards others (blame others, fights, cruelty to people/animals)
Behaviour towards property (destructive, theft, run away, other crimes)
Risk factors (FHx - psych, forensic, substances; developmental problems; abuse)
Comorbidity (mood, enjoyment, anxiety, sleep, appetite, ADHD, learning, drug use)
CAMHS ASD (history)
Clarify HPC (onset, duration)
Explore social interaction (eye contact, affection, friendships, imaginary play)
Explore social communication (language development, repetitive speech, echolalia, accents, facial expression)
Restricted/stereotyped behaviour (special interests, routines/rituals, repetitive movements, sensory sensitivity)
Comorbidities (mood, sleep, appetite, anxiety, ADHD, epilepsy, LD)
Risk (aggression, self-injury)
Developmental history (pregnancy, milestones) and FHx
CAMHS psychosis (history)
Clarify HPC (onset, duration)
Delusional beliefs
Explore auditory hallucinations (quality, content, number, 2nd/3rd person, commentary, commands, insight)
Hallucinations in other modalities
Thought interference and passivity phenomena
Mood (mood, sleep, appetite, enjoyment)
PPHx, PMHx, substance use
Risk (self and others)
CAMHS psychosis (d/w consultant)
Summarise case and formulation
Differential diagnosis
Management (drug screen, bloods, medication)
Alternative treatments (education, CPN, CBT)
Address concerns
35% conversion to SCZ
CAMHS sexual abuse (d/w consultant)
Summarise case and formulation
Explain need to break confidentiality
Acute management of presenting issue
Urgent discussion with either social work or CP cons (who will alert other core agencies and arrange full history/forensic examination etc)
Other children at risk
Longer term management (full investigation, counselling, accommodation)
CAMHS bullying and overdose (history)
Explore current suicide attempt (chronology, final acts, intent, current feelings)
Underlying stressors
Explore bullying (name-calling, violence, rumours, disclosure)
Psychiatric comorbidities (mood, enjoyment, sleep, appetite, nightmares/flashbacks, school avoidance)
Risk (drugs, alcohol, self-harm, ongoing suicidality)
CAMHS enuresis (history)
Clarify HPC (onset, duration)
Explore enuresis (daytime dryness, bowel problems, parental response)
Identify stressors (home, school)
Psychiatric comorbidities (mood, enjoyment, sleep, appetite, nightmares/flashbacks, school avoidance)
Developmental history (pregnancy/delivery, delay, potty training)
Medical causes (UTI, PMHx, medications)
CAMHS selective mutism (explanation)
Clarify likely diagnosis and DDx (anxiety, shyness)
Identify stressors (home, school)
Developmental history (pregnancy/delivery, delay, PMHx)
Investigations (physical examination, ed psych Ax, SLT)
Treatment (Behavioural therapy, SLT, family therapy, art/play therapy)
Gain consent to share information with school
CAMHS self-harm (discussion with student)
Summarise case
Explain difference between self-harm and suicide
Reasons for self-harm
Explain suicide risk assessment
Exclude underlying mental disorder (depression, PD)
Explain management plan (consider admission, safety plan, medication, CBT)