CAMHS Flashcards
List some aetiological factors thought to influence childhood mental health problems
Biological - genetics, temperament, neurodevelopmental
Developmental - attachment, abuse
Family/parenting - family dynamics, pressure, conflict, bereavement
School - bullying
Acute stressors
Chronic adversity
Success/failures
List some factors which are thought to be protective against childhood mental health illness
- Coping strategies
- High confidence
- Stability
- Supportive family
- Friends
- Achievement
How do anxiety disorders classically present in children?
With somatic symptoms, e.g. tummy ache, nausea
How does depression tend to present in children?
- Low mood not a key feature
- Appetite may not be affected
- Anhedonia is key
- Somatic symptoms prominent
How is anxiety managed in children and adolescents?
Behaviour therapies, family therapy, non-BZD anxiolytics
How is depression managed in children and adolescents?
CBT
SSRI - Fluoxetine is the only one licensed in children
What are the two behavioural disorders seen in children/adolescents?
Oppositional Defiant Disorder
Conduct Disorder
What is oppositional defiant disorder?
Continuation of “toddler tantrum”-like behaviour beyond age 5, but usually only in one setting, i.e. either school or home.
Behaviour tends to be bad, but not dangerous or violent.
What is conduct disorder?
ODD which persists beyond age 10.
Characterised by persistent disruptive/deceptive/aggressive behaviour, e.g. lying, stealing, violence, with NO remorse.
Distinguish between socialised and unsocialised conduct disorder.
Which is more worrying?
Socialised - child integrated within peer group. Behaviour episodic, and often just at home.
Unsocialised - child not integrated into peer group. More worrying - often leads to antisocial PD/criminality
What is the management for ODD/CD?
Behavioural therapies, psychoeducation for parent, school interventions.
Define ADHD and outline the diagnostic criteria
Early onset, persistent pattern of inattention, hyperactivity and impulsivity
For diagnosis:
- Must be present in 2+ settings for 6+ months
- Onset must be before age 7
What are the key clinical features of ADHD?
- Poor attention/concentration, e.g. losing things, not listening, not finishing tasks
- Hyperactivity - full of energy, fidgety, noisy
- Impulsivity - impatient, interrupts, tantrums, disobedient, risky behaviours
Outline the management for ADHD
- Parent training and psychoeducation if pre-school age
- Psychoeducation +/- CBT if school-age
- If severe, drug treatment may be needed (see pharm)
Define Autistic Spectrum Disorder
Pervasive developmental disorder characterised by classic triad of impaired social interaction, impaired communication, and rigidity of behaviour.
Onset before age 3
Outline some of the clinical features of ASD
- Impaired social interaction - few gestures, little eye contact, lack of smiling, few friends
- Impaired communication - delayed speech, literal understanding, problems sensing non-verbal cues
- Rigidity of behaviour - rocking, dislike of change, limited imagination, obsessional interests
How does Asperger’s differ from ASD?
No impairment of language, cognition or intelligence
How is ASD managed?
- Risperidone for challenging behaviour
- Melatonin for sleep
- SALT
- Psychoeducation/CBT
- Social support, special schooling
Define “learning disability”
- IQ <70
- Significant functional impairment
- Onset before age 18
How is the severity of LD classified?
Mild = IQ 50 - 69 Moderate = IQ 35 - 49 Profound = IQ 34 or under
List some possible causes of LD
- Antenatal infection
- Prematurity
- Cerebral palsy
- Genetic condition, e.g. Down’s
What is “diagnostic overshadowing”?
Symptoms overlooked as attributed to LD
