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Psychiatry > Child & Adolescent Psychiatry > Flashcards

Child & Adolescent Psychiatry Flashcards

1
Q

What factors must be considered when formulating a management plan for psychiatric patients?

A
  • Biological
  • Psychological
  • Social
  • Predisposing, precipitating, maintaining and protective factors
  • Risk assessment (harm to self/others)
  • Consider patients:

1) Consent

2) Capacity

3) Legislation

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2
Q

What are the biological factors that can influence psychiatric patients?

A
  • Genetic predispositions
  • Neuordevelopmental insults
  • Illness
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3
Q

What are the psychological factors that can influence a psychiatric patient?

A
  • Temperament
  • Attachment style
  • Impulsivity
  • Low-self esteem
  • Belief systems
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4
Q

What are the social factors that can affect a psychiatric patient?

A

1 - Family relationships

2 - Peer relationships

3 - Hobbies/interests

4 - School

5 - Criminality

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5
Q

What is the definition of a conduct disorder?

A

Characterised by repetitive and persistent patterns of antisocial, aggressive or defiant behaviours which violate age-appropriate societal norms

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6
Q

What are some of the long-term outcomes for patients with conduct disorders?

A

1 - Early, sudden death

2 - Social exclusion

3 - Poor school achievement

4 - Long-term unemployment

5 - Criminal activity

6 - Adult mental health problems

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7
Q

What are some of the approaches to management of conduct disorders?

A

1 - Parent training programme

2 - Modification of school environment (behavioural support)

3 - Functional family therapy

4 - Multi-systemic therapy

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8
Q

What are core features of hyperkinetic disorders, such as ADHD?

A
  • Developmentally abnormal inattention
  • Hyperactivity
  • Impulsivity
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9
Q

What are the most common co-morbid conditions that go along with ADHD?

A

1 - Learning disability

2 - Autism spectrum disorder

3 - Conduct disorders

4 - Tics

5 - Motor coordination problems

6 - Anxiety & depression

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10
Q

How is ADHD managed?

A

1 - Psychoeducation

2 - Medication - stimulants, atomoxetine, guanfacine

3 - Behavioural interventions

4 - Parent training

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11
Q

What are the medications used to manage ADHD?

A

Stimulants (Ritalin)

Atomoxetine

Guanfacine

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12
Q

What is the brand name for methyphenidate?

A

Ritalin

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13
Q

What drug is methyphenidate closely related to?

A

Amphetamine

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14
Q

What are the side effects of methyphenidate?

A

Appetite loss

Weight loss

Sleep disturbance

Mild change in BP

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15
Q

How does methyphenidate work?

A
  • Prevents dopamine re-uptake therefore increasing circulating dopamine levels
  • Prevents re-uptake of Noradrenaline therefore increasing circulating noradrenaline levels
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16
Q

What is the 1st line treatment for ADHD?

A

Methylphenidate

17
Q

What is the 2nd line treatment for ADHD?

A

Atomoxetine

18
Q

What are the similarities and differences of methylphenidate and atomoxetine?

A

Simlarities - works on NAD system

Differences - Atomoxetine is non-stimulant

19
Q

Consider the following case and then list the biopsychosocial factors affecting this patient:

  • 16 y.o. male
  • Commited serious assault
  • History of antisocial behaviour, impulsivity, poor conc. and hyperactivity
  • Poor academically, father left age 4 with anger problems and has no contact
  • Cousin diagnosed with AHDH
  • Mum suffered with depression and smoked during pregnancy to deal with stress caused by husband
A

Biological:

  • Genetic predisposition to ADHD
  • Possible neurodevelopmental issues caused by antenatal stress and cigarette use
  • Postnatal depression/stress

Psychological:

  • Insecure attachment style with mum
  • Anger at fathers rejection
  • Impulsivity & low slef-esteem

Social:

  • Mix of conflict and caring in relationship with mum
20
Q

What is self-harm and why do people do it?

A

Self-harm:

  • A coping mechanism whereby an individual harms their physical self to deal with emotional pain or to break feelings of numbness by arousing sensation
21
Q

What are examples of self-harm?

A

Self-poisoning

Cutting

Burning

22
Q

What other problems can self-harm be an indicator for?

A

Psychiatric disorders

Psychosocial problems

23
Q

What factors increase risk of suicide?

A
  • Persistent suicidal ideas
  • Previous suicidal behaviour
  • High lethality of method used
  • High suicidal intent and motivation
  • Ongoing precipitating stresses
  • Mental disorder
  • Poor physical health
24
Q

How is a suicidal young person managed?

A
  • Safety of the young person is the priority!
  • Take it seriously
  • Admit to medical ward after serious attempts for medical treatment and psychosocial assessment
  • Mental health & risk assessment
  • Confidentiality

Psychiatry (18 decks)

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