child and adolescent - mentor & more 7 Flashcards
Munchausen’s syndrome by proxy recently renamed
fabricated or induced illness
Munchausen’s syndrome by proxy is
a rare form of child abuse in which a parent falsifies illness in a child by fabricating or producing symptoms and presenting the child for medical care while disclaiming knowledge of the cause of the problem.
Munchausen’s syndrom by proxy is, in the majority of cases, perpetrated by
the mother
Typical victims of munchausen’s syndrome by proxy is
4 years old
75% are under six years old
—– % of munchausen’ys syndrome by proxy are under six years old
75%
Munchausen’s syndrome by proxy (MSP) in dsm -5
Factitious Disorder Imposed on Another
DSM-5 criteria for Factitious Disorder Imposed on Another
A. Falsifying signs or symptoms in another through deception.
B. Presenting someone else as ill or injured.
C. Deceptive behavior exists without clear rewards.
D. Behavior is not due to another mental disorder.
Symptoms abate following separation of the child from the caregiver in Munchausen syndrom by proxy (MSP).
True or false
True
The most frequently reported problems are in MSP
- apnoea (26.8% of cases)
- anorexia / feeding problems (24.6%)
- diarrhoea (20%)
- seizures (17.5%)
- cyanosis (11.7%)
- behaviour (10.4%)
- asthma (9.5%)
- allergy (9.3%)
- fevers (8.6%)
Neimann-pick type typically associated with psychiatric presentations
Type C (NPC)
Approximately 1/3 of NPC cases present in
adolescence / adulthood
the typical presentation is of NPC is
is progressive ataxia / dystonia, cognitive decline (memory and executive function), and atypical psychotic symptoms (treatment resistant psychosis).
Psychiatric manifestations onset in relation to other symptoms in NPC - Neurologics
Psychiatric manifestations occur before or at neurological disease onset in approx 80% patients;
Psychiatric manifestations onset in relation to other symptoms in NPC - Organic signs
organic signs (e.g., hepatosplenomegaly, hearing problems) are reported before psychiatric manifestations in 20%.
Substantial delays to diagnosis are observed in NPC
True or false
True
(5–6 years between psychiatric presentation and NPC diagnosis)
Adult onset Neimann-Pick ?
NP-type C
What are night terrors?
Night terrors, also known as pavor nocturnus or sleep terrors, are episodes of intense crying and distress during sleep.
At what age do night terrors typically occur?
Night terrors generally occur in children aged 3-12, most often when a child is 3-4.
Are night terrors more common in boys or girls?
Night terrors are equally common in boys and girls.
Do night terrors persist into adulthood?
Night terrors normally spontaneously remit in adolescence, but they can occur in adults.
How long does a typical night terror episode last?
A typical episode lasts between 1 to 15 minutes.
When do night terrors typically begin after sleep onset?
Night terrors typically begin 1 to 3 hours after sleep has begun.
How do night terrors differ from nightmares?
Night terrors occur in the transition from stage 3 to stage 4 sleep, while nightmares occur in REM sleep.
