Child And Adolescent Psychiatry Flashcards
Course and outcome of conduct disorders
Persistent disorder, associated with increased risk of early death, often by sudden or violent means.
Also increased risk of social exclusion, poor school achievement, long term unemployment, criminal activity, adult mental health problems, and poor interpersonal relationships
Management of conduct disorder
Based on biopsychosocial assessment and is likely to need multiagency communication and cooperation
Parent training program Behavioural support in school Functional family therapy Multi-systemic therapy Child interventions: social skills, problem solving, anger management Treat co-morbidity Assess child protection concerns
Hyperkinetic disorders
HKD or ADHD
Core features of developmentally abnormal inattention, hyperactivity and impulsivity present across time and situations
Co-morbidity of ADHD
specific learning disorder ASD Conduct disorder Motor coordination problems Substance misuse Anxiety Depression
Outcome of children with hyperkinetic disorders
Majority are symptomatic into adulthood, especially inattention
Reduced academic and employment success, increased criminal activity and increased adult mental health problems
Management of ADHD
Psychoeducation - inform child and parent about disorder
Behaviour interventions - realistic expectations, contingency management
Parent training
Medication - stimulants, atomoxetine
School intervention - e.g. Learning support
Treat co-morbidity
Medical management of ADHD
Methylphenidate - closely related to amphetamine
Non addictive
Purely symptomatic treatment
Lasts 4 hours and wears off
Side effects- appetite, weight loss, sleep…
Acts on nor adrenaline and dopamine system
2nd line medical treatment of ADHD
Atmoxetine - non stimulant
Thought was an anti depressant
Affects aren’t seen immediately
Also used for Tourette’s
Self harm
Self injury is a coping mechanism.
To deal with emotional pain, or to break feelings of numbness by arousing sensation
Can indicate psychiatric disorder but isn’t a disorder in itself
Strong link between depression and suicide
Combo of mood disorder, substance misuse and conduct disorder
Management of self harming patient
SAFETY is first priority
Admit to medical ward after serious attempt for medical treatment and psychosocial assessment
Mental health and risk assessment by specially trained member of staff
Further referral to agencies as appropriate
Onset of autism
Before 3 years of age
Clinical picture of autism
Reciprocity
Language
Obsessions
Affected by age and IQ
Conduct disorder
Repetitive and persistent patterns of antisocial, aggressive or defiant behaviours which violate age-appropriate societal norms
NOT STRICTLY MEDICAL DISORDER
