Child and Adolescent psychiatry

Question 1

What are some mental health problems associated with being out of school?

Answer 1

Anxiety
Conduct disorder
Autism
Depression
OCD

Question 2

How might mental health problems affect school attendance?

Answer 2

Learning difficulty
Difficulty controlling emotion
Anxiety
Apathy
Difficulty joining in
Sensory overload
Preoccupation

Question 3

What is separation anxiety?

Answer 3

Fear of leaving parents and home

Problems on doorstep

Question 4

What is a social phobia?

Answer 4

Fear of joining group

Problems at school gate

Question 5

What are the 3 A’s of anxiety disorders?

Answer 5

Anxious thoughts/feelings
Autonomic symptoms
Avoidant behavious

Question 6

How do children usually present? Who requests for them?

Answer 6

School
Social care
Parents
GP
Usually with a problem e.g. child who is very hyperactive or doesn't want to eat

Question 7

What may be causing unwillingness to go to school?

Answer 7

Learning difficulties
Lack of friends and relationships
Bullying
Lack of parental attention or concern 
Maternal depression

Question 8

How does GAD affect amygdala?

Answer 8

Amygdala activity is supressed by right ventrolateral cortex when labelling emotions
Reduced connectivity between right ventrolateral cortex and amygdala

Question 9

How do you manage a child scared of school?

Answer 9

Behavioural therapies like learning alternative patterns of behaviour, desensitisation, overcoming fear, managing feelings
SSRI like fluoxetine if extreme and untreatable

Question 10

What are the long term effects of successful behavioural therapy?

Answer 10

Challenge
Success
Self-confidence
Resilience

Question 11

What are the long-term effects of no behavioural treatment?

Answer 11

Challenge
Avoidance
Low self-confidence
Vulnerability

Question 12

What is psychoeducation in therapy?

Answer 12

Explaining the problem in terms that make sense to everyone

Question 13

What is autism spectrum disorder?

Answer 13

Reciprocal conversation
Expressing emotional concern
Non-verbal communication
Poor eye contact
Obsession/preoccupation
Rigid and inflexible behaviour patterns

Question 14

What are some congenital/genetic disorders strongly associated with ASD?

Answer 14

Rubella
Callosal agenesis
Down's syndrome
Fragile X
Tuberous sclerosis

Question 15

How does ASD affect depression, OCD, anxiety and language impairment rates?

Answer 15

Increased

Question 16

Why are there more ASD individuals in computing, engineering and mathematics?

Answer 16

Poor set-shifting ability

Increased visuospatial ability

Question 17

Is GABA associated with ASD?

Answer 17

Yes

Found preferentially at glutaminergic sites

Question 18

How does severity of neurotransmitter dysfunction affect ASD?

Answer 18

Increased LD and affects synaptic function, neural migration, brain development

Question 19

What are some key features of oppositional defiant disorder?

Answer 19

Refusal to obey adults requests
Often argues
Often loses temper
Deliberately annoys people
Touchy
Spiteful or vindictive

Question 20

What are some differences in adhd compared to odd?

Answer 20

Often remorseful
More genetic cause than adversity/parenting
Poor cognitive control compared to enacting to obtain a desired goal

Question 21

What are some useful steps for hard-to-manage children?

Answer 21

Parent training

Multi-systemic treatment attempts to correct all causes

Question 22

What is parent training?

Answer 22

Focus on positive reinforcement of desired behaviour and developing positive parent-child relationships
Highlight to parents the effect of their actions and how kids mimic them