Child health- mental health (CAMS) Flashcards
what is autism spectrum disorder
characterised by persistent deficits in the ability to initiate and sustain reciprocal social interactions and social communication, and by a range of restricted, repetitive, and inflexible patterns of behaviour, interests or activities that are clearly atypical or excessive for the individuals age and sociocultural content
male:female ratio of autism spectrum disorder
4:1
risk factors for developing autism
rubella in pregnant mother
tuberous sclerosis
fragile X syndrome
Encephalitis
untreated pku
which parts of the brain appear pathological in autism spectrum disorder
frontal lobes
amygdala
cerebellum
which neurotransmitters in the brain and implicated in autism spectrum disorder
GABA
glutamine receptors
serotonin
how many children under 5 have reactive attachment disorder- normal vs looked after children
1%
20%
risk factors for reactive attachment disorder
adverse childhood experiences- abuse, neglect, household dysfunction
increased likelihood if child is orphaned at young age
inhibited vs uninhibited reactive attachment disorder
inhibited- avoids interaction, emotionally distant, rarely seeks comfort
uninhibited- overly friendly, no fear of strangers, seeks comfort from any adult, overly trusting
what does ADHD stand for
attention deficit hyperactivity disorder
what percentage of children have ADHD
4-5% of children
which transporter genes are mainly involved in ADHD
dopamine and serotonin
perinatal factors of ADHD
tobacco and alcohol use during pregnancy
significant prematurity and perinatal hypoxia
unusually short/long labour, foetal distress
some evidence- exposure to viral infection in first trimester
psychosocial risk factors of ADHD
severe marital discord
low socioeconomic class
large family size
paternal criminality
maternal mental disorder
maltreatment
emotional trauma
what is the typical brainmap pattern seen in children with ADHD
underachieve function of frontal lobe- frontal lobe mainly responsible for reasoning, planning, impulse control etc
ADHD classic triad of symptoms
inattention
hyperactivity
impulsivity
diagnostic criteria for ADHD in children
6 or more symptoms of inattentiveness and/or
6 or more symptoms of hyperactivity and impulsiveness
present before 5 years
symptoms get in way of daily life
diagnostic criteria for ADHD in adulthood
5 or more symptoms of inattentiveness
and/or
5 or more symptoms of hyperactivity and impulsiveness
moderate effect on areas of life- work/education, friends and relationships, driving dangerously
1st line drugs for ADHD
stimulants-
methylphenidate
dexafetamine
lisdexafetamine
moa of methylphenidate
increases dopamine by blocking its transporter
moa of dexafetamine
increases dopamine by blocking its transporter
increases extracellular norepinephrine and possibly serotonin
2nd line drugs for ADHD
SNRI-
atomoxetine
3rd line drugs for ADHD
alpha agonists-
clonidine
guanfacine
what is the most common diagnosis of ‘mental disorders’ in children (around 6%)
disruptive/behavioural disorders
what ages is separation anxiety considered normal
7 months- preschool years
what is conduct disorder
repetitive and persistent pattern of behaviour in which the basic rights of others or major age-appropriate norms or rules are violated
clinical features of conduct disorder- diagnostic criteria
3 or more of following in past 12 months with at least 1 in the past 6 months-
aggression to people/animals
destruction of property
deceitfulness or theft
serious violation of rules
drug of choice for severe conduct disorder
risperidone (atypical antipsychotic)
