Child Psych! Flashcards
What is the first line treatment for depression and children and adolescent
Psychological intervention especially for mild to moderate depression
What is the Sprucepine antidepressant recommended for treatment of depression in children
Prozac
What are the two FDA approved and a depressant for children
Prozac and Lexapro
Why do anti-depressants have to sometimes be scheduled twice a day in children
Metabolize the antidepressant quickly
What is the efficacy of TCA in children and adolescents
Not effective in preview Berto children but there is some marginal Efficacy in adolescence
Is ECT recommended and children under 12
No because it is unclear about the effects does ECT on the developing brain
What is the side effect burden of PCAs and children and its relative effect on the heart
Vertigo, orthostatic hypotension, summer and dry mouth
It is awesome more cardio toxic and young people and then an adult
What are common side effect seeing with antidepressant in children
Sedation, insomnia, gastrointestinal symptoms
Barely at least two leading, serotonin syndrome, activation and mania
What is the evidence associated with suicidality and antidepressant used in children
Evidence has found that antidepressants increase the risk of suicidal behavior and aggression in the short term but the studies have not seen completed suicide in these trials
In studies they have also found that a population decreased different question of SSRIs there was an increase in the rate of suicide
What are the first line medications for treating acute mania in children
Abilify, olanzapine, quetiapine, risperidone, asenaphine
Recommended first line treatment for bipolar depression
Olanzapine and Prozac combo, Seroquel, Latuda
Why are first generation and I psychotics avoided in children
They will experience EPS and a lot of sedation more when given fresh generation antipsychotics
What antipsychotics did you try before giving a child clozapine
Olanzapine
Which second generation antipsychotic is less effective out of all of them
Ziprasidone, their concerns about is cardiac safety as well
Criteria for generalizing Anxiety disorder in children
Worrying plus one of the following symptoms: restlessness, fatigue, difficulty concentrating, irritability, muscle tension, sleep disturbances
They tend to worry about school peers etc.
What ratio of males to females are affected by anxiety
1 to 2 respectively a.k.a. females are affected more
Typical PRN medication as we used for anxiety
BuSpar, Atarax, gabapentin
Common antidepressants we use for anxiety treatment
Prozac, Lexapro, Zoloft
What is one of the main reasons why children avoid school
High levels of distress or anxiety related to school
Could be related to tests, bullies, Devotie in school, separation anxiety
What is a key unique feature of depression in children
Irritability
What are the key features of disruptive mood dysregulation disorder
They will experience verbal and or behavioral tantrums out of proportion to a situation and it is also inconsistent with your development
They will have tantrums about three times a week with irritability in between
Dissent does this last for one year without a three month break and typically the symptoms occur before 10 years old
Must be between the ages of six and 18 for this diagnosis
How does bipolar typically initially present in children
Typically presents first with a depressive episode
Why do we typically avoid Paxil in children
Increases the risk of suicide
What are two medication that we typically don’t use as first line in children
Bupropion and mirtazapine
Inattentive symptoms of ADHD
Mistakes, poor attention, filter finish, loses things, distractible, for organization, avoids effort, forgetful, not listening
Hyper active or impulsive symptoms of ADHD
Can’t sit, on the go, fidgety, can’t play quietly, talkative, running or climbing, impulsive or blurts out, Can’t wait turn, interupts others
How many of the ADHD Criteria is required to be diagnosed with ADHD
6+ symptoms for at least six months in two different settings and they have to have some thoughts before the age of 12 years old
What type of ADHD are girls more likely to have
Inattentive type
What are some consequences of untreated ADHD
Poor performance in school, social rejection, higher rates of unemployment, higher risk of developing conduct disorder or oppositional defiant disorder, increase risk of developing substance abuse, higher risk for traffic accidents, high risk for accidental injury
What percentage of Children continues to have symptoms of ADHD as an adult
50%, and attention is more likely to continue then be hyper activity or impulsivity
What is the first line treatment for ADHD
Stimulants like methylphenidate (Ritalin) or Adderall (amphetamine)
Methylphenidate is typically used in younger children
Stimulus going to be helpful for all symptoms of ADHD
What symptoms are alpha agonist like clonidine and guanfacine helpful for when managing ADHD
Helpful for management of hyperactivity or impulsivity, models helpful for an attention.
It can also help with sleep
What are the less helpful ADHD treatment
Animosity and bupropion
What are things you want to look for when treating somebody with ADHD
Assess for personal family cardiac history and after starting it assessed for low appetite, irritability, sleep difficulties, elevated heart rate and blood pressure
What are the different types of methylphenidate
Ritalin, Concerta, Focalin
What are the different amphetamine derivatives
Adderall and Vyvanse
What are the key features of OCD, in a way that you can easily describe it
The obsessions are intrusive thoughts that lead to anxiety or tension that is relieved by engaging in the compulsions, which can be engaging in a mental act or a physical act
Is there a genetic component to OCD
Yes, it is a heterogeneous disorder that runs in families. For a firstdegree relative there is a four Fold increased risk of developing OCD
What neurotransmitters are thought to play a role in OCD
Serotonin and dopamine
What can happen to OCD symptoms when treating the patient also for ADHD
Bye using a stimulant there may be some exacerbation of OCD symptoms. That is why you were sometimes see the use of dope me an antagonist plus an SSRI to get the best OCD treatment
What is OCD typically comorbid with
ADHD and take disorders like Tourette’s.
It is also commonly called worried with other anxiety disorders as well
What are common clinical features seeing an OCD
Fear of dirt germs or disease or harming themselves or others.
Compulsions of cleaning, checking, accounting, repeating behaviors, and arranging items
What is the definition of a compulsion
A repetitive behavior or mental act ,like praying counting or repeating words silently, that is aimed at preventing or reducing the distress or anxiety
Differentiating between severe OCD and psychosis
When the patient still has insight and there is still underlying anxiety press it it is most likely to be OCD over psychosis
What feature predicts the best outcome for patients with OCD
The absence of comorbid disorders Mike take disorder and ADHD depression
Any minority of cases what is OCD sometimes a prodrome of
A psychotic disorder
What medications are FDA approved for treatment of OCD in children
Zoloft, Prozac, Luvox
Can also argument with an ETA boy and I psychotic like risperidone if there is only a partial response with the serotonergic medication
Which type of temperament and children it’s likely to develop anxiety disorders
Children with the Shy temperament who wants that are likely to withdraw and unfamiliar situation
What type of attachment increases the risk of a child developing anxiety
An insecure attachment, typically seen in anxious mothers
How might a parents behavior influence a child developing anxiety
Social learning, if they see their parents often times expressing fear they will learn that response ( like cringing when there is a lightning storm)
What is first line treatment for anxiety disorders in children
Cbt!
Luvox is also approved for anxiety disorder treatment as well as ssri’s
