Child psychiatry Flashcards
Epidemiology of psychiatric disorders in children
10% of children
50% present to GP
Aetiology of common psychiatric disorders in children
Parental mental illness (being a carer) Sibling mental illness Family difficulties Adversity/poverty Domestic violence/abuse
Attachment in infants is important: can lead to internal model of the self as unlovable and inadequate (and of others as unresponsive and punitive)
Possible impact of illness on development of child
May halt development (preoccupation with illness)
Delay/regression in achieving normal social/emotional developmental milestones
Separation out of normal adolescent development
What are neurodevelopmental disorders?
Autistic spectrum disorde
ADHD
Dyslexia
Prevalenceof autistic spectrum
1 in 100
More boys than girls 4:1
May present any age
Triad of deficits in autism
Socialisation
Communication
Repetitive behavior
Aetiology of autism spectrum
Genetic
Biological (neurological/brain injury)
Psychological/social factors - affects how patient copes with problem
Epidmiology of ADHD
1-5% prevalence
More boys 3:1
Onset <7 years
Core symptoms of ADHD
Need to be persistent (more than 1 setting)
Inattention
Hyperactivity
Impulsivity
Inconsistent with child’s development
Aetiology of ADHD
Genetic
Biological, neurotransmitters, brain injury.. certain foods? - ADHD symptoms
Psychological/social
Epidemiology of dyslexia
10% (wide definition)
Most severe 4%
Boys more than girls 4:1
May present at any age
Aetiology of dyslexia
Genetic
Biological, NTs, brain injury
Psychological/social (presentation and coping)
General treatment of psychiotric conditions in childhood
Biological:
Less common as 1st line (limited evidence base)
Psychological more common - CBT, family therapy
Social - Very important - link to educational services
Which antidepressant is deemed safe in teenagers?
Suicidal behaviors with SSRIs?
Specialist prescribing only… FLUOXETINE (suggested)
Management of ADHD
Biological:
stimulants: Methylphen (ritalin, concerta)
non-stimulants: atomoxetin
Psychological: parenting course
Social: liasion with education (eg. special needs)
