Child Psychiatry

Question 1

Which gender is more likely to have autism?

Answer 1

Boys
They are 4x more likely
75% children Male

Question 2

What age does autism usually develop before?

Answer 2

The age of 3

Question 3

What are the 3 main hallmarks of autism?

Answer 3

Communication impairment - Global impairment of language and communication
Interaction impairment - Impairment of social relationships
Imagination impairment - Ritualistic and compulsive phenomena

Question 4

What medical conditions are associated with autism?

Answer 4

Fragile X syndrome
Rett syndrome
Tuberous sclerosis

Question 5

What are the structural brain changes seen in children with autism?

Answer 5

Brain enlargement

Larger lateral and 4th ventricles

Question 6

Autism is managed used a biological, psychological and social approach. What biological agents are used and why?

Answer 6

SSRIs - in low doses to manage repetitive behaviours
Antipsychotics - risperidone used to manage challenging behaviour
Melatonin - can be used to reduce sleep latency (the time it takes to fall asleep

Question 7

Which is the only antipsychotic licensed for use in children?

Answer 7

Risperidone

Question 8

Autism is managed used a biological, psychological and social approach. What psychosocial management is used?

Answer 8

CBT
Applied behavioural analysis programme
Educational psychology

Question 9

Autism is managed used a biological, psychological and social approach. What social support is used?

Answer 9

Special teaching and schools for autistic children
Educate families and siblings
Healthcare support

Question 10

What are the different autism screening tools used?

Answer 10

ADI-R - autism diagnosis interview revised
ADOS-2 - autism diagnostic observation schedule
DISCO - diagnostic interview for social and communication disorders

Question 11

What are the 3 core symptoms of ADHD?

Answer 11

Inattention - easily distractible, unable to focus
Impulsivity - act without thinking, interrupting conversations, no sense of danger e.g, walking into a road
Hyperactivity - unable to sit still, climbing on things

Question 12

At what age are children often diagnosed with ADHD?

Answer 12

Between the ages of 7-15

Younger children are often more active so its more difficult to determine in younger children

Question 13

What is the diagnostic criteria for ADHD?

Answer 13

Symptoms must be present in multiple settings e.g, home and school
Onset of symptoms must be before 7 years of age
Symptoms must be present for at least 6 months
Must cause significant functional impairment
Not better accounted for by other disorders e.g, ASD, depression, anxiety

Question 14

What questionnaire is used to assess a child with suspected ADHD?

Answer 14

Corners questionnaire

For parents and teachers of the child

Question 15

How is ADHD managed?

Answer 15

1st line - psychoeducation for families and school
2nd line - methylphenidate (Ritalin)

CBT can also be useful for children with significant impairment

Question 16

What are the main side effects of methylphenidate (Ritalin)?

Answer 16

Loss of appetite

Problems with sleep

Question 17

What is oppositional defiance disorder?

Answer 17

Negative, hostile, disobedient and defiant behaviour
Symptoms may be present at home but not at school
Usually presents by age 8
More likely in children with ADHD

Question 18

What other mental health conditions are more common in autistic children?

Answer 18

Depression
Bipolar affective disorder
Schizophrenia

Question 19

What increases the risk of developing autism?

Answer 19

Genetic link - more likely if someone in family has it

Question 20

What is the sally-Anne test used to assess?

Answer 20

Theory of mind
The sally anne test is where Anne moves the marble and sally goes to find it. The patient is asked where she will look
In order to get the correct answer of “the basket”, one must understand that sally does not know that Anne has moved the marble
85% of 5 year olds will pass the test
80% of autism children will fail the test

Question 21

How is conduct disorder in children managed?

Answer 21

Using a multi-systemic therapy

Multi-modal, family based and social systems based approach

Question 22

What is the difference between oppositional defiant disorder (ODD) and conduct disorder?

Answer 22

ODD is difficult behaviour at home with known adults or peers, but not at school

Conduct disorder is oppositional behaviour in all areas of life, and is extreme aggressive behaviour