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Psychiatry > Childhood and Adolescent Pyschiatric Disorders > Flashcards

Childhood and Adolescent Pyschiatric Disorders Flashcards

1
Q

Common Disorders

A

Autism Spectrum disorder
ADHD
Intellectual disability
Tic disorders
Anxiety disorders
Elimination disorders

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2
Q

Autism spectrum disorder is also known as

A

childhood autism, infantile autism, or early infantile autism

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3
Q

ASD is marked and sustained

A

impairment in social interaction and communication with restricted or stereotyped patterns of behavior and interest.

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4
Q

Asd abnormalities must be present by

A

age 3

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5
Q

Most common comorbidity with asd

A

intellectual disability

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6
Q

Presentation and Clinical features of asd
Parental -
School -
Routine -
Specialists -

A

Parental - Early Parental concerns
School - Concern from school
Routine - Routine well child clinics.
Specialists - Paediatricians and GPs

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7
Q

Common parental concerns with asd

A

Child’s lack of language,
inconsistencies in responsiveness
concern that the child might be deaf
In children with autism, social and communication skills increase by school age
Loss of earlier acquired words or language
Problems dealing with change and transitions and various self-stimulatory behaviors (sometimes including self-injury) also may become more prominent during this time.

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8
Q

Asd dsm 5 core symptom domain

A

A. Persistent deficits in social communication and social interaction across multiple contexts (SCI)

B. Restricted, repetitive patterns of behavior, interests, or activities. (RRBI)

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9
Q

asd dsm 5 lesser core symptoms

A

C. must be present in the early developmental period (manifest until social demands exceed limited capacities, or masked by learned strategies in later life).
D. cause clinically significant impairment in social, occupational, or other important areas of current functioning.
E. not better explained by id or global developmental delay. ID &ASD frequently co-o

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10
Q

Persistent deficits in social communication and interaction in asd include

A
  • Deficits in social-emotional reciprocity
  • Deficits in non verbal communicative behaviours
  • Deficits in developing, maintaining and understanding relationships
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11
Q

Differential diagnosis of asd

A

Sensory impairment (hearing loss, visual impairment)
Intellectual disability
Severe Psychosocial deprivation
Selective mutism & separation anxiety disorder
Specific language disorder
Childhood schizophrenia
OCD, ADHD

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12
Q

The goal of treatment of asd are

A

to reduce disruptive behaviors and to promote learning,
particularly language acquisition and communication and self-help skills.

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13
Q

Children with ADHD display___

A

the early onset symptoms consisting of developmentally inappropriate activity, inattention, academic underachievement and impulse behaviour

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14
Q

Making diagnosis of hyperkinetic disorder requires

A

definite presence of abnormal levels of inattention, hyperactivity, and restlessness that are pervasive across situations and persistent over time and that are not caused by other disorders such as autism or affective disorders for at least six months

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15
Q

Risk factors of ADHD

A

Genetics, Obstetric complications and Psychosocial adversity

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16
Q

Aetiology of ADHD

A

Evidence from animal and human studies implicates the dysregulation of frontal-subcorticalcerebellar catecholaminergic circuits in the pathophysiology of ADHD, and molecular imaging studies suggest that abnormalities of the dopamine transporter lead to impaired neurotransmission.

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17
Q

ADHD Epidemiology
Prevalence:
Sex Ratio:
Social class:
Ethnic origin:
Age:

A

6-12% globally
Commoner in men
Commoner in lower economic strata
Under identified and Under treated in minority groups
Prevalence falls with age

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18
Q

ADHD treatment

A

Studies during the past decade have shown the safety and effectiveness of new non-stimulant drugs (Atomoxetine) and long-acting formulations of methylphenidate and amphetamine.

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19
Q

Parental training and behavioural management techniques will be useful for children below

A

6 years

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20
Q

Definition of intellectual disability

A

A disability characterized by significant limitations both in intellectual functioning and in adaptive behaviour.

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21
Q

IQ test score below _ indicate a limitation in intellectual functioning

A

70 (2SD)

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22
Q

Degrees of severity
Mild mental retardation-
Moderate retardation-
Severe mental retardation-
Profound mental retardation-

A

50/55 - 70
35/40 - 50/55
20/25 - 35/40
below 20/25

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23
Q

Signs of ID in children

A

Delayed sitting, crawling, walking
Speech delays
Delayed potty training
Problems in memory & concentration
Behaviour problems: temper tantrums, aggression, self harm, poor social skills
Appears clumsy or uncoordinated
Fine motor skills slow to develop

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24
Q

Most wildly recognised and most severe form of tic disorder is

A

Gilles de la Tourette syndrome, or Tourette’s disorder.

25
Q

The tic disorders are increasingly recognized as __

A

highly familial conditions involving disruptions of frontal, striatal, and subcortical brain circuitry and commonly accompanied by other forms of psychopathology.

26
Q

What is a tic

A

Sudden, rapid, recurrent, nonrhythmic motor movement or vocalization.

27
Q

Tics may be classified according to

A

degree of complexity (simple, complex)
their quality (motor, vocal)
Duration (Transient, Chronic)

28
Q

Copropraxia

A

a complex motor tic presenting as an obscene gesture

29
Q

Echopraxia

A

complex motor tic where a person is compelled to repeat or imitate a movement observed in another person

30
Q

Coprolalia

A

complex vocal tic with utterance of obscene or aggressive words or sentences

31
Q

Management of tic disorders

A
  • Psychoeducation
  • Psychotherapy
  • Medication
32
Q

Useful psychotherapy include

A

habit reversal training, Exposure and response prevention, Relaxation training, Contingency management, family therapy

33
Q

Characteristics of attachment

A
  • Proximity maintenance
  • Safe haven
  • Secure base
  • Separation distress
34
Q

RAD?

A

Reactive Attachment disorder: linked to early childhood maltreatment, is characterized by inhibition of the normal developmental tendency to seek comfort from caregivers.

35
Q

DSED?

A

Disinhibited social engagement disorder (DSM 5) : linked to institutionalization or exposure to multiple caregivers before age 5, is characterized by a relative hyperactivation of the attachment system, resulting in “diffuse” and unselective attachments, and patterned behavior labeled “indiscriminate sociability.“

36
Q

Encopresis four related criteria

A

(1) the repeated inappropriate passage of feaces, usually involuntary;
(2) occurrence at least once a month for at least 3 months;
(3) a chronological or mental age of 4 years and
(4) exclusion of a substance or medical
condition as a cause.

37
Q

Enuresis criteria

A
  • Diagnosis is made after five years of age
  • Severity is determined by frequency
  • Wetting just occur at least twice a week for 3 consecutive months or produce significant distress
  • Physical causes must be excluded
38
Q

ODD

A

Oppositional Defiant Disorder

39
Q

DSM-4 ODD symptoms

A

Is often angry and resentful
• Often argues with adults
• Is often touchy or easily
annoyed by others
• Often loses temper
• Often deliberately annoys or irritates
others
• Often blames others for his or her
mistakes or misbehaviour
• Often actively defies or refuses
to comply with adult requests or rules
• Is often spiteful and vindictive

40
Q

In ICD-10 symptoms of ODD

A

Milder form of conduct disorder

41
Q

Comorbidities of ODD

A

Anxiety
Depression
Conduct disorder
Substance abuse
ADHD

42
Q

Treatment of ODD

A

Parent training
Anger management
Medication

43
Q

Examples of behaviours the diagnosis of conduct disorders are based

A

excessive levels of fighting or bullying;
cruelty to animals or other people; severe destructiveness to
property;
firesetting; stealing; repeated lying; truancy from school
and running away from home; unusually frequent and severe
temper tantrums; defiant provocative behaviour; and persistent
severe disobedience. Any one of these categories, if marked, is
sufficient for the diagnosis, but isolated dissocial acts are not.”

44
Q

Symptoms of conduct disorder

A

Aggression to people and animals
Destruction of property
Deceitfulness or theft
Serious violatons of rules

45
Q

Subtypes of conduct disorder

A
  • Confined to family context
  • Unsocialised
  • Socialised
46
Q

To be diagnosed with MDD, a child or adolescent must have___

A

at least 2 weeks of persistent change in mood manifested by either depressed or irritable mood and/or loss of interest and pleasure plus a group of other symptoms including wishing to be dead, suicidal ideation or attempts; increased or decreased appetite, weight, or sleep; and decreased activity, concentration, energy, or self-worth or exaggerated guilt

47
Q

Development response
Infants -
Toddlers –
School age –
Older children /adolescents –

A

Infants - fear of loud noises
Toddlers – fear of strangers, imaginary creatures.
School age – injury , natural events like storms
Older children /adolescents – worries and fears relating to school performance.

48
Q

Developmental response
• Animal phobias –
• Separation anxiety disorder –
• Generalised anxiety disorder –
• Social anxiety disorder –
• Obsessive compulsive disorder –
• Panic disorder –

A

Animal phobias – early childhood (around 6-7 years)
• Separation anxiety disorder – early to mid-childhood (around 7-8
years)
• Generalised anxiety disorder – late childhood (around 10-12 years)
• Social anxiety disorder – early adolescence (around 11-13 years)
• Obsessive compulsive disorder – mid adolescence (around 13-15
years)
• Panic disorder – early adulthood (around 22-24 years)

49
Q

Common behavioral features seen in human adolescents and their counterparts in other species ; include

A

elevations in peer-directed social interactions along with occasional increases in fighting with parents, increases in novelty-seeking, sensation-seeking and risk-taking , and greater per occasion alcohol use.

50
Q

Adolescent Psychiatric Disorders

A

ADHD
ANXIETY DISORDERS
MOOD DISORDERS (Depression and Bipolar disorders)
DELIBERATE SELF HARM
SUBSTANCE ABUSE
PUI
EATING DISORDERS
PTSD

51
Q

most common OCD comorbidities

A

tic disorders, attention deficit hyperactivity disorder (ADHD), other anxiety disorders, mood and eating disorders.

52
Q

Components of OCD

A

Obsession – thought component – intrusive, ego dystonic.
Compulsion – to relieve the obsession

53
Q

OCD is characterized by

A

the presence of obsessions or compulsions that are time consuming (at least one hour per day), cause subjective distress or interfere with the patient’s or the family’s life.

54
Q

Obsessions are

A

intrusive, unwanted ideas, images, fears, thoughts or worries that are experienced as uncomfortable, unpleasant, distressing or anxiety provoking.

55
Q

Compulsions are

A

repetitive behaviours or mental acts performed to ignore, reduce or eliminate the anxiety or distress caused by the obsessive thoughts.

56
Q

Types of substance abuse disorders

A

Intoxication
SIPD
SUD ( Use /Abuse/dependence)

57
Q

treatment of substance abuse disorders

A

Aim to achieve motivation to stop usage.
Detoxification
Rehabilitation and Treatment of comorbid psychiatric conditions.

58
Q

PTSD is characterised by

A

triad of intrusive thoughts (flash backs), hyperarousal, and avoidance

Psychiatry (12 decks)

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