Childhood disorders

Question 1

Autism Spectrum Disorder

Answer 1

• Social communication deficits
• Restricted interests/behaviors
• Present since very early age

High co-morbidities:

• Intellectual disability
• Language difficulties
• Anxiety disorders

Prognosis depends on language development and intellectual capacity

Question 2

ANXIETY DISORDERS

Answer 2

5% of children

Excessive worry (interfering with function)

Separation Anxiety Disorder, Obsessive Compulsive Disorder, and Social Phobia

AVOIDANCE!

Somatic complaints

Disruptive symptoms: tantrums

Academic failure

Tx: Cognitive Behavioral Therapy vs. other therapies + SSRIs

Question 3

DEPRESSION in children

Answer 3

3% of children; 5-8% of adolescents

Lifetime prevalence by end of adolescence: 20%

Suicidal behavior

Risk of academic failure, poor relationship, and less than optimal occupational outcome

Tx: Psychotherapy + SSRIs

Question 4

Adolescent suicide- Risk factors

Answer 4

EMALES -> MORE ATTEMPTS

MALES more COMPLETED suicides

Previous attempts -> increase risk

Self-mutilation are associated with suicide attempts

Early childhood abuse, current behavior problems, disinhibition secondary to intoxication increase risk

Chronic difficulties and recent acute stressor (shame or hurtful argument)

Question 5

POST-TRAUMATIC STRESS DISORDER

Answer 5

Abuse, neglect, observing domestic violence, accidents, illness (including hospitalizations)

Symptoms include hypervgilance, avoidance, and re-experiencing

“The Great Masquerader”

Co-morbidity: depression, substance abuse, risk-taking behavior

Tx: Psychotherapy

Question 6

ATTENTION DEFICIT HYPERACTIVE DISORDER

Answer 6

Affects 5-12% of children worldwide

Sx: Inattention, Hyperactivity, Impulsivity, Disorganization

Problems in at least 2 settings

Comorbidity: Learning disorders, substance abuse

Tx: stimulants, school support, parent support

Question 7

SUBSTANCE ABUSE

Answer 7

Indicative of other psychiatric disorder

Use of multiple substances is common

Has DECLINED in youth in past 15 years

Associated with poor family relations and parental supervision

Tx: Building family relations and child/adolescent’s capabilities

Question 8

ALCOHOL ABUSE

Answer 8

Alcohol use among teens has DROPPED to historically low levels

In 2012, 3.6 percent of 8th graders, 14.5 percent of 10th graders, and 28.1 percent of 12th graders reported getting drunk in the past month

In 2012, 23.7 percent of high-school seniors reported binge drinking (defined as 5 or more drinks in a row in the past 2 weeks)—a drop of one-quarter since the late 1990s.

Question 9

CONDUCT DISORDER

Answer 9

More Common in Boys

Rights of others or social norms are violated

With limited pro-social emotions: lack of remorse, guilt, and empathy

Can develop into antisocial personality and lifelong of criminality

Associated with poor family relations and parental supervision

Associated with substance abuse

Tx: Home-based, intensive family treatment leads to 75% recovery

Question 10

PEDIATRIC BIPOLAR DISORDER

Answer 10

Can occur in childhood and adolescence

Mood fluctuations are associated with marked irritability, temper outbursts and impulsivity

Can be difficult to treat and is often chronic

Frequently occurs in families with other member with Bipolar Disorder which can complicate treatment