childhood/early onset disorders Flashcards
infant deprivation effects
- 4Ws: weak, wordless, wary, wanting
- failure to thrive (weak)
- poor language/socialization skills (wordless)
- lack of basic trust (wary)
- reactive attachment disorder: infant withdrawn/unresponsive to comfort
- deprivation for >6m –> irreversible changes
- severe deprivation can cause death
vulnerable child syndrome
- parents irrationally perceive the child as esp susceptible to illness/injury. usually follows serious illness/life-threatening event.
ADHD
- onset b4 12
- tx: methylphenidate +/- CBT
- alternative tx: atomoxetine, guanfacine, clonidine
Autism spectrum disorder
- poor social interactions, social communication deficits, repetitive/ritualized behaviors, restricted interests
- must present in early childhood
- may be accompanied by intellectual disability
- MC boys
- assoc with increased head/brain size
Rhett Syndrome
- x-linked dominant
- most de novo mutation of MECP2
- seen almost exclusively in girls (affected males die in utero),
- sx apparent around age 4: regressionk loss of development, loss of verbal abilities, intellectual disability, ataxia, stereotyped hand-wringing
conduct disorder
- repetitive and pervasive behavior violating the basic rights of others or societal norms (ie aggression to people/animals, destruction of property, theft)
- after age 18 often reclassified to antisocial personality disorder
- tx: CBT
oppositional defiant disorder
- enduring pattern of hostile, defiant behavior to authority figure in the absence of serious violations of social norms; tx: CBT
disruptive mood dysregulation disorder
- onset b4 10
- severe, recurrent temper outbursts out of proportion to situation
- child constantly angry/irritable btw outbursts
- tx: stimulants, antipsychotics, CBT
dissociative identity disorder
- formerly multiple personality disorder
- presence of 2 (+) distinct identities/personality states
- MC women
- assoc with history of sexual abuse, PTSD, depression, substance abuse, borderline personality, somatoform conditions
depersonalization/derealization disorder
- persistent feelings of detachment/estrangement from one’s own body, thoughts, perceptions, and actions (depersonalization) or one’s environment (derealization)
causes of reversible dementia
- dementia: decrease in function, not consciousness
- hypothyroidism, depression, vit deficiency (B1, B3, B12), normal pressure hydrocephalus, neurosyphilis
- EEG usually normal
- as opposed to delirium (reversible) where consciousness waxes and wanes, and there is diffuse slowing of EEG
causes of irreversible dementia
- dementia: decrease in function, not consciousness
- alzheimers, lewy body, huntington, pick disease, cerebral infarct, wilson disease, creutzfeldt-jakob disease, chronic substance abuse (due to neurotoxicity), HIV
- EEG usually normal
- as opposed to delirium (reversible) where consciousness waxes and wanes, and there is diffuse slowing of EEG
hypnopompic hallucination
- occurs while waking from sleep
- “pompous upon waking”
- sometimes seen in narcolepsy
visual vs auditory hallucination
- visual MC seen in medical illness (ie drug intox), auditory MC feature of psych illness
- gustatory: rare but seen in epilepsy
Olfactory hallucination
- often occur as aura of temporal lobe epilepsy (ie burning rubber) and in brain tumors
tactile hallucination
- common in alcohol withdrawal and stimulant use
- delusional parasitosis “cocaine crawlies”
hypnagogic hallucination
occurs while going to sleep; sometimes seen in narcolepsy
Decreased in narcolepsy
Caused by decreased hypocretin (Orexin) production in lateral hypothalamus
Night terrors occur during
Slow-wave/deep (N3) sleep. Bc occurs during non-REM sleep there is no memory. Vs nightmares occur in REM.
Refeeding syndrome
Seen in anorexia. Increased insulin —> hypophosphatemia —> heart complications
Physical changes seen in schizophrenia
- increased D activity
- decreased dendritic branching
- ventriculomegaly
- negative sx persist after tax but + disappear
Psychotic disorder vs schizophreniform vs schizoaffective vs schizophrenia
- Brief psychotic disorder: lasts <1m, usually stress related
- Schizophreniform: 1-6m
- Schizophrenia: lasts >6m
- Schizoaffective disorder: schizophrenia + major mood disorder (major depressive or bipolar). Pt must have >2 weeks of hallucinations/delusions w/o major mood episode
