Childhood Psychiatric Disorders

Question 1

Depression in kids/adolescents. How common is this and how does it usually present?

Answer 1

8% in adolescents, 5% in children

Sx present as:

1. Physical complaints (stomach pain, trouble sleeping, nightmares, tension)
2. Disruptive behavior

Question 2

How should you treat childhood/adolescent depression?

Answer 2

Combo of meds and psychotherapy:
Fluoxetine and Escitalopram are first line treatments

May increase risk for suicide ideations (not completed suicides).

Question 3

Schizophrenia in kids. How common, and characterize the sx. Treatment.

Answer 3

1. SUPER RARE before adolescence (VEOS)
2. Sx can start with apathy, change in hygiene, withdrawal
3. Sx can be confused with normal child fantasies and slow development (vs hallucinations and disorganized speech) Are they normal kids or are they crazy. That is the question.
4. Low dose antipsychotics

Question 4

What’s going on with the brain of kids with schizophrenia

Answer 4

Their brains shrink over time. So sad

Question 5

How does the prognosis of EOS compare to adult onset schizophrenia

Answer 5

It’s worse. Makes sense, if there is more time for their brain to go crazy

Question 6

Key sx to remember with schizophrenia

Answer 6

1. Motor impairments: repetitive movements, delayed motor milestones
2. Social impairments: weird behavior, isolation, withdrawal
3. Intellectual abilities: lower IQ and decline of function

Question 7

What is the most important thing to discern from someone who is suicidal?

Answer 7

Plan and intent

Question 8

Bipolar in kids. How does this present?

Answer 8

Characterized by mood sx: feelings that aren’t appropriate for the situation and being episodic

1. Irritability
2. Overly happy (I’m concerned for myself sometimes..)
3. Giddy/euphoria

Question 9

Disruptive Mood Regulation Disorder. What is the diagnostic criteria

Answer 9

1. SUPER bad temper tantrums that don’t make sense based on context.
2. Occur about 3+/week for a year
3. More than 1 setting (school and home)
4. Sx onset before age 10 but not before 4 or after 18

Question 10

Conduct Disorder

Answer 10

1. You’re just a huge pain in the butt. (Stealing, destroy property, aggressive towards animals and people)
2. Onset sx before 18 years
3. Sx present for 1+ year

Question 11

General trend between age of onset of disorder and severity of symptoms?

Answer 11

Earlier onset=worse sx.

Pretty self explanatory.

Question 12

What are some tx options for Conduct Disorder

Answer 12

Drugs:
Mood stabilizers
B-Blockers
Neuroleptics

Psychotherapeutic Interventions

Question 13

Oppositional Defiant Disorders

Answer 13

1. Angry/Irritable Mood
2. Argumentative/Defiant Behavior
3. Vindictiveness

Question 14

Tx for ODD

Answer 14

1. Parenting classes (since this order can often result from inconsistent parenting techniques)
   2.

Question 15

Elimination Disorders

Answer 15

1. Encopresis: passes of feces into inappropriate places (1x/month for 3+ months
2. Enuresis: same as #1 with urine

Question 16

Tx for enuresis

Answer 16

1. Bell and pad (alarm)
2. Behavioral
3. Drugs: desmopressin or TCA’s

Question 17

Separation Anxiety Disorder. Tell me about common sx and what the future risks are for the kid

Answer 17

1. Too much anxiety when leaving home or attachment figures
2. Often stay home from school (think that something bad will happen to parent if they leave)
3. Risk factor for future anxiety disorders

Question 18

Selective Mutism. Tell me about it.

Answer 18

1. Don’t speak about certain topics

2. Tx with psychopharmacology and behavioral therapy