Childhood Psychiatric Disorders - Ryst

Question 1

Child treatment aims to maximize the kid’s adjustment in what domains?

Answer 1

Home
friends
school
play

Question 2

What are the types of psychotherapy used with kids?

Answer 2

Play therapy
Interpersonal psychotherapy
CBT
guidance therapy
family therapy

Question 3

Therapeutic and adverse effects of meds vary by (blank) stage and in dev disorders

Answer 3

developmental stage

Question 4

T/F: kids metabolize drugs differently than adults

Answer 4

true

Question 5

What’s the outcome of an untreated developmental disorder?

Answer 5

they get worse as they progress and the disrupted development has long term conseuqences, therefore we should treat our kids

Question 6

Describe oppositional defiant disorder?

Answer 6

Recurrent pattern of negativistic, hostile, and defiant behavior

Question 7

What disorder do these characterize?
Often loses temper
Often argues with adults.
Often actively defies or refuses to comply with adults’ requests or rules.
Often deliberately annoys people.
Often blames others for mistakes or misbehavior.
Often touch and easily annoyed.
Often angry and resentful
Often spiteful and vindictive

Answer 7

Oppositional defiant disorder

Question 8

What is conduct disorder?

Answer 8

Violation of the rights of others and age-appropriate social norms

Question 9

What are some examples of conduct disorder?

Answer 9

Bullying
Fighting
Physical cruelty to people/animals
Lying or conning
Fire setting
destruction of property
Rape

Question 10

What are the criteria for the “limited prosocial emotions” specifier for conduct disorder?

Answer 10

show lack of guilt and empathy
lack of concern over performance in activities
shallow affect
Are more aggressive, have more stable course and more severe symptoms

Question 11

ODD is twice as common in which gender?

Answer 11

males, duh

Question 12

Males with early onset CD are likely to show what type of symptoms?

Answer 12

aggressive

Question 13

Onset of CD is particularly early in boys with what disorder?

Answer 13

ADHD

Question 14

T/F: boys that have both CD and ADHD have a worse outcome

Answer 14

true

Question 15

Early onset of CD is preceded and predicted by persistent (blank) symptoms

Answer 15

ODD

Question 16

T/F: all children with ODD go on to develop CD

Answer 16

false

Question 17

What is predictive of the future of CD?

Answer 17

severity of ODD symtpoms

Question 18

What Sx were best predicitive of CD?

Answer 18

cruelty to people and weapon use
or
physcial fighting + ODD

Question 19

Is proactive or reactive aggression worse in the dev of CD?

Answer 19

proactive aggression

Question 20

What factors are PROGNOSTIC of a later outcome of CD?

Answer 20

age and gender atypicality

Question 21

In younger kids, what was prognostic of later CD outcome?

Answer 21

Sx of cruelty, running away and breaking into a building

Question 22

In girls, what Sx are prognostic for later CD outcome?

Answer 22

fighting

cruel behavior

Question 23

What are psychopathy related symptoms?

Answer 23

egocentricity, callousness, manipulativeness

Question 24

Presence of early anti-social personality or traits of psychopathy may predict the dev of what?

Answer 24

Anti-social personality disorder

Question 25

What are the links between ADHD and CD?

Answer 25

earlier age of onset of CD, more physical aggression, more persistent CD

Question 26

what are the links between anxiety and CD?

Answer 26

Youths with CD are increased risk for anxiety disorders.

Question 27

what are the links between mood disorders and CD?

Answer 27

Joint presence of these two increases risk of substance abuse and suicide.

Question 28

What are the links between SUD and CD?

Answer 28

Reciprocal relationship: each exacerbates the other.

Question 29

what are the links between learning disorders and CD?

Answer 29

Language problems, memory, sensory integration, executive function deficits, academic deficiencies, low intellectual functioning.

Question 30

t/F: conduct disorder youth are more likely to have greater psychiatric impairment

Answer 30

true

Question 31

What is the link between legal issues and CD?

Answer 31

Have higher rates of driving while intoxicated, criminal behavior, arrest records, convictions and period of time spent in jail.

Question 32

what are the components of successful treatment of disruptive behavior?

Answer 32

parent-directed component, social-cognitive skills training, academic skills training and proactive classroom management and teacher training.

Question 33

T/F: there are no FDA approved meds for DBD

Answer 33

true

Question 34

what from clinical experience are helpful in treating DBD?

Answer 34

mood stabilizers, typical and atypcial antipsychotics Clonidine stims

Question 35

What is well established tx for ODD in young kids?

Answer 35

Parent management training | Parent child interaction training

Question 36

which treatment model for DBD looks at all the shit in the environment?

Answer 36

multisystemic therapy MST

Question 37

What are the only differences between depression Dx in adults vs kids?

Answer 37

Kids: 1. can be irritable instead of depressed. 2. failure to make expected wt. gains = wt. loss 3. for PDD, is 1 year instead of 2

Question 38

How is depression different in kids?

Answer 38

somatic complains, psychomotor agitation, mood-congruent hallucinations more prevalent

Question 39

What are other ways that depression can manifest in kids?

Answer 39

Separation anxiety Phobias behavioral problems

Question 40

What should you look for to Dx depression in a kid?

Answer 40

deviation from dev. trajectory school failure withdrawal from peers lack of interest in activities

Question 41

What are the differences in adolescents with depression?

Answer 41

``` Antisocial behavior SUD restleness, grouchiness, agression withdrawal school/family problems wanting to leave home not being understood/loved ```

Question 42

T/F: juvenile Bipolar has the same criteria as adult

Answer 42

true

Question 43

The presentation of mania in kids is (blank) by adult standards

Answer 43

atypical: mixed states rapid cycling chronic and continuous rather than acute and episodic

Question 44

Juvenile bipolar is seldom associated with euphoria and usually (blank) with prolonged aggressive temper outbursts and emotional lability

Answer 44

irritibility

Question 45

in what age kids is euphoria, elation , and grandiosity more common?

Answer 45

older than 9

Question 46

What are the associated symptoms in juvenile bipolar?

Answer 46

``` Decreased need for sleep Rapid speech, talkativeness Distractibility, racing thoughts, tangentiality Hypersexuality Increased goal-directed activity Impulsivity Abnormal thought content, paranoia ```

Question 47

What is a specific criteria for mania or hypomania in kids?

Answer 47

increased energy and activity

Question 48

Mixed episode is now mixed features for manic hypomanic, and MDD why?

Answer 48

sizeable population of individuals with subthreshold mixed states who did not meet full criteria for major depression and mania, and thus were less likely to receive treatment.

Question 49

What is the most common comorbidity with depression?

Answer 49

anxiety

Question 50

Can you diagnose someone with MDE if they are bereaving?

Answer 50

Yes, no longer need to follow the 2 month time frame

Question 51

When do you Dx disruptive mood dysregulation disorder?

Answer 51

children with extreme behavioral dyscontrol but persistent, rather than episodic, irritability NO DUAL DIAGNOSIS WITH ODD BUT CAN BE WITH CD

Question 52

what is the usual length of kid depression?

Answer 52

3-9 months

Question 53

what is the recurrence rate in five years of kid depression?

Answer 53

70%

Question 54

20-40% of kids with depression develop what within five years?

Answer 54

bipolar disorder and recurrent depressive episodes in adulthood

Question 55

What are the adverse outcomes of kid depression?

Answer 55

Impairment in school, family, friendships. Increased risk of suicidal behaviors and suicide. Tobacco and substance abuse. Early parenthood.

Question 56

Juvenile bipolar has a high ocurrence of what?

Answer 56

psychosis

Question 57

What is the average length of recovery in juvenile bipolar?

Answer 57

28 weeks

Question 58

what makes the course of recovery poor in juvenile bipolar?

Answer 58

high rates of psychosis 28 week recovery low rates of recovery high relapse before 2nd year

Question 59

T/F: CBT and IPT are as effective as anti-depressants

Answer 59

true

Question 60

(CBT/IPT) contains the following: Challenge though process behavioral activation mood monitoring

Answer 60

CBT

Question 61

what is interpersonal therapy?

Answer 61

Focus on interpersonal conflicts, grief, role disputes, role transitions, interpersonal deficits.

Question 62

what must you watch for when giving SSRIs?

Answer 62

mania and suicide

Question 63

What type of antidepressant should we not use?

Answer 63

TCAs

Question 64

what is the most effective Tx of MDD in adolescents

Answer 64

COMBO meds and CBT

Question 65

What can you use to treat juvenile bipolar

Answer 65

Lithium, Valproate, Carbamazepine Atypical antipsychotics If psychotic, start with combination of mood stabilizer and antipsychotic