Common child psychiatric disorders Flashcards
what is the prevalence of childhood psychiatric disorders
High Prevalence of childhood psychiatric disorders(2)
- 7-12 year olds: 1 in 4
- 13-16 year olds: 4 in 10
Half of people with lifetime mental health problems had difficulties since before age 14(3
what group of children have high mental health problems
children in care
what is the factors that make up the childrens mental health and what can influence it
- the child itself
- family
- environment that there in
what things can cause mental health issues
- Low intelligence
- Difficult temperament
- Physical illness
- Developmental delay
- Genetic factors
- Peer relationship problems
- Social deprivation
- School factors
it is important to determine whether the child family and environmental factors are…
PREDISPOSING- can make you vulnerable to the illness
PRECIPITATING - trigger in the illness
PERPETUATING - keep the illness going
what are the risk factors for the child that can cause mental illness
- genetic influence
- low IQ
- specific developmental delay
- physical illness
- low self-esteem
- communication difficultés
what are the risk factors of family that can cause mental illness
- family disharmony
- inconsistent discipline style
- parent with mental illness or substance abuse
- physical, sexual, neglect or emotional abuse
- death and loss
what are risk factors of school that can cause mental illness
- bullying
- discirimaintion
- breakdown and no positive freindships
- deviant peer influences
- peer pressure
- poor pupil to teacher relationship
what are the risk factors of the community that can cause mental illness
- socioeconomic disadvantage
- homelessness
- disaster, accidents, war
- discrimination
- other significant life events
- lack of access to support services
name some common childhood psychiatric disorders
Pre-school behavior problems
Conduct disorders
Emotional disorders
Adjustment disorders
Disorders of activity and attention
Failures of normal development
Attachment disorders and abuse
Eating disorders
Adult-type disorders
when are preschool behaviour problems a problem
those under the age of 5
give an example of a disorder of activity and attention
ADHD
what are preschool behaviour problems
Habit problems e.g. toileting
Failure to develop routines e.g. sleep and feeding
Temper Tantrums
Attachment Difficulties
Autism/Social Communication Problems
Hyperkinetic disorder (ADHD)
Anxiety, including separation anxiety
Abuse - emotional/behavioural consequences of physical, sexual or emotional abuse
how do you treat pre-school behaviour problems
- usually about parenting therefore there are parenting groups around to help parents learn how to cope
what is a conduct disorder
Disorder of behaviour characterised by repetitive and persistent pattern of dissocial, aggressive or defiant conduct
How long does the behaviour have to last for it to be diagnosed as a conduct disorder
More severe than ordinary childish mischief or adolescent rebelliousness
Behaviours present >6 months
what are the possible negative outcomes of a conduct disorder
Antisocial personality disorders
Criminal and violent offending
Drug use
Poor physical healthy
Sexually transmitted infections
Other psychiatric disorders (mania, schizophrenia, suicidal behaviour)
what are the symptoms of a conduct disorder in
- under 5s
- 5-12s
- adolescence
under 5s
- Physical/verbal aggression
- Destructive
- Poor attention
- Frequent, severe tantrums
5-12s
- Lying
- Stealing
- Defiance
- Cruelty to animals
- Fire setting
adolescence
- Truancy
- Delinquency
- Violence
- Sex offences
- drug/ alcohol/ substance misuse
who’does conduct disorder affect usually
Boys»_space; girls
Inner cities > rural areas
Socio-economic disadvantage
Family conflict and poor communication in the family
Increased incidence in looked after children
“Difficult” temperament
Specific reading disability
what are emotional disorders
Disturbances of mood, persistent and not in response to a single identified stressor
name some emotional disorders
Anxiety and fearfulness
Depression
what are the symptoms of emotional disorders
Fears - separation anxiety; social anxiety; specific phobias
Lack of pleasure; loss of interest; hopelessness; despair; sadness; tearfulness; lack of energy
Physical symptoms - abdominal pain, headaches - somatic symptoms
Fall off in school performance, truancy, fear of school (bullying)
what is the difference between adult and children emotional disorders
- Often mixed symptoms, including somatic complaints.- Less pervasive
what are the risk factors for emotional disorders
Boys = girls
No association with socio-economic status
Family factors - overprotection; parental anxiety
Quiet, compliant temperament
No specific educational problems
what are the risk factors of self harm cases
- Self harm cases
- girls more likely to report self harm than boys
- more likely in children dealing with mental health issues
- family factors
- long term health conditions
- children using alcohol and drugs
- bereavement or experience with sucide
- social isolation
- abuse
- safeguarding
those that self harm are more likely to commit sucide by ..
100 times in the next year
How do you treat self harm
- form a safety plan with parent - lock away knives or things they can use
- social media platforms sensitised so can’t see images of self harm
- followed up by CAMS
what are adjustment disorders
Distress and emotional disturbance arising in a period of adaptation to a significant life change or to the consequence of a stressful life event
give examples of adjustment disorders
Bereavement
Divorce
Physical illness
when do symptoms occur with adjustment disorders
usually occur within 3 months and disappear within 6 months
what are the three symptoms of attention deficit hyperactive disorder (ADHD)
- Hyperactivity
- inattention
- impulsivity
ADHD is a…
persavie and persistent disorder - although there are affective treatments if it is not treated this can continue and persist
How do you diagnose ADHD
- symptoms have be to present in more than one setting
- if they are only in one setting then it is unlikely to be ADHD
what can ADHD cause to happen
- Under performance and trouble at school, which can later effect employment
- Issues in forming relationships
- Crime, as well as drug and alcohol use.
name the symptoms for - hyperactivity - impulsivity - inattention in ADHD
Hyperactivity
- Restless and fidgety
- Unable to wait
Impulsivity
- Acts without thinking
- Answers before questions finished
Inattention
- Jumps from task to task
- Makes carless mistakes
- Doesn’t listen properly
what are the risk factors of ADHD
- Boys > girls (4:1)
- Genetic factors
- Neuro-developmental abnormalities
- Maternal depression
- Smoking during pregnancy
What does ADHD stand for
Attention Deficit Hyperactivity Disorder
How do you treat ADHD non pharacologically
PARENTING PROGRAMMES - important to treat parents how to parent children with ADHD and certain stragities that can make a difference
BEHAVIOUR THERAPY
ADVICE FOR TEACHERS
what is the pharmacological treatment of ADHD
- Offer methylphenidate (either short or long acting) as the first line pharmacological treatment for children aged 5years and over and young people with ADHD
- Consider switching to lisdexamfetamine (prodrug version of methylphenidate)
How do you monitor ADHD
Height and weight - drugs can cause growth restriction
CVS – HR and BP
Sleep - drugs can cause sleep disturbance
Tics - can develop tics with the medication so you change which medication you are giving
what are specific failures of normal development
Speech and language (receptive and expressive)
Reading (dyslexia)
Spelling
Arithmetic skills
Motor function (dyspraxia)
Enuresis / encopresis
what can cause speech delay
- extreme enviornemtnal deprivation - for example if they are being neglected or abused they won’t learn to speech
- prematurity
- neurological problems such as cerebral palsy
- autism - can affect ability to communicate
- apraxia - difficulty sequencing and executing speech movements
- selective mutism
What is autism
- it is an impaired quality of reciprocal social interaction
what do children with autism usually have
- developmental delays
- difficulty developing peer relationships
- impaired communication
- verbal and non verbal
- retracted and repetitive behaviours - specific and fixed routines that can cause emotional distress when they have to deviate away
what is attachment disorder
Marked distress and social impairment as a result of an extremely abnormal pattern of attachment, typically due to repeated changes of care-giver in early childhood
what can cause attachment disorder
- problem with parental figure
- abuse
- put in care
how can attachment disorder present
- as affectionate with strangers as much of their parents
what are the types of abuse
Physical (non-accidental injury) Emotional Sexual Neglect Munchausen Syndrome by Proxy/Factitious Induced Illness (FII) - mental illness and a form of abuse where the parent makes up symptoms that make it look like the child is sick
what are eating disorders
- conditions in which the person have issues with their body weight and shape which disturbs there eating routine
what are the risk factors for eating disorder
- biological
- social
- psychological emotional distress
- interpersonal relationships
what are the physical impacts of eating disorder
- anxiety depression, obsessive behaviours
- changes in hair and skin
- tooth erosion, dry mouth, tooth decay
- increase risk of heart failure
- brittle bones
- kidney stones, renal failure
- constipation
- irregular or absent periods
how do you manage eating disorders
- presentation through school based peer support
- family therapy
- CBT
- hospital care
what are adult type disorder that can present in children
Psychoses - schizophrenia; bipolar disorder
Post traumatic stress disorder
Obsessive compulsive disorder
what are the risk factors of schizophrenia
- genetic makeup
- family history
- birth complications
- emotional distress
- history of abuse
- cannabis use
how do you manage schizophrenia
- exclude organic causes
- antipsychotic medication
- psychoeducatioanl group intervention
- help them continue their education
- supported employment programme
- discuss and plan transition to adult services
How do you assess child psychiatry
Description and history of main problems
Child’s peri-natal, developmental, medical, educational and social history
Family history including any psychological health problems and information regarding parents own experience of being parented
Mental state of the child
Family communication and relationships
Interventions so far
What does the prognosis of child psychiatry depend on
This depends on
- nature and severity of the disorder
- family and environmental context
- treatment offered
Symptoms tend to be stubborn without treatment
