Introduction to childhood and adolescent psychiatric disorders

Question 1

Name 7 pre-school behaviour problems [7]

Answer 1

• Habit problems (e..g toilieting)
• Failure to develop routines (e.g. sleep & feeding)
• Temper tantrums (beyond normal age of expectation & when have impact on the familty)
• Attachment difficulties
• Autism / social communication problems
• ADHD
• Anxiety

Question 2

What is a conduct disorder? [1]

How long do behaviours need to be present for for a diagnosis? [1]

Answer 2

A disorder of behaviour characterised by repeititve and persistent pattern of dissocial, aggressive or defiant conduct

(more severe that ordinary childhood mischief)

Diagnosis: needs to be present for >6 months

Question 3

If conduct disorder is mismanaged what can it lead to ? [3]

Answer 3

Mismanagment of own physical health

Lead to mania/ schizophrenia and / suicidal behaviour

Increase drug use

Question 4

How do conduct disorder symptoms present when a child is:

under 5 [4]
5-12 yrs old [5]
In adolescence [5]

Answer 4

under 5
* Physical / verbal aggression
* Destructive
* Poor attention
* Frequent / severe tantrums

5-12 yrs old [5]
* Lying
* Stealing
* Defiance
* Cruelty to animals
* Fire setting

In adolescence [5]
* Truancy
* Delinquency (minor crime, especially that committed by young people)
* Violence
* Sex offences
* Drug / alcohol abuse

Question 4

How do conduct disorder symptoms present when a child is:

under 5 [4]
5-12 yrs old [5]
In adolescence [5]

Answer 4

under 5
* Physical / verbal aggression
* Destructive
* Poor attention
* Frequent / severe tantrums

5-12 yrs old [5]
* Lying
* Stealing
* Defiance
* Cruelty to animals
* Fire setting

In adolescence [5]
Truancy
Delinquency (minor crime, especially that committed by young people)
Violence
Sex offences
Drug / alcohol abuse

Question 5

Risk factors for conduct disorder? [5]

Answer 5

Boys
Inner cities
Socioeconomic disadvantage
Fx of conflict
Difficult temperament

Question 6

What is an emotional disorder? [1]

Give 3 examples

Answer 6

Disturbance of mood, persistent and not in response to a single identified stressor

E.g. Anxiety, fearfulness or depression

Question 7

Give symptoms of emotional disorders [3]

Answer 7

Fears (seperation, social, anxiety)
Somatic symptoms: abdominal pain / headaches
Fall off in school performance, truancy and fear of school

Question 8

What are risk factors for emotional disorders? [4]

Answer 8

• Boys = girls
• No association between socio-economic status
• Family factors (overprotection; parental anxiety)
• Quiet, compliant temperament

Question 9

Give the definition of an adjustment disorder [1]

How long do symptoms usually last? [1]

Answer 9

Distress and emotional disturbance arising in a period of adaptation to a significant life change or to the consequence of a stressful life event (Bereavement, divorce, physical illness)

3-6 months

Question 10

What is the triad that makes ADHD? [3]

Answer 10

Hyperactivity
Inattention
Impulsivity

(But can have 2/3 and have a subtype)

Question 11

Expand how each of the following present in ADHD children

Hyperactivity [2]
Inattention [3]
Impulsivity [2]

Where do symptoms need to occur for a diagnosis of ADHD? [1]

Answer 11

Symptoms need to be present in two locations (e.g. school and home)

Hyperactivity
* Restless and fidgety
* Unable to wait

Impulsivity
* Acts without thinking
* Answers before questions finished

Inattention
* Jumps from task to task
* Careless mistakes
* Doesnt listen properly

Question 12

Risk factors for ADHD? [4]

Answer 12

• Boys > girls (4:1)
• Genetics
• Neurodevelopmental abnormalites
• Maternal depression
• Smoking during pregnancy

Question 13

What are the pharmacological treatments for ADHD? [2]

Answer 13

Methlyphenidate (aka ritalin)
Lisdexamfetamine

Question 14

What are non- pharmacological treatments for ADHD? [2]

Answer 14

• parenting programmes
• behaviour teacher
• advice for teachers

Question 15

Name some failures of normal development

Answer 15

• Speech and language
• Reading (dyslexia)
• Spelling
• Arithmetic skills
• Motor function (dyspraxia)
• Enuresis

Question 16

How can autistic spectrum disorders present [5]

Answer 16

• Imparied quality of social interaction
• Difficulties developing peer relationships
• Preoccupation with certain toy / object
• Stereotyped mannerisms (e.g. hand flapping)
• Strict routines

Question 17

Define what an attachment disorder is [1]

What are the two types of attachment disorders? [2]

Answer 17

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

2 types:
- Reactive attachment disorder
- Disinhibited attachment disorder

Question 18

Explain how the following present

• Reactive attachment disorder
• Disinhibited attachment disorder

Answer 18

Reactive attachment disorder (inhibited type):
* Child is extremely withdrawn
* Emotionally dettached
* Hypervigilant / v aware of whats going on
* Ignore others / can get aggressive if others try to get too close

Disinhibited attachment disorder
* Not seem to prefer parents to strangers
* Comfort and attention from anyone (without distinction)
* Act younger than their age

Question 19

What are the 5 types of abuse [5]

Answer 19

Physical
Emotional
Sexual
Neglect
Munchausen Syndrome by proxy (parent makes up / fakes symptoms so that the child looks sick)