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Psychiatry > Mental Disorders in Adolescence > Flashcards

Mental Disorders in Adolescence Flashcards

1
Q

How common are mental disorders in children and young people?

A

1 in 10 children and young people aged 5-16 diagnosed

1 in 3 child in every class

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2
Q

What is the aetiology of anxiety in young people?

A

Complex interactions of specific characteristics related to the young person and their environment

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3
Q

Which neurotransmitters are abnormal in anxiety?

A

Serotonin
NA
Dopamine
GABA

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4
Q

How does anxiety tend to present in children?

A

Irritable
Shy
Cautious
Quiet temperament

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5
Q

What behaviour factors can contribute to anxiety in children and young adults?

A

Acquisition of fear through classical conditioning
Maintenance of fear though operant conditioning
Observational learning

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6
Q

How is negative reinforcement manifested?

A

Avoidance and/or escape learning

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7
Q

What cognitive factors can contribute to anxiety in children and young adults?

A 
Attentional biases
Selective attention 
Distorted judgements of risk
Neg spin on ambiguous/ non-threatening solutions
Select avoidant solutions
Selective memory processing
Tendency to remember anxiety-provoking cues 
Perfectionistic beliefs
Inflated sense of responsibility
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8
Q

What are the different types of anxiety disorders?

A 
Social phobia
GAD
OCD
Panic disorder 
Phobias
PTSD
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9
Q

How is mild anxiety managed in young people?

A

CBT

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10
Q

How is moderate to severe anxiety managed in young people?

A

SSRI (sertraline, fluoxetine, fluvoxamine, citalopram)

Up to 12 weeks to effect

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11
Q

How long should ADs be continued in young people with anxiety?

A

1 year

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12
Q

Should you give propranolol to manage anxiety in young people?

A

NO

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13
Q

Who are vulnerable groups to depression?

A 
Young offenders
Looked after children
LGBT; 44% have considered suicide
Ethnic minorities
Disability
Homeless youth
Young people in ganga
Unemployed young people
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14
Q

What are common stressful triggers for depression in young adults?

A 
Conflict between parents 
Depression in parents
Separation or divorce of parents
Conflicts with friends/ classmates
Social disadvantage
School stress
Bullying
Loss of someone important
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15
Q

Which form of psychotherapy is 1st line in mood disorders and anxiety?

A

CBT

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16
Q

What are the different forms of psychotherapy?

A 
CBT
Interpersonal Therapy
EMDR (commonly used in PTSD) 
Solution focussed therapy
CAT
Psychodynamic psychotherapy
17
Q

Commonly used medications in the treatment of depression in children and young adults?

A

SSRIs are 1st lie
Consider augmentation with low dose antipsychotic if poor response to 2 SSRIs; quetiapine, risperidone, aripiprazole or olanzapine
Venlafaxine or mirtazapine in older groups as alternative to SSRI¬

18
Q

What parenting training and guidance can be given in the management of emotional disorders?

A

Young children are often treated with their family
Work with parents to help them help their child
Family therapy as a systemic approach if family relationships are considered precipitating or perpetuating factors

19
Q

Should you prescribe medication alone in children?

A

No; prescribe in combination with psychotherapy

20
Q

Cautions with SSRIs?

A 
Suicidal behaviour
Increasing self harm 
Agitation and hostility
Increase or decrease appetite
Hyponatraemia
21
Q

How common is self harm in young people?

A

7% in 14-16 y/o at school
13% of 11-16 y/o in community
1 in every 12 children DSH

22
Q

What are the functions of DSH?

A

Coping with intense emotions
Communicating distress
Re-connecting with self
Suidial lintent

23
Q

What is the biological basis of self-harm?

A

Promotes the release of endorphins

Due to the temporary distress reduction; through negative reinforcement it tends to result in repeated behaviours

24
Q

Characteristics of non-suicidal self-injury?

A

Periods of optimism and sense of control
Successful decrease in discomfort
Frequently chronic and repetitive
Intent to relief from unpleasant emotions
Uncomfortable but intermittent psychological pain
Choices available; temporary solution

25
Q

Characteristic of suicidal self-injury?

A

Hopeless and helplessness
No release of discomfort
Generally not chronic or repetitive
Intent to escape pain or end consciousness
Unendurable, persistent psychological pain
Tunnel vision`

26
Q

What is self harm often a marker for?

A

Substance misuse
Poor school attendance
Low academic achievement
Unprotected sex

27
Q

Initial management of self harm?

A

Educate about signs of distress; use of positive coping skills
Try not to push
Refer to specialist mental health professional for assessment of risk and underlying cause

Psychiatry (35 decks)

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