Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MDCN 470: Course 7 > Mood and Anxiety Disorders in Children > Flashcards

Mood and Anxiety Disorders in Children Flashcards

1
Q

DSM criteria for ADHD:

  • ___out of 9 inattention OR hyper-impulsive symptoms OR both that caused impairment before age of 12, AND
  • Symptoms are present in two or more settings, AND
  • Symptoms significantly impair social, academic or occupational functioning.
A
  • 6 out of 9 inattention OR hyper-impulsive symptoms OR both that caused impairment before age of 12, AND
  • Symptoms are present in two or more settings, AND
  • Symptoms significantly impair social, academic or occupational functioning.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Inattention symptoms (6/9 for ADHD)

A

Inattention: at least 6 out of 9 of for 6mo+:

  • Fails to give close attention to details or makes careless mistakes
  • Has difficulty sustaining attention
  • Does not seem to listen when spoken to directly
  • Does not follow through on instruction and fails to finish tasks
  • Has difficulty organizing
  • Avoids, dislikes or is reluctant to engage in task that require sustained effort
  • Loses things necessary for tasks/activities
  • Easily distracted
  • Forgetful in daily activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hyperactivity-Impulsivity symptoms (6/9 for ADHD)

A

Hyperactivity-impulsivity: at least 6 out of 9 for 6mo+:

  • Fidgets with hands or feet or squirms
  • Leaves the seat in classroom or other situations
  • Runs about or climbs excessively in situations that are inappropriate
  • Difficulty playing or engaging in activities quietly

• “on the go”

  • Talks excessively
  • Blurts out answers before questions have been completed
  • Difficulty awaiting turn

• Interrupts or intrude on others

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Depressive Disorder in Pediatrics

Differences from adults:

Major depressive episode: ___ mood may substitute for depressed mood, failure to make expected weight gains may substitute weight loss or gain

Persistent depressive disorder: duration is ___ year(s) (instead of ___ year(s) in adults)

A

Differences from adults:

Major depressive episode: irritable mood may substitute for depressed mood, failure to make expected weight gains may substitute weight loss or gain

Persistent depressive disorder: duration is 1 year (instead of 2 years in adults)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Disruptive Mood Dysregulation Disorder

A

o Severe recurrent temper outbursts which are inconsistent with developmental level (3+ times a week).

o Between outbursts, their mood is persistently angry or irritable.

o At least 12months and no periods greater than 3mo without symptoms

o Present in at least 2 settings and severe in at least 2 settings

o Cannot make dx before age of 6yo and after the age of 18yo; onset before the age of 10

o Never a period lasting greater than 1d in which full criteria for hypomania/mania have occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Bipolar Disorder in Pediatrics

Differences: Exact same as diagnostic criteria as in adults (ex/ mania lasts 1+ week DIGFAST symptoms).

However, children have more __, increase __, increase rates of ___, increase __ symptoms, more functional impairment, higher rate of mixed episodes

A

Bipolar Disorder in Pediatrics

Differences: Exact same as diagnostic criteria as in adults.

However, children have more episodes, increase suicidality, increase rates of violence, increase psychotic symptoms, more functional impairment, higher rate of mixed episodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

risk factors to bipolar disorder in peds

A

Risk Factors: genetics (8-10 fold higher, 80% heritability), low SES, exposure to negative events, high expressed emotion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

bipolar disorder can be confused with ADHD in the peds population. Contrast the two.

A

Contrast with ADHD:

bipolar is More common than ADHD

Especially if over 10 and “adhd” appears rapidly– probs bipolar

bipolar disorder is refractory to stimulant treatment

No mania symptoms like DIG FAST

If there is a strong family history of bipolar disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

specific criteria for social phobia in children

A

Social Phobia

o Same duration as in adults

o Must occur in peer settings (not just with adults)

o Fear may be represented by crying, tantrums, freezing or clinging

o Clinical: extreme shyness, school avoidance, trouble eating in public

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pediatric OCD:

  • mean age of onset is ____ years, with 25% of cases starting by 14.
  • if onset under 10 years old, it’s more common in ___, fam history is __, and may be sudden, especiailly if following a period of __ __.

treatment is __, both __ and __ prevention, +/- an ___ (sertraline, fluoxetine or fluvocamine)

A

Pediatric OCD:

  • mean age of onset is 19.5 years, with 25% of cases starting by 14.
  • if onset under 10 years old, it’s more common in males, fam history is significant, and may be sudden, especiailly if following a period of high stress.

treatment is CBT, both expsoure and repsonse prevention, +/- an SSRI (sertraline, fluoxetine or fluvocamine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Definition: age inappropriate stubborn, hostile and defiant behaviours

Epi: usually appears by age 8, second peak at age 14-15 yo; prevalence 1-7%.

Higher in boys in childhood

Symptoms: requires 4+ over at least 6mo; at least one individual is not a sibling and leads to impairment in academic/social/occupational functioning:

• Often loses temper

• Often angry or resentful

• Touchy or easily annoyed

• Deliberatively annoys others

• Actively defy or refuse to complex

• Often argues with authority figures

• Often blames others for mistakes

• Spiteful or vindictive at least twice within past 6mo

Subtypes: mild, moderate vs severe specifier Etiology: terrible twos that persists. Combo of parenting practices and parenting

A

Definition: age inappropriate stubborn, hostile and defiant behaviours

Epi: usually appears by age 8, second peak at age 14-15 yo; prevalence 1-7%.

Higher in boys in childhood

Symptoms: requires 4+ over at least 6mo; at least one individual is not a sibling and leads to impairment in academic/social/occupational functioning:

• Often loses temper

• Often angry or resentful

• Touchy or easily annoyed

• Deliberatively annoys others

• Actively defy or refuse to complex

• Often argues with authority figures

• Often blames others for mistakes

• Spiteful or vindictive at least twice within past 6mo

Subtypes: mild, moderate vs severe specifier Etiology: terrible twos that persists. Combo of parenting practices and parenting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

example of limited prosocial emotions in conduct disorder

A

2+ of lack of remorse/guilt; callous; unconcerned about performance; shallow/deficient affect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Conduct Disorder

Definition: a repetitive and persistent pattern of behaviour in which the basic rights of other and major age appropriate societal norms or rules are violated

Epi: 1-10%; more common in boys (more aggressive behaviour in boys than in girls)

Symptoms: at least ___of the following over the past year and ___ in the past 6mo that causes impairment:

A

Conduct Disorder

Definition: a repetitive and persistent pattern of behaviour in which the basic rights of other and major age appropriate societal norms or rules are violated

Epi: 1-10%; more common in boys (more aggressive behaviour in boys than in girls)

Symptoms: at least 3 of the following over the past year and 1 in the past 6mo that causes impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

questionnaires to investigate pediatric ADHD

A

conner’s, SNAP-IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

first, second and thirdline meds for pediatric ADHD

A
  1. stimulants– amphetamines or methylphenidates
  2. atomoxetine (SNRI)
  3. alpha -2-receptor agonists guanfacine
17
Q

if a kid has ADHD and tics, what might be the best pharmacotherapy

A

Atomoxetine (non-stimulant, 2nd line): SNRI (targets both ADHD and anxiety)

Mechanism: blocks reuptake of NE via NET → increases NE and DA in prefrontal cortex (not in Nacc→ no abuse potential!!)

Side effects: sedation, GI, appetite, irritability, headache, suicidal ideation

Atomoxetine may be good if the person has anxiety or tics in addition to the ADHD

18
Q

t/f there is abuse potential for SNRIs

A

false.

Mechanism: blocks reuptake of NE via NET → increases NE and DA in prefrontal cortex (not in Nacc→ no abuse potential!!)

19
Q

PANDAS

Definition: Lightening-fast onset of symptoms in association with an underlying infectious inflammatory process (usually ___)

A

PANDAS

Definition: Lightening-fast onset of symptoms in association with an underlying infectious inflammatory process (usually strep)

20
Q

PANDAS

Criteria: OCD OR eating restrictions AND at least 2 of:

A

Anxiety

Emotional lability or depression

Irritability, aggression, and/or severely oppositional behaviors

Regression

Deterioration in school performance related to new onset memory deficits OR cognitive changes

New sensory or motor abnormalities

Somatic changes (sleep disturbance, enuresis)

Management: identity and treat the underlying infectious/inflammatory processes. Treat the psychiatric and behavioural symptoms the same as you would otherwise

21
Q

rating scales for pediatric depression

A

Becks Children Depression INventory

22
Q

pediatric depression management

A
23
Q

first line type of SSRI for pedatric depression

A

fluoxetine

24
Q

rating scales for pedaitric bipolar disorder management

A

Rating Scales: Young Mania, KSADS Mania, General Behaviour Inventory

25
Q

when to suspect bipolar in a child who you think has ADHD

A

Suspect Bipolar in a child with ADHD… ADHD symptoms later in life, abrupt onset, not responding to treatment, mood changes (exaggerated elation, grandiosity, depression, no need for sleep, inappropriate sexual behaviours), hallucinations/delusion, family history of bipolar disorder

26
Q

medications for pediatric bipolar disorder management

• Medication:

o Mania Phase: 2nd/3rd Generation ___ (peds bipolar is more susceptible than in adults), __, divalproex

o Depressive Phase: __

O Maintenance: continue treatment for 12-24months (high rates of recurrence with or without treatment); consider long-acting injectable medications

A

• Medication:

o Mania Phase: 2nd/3rd Generation Antipsychotics (peds bipolar is more susceptible than in adults), lithium, divalproex

o Depressive Phase: Lamotrigine

O Maintenance: continue treatment for 12-24months (high rates of recurrence with or without treatment); consider long-acting injectable medications

27
Q

management for pediatric anxiety disorder

A

Management:

CBT: graduated exposure to feared stimulus (you need significant family and school involvement)

**for selective mutism: CBT + reward approximation to desired behaviour

Family therapy: increase exposure to feared stimuli, decrease anxiogenic family interactions

School based interventions: decrease school avoidance and refusal

Pharmacologic: in severe cases + CBT → almost never in isolation

SSRI: sertraline, fluoxetine, fluvoxamine

28
Q

Note: for oppositional defiant disorder and conduct disorder, the first line is psychosocial interventions

A

MDCN 470: Course 7 (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions