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7. Child and adolescent psychiatry > Mood and psychotic disorders > Flashcards

Mood and psychotic disorders Flashcards

1
Q

Prevalence of depression pre puberty

A

1%

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2
Q

Prevalence of depression post puberty

A

3%

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3
Q

Sex pattern of depression in children and adolescents

A

Male and female equally affected pre puberty
More common in females after puberty

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4
Q

Percentage of young people with depression who remain depressed after 12 months

A

50%

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5
Q

Clinical features of depression in young children

A

Poor feeding
Failure to thrive
Tantrums
Separation anxiety
Regressed behaviours

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6
Q

Clinical features of depression in older children

A

Somatisation e.g. headache, stomach ache
School refusal
Poor school achievement
Sleep issues
Antisocial behaviour

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7
Q

Percentage of young people with depression who also have anxiety

A

50-80%

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8
Q

Percentage of young people with depression who also have conduct disorder

A

25%

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9
Q

Percentage of young people with depression who also have OCD

A

15%

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10
Q

Percentage of young people with depression who also have an eating disorder

A

5%

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11
Q

Treatment options for mild depression in young people

A

Watchful waiting
After 4 weeks - supportive therapy, self help, or group CBT

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12
Q

Treatment options for moderate to severe depression in young people

A

CAMHS review
3 months of individual CBT, IPT or family therapy
Pharmacology once psychotherapy considered/tried

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13
Q

First line antidepressant for young people

A

Fluoxetine

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14
Q

Second line antidepressants for young people

A

Sertraline
Citalopram

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15
Q

SSRI most likely to cause increased suicidal behaviour in young people

A

Paroxetine

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16
Q

Results of Treatment of Adolescents with Depression Study

A

CBT not superior to placebo
Fluoxetine superior to placebo
CBT and fluoxetine combination superior to placebo and had fastest effect
CBT and fluoxetine combination best at preventing relapse

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17
Q

Three leading causes of death in adolescents

A

Accidents
Homicides
Suicides

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18
Q

Percentage of adolescent deaths due to suicide

A

12%

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19
Q

Percentage of adolescent boys with suicidal ideation

A

14%

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20
Q

Percentage of adolescent girls with suicidal ideation

A

25%

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21
Q

Sex patterns of suicide in teenagers

A

Suicide attempts more common in females
Completed suicides more common in males

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22
Q

Most common method by teenage boys with completed suicide

A

Hanging

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23
Q

Most common methods by teenage girls with completed suicide

A

OD
Jumping from heights

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24
Q

Percentage of adolescents who attempt suicide that repeat within a year

A

10%

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25
Q

Prevalence of bipolar affective disorder in adolescents

A

1%

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26
Q

Percentage of adults with bipolar affective disorder who had their first symptoms aged <20

A

60%

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27
Q

Most common comorbidity with adolescent bipolar affective disorder

A

ADHD

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28
Q

Percentage of adolescents who have an episode of major depression who go on to have a manic episode by adulthood

A

20%

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29
Q

Features which increase the likelihood of a subsequent manic episode in adolescents with depression

A

Rapid onset
Psychomotor symptoms
Psychotic features
Family history of mania/other mood disorder
Mania/hypomania following treatment with antidepressants

30
Q

Percentage of teenagers with bipolar affective disorder who complete suicide

A

10%

31
Q

Age at which childhood onset schizophrenia develops by

A

12

32
Q

Age at which early onset schizophrenia develops by

A

18

33
Q

Age at which very early onset schizophrenia develops by

A

13

34
Q

Prevalence of schizophrenia among adolescents

A

1-2 per 1000

35
Q

Male:female ratio of very early onset schizophrenia

A

2:1

36
Q

Premorbid features associated with early onset schizophrenia

A

Language delays
Delays in reading
Delays in bladder control
Delays in social functioning

37
Q

Prognosis of early onset schizophrenia compared to adult onset

A

Worse prognosis in early onset schizophrenia

38
Q

Risk of EPSEs in children/adolescents compared to adults

A

Higher risk overall
Higher risk of acute dystonia
Lower risk of akathisia

39
Q

First line treatment for early onset schizophrenia

A

Oral, atypical antipsychotic

40
Q

Common clinical features of children presenting with a manic episode

A

Atypical or mixed features
Irritability
Labile mood
Behavioural problems
Periods of depression

41
Q

Sex predominance of bipolar affective disorder in children and young people

A

Male>female in children
Male = female in adolescents

42
Q

Typical first mood disorder seen in bipolar affective disorder in young people

A

Depression

43
Q

First line treatment for mania in young people

A

Second generation antipsychotic

44
Q

Prevalence of adolescent suicidal ideation in the past year in the UK

A

15%

45
Q

Most common psychiatric emergency seen in children and adolescents

A

Suicidal behaviour

46
Q

Overall prevalence of psychiatric problems in adolescence

A

16-20%

47
Q

Most common mental health problems in adolescents

A

Depression
Anxiety

48
Q

Most common comorbidity in children and adolescents with bipolar disorder

A

ADHD

49
Q

Percentage of children and adolescents with bipolar disorder who also have ADHD

A

53%

50
Q

Percentage of children and adolescents with bipolar disorder who also have ODD

A

43%

51
Q

Percentage of children and adolescents with bipolar disorder who also have conduct disorder

A

27%

52
Q

Most common positive symptom among young people with schizophrenia

A

Delusions

53
Q

Percentage of adolescents who experience an episode of depression by the age of 19

A

20%

54
Q

Percentage of 15-16 year olds who admit to deliberate self harm

A

6.9%

55
Q

Treatment options for manic episodes in adolescents

A

Aripiprazole
Consider the adult recommendations

56
Q

Age at which fluoxetine may be considered for depression in young people

A

12

57
Q

Starting dose of fluoxetine to treat depression in children and young people

A

10mg daily

58
Q

Usual maximum dose of fluoxetine to treat depression in children and young people

A

20mg daily

59
Q

Antidepressants which should not be used to treat depression in children and young people

A

Paroxetine
Venlafaxine
TCAs
St John’s wort

60
Q

Proportion of children aged 5-19 with a mental disorder

A

1 in 8

61
Q

Three most common types of mental disorder among children aged 5-19

A

Emotional e.g. anxiety, depression
Behavioural e.g. conduct disorder
Hyperactivity

62
Q

Type of mental disorder which has become more common in children over the last 15-20 years

A

Emotional

63
Q

Percentage of girls aged 17-19 with a mental disorder

A

23.9%

64
Q

Proportion of preschool children with a mental disorder

A

1 in 18

65
Q

Proportion of primary school aged children with a mental disorder

A

1 in 10

66
Q

Proportion of secondary school aged children/young people with a mental disorder

A

1 in 7

67
Q

Proportion of people aged 17-19 with a mental disorder

A

1 in 6

68
Q

Most common type of mental disorder among young people aged 11-19

A

Emotional disorders

69
Q

Most common type of mental disorder among children aged 5-10

A

Behavioural disorders

70
Q

Prevalence of schizophrenia in children aged <15

A

1 in 2000

71
Q

Type of psychosis which has the worse prognosis when it begins in childhood

A

Schizophrenia

72
Q

Advice on admission for children who self harm

A

All children who self harm should be admitted to a paediatric ward for an overnight stay

7. Child and adolescent psychiatry (9 decks)

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