Paediatric Psychiatry Flashcards
how can children psychiatry disorders be split
internalising or emotional behavior disorders
externalising disorders or disruptive behvaiour disorders
define internalising or emotional behavior disorders
probelsm within self
children cope with these problems internally rather than acting out in environment
examples of internalising or emotional behavior disorders 4
axiety disorders -eg phobias
OCD
depression
psychosomatic complaints
define externalising disorders or disruptive behvaiour disorders
characterised by behaviours directed outwards, tupcoally towards people
exapmles of externalising disorders or disruptive behvaiour disorders 3
ADHD
conduct disorders
oppositional defiant disorder
what conditions do not fit into these psych categories 3
ASD
psychotic illness
eating disorders
presentation of child with ADHD 5
restless, fidgety and overactive
often excessively talkative or interrupt people
easily distracted and do not finish tasks
inattentive and poor concentration on tasks
impulsive, suddenly doing things without thinking
what must occur for childnre with ADHD to be diagnosed
syx must occur in more than one setting ie school, home and in social settings
diagnosis is by careful evaluation of developmental medical and social history, school observations dn teacher/parent rating scales
define conduct disorder
gorup of behvaioural problms where a child is aggressive (verbal or physical), antisocial and defiant to a much greater degree than expected for their age
how does conduct disorder differ from deliquency
delinquency is a legal term
CD is seen as a risk factor for delinquent behaviour
characteristcs of conduct disorder 5
major one:
- violation of rights of others
-violation of social norms
common examples
-fighting and physical cruelty (people and animals)
-destructiveness
-lying and stealing
violation f rules (truancy)- includes running away form home
classifications of conduct disorders 2
early onset conduct disorder
adolescent onset conudct disorder
define early onset conduct disorder
child shows at least one characteristd before age of 10
-often assoc w ADHA
define adolescent onset conduct disorder
child doestn show characteristics before age of 10
-more common type
risk factors for conduct disorders 5
genetic - FHx of antisoical personality disoder or CD
individual
physical - cant process social info or social cues
-due to learning difficulty or brain injury
environmental
-family probelsm - harsh or poor parenting
-deprivation
emotional
-depression
-social isolation due to lack of peers
treatment for conduct disorders
gorup based parent training/ education programmes
indidual CBT can also be used
how is reactive attachment disorders characterised
persistent difficulties in a childs patern of attachment relationships
leads to varying degrees of emotional distrubance
many children in care meet the criteria
children are hypersenstive to changes due to early life adverse experiences
syx of reactive attachment disorder 3
lack of emotional responsiveness
fearfulness
hypervigilance
how can anxiety disorders affect children 5
can affect a childs thinking
decsion making ability
perception of environment
learning and concentration
may have physical complaints also
define generalised anxiety disorder
recurring fears and worries they find difficult to control
syx of generalised anxiety disorder 6
often reports of inner tension and restlessness
feeling irritable or easily tired
physical complains
sleeping problems also common
trouble concentrating
perfectionisitic tendencies
treatment of anxiety disorders 3
CBT group or individual
family therapy
parenting strategies ionn
treatment of anxiety disorders 3
CBT group or individual
family therapy
parenting strategies ionn
treatment of anxiety disorders 3
CBT group or individual
family therapy
parenting strategies ionn
define separation anxiety disorder
child has intense anxiety about being away from home or their caregivers
syx of sepaarrting anxiety disorder 4
school refusal
clingy behaviours
anger outburts cna occur when separating form parents
may refuse to sleep alone
define social phobia
usually occurs in mid teens tho can be earlier
-constant fear of social situations
-eg speaking in class or eating in public
fear often assoc w physical syx and anxiety
typical child with social phboies 3
overly sensitivite to critisim
suffer from low self esteem
lack confidence w peer relationships
what can often cause PTSD in children 2
signficant threat to their saftey- ie house fire
repeated trauamitc events- sexual abuse
treaetmetn for PTSD in children 4
re-establish child saftery
psychoeduaction
relaxaiton technqiues
psychotherapreutic approach to understand of traumatic event
syx of specifc phobias in children 3
excessive perisitnt fear to specific situation or object
exposure can cause immediate extreme distress
may suffer panic attacks and agoraphobia
define OCD
frequent and uncontrablle thoughts (obsessions), images and impulses which are intrusive in nature
-can have significant impact on daily life due to time spent on obsession and compulsions
syx of OCD 1
perform routines or rituals in an attempt to eliminate the unwanted thought
common compulsions
excessive washing, checking, counting or tapping to relieve anxiety
what medical conditon can OCD be associated with 1
PANDAS
paediatric autoimmune neuropsychiatric disoders associated with strep A infection
different to standard OCD as this presents suddenly
standard OCD is over months to years
psychological syx of depression in children 5
simply appearing unhappy much of the time
outburst of shouting, crying or unexplained irritability
poor self estem guilt or feeling of worhtlessness
loss of intrest/lack of pleasure
suicial thoughts- SEVERE
biological syx of depression 3
spending alot of time in bed but spleeing poorly
early morning awakening
major changes in weihgt/appeeitie
headaches, stomach aches, tirdness
behaviors that are signs of childhood depression 6
-remember children often don’t have the vocab to accureltately describe how they feel
a sudden drop in school performance
aggression, refusal to cooperate, antisocial behaviour
slowed body movements, monotonous speech or muteness
becoming quiet and introverted.
regressive behaviours
Self injurious or self harming behaviour in severe depression
treatment for depression in kids 3
family therapy
inidivual CBT
psychtherapy
ASD triad
qualitative impairement in reciprcating social interactions
deficies in use of language for social situations
steroitypes behaviours
-sensory sensitivities
-restritied interests
define tic disorders
sudden invulntary non-rhythmic motor movements or vocal production
purposeless, happen rapidly and often repetitive in nature
how can tics be diffrenneits
simple motr - using.a few muscles
-blinking eyes, nose twichm head jerk
simple vocal- grunt or cough
complex motor -many muscles -
-slower longer more complex moves
complex vocals- full words or sentvens
define tourretts
*what is assoc w tourretss 2
combined vocal and motor tic disordre
often persists into adult life
-* ADHD, OCD
eating behvaiour problems
Fussy Eater (impacting on health)
* Under eating
* Food Refusal
* Neophobia (fear of new food)
* Non adherence to a prescribed diet e.g. Phenylketonuria (PKU), Kidney
failure, diabetes
syx of anorexia 5
Intense fear of weight gain. Obsession with eating, food, and weighs herself or
himself repeatedly
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May state he/she is overweight and exercises excessively.
Counts or portions food carefully and may only eat certain foods; may avoid foods
like dairy products, meat, wheat (apart from vegetarian preference or specific food
allergies)
May increase consumption of liquids.
Adopts rigid meal or eating rituals and may refuse to eat in front of others
phsyical syx and sxs of naorexia 4
Weight loss (through loss of body fat & muscle atrophy).
Lack of weight gain/cessation of growth/arrested pubertal development.
Amenorrhoea can occur post menarche.
Osteopenia, which may lead to osteoporosis and fractures.
Growth of ‘lanugo’ body hair. Brittle hair, nails. Dry skin which may bruise easily.
Constipation/bloating/abdominal discomfort.
Physical symptoms are extensive and this list is not exhaustive.
cognitive /psychosocla syx of anorexia 5
dpressed mood
sucicdal thoguhts
decreased ability to concentrate
poor decision making skills
feeling of guil or worthlesness
social syx of anorexia 4
General apathy which may present as less/loss of interest in people and activities
Physical
Behavioural
Emotional Social
Cognitive/Psychological
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which previously were enjoyed.
Family often notices child becomes argumentative.
Lack of confidence, withdrawal from friends.
Dependency or over-involvement with parents (for stage of development), instead of
developing independence.
