Paediatric Psychiatry

Question 1

how can children psychiatry disorders be split

Answer 1

internalising or emotional behavior disorders

externalising disorders or disruptive behvaiour disorders

Question 2

define internalising or emotional behavior disorders

Answer 2

probelsm within self

children cope with these problems internally rather than acting out in environment

Question 3

examples of internalising or emotional behavior disorders 4

Answer 3

axiety disorders -eg phobias

OCD

depression

psychosomatic complaints

Question 4

define externalising disorders or disruptive behvaiour disorders

Answer 4

characterised by behaviours directed outwards, tupcoally towards people

Question 5

exapmles of externalising disorders or disruptive behvaiour disorders 3

Answer 5

ADHD

conduct disorders

oppositional defiant disorder

Question 6

what conditions do not fit into these psych categories 3

Answer 6

ASD

psychotic illness

eating disorders

Question 7

presentation of child with ADHD 5

Answer 7

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

Question 8

what must occur for childnre with ADHD to be diagnosed

Answer 8

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

Question 9

define conduct disorder

Answer 9

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

Question 10

how does conduct disorder differ from deliquency

Answer 10

delinquency is a legal term
CD is seen as a risk factor for delinquent behaviour

Question 11

characteristcs of conduct disorder 5

Answer 11

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

Question 12

classifications of conduct disorders 2

Answer 12

early onset conduct disorder

adolescent onset conudct disorder

Question 13

define early onset conduct disorder

Answer 13

child shows at least one characteristd before age of 10
-often assoc w ADHA

Question 14

define adolescent onset conduct disorder

Answer 14

child doestn show characteristics before age of 10
-more common type

Question 15

risk factors for conduct disorders 5

Answer 15

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

Question 16

treatment for conduct disorders

Answer 16

gorup based parent training/ education programmes

indidual CBT can also be used

Question 17

how is reactive attachment disorders characterised

Answer 17

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

Question 18

syx of reactive attachment disorder 3

Answer 18

lack of emotional responsiveness

fearfulness

hypervigilance

Question 19

how can anxiety disorders affect children 5

Answer 19

can affect a childs thinking

decsion making ability

perception of environment

learning and concentration

may have physical complaints also

Question 20

define generalised anxiety disorder

Answer 20

recurring fears and worries they find difficult to control

Question 21

syx of generalised anxiety disorder 6

Answer 21

often reports of inner tension and restlessness

feeling irritable or easily tired

physical complains

sleeping problems also common

trouble concentrating

perfectionisitic tendencies

Question 22

treatment of anxiety disorders 3

Answer 22

CBT group or individual

family therapy

parenting strategies ionn

Question 22

treatment of anxiety disorders 3

Answer 22

CBT group or individual

family therapy

parenting strategies ionn

Question 23

treatment of anxiety disorders 3

Answer 23

CBT group or individual

family therapy

parenting strategies ionn

Question 24

define separation anxiety disorder

Answer 24

child has intense anxiety about being away from home or their caregivers

Question 25

syx of sepaarrting anxiety disorder 4

Answer 25

school refusal

clingy behaviours

anger outburts cna occur when separating form parents

may refuse to sleep alone

Question 26

define social phobia

Answer 26

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

Question 27

typical child with social phboies 3

Answer 27

overly sensitivite to critisim

suffer from low self esteem

lack confidence w peer relationships

Question 28

what can often cause PTSD in children 2

Answer 28

signficant threat to their saftey- ie house fire

repeated trauamitc events- sexual abuse

Question 29

treaetmetn for PTSD in children 4

Answer 29

re-establish child saftery

psychoeduaction

relaxaiton technqiues

psychotherapreutic approach to understand of traumatic event

Question 30

syx of specifc phobias in children 3

Answer 30

excessive perisitnt fear to specific situation or object

exposure can cause immediate extreme distress

may suffer panic attacks and agoraphobia

Question 31

define OCD

Answer 31

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

Question 32

syx of OCD 1

Answer 32

perform routines or rituals in an attempt to eliminate the unwanted thought

Question 33

common compulsions

Answer 33

excessive washing, checking, counting or tapping to relieve anxiety

Question 34

what medical conditon can OCD be associated with 1

Answer 34

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

Question 35

psychological syx of depression in children 5

Answer 35

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

Question 36

biological syx of depression 3

Answer 36

spending alot of time in bed but spleeing poorly

early morning awakening

major changes in weihgt/appeeitie
headaches, stomach aches, tirdness

Question 37

behaviors that are signs of childhood depression 6
-remember children often don’t have the vocab to accureltately describe how they feel

Answer 37

 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

Question 38

treatment for depression in kids 3

Answer 38

family therapy

inidivual CBT

psychtherapy

Question 39

ASD triad

Answer 39

qualitative impairement in reciprcating social interactions

deficies in use of language for social situations

steroitypes behaviours
-sensory sensitivities
-restritied interests

Question 40

define tic disorders

Answer 40

sudden invulntary non-rhythmic motor movements or vocal production

purposeless, happen rapidly and often repetitive in nature

Question 41

how can tics be diffrenneits

Answer 41

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

Question 42

define tourretts

*what is assoc w tourretss 2

Answer 42

combined vocal and motor tic disordre

often persists into adult life

-* ADHD, OCD

Question 43

eating behvaiour problems

Answer 43

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

Question 44

syx of anorexia 5

Answer 44

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

Question 45

phsyical syx and sxs of naorexia 4

Answer 45

 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.

Question 46

cognitive /psychosocla syx of anorexia 5

Answer 46

dpressed mood

sucicdal thoguhts

decreased ability to concentrate

poor decision making skills

feeling of guil or worthlesness

Question 47

social syx of anorexia 4

Answer 47

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.