Paediatric Psychiatry

Question 1

Paediatric Psychiatry

Childhood Psychiatric Conditions

Answer 1

• Autism Spectrum Disorder
• Attention Deficit Hyperactivity Disorder
• Conduct Disorder
• Oppositional Defiant Disorder
• Separation Anxiety Disorder
• Tourette’s Disorder (& other Tic Disorders)

Question 2

Paediatric Psychiatry

Define Autism Spectrum Disorder

Answer 2

Impairments in socialisation, communication and behaviour (see Paediatrics)

Question 3

Paediatric Psychiatry

Define Conduct Disorder

Answer 3

A repetitive and persistent pattern of behaviour in which the basic rights of others or major age-appropriate societal norms or rules are violated. (Paediatric antisocial PD)

Question 4

Paediatric Psychiatry

Define Oppositional Defiant Disorder

Answer 4

A recurrent pattern of negativistic, defiant, disobedient and hostile behaviour toward authority figures that persists for at least 6 months.

Question 5

Paediatric Psychiatry

Define Separation Anxiety Disorder

Answer 5

Developmentally inappropriate and excessive anxiety concerning separation from home or to whom the individual is attached. The duration of the disturbance is at least 4 weeks and onset is before age 18

Question 6

Paediatric Psychiatry

Define Tourette’s Disorder (& other Tic Disorders)

Answer 6

The presence of multiple motor tics and one or more vocal tics

Question 7

Paediatric Psychiatry

Define ADHD

Answer 7

A persistent pattern of inattention and/or hyperactivity impuslivity that is more frequently displayed and more severe than is typically observed in individuals at a comparable level of development. Unknown cause

Question 8

Paediatric Psychiatry

ADHD Epidemiology

Answer 8

Prevalence is 2.3-6% in school-age children
Male predominance (2:1). 
Co-morbid conditions common 
- oppositional defiant disorder
- conduct disorder
- depression
- anxiety disorder
- learning disabilities.

Question 9

Paediatric Psychiatry

Clinical Criteria for ADHD

Answer 9

DSM-V Criteria

• Either inattention or hyperactivity-impulsivity symptoms that have persisted for > 6 months
• Have been present before age 12 years.
• Some impairment in two or more settings.

Question 10

Paediatric Psychiatry

ADHD Management

Answer 10

Non-pharmacological
- Behaviour Therapy
- Positive Re-enforcement
- Time-out
- Response cost (withdrawing rewards when a behaviour occurs)
- ?Restrictive diet
Pharmacological (6+ y.o.)
- Short Acting - Dexamphetamine
- Long Acting - Methylphenidate

Question 11

Paediatric Psychiatry

ADHD Prognosis

Answer 11

• Hyperactivity usually lessens by adolescence
• Learning difficulties can persist
• Can develop to adult antisocial behaviour.
• Some childhood ADHD may be part of an affective (manic) disorder