Pediatric Psychiatry Flashcards
What are the standardized screening tools for mental health disorders
PHQ9
Beck Depression Inventory
according to USPSTF when does MDD screening begin
age 12-18
what are the etiologies of depression
genetic and environmental
F>M
What is SIG ECAPS
DSM-V Criteria for depression in Adolescents
Sleep, Interest, Guilt
Energy, Concentration, Appetite, Psychomotor, Suicidal
What is the treatment for depression
Rule out physical source
therapy (psycho, family, CBT)
Medications: SSRI
exercise and nutrition are important
what is the black box warning on SSRIs
may increase suicidal ideation and attempts
informed consent is important
What is generalized anxiety disorder
excessive, uncontrollable anxiety about events or activities that occurs more oftan than not for at least 6 months
associated with atleast one of the following: restlessness, muscle tension, easy fatigue, difficulty concentrating, irritability, sleep disturbances
What lab work and tests should be done for the workup of GAD
TSH and FT4, UDS, metanephrines, PFT, Echo, EKG, EEG
what is the treatment of GAD
combo of therapy and mood stabilizers
hydroxyzine, fluoxetine, escitalopram, sertraline, citalopram
what is the definition of obsessions
recurrent and persistent thoughts, impulses or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress
what is the definition of compulsions
repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession
aimed at preventing or reducing distress
what is the treatment for OCD
therapy (and mood stabilizers?)
What is Bipolar Disorder
severe mood changes
inflated self esteem or grandiosity
increased energy
decreased need for sleep
talkative, frequent subject changes
distracible, constant movement
risk-taking behaviors
assess. forfamily hx
What is the DSM-V criteria for bipolar disorder
A distinct period of abnormally and persistently elevated, expansive or irritable mood (mania), lasting at least 1 week +/- episodes of lowered mood and activity (depression)
What is the treatment of Bipolar disorder
combo therapy and meds
refer to psychiatry
what is ODD
negative, hostile and defiant behavior which is excessive compared to others at same age
what are the clinical features of ODD
active defiance, argumentative, argues
easily loses temper
blames others
deliberately does things to annoy others
what is the treatment of ODD
parent education
refer for confirmation and therapy
collaborate with school
what are the ADHD tools
Narrow band
* -ADHD rating scales
* Vanderbilt Scales
* Connors scales
Broad band
* Achenbach Child behavior checklist (CBCL)
* behavior assessment scales for children (BASC)
* Brown attention Deficit disoder scales (BADDS)
Who is the Connor’s scale appropriate for
(ages)
ages 6-18 years
what tool is one of the most widely used broad-based behavioral instruments in the world for ADHD
Achenbach Child behavior checklist (ACBC)
what is the treatment of ADHD
combo medication plus therpeutic intervention has the best results
What is the treatment of ADHD in preschool children (4-5 years)
evidence-based behavior therapy
prescribe methylphenidate if not effective and mod-severe disturbance
what is teh treatment of ADHD in school ages (6-11 years)
medication + behavioral intervention
-stimulant, followed by atomoxetine, extended release guanfacine
