Psych Flashcards
3 developmental disorders?
ADHD
Autism Spectrum disorders
Mental Retardation
Psychiatric disorders? 8
Somatoform Disorders
Anxiety , PTSD, phobias, OCD
Depression , Bipolar
Schizophrenia
Pseudoseizures are a symptom of which Disorder?
Conversion Disorder
What is the most common depressive mood disorder in children and adolescents?
Adjustment Disorder with depressed mood
What is the mainstay of treatment for ADHD
Stimulants
what does PSYCH stand for
Parent Child interactions
School – academically, behaviorally, socially
Youth – peers, friendships, relationships
Casa – things at home..siblings..stress
Happiness – how would you describe your mood? Your childs mood?
what is PSYCH
surveillance you can ask parents and child
what is A characteristic cluster of signs and symptoms that are associated with subjective distress or maladaptive behavior
Psych d/o
what presents asLoss of interest, feelings of worthlessness, decreased energy, crying spells, irritability, isolation, low self esteem.
depression
can depression present with somatic symptoms
yes d/t the inability to tolerate sadness
what May present with running away, self destructive behavior, drug abuse, sexual acting out, delinquency.
depression
depression may have change in 4 things
attitude, sleep, appetite, friends
what are comorbidities of depression? 4
ADHD, conduct disorders, anxiety, substance abuse
what is Beck?
what is Reynolds?
Depression rating scales
what should be part of Ddx of depression? 4
Hypothyroid
Substance abuse
Eating disorder
2ndary to medical illness
What are complications of depression? 4
suicide , school performance, loss of friends, family tension
what are treatments for depression? 3
CBT (cognitive behavioral therapy)
Referral for psychotherapy , medications SSRI
what is the most frequent psych d/o in kids?
ADHD
what is dysthymic d/o?
chronic, milder form of depression, sx present for at least a year
what is the most common depressive mood d/o in kids?
Adjustment disorder with depressed mood
what has Symptoms that start within 3 months of an identifiable stressor (e.g., loss of a relationship), with distress in excess of what would be expected and interference with social, occupational, or school functioning. (last less than 6 months)
Adjustment disorder with depressed mood
what is Variable course of mood instability combined with aggressive behavior and impulsivity
bipolar disorder
what d/o may be dx as a kid but its really BP d/o
ADHD
what is Manic or hypomanic moods can be high energy level, difficulty concentrating, hypersexual activity, decreased sleep
Bipolar d/o
what is very often comorbid with adhd?
bipolar d/o
if kid has Problems with friends, impulsivity, criminal activity, legal difficulties what should you think
Bipolar d/o
how do you treat bipolar do
mood stabilizers (lithium)
what is the 3rd leading cause of death in adolescent
suicide
what is a black box warning of antidepressants
suicide
what is the most commonly used method of suicide
firearms
what is most commonly associated with mood d/o
Suicide
who is at highest risk of suicide
white adolescent males
when is the onset of schizophrenia
middle to late teens - early 30’s
when do signs of schizophrenia begin?
Sx usually begin after puberty
Childhood onset rare, more likely to be boys
1degree relatives have 10X risk of what?
schizophrenia
what should psychotic symptoms warrant? - what diseases?2
medical evaluation for neurologic disease (MRI, EEG), metabolic disease, wilsons disease
what are psychotic symtoms in children?
Children often have learning disorders, delusions, disorganized thoughts
what are psychotic symptoms in adolescents
hard to diff from mania
how do you treat schizophrenia
with antipsychotic
what helpsreduce hallucinations, delusions in schizophrenia
Supportive reality based focus in relationships
what Overlaps with ADHD, substance abuse, learning disabilities, mood disorders, family dysfunction
conduct d/o
if there is Boy with a turbulent home life and academic difficulties what should you think
conduct d/o
what is associated with truancy, aggression, defiance, fighting, destruction of property, theft …fire setting, sexual perpetration, substance abuse
conduct d/o
when is oppositional defiant d/o evident?
before 8
what is panda? associated with what psych d/o?
pediatric autoimmune neuropsychiatric disorder assoc w Strep
OCD
how do you treat OCD?
CBT and SSRI
what has signs and symptoms of Somatic, behavioral, emotional
Irritability, poor sleep, poor school, N/V/D
Restlessness and hyperactivity , SOB
anxiety
what do children with GAD present as
perfectionists, overly concerned with approval of others
how do you treat anxiety
CBT and SSRI
what is Contamination, need for orderliness, repeated doubts, aggressive or horrific impulses, sexual imagery
obsessions
what is Handwashing, ordering, checking, counting, repeating words silently, hoarding
compulsions
in OCD what predominates in children
compulsions
what has Very high comorbidity with other mood and anxiety disorders, ADHD, and developmental disorders
OCD
what has Strong relationships with Tourette’s disorder, body dysmorphic disorder
OCD
how do you treat OCD
CBT and SSRIs
what is The term is used to describe a subset of children who have Obsessive Compulsive Disorder (OCD) and/or tic disorders such as Tourette’s Syndrome, and in whom symptoms worsen following strep. infections such as “Strep throat” and Scarlet Fever
PANDAS
what are the 5 diagnostic criteria for panda?
Presence of obsessive-compulsive disorder and/or a tic disorder
Pediatric onset of symptoms (age 3 years to puberty)
Episodic course of symptom severity
Association with group A Beta-hemolytic streptococcal infection (a positive throat culture for strep or history of Scarlet Fever)
Association with neurological abnormalities (motoric hyperactivity, or adventitious movements, such as choreiform movements)
what is associated with Fear, anxiety, hypervigilance. May regress developmentally. Nightmares
PTSD
Individual and family psychotherapy are mainstays of therapy for?
PTSD
what can you use Sertraline and Clonidine for?
aggressive or psychosis in PTSD
what has High comorbidity with other anxiety disorders
Phobias
how do you treat phobias
CBT is best. SSRI
what are 6 somatoform d/o?
Body Dysmorphic disorder, Conversion Reaction, somatization d/o, hypochondriasis, malingering, factious disorder
what somatoform d/o has neurologic / GI sx
conversion rxn
what somatoform d/o seeks fo gain reward?
malingering
what is equivalent to muchausen syndrome and seeks to attain medical attention
factitious disorder
what involves a complaint of physical symptoms (pain or loss of function) that suggest a medical condition but are not fully explained by either a medical condition, a pharmacologic effect, or another psychiatric condition
somatoform disorders
in somatoform d/o are they consciously fabricating the sx
nope
Hx of: sexual trauma, physical threats
Parental neglect, substance abuse
Depression, Anxiety may have what?
somatoform d/o
how do you treat somatoform d/o
Treat co-morbid illnesses
CBT ( cognitive behavioral therapy)
Some with SSRI (CBT + SSRI)
what is unexplained headaches, fibromyalgia, body dysmorphic disorder, pain disorder, Irritable bowel disorder, functional gastrointestinal disorders
somatoform d/o
how common is Autism spectrum d/o
1:150
is ASD more common in boys or girls
boys 3-4:1
can ASD be diagnosed in children before 2
yes
ASD is Primarily due to a genetic disorder or disease
nope
ASD pt need referral to early intervention programs
yes
what is a neurodegenerative disorder
Age of onset: typically between ages 2 and 4 (can be recognized in first 12-18mo)
autism
what d/o has Consistent failure to orient to one’s name, regard people directly, use gestures, and develop speech.
autism
what d/o has Delayed or absent social smiling as infant
autism
what are the 4 hallmarks of autism?
Impaired communication
Impaired social interaction
Stereotypic behaviors, interests, activities
MR is common
what has Deficits in reciprocal social interaction
Joint attention by 18mo , and functional play
Echolalia and nonsensical speech
autistic d/o
what can puberty do in autism
Puberty can bring worsening of aggression, hyperactivity, self destructive activity (seizures)
3 non pharm treatments in autism
Occupational therapy Sensory integration services Behavioral therapy ( self care, linguistics)
what drugs are used in autism
Antipsychotics, antidepressants/mood stabilizers
for symptoms
what are 4 Non Autistic Pervasive Developmental Disorders
Asperger syndrome, childhood disintegrative disorder, PDD-not otherwise specified and Rett Syndrome
what PDDs have bad prognosis?
rett and childhood disintegration
what has impairment in social interaction and restricted interest/repetitive behaviors
Not delayed in cognitive, language or self help
asperger
what has Mild Impairment in reciprocal social interaction
Impairment in communication skills
Restricted interests and repetitive behaviors
PPD - NOS
what has Typical development for at least 2 years, then regression in at least 2 of 3 areas
Social interaction
Communication
Behavior
Childhood disintegrative d/o
what is Genetic, due to mutation on X chrom
Almost exclusively girls
Rett Syndrome
what has Regression in skills in the first year of life
Characteristic handwringing
Rett Syndrome
what has Severe deficits in development of language, motor skills, attention, abstract reasoning, visual-spatial skills, and academic or vocational achievement.
Mental retardation
what has an IQ<70 and skills more than 2 standard deviations below the mean
mental retardation
how do you eval mental retardation in 0-31/2 y/o?
bayley scales of infant devp
how do you eval mental retardation in >3y/o
Wechsler Intelligence Scale, Stanford-Binet IV
3 subtypes of ADHD
Hyperactive Impulsive : 10% . Can pay attention
Inattentive :30-40% (old ADD term)
Combined : 50-60%
how do you asses for ADHD
Vanderbuilt Assessment Scales for AD/HD
when can symptoms of ADHD diminish
10-25
in ADHD what declines more rapidly? impulsivity, inattentiveness, hyperactivity
hyperactivity
what are d/o with ADHD - 8
Fragile X Williams syndrome Angelman syndrome XXY Syndrome (kleinfelter syndrome) Turner Syndrome FAS CNS trauma or infection Prematurity
what is the mainstay tx of ADHD
Methylphenidate (Ritalin) , Concerta
Dextroamphetamine, Adderall
t/f Comorbidity in ADHD increases substance abuse at least 5 fold.
T
t/f Stimulant treatment of ADHD leads to an increased incidence of later substance abuse.
F
t/f 25% of unmedicated ADHD patients practice substance abuse.
f - 75%
t/f Those treated with stimulant drugs commonly abuse their prescribed agents.
F - protective
