Psychiatry 2

Question 1

What is conduct disorder?

Answer 1

mostly affects boys by the age of 10-12 and girls by 14-16
characterised by the repetitive and persistent pattern of aggression to people and animals, destruction of property, deceitfulness or theft and major violations of age appropriate societal expectation or rules e.g. truancy

Question 2

What re the aetiological factors for conduct disorder?

Answer 2

o	Genetics
o	Parental psychopathology
o	Abuse
o	Neglect
o	Education
o	Socioeconomic status
affects 5-15% of adolescent boys and 2-10% of girls with a female to male ratio of 3-12:1

Question 3

What is opposition defiant disorder?

Answer 3

describes a pattern of defiant and hostile behaviour that does not violate the law or basic rights of others

Question 4

What is the management for depression?

Answer 4

Period of watchful waiting for 4 weeks may be appropriate- alternatively non-directive support therapy can be offered or guided self-help
If mild depression does not respond to these in 2-3 months, then the child should be referred to a specialist- all children with moderate or severe depression should be referred
In a specialist setting they may offer CBT, IPT, and family therapy if psychotherapy is insufficient after 6 weeks then an SSRI (fluoxetine) should be considered if suicidal then admission may be needed.

Question 5

What is the PATHOS tool for self harm/suicide?

Answer 5

o P – Have you had problems for longer than a month?
o A – Were you alone in the house at the time?
o T – Did you plan the overdose for longer than three hours?
o HO – Are you feeling hopeless about the future?
o S – Were you feeling sad for most of the time before the overdose?
• Score 1 for yes and 0 for no. Child is a high risk of >2

Question 6

What are the categories of recreational illicit drugs?

Answer 6

Class A – ecstasy, LSD, heroin, morphine, cocaine and methadone
Class B – amphetamine, cannabis and dihydrocodeine
Class C – GHB, temazepam, valium, temgesic, ketamine

Question 7

What can cause sleep disturbance?

Answer 7

o Too much sleep in the afternoon
o Displaced sleep wake cycle (sleeping in late due to disturbed sleep)
o Separation anxiety
o Overstimulation in the evening
o Kept awake by sibling, noisy neighbours of TV
o Erratic parental practices (no bedtime routine, sudden removal from play to bed)
o Use of bedroom as punishment
o Dislike of darkness and silence
o Some chronic physical conditions