Term
| How are Childhood Psychiatric disorders classified? |
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Definition
1) Developmental
- Autism
- Language and Learning
2) Disruptive Behavior
- ADHD
- Oppositional Defiant Disorder; Conduct disorder
3) Anxiety
- Separation
- Social phobia
- GAD
4) Mood
- Depression
- Bipolar
5) Tourette's
6) Eating
7) Substance Use |
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Term
| What important epidemiological features define Childhood psychiatric conditions? |
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Definition
Depression hits more adolescents, while Anxiety hits more children
1) 15-20% prevalence
2) 20-50% co-morbidity
3) Anxiety 3-8% (child > adol.)
4) Depression 2-6% (adol. > child)
5) Disruptive 5-15% |
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Term
| What questions should you ask yourself when diagnosing a childhood psychiatric disorder? |
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Definition
1) Do I understand the child's internal experience?
2) Are their symptoms appropriate/abnormal for their developmental level?
3) What context are they occurring in? |
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Term
| How does age impact the presentation of Separation anxiety disorder and what treatments are available? |
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Definition
1) Ages 9-12 expression distress at times of separation, while ages 5-8 manifest somatic complaints and school refusal
2) Modified CBT and SSRIs/SNRI |
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Term
| How can you tell if a child has Depression? How could you treat? |
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Definition
Tell-tale signs
1) Irritability
2) School performance drops
3) Brighten temporally in presence of friends
Treat
1) CBT and Interpersonal Therapy
2) Only Fluoxetine shows clear benefit |
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Term
| What is pediatric bipolar disorder most commonly confused for and how is it treated? |
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Definition
1) ADHD or irritable depression
2) Treat
- Second Gen Antipsychotics
- Mood stabilizers
- Educate family and patient. |
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Term
| What are the 3 primary symptom clusters of ADHD? How do you treat? |
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Definition
Younger than 7 (3-8% with 3:1 male:female)
- Treat with stimulants such as methylphenidate and mixed amphetamine salts
1) Hyperactivity ("cant sit still" most often pre-pubescent)
2) Inattention/distractibility
3) Impulsivity |
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Term
| What significant co-morbidities are associated with ADHD? |
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Definition
Kids don't "grow out of it"
1) Oppositional-Defiant Disorder (40%)
2) Conduct (30%)
3) Anxiety (15-20%)
4) Depression (15-20%) |
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Term
| Distinguish between Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD). How do you treat these conditions? |
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Definition
1) ODD includes oppositional behavior, violations of rules and irritability (often progress to CD).
2) CD involves physical fighting, stealing, conning, fire-setting and even cruelty to animals
3) CBT, environmental intervention.
- Treat ADHD as comorbidity with amphetamine stimulant.
- Talk/behavioral therapy not demonstrated to be effective |
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Term
| How does Autism generally present? |
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Definition
With social and language impairments, as well as abnormally restricted interests.
- Young males (under age 3, 5:1 M:F)
- 70-80% co-morbid mental retardation
- Seizures are common
1) Social
- no ToM
- no comfort-seeking
- Absent social play
2) Language
- Little verbal communication and production abnormalities, as well as echolalia
3) Interest
- Unreasonable insistence on following routines
- Preoccupation with parts of objects |
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Term
| Differentiate between Autism, Asperger's and PDD |
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Definition
- Asperger's is like Autism but WITH early language development and intelligence
- PDD presents with some, but not all symptoms of autism/asperger's
** Treat PDD with resperidone and intense behavioral treatments |
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Term
| What is "CAMbox" and how is it used for ADHD? |
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Definition
Zinc acts as cofactor for NT metabolism (DA) and is low in Autism.
- Some evidence that it improves hyperactivity, impulsivity and socialization (either as adjuvant or mono-therapy)
- Safety may be issue since required doses are high |
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Term
All of the following factors may explain why psychiatric disorders present differently in childhood, EXCEPT:
a. Neurodevelopmental factors
b. Cognitive maturity
c. Social context
d. Insurance coverage |
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Definition
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Term
Compared to depressed adults, children who present with depression are more likely to have which core symptom?
a. Anhedonia (loss of interest)
b. Dysphoria (depressed mood)
c. Irritability
d. Somatization |
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Definition
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Term
A 14-year old girl is brought for psychiatric evaluation by her parents, concerned that she may have ADHD. , Her new teacher has been regularly calling the parents to say that she has been very talkative, blurting out answers, interrupting others, is easily distracted from her work and very fidgety in her seat. She has never had any problems before this school year, and always had a good attention span, excellent grades and was well-behaved in class and at home. What’s the best explanation for why this is unlikely to be ADHD?
a. Girls are much less likely to get ADHD.
b. Some ADHD symptoms usually are present prior to age seven.
c. There are no symptoms of inattention.
d. Conduct disorder is a much more likely diagnosis. |
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Definition
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Term
How many kids with ADHD will continue to have symptoms in adulthood?
a. None—kids “grow out of it.”
b. One-third
c. Two-thirds
d. All—kids never “grow out of it.” |
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Definition
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Term
5. Which of the following functions are impaired in autism?
a. Social relatedness
b. Communication and language
c. Interest in activities
d. a and b
e. All of the Above |
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Definition
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Term
Antipsychotic medication may be useful in the treatment of the following condition(s) in child psychiatry:
a. Psychotic disorders
b. Autism
c. ADHD
d. A+B
e. All of the above |
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Definition
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