Child and Adolescent Psychiatry: DSM-5 Disorders and Developmental Assessment

Why are children less likely to initiate referrals for mental health issues?

Children seldom initiate referrals due to their developmental stage and limited ability to express themselves.

What is a key consideration during the assessment of children in psychiatry?

Children are developing, and this must be considered during assessment.

What is the trend regarding medication use in treating children with mental health problems?

There is less use of medication in the treatment of children compared to adults.

What are common emotional problems in children?

Persistent fear and anxiety, school refusal, depression, suicidal ideas and attempts, daydreaming, jealousy, sibling rivalry, and mood swings.

What behavioral issues may indicate mental health problems in children?

Unusually shy behavior, anti-social behavior, disobedience, lying, stealing, hyperactivity, and disruptive behavior.

What developmental problems might children face?

Language and speech delay, stuttering, bedwetting, socialization difficulties, and learning problems.

What are some other factors that can affect children's mental health?

Parent-child relationship problems, marital issues, bodily pains, child abuse, and eating problems.

What dimensions should be considered when assessing a child's behavior?

Appropriateness, intensity, persistence, pervasiveness, and impairment.

How many major categories of psychiatric disorders are included in the DSM-5?

18 major categories.

What are the first three categories of psychiatric disorders in the DSM-5?

1. Neurodevelopmental Disorders, 2. Schizophrenia Spectrum and Other Psychotic Disorders, 3. Bipolar and Related Disorders.

What is included in the category of Neurodevelopmental Disorders?

Intellectual disability, communication disorders, specific learning disorder, motor disorders, tic disorders, autism spectrum disorder, and ADHD.

What are the components of Autism Spectrum Disorder (ASD) as per DSM-5 criteria?

Deficits in social communication and interaction, and restricted, repetitive patterns of behavior.

What are early signs of autism in infants?

Limited eye contact, no meaningful gestures, no babbling by 12 months, and difficulty being consoled.

What factors contribute to the etiology of Autism Spectrum Disorder?

Genetic factors, neurobiological factors, and possibly environmental factors.

What is the prevalence of childhood autism according to estimates?

4 per 10,000 for childhood autism.

What is the male to female ratio for autism prevalence?

4:1.

What is the risk of having a second child with autism?

5%, which is 100 times the general population risk.

What is the most common presenting concern in developmental assessments?

Speech and language delay.

What are some diagnostic assessment tools for Autism Spectrum Disorder?

Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule (ADOS).

What types of problems are common in children with high-functioning Autism Spectrum Disorders?

Emotional and behavioral problems, including affective issues, anxiety, ADHD, and conduct problems.

What are some management strategies for children with Autism Spectrum Disorder?

Educational/vocational support, behavioral intervention, family support, psychotherapy, and pharmacotherapy.

What is the significance of early identification in Autism Spectrum Disorder?

It allows for timely referral for assessment and early intervention.

What is the DSM-5 classification for Rett's Syndrome?

Rett's Syndrome is not included in DSM-5 as it is a genetic disorder that develops until age 4 and then leads to regression.

What are the symptoms of restricted, repetitive patterns of behavior in ASD?

Stereotyped speech, adherence to routines, fixated interests, and hyper/hypo-reactivity to sensory input.

What is the prevalence of intellectual disability in individuals with Autism Spectrum Disorder?

Profound ID affects 40%, mild to moderate ID affects 30%, and normal intellectual function affects 30%.

What are the main components of intervention for ASD?

Earliest possible age, high intensity, parent involvement, various modules to stimulate social and communicative functioning, systemic instruction with individual goals, and generalization of skills to daily life.

What is the significance of intervention timing for children with ASD?

Children with intervention before 3 years have a significantly better outcome than those beginning after 5 years.

Which medications are commonly used for anxiety and repetitive behaviors in ASD?

Selective Serotonin Reuptake Inhibitors (e.g., Fluoxetine, Fluvoxamine) and Tricyclic Antidepressants (e.g., Clomipramine).

What medications are used to address aggression and irritability in ASD?

Typical Antipsychotics (e.g., Haloperidol), Atypical Antipsychotics (e.g., Risperidone, Olanzapine), and Mood Stabilizers (e.g., Sodium Valproate, Carbamazepine).

What are the core symptoms of Attention Deficit Hyperactivity Disorder (ADHD)?

Symptoms of inattention and symptoms of hyperactivity-impulsivity.

What is the onset age for ADHD according to DSM-IV TR?

Before age 7.

What is the onset age for ADHD according to DSM-5?

Before age 12.

What must ADHD symptoms cause to meet diagnostic criteria?

Impairment in two or more settings resulting in significant impairment in social, academic, or occupational functioning.

What is the prevalence of ADHD?

5-7%.

What are the consequences of untreated ADHD?

Academic underachievement, relationship difficulties, low self-esteem, social-occupational impairment, and motor accidents.

What is the definition of a tic?

A sudden, repetitive movement, gesture, or utterance that typically mimics some aspect of normal behavior.

What is Tourette's Syndrome?

A combined vocal and motor tic disorder occurring many times a day, nearly every day for 1 year, causing marked distress or significant impairment in functioning.

What are the types of tic disorders?

Tourette's Disorder, Chronic Motor or Vocal Tic Disorder, Transient Tic Disorder, Tic Disorder NOS.

What is the treatment focus for Tourette's Syndrome?

The overall level of functioning.

What is the definition of Specific Learning Disorder (SLD)?

Ability is substantially below that expected and interferes with academic achievement or activities of daily living.

What are the areas of impairment in Specific Learning Disorder?

Reading (dyslexia), Mathematics (dyscalculia), and Written Expression.

What is the Discrepancy Model in diagnosing SLD?

Identified if attainment was below that expected compared to peers, showing a discrepancy between intelligence and attainment.

What is the Response To Instruction (RTI) Model for diagnosing SLD?

Diagnosis is postponed until after intervention is offered; a child is diagnosed if they continue to struggle despite substantial individualized help.

What is Oppositional Defiant Disorder (ODD)?

A pattern of negativistic, hostile, and defiant behavior.

What behaviors characterize Conduct Disorder (CD)?

Aggression to people and animals, destruction of property, deceitfulness or theft, and serious violation of rules.

What are the treatment methods for CD and ODD?

Community-based programs, family therapy, parent training, child interventions, and medication for severe behaviors.

What is Separation Anxiety Disorder?

Anxiety concerning separation from home or those to whom the individual is attached, resulting in impairment in functioning.

What is Selective Mutism?

Consistent failure to speak in specific social situations despite speaking in other situations, lasting at least one month.

What is School Refusal?

Fear of going to school with somatic symptoms, potentially linked to separation anxiety, specific phobia, or general psychiatric disturbance.