Child and adolescent psychiatry Flashcards
What areas of developent do you need to assess in a child?
- Motor/physical
- Language
- Cognitive
- Social
- Emotional
- Spiritual and moral
Development of attactment
Percentage of children affected by mental health?
How many need specialist help?
10% affected
1% need specialist help
What is the general management structure of mental health disorders in children and adolescents?
Bio-psycho-social approach
Biological:
- not usually first line
- NICE guidelines, depression in adolescents, ADHD in children (ritialin)
Psychological:
- CBT
- Family therapy
Social:
- Very important
- Link to wide-network especially education and social services
Define learning disability
- Failure to develop a normal level og cognition rather than loss of it
- Coginition is measure by IQ and a value less that 70 is said to be sub average
How are intellectual disablilites classified?
Describe each classification
What are the major causes intelluctual disabilities?
- 30% no cause
- polygenic inheritance of low intelligence
- Social/educational deprivation
- other factors (genetic, peri-natal)
Chromosomal abnormalities assoicated with intellectual disabilities?
(6)
Down’s Syndrome
- Trisomy 21
- Associated with dysmorphic features
- Increased risk of deafness, cataracts, hypothyroidism and early onset Alzheimer’s
Fragile X Syndrome
- 2nd most common cause of ID
- More common in Males (X linked)
- Elongated face and protruding ears)
Cri du chat syndrome (5p-)
- Deletion in chromosome 5
- Infants often have a high-pitched cry that sounds like that of a cat
Tuberous Sclerosis
- Mutation in TSG on 9 or 16
- Can result in autism and epilepsy with ID
- Skin changes and tumours of brain and other organs
Neurofibromatosis
- Mutation on 17
- Mild ID
- Café au lait spots and abnormalities, soft tissues NS and bone
Phenylketonuria
- 1/10,000
- Autosomal recessive
- High serum phenylalanine
- Short statue, hyperactivity, irritability, epilepsy, lack of pigment and exzema
What are risk factors for learning disabilities?
- Males>Females.
- Higher in lower social classes
- Associated with overcrowding, poverty and unskilled employment
What are the 3 persistant triad of deficits for autism?
- Impairment of social interaction
- Impairment in communication
- Repetitive behaviour
Prevelance of autism?
gender ratio?
0.05%
male to female - 4:1
Causes of autism? general
genetic, prenatal and immunological factors all indicated
Phenylketonuria, tuberous sclerosis and congential rubella are associated condition
Difference between asperger’s syndrome and autism
(dispite asperger’s syndrome being on the autism spectrum)
For asperger’s syndrome there are no abnormalities in language acquisition and ability in congnition development and intelligence
(Chris Noakes)
What are the core symtpoms of ADHD?
What is needed for diagnosis of ADHD
- Inattention
- Hyperactivity
- Impulsivity
These symptoms are evident in more than on situation i.e. at school and home, and should be present for at least 6 months
(No other concurrent mental illnesses such as depression)
Prevelance of ADHD?
Male female ratio?
1-5% in UK
3:1 boys to girls
