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7. Child and adolescent psychiatry > Anxiety disorders > Flashcards

Anxiety disorders Flashcards

(109 cards)

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1
Q

Prevalence of anxiety disorders in young people

A

5-15%

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2
Q

Male:female ratio of anxiety disorders in young people

A

Equal before adolescence
1:2 after adolescence

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3
Q

Prevalence of separation anxiety in children

A

3-5%

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4
Q

Prevalence of separation anxiety in adolescents

A

0.8%

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5
Q

Prevalence of GAD in adolescents

A

4%

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6
Q

Presence of phobia in young people

A

10%

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7
Q

Presence of social phobia in children

A

1%

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8
Q

Presence of social phobia in adolescents

A

5-15%

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9
Q

Presence of panic disorder in adolescents

A

3-6%

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10
Q

Most common symptoms of anxiety in preschool children

A

Tearfulness
Clingy behaviour

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11
Q

Most common symptoms of anxiety in school aged children

A

Somatic complaints
Hypochondriasis
Irritability
Aggressive behaviour

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12
Q

Length of time symptoms need to be present for a diagnosis of separation anxiety

A

4 weeks

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13
Q

Age at which separation anxiety is expected to develop

A

6-18

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14
Q

Most common symptoms of separation anxiety leading to families seeking help

A

School refusal
Somatic complaints

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15
Q

Four types of childhood attachment

A

Secure
Insecure avoidant
Insecure ambivalent
Disorganised

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16
Q

Percentage of children who show secure attachment

A

60%

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17
Q

Percentage of children who show insecure avoidant attachment

A

15%

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18
Q

Percentage of children who show insecure ambivalent attachment

A

10%

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19
Q

Percentage of children who show disorganised attachment

A

15%

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20
Q

Symptoms of secure attachment

A

Child uses carer as a secure base
Child explores but comes back to their carer

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21
Q

Symptoms of insecure avoidant attachment

A

Child appears uninterested in carer
Child does not show distress at separation from carer

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22
Q

Symptoms of insecure ambivalent attachment

A

Child shows significant distress at separation from carer but resists comforting and takes a long time to settle

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23
Q

Symptoms of disorganised attachment

A

Child shows contradictory behaviour patterns
Child sometimes appears frozen and confused

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24
Q

Figure who studied child attachment and developed the Strange Situation procedure to identify attachment types in children

A

Mary Ainsworth

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25
Percentage of children who had significant disturbances aged 6 in the Romanian Adoptees study
20%
26
Cause of reactive attachment disorder
Severe parental neglect, abuse and mishandling
27
Features of reactive attachment disorder
Fearfulness Hypervigilance Poor social interactions Aggression towards self and others
28
Age at which reactive attachment disorder is diagnosed
<5
29
Features of disinhibited attachment disorder
Clinging behaviour Attention seeking Indiscriminately friendly behaviour
30
Timing of onset of sibling rivalry disorder
Within 6 months of the birth of the sibling
31
Time symptoms need to last for a diagnosis of sibling rivalry disorder
4 weeks
32
Three peaks of age for school refusal
5-7 11 14
33
Possible cause of school refusal in children aged 5-6
Separation anxiety
34
Possible cause of school refusal in children aged 11
Triggered by the transition to high school
35
Possible causes of school refusal in children aged 14
Bullying First presentation of mood/anxiety disorders Exam stresses
36
Percentage of young people with school refusal who will successfully reintegrate into school
70%
37
Age at which selective mutism normally starts
3-5
38
Main treatments for anxiety disorders in young people
CBT SSRIs
39
Percentage of people aged 11-15 diagnosed with PTSD
0.4%
40
Trigger type in type 1 PTSD in young people
Single, acute, traumatic event
41
Trigger type in type 2 PTSD in young people
Longstanding or repeated exposure to traumatic events
42
Symptoms in type 1 PTSD in young people
Detailed memories of the event Misperceptions
43
Symptoms in type 2 PTSD in young people
Denial Numbing Depersonalisation and dissociation Self harm Extreme passivity
44
Main treatment for PTSD in young people
Trauma focused CBT
45
Prevalence of OCD in young people
0.5%
46
Average age of onset of OCD in young people
10
47
SSRIs licensed for treatment of OCD in young people
Fluvoxamine Sertraline
48
Main treatments for OCD in young people
SSRIs CBT
49
Disease characterised by OCD and/or tic symptoms following a beta haemolytic streptococcal infection
PANDAS
50
Minimum age to diagnosis eneuresis
5
51
Percentage of children dry at night by age 2
50%
52
Percentage of children dry at night by age 3
75%
53
Percentage of children who have daytime wetting age 5
1%
54
Percentage of boys who have night time wetting age 5
15-22%
55
Percentage of girls who have night time wetting age 5
7-15%
56
Most important predictor of night time eneuresis
Family history
57
First line treatments for eneuresis
Rule out physical issues e.g. UTI Behavioural interventions e.g. alarm, bell and pad
58
Medication which has been approved for childhood eneuresis
Imipramine
59
Alternative medication for childhood eneuresis which has shown positive results in trails
Desmopressin
60
Definition of encopresis
Voluntary or involuntary soiling of normally formed stools in inappropriate places by a child aged 4 or over (and developmentally aged >4) without organic cause, occurring at least once a month for 3 months
61
Male:female ratio of encopresis
6:1
62
Percentage of children with soiling aged 5
5%
63
First line treatments for encopresis
Rule out physical causes Treat constipation and evacuate the stool Behavioural therapies Family support/therapy
64
Definition of pica
Eating of non-nutritive substances at the age of >1, at least twice a week for over a month
65
Age at which pica usually starts
2-3
66
Most common substances eaten with pica
Dirt Stones Plastic Hair Faeces Wood Paper
67
Condition pica is associated with
Learning disability/developmental delay
68
Common comorbidities of PANDAS
Anxiety Emotional lability/depression Irritability Aggression Behavioural regression Deterioration in school performance Somatic symptoms
69
Percentage of children who are dry at night by age 5
90%
70
Features seen in truants rather than school refusers
Antisocial behaviour Poor academic record Large families more likely
71
Features seen in school refusers rather than truants
Family history of neurotic disorders Satisfactory academic record Over-protective parenting Small families more likely
72
Sex distribution of school refusal
Equal
73
Disorder comorbid in the majority of children with selective mutism
Social anxiety
74
Most effective treatment for OCD in children and young people
Combination of SSRI and CBT
75
Most common age of presentation of school refusal
11
76
Chief medical problem to be excluded in children with encopresis
Hirschsprung's disease
77
Element of sleep which improves with melatonin
Sleep onset latency
78
Position in family associated with school refusal
Being the youngest child
79
Male:female ratio for childhood bulimia nervosa
1:10
80
Medication which has been used for eneuresis which can be given as an intranasal spray
Desmopressin
81
First line treatment for PTSD in children and young people if symptoms have been present for at least a month
Trauma focused CBT
82
First line treatments for PTSD in children and young people if symptoms have been present for under a month
Active monitoring Trauma focused CBT
83
Role of drugs for treatment of PTSD in people aged <18
Should not be used
84
Circumstances where EMDR may be considered for children and young people with PTSD
Aged 7-17 Precipitating event more than 3 months ago They have not responded to trauma focused CBT
85
Percentage of 7 year olds who have night time wetting
7%
86
Percentage of 10 year olds who have night time wetting
5%
87
Percentage of children with nocturnal eneuresis who have a first degree relative who had the same
75%
88
Percentage of children with faecal incontinence who are constipated
80%
89
First line medication for childhood insomnia
Melatonin
90
Age at which fear of strangers usually develops
End of first year
91
Age at which fear of being alone usually develops
3-4
92
Age at which separation anxiety usually develops
End of first year
93
Age at which fear of the dark usually develops
3-4
94
Age at which fear of animals usually develops
3-4
95
Age at which fear of bodily injury usually develops
4-12
96
Age at which fear of illness usually develops
4-12
97
Age at which fear of social situations usually develops
4-12
98
Age at which fear of supernatural things usually develops
4-12
99
Age at which fear of criticism usually develops
4-12
100
Most common symptom in children with bodily distress disorder
Abdominal pain
101
Percentage of encopresis thought to be functional
90%
102
Percentage of 10 year olds who experience nocturnal eneuresis at any one time
5%
103
Factors associated with nocturnal eneuresis in children
Stressful life events UTI Constipation Low socioeconomic background Large family size Overcrowded home conditions
104
Most important intervention for children with reactive attachment disorder
Providing an emotionally available attachment figure
105
First line medication for body dysmorphic disorder in children
Fluoxetine
106
Percentage of 4 year olds affected by encopresis
3%
107
Treatments compared in the POTS study looking at OCD treatments in children
SSRIs CBT
108
Findings of the POTS study looking at OCD treatments in children
Treatment should be either CBT alone or CBT + SSRI
109
Youngest age reactive attachment disorder can be diagnosed
1 year

7. Child and adolescent psychiatry (9 decks)

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