Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Paediatrics > CAMHS > Flashcards

CAMHS Flashcards

(80 cards)

Start Studying
1
Q

How common is childhood mental health problems?

A

High on government and media agenda
Increased incidence and severity of referrals
Evolving speciality - lots of neuroscience underpinning child mental health
Children cannot get dementia
Cannot decrease likelihood of recurrent illness
Increased incidence of self-harm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the differences between CAMHS and AMH?

A

Both deal with severe mental illnesses
Both deal with developmental disorders
CAMHS works on a systemic framework
AMH medication is main treatment whereas CAMHS breadth of treatment options
CAMHS works mainly on preventative measures - primary and secondary, whereas AMH works with secondary and tertiary prevents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the developmental approach in CAMHS?

A

Some conditions treated are developmental disorders - ADHD, ASD
Need to take into account the developmental stage when assessing young people - use play, assessment of suicidal ideas needs to take into account concept of death at different ages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the systemic approach of CAMHS?

A

Central to CAMHS
Holistic approach
Emphasises effect of systems around child on presentation and potential treatment
Interview patient and parents before treatment
Family/systemic therapy treatment used
System around young person - family, friends, school, neighbourhood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the prevention used in CAMHS?

A

Provides opportunity for early prevention in mental illness eg treatment of attachment disorder to prevent development of personality disorder
Chronic illness CBT decreases chance of recurrence of depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What kind of treatment do CAMHS use?

A

Family
Friends
School
Neighbourhood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How does ASD present in children?

A

Rituals
Unusual/delayed language
Social difficulty - lack of theory of mind, can’t read others

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does PTSD present in children?

A

Intrusive sensations/memories - flashbacks
Avoidance
Anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How long might children have ASD?

A

Lifelong

May present with different severity at different times in life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the diagnostic criteria of anorexia in the ICD-10?

A

Deliberately keeping weight below 85% of expected
- Restricted dietary choice
- Excessive exercise
- Induced vomiting, use of appetite suppressants and diuretics
Dread of fatness - intrusive overvalued ideas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the endocrine effects of anorexia?

A

Menstruation stops or puberty is delayed if menarche not yet achieved
In men - loss of sexual interest/potency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How common is anorexia?

A 
1 in 250 females
1 in 2000 males
1 15 year old girl in every 150
1 15 year old boy in every 1000
Mean age of onset 16-17
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What can cause/increase the risk of anorexia?

A 
Social pressure
Perfectionist characteristics
Reversing or halting effects of puberty
Family
- Attitudes to food in family to food and body shape
- Refusing food as a way of being heard
Some genetic links
Depression
Low self-esteem
Occupation and interest eg ballet dancers
Anxiety disorders
Past or present events
- Life difficulties
- Sexual abuse
- Physical illness
- Upsetting events - death/break-up of a relationship
- Important events - marriage or leaving home
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is anorexia diagnosed?

A

Screening for eating problems SCOFF

History

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the SCOFF questionnaire?

A

Do you make yourself Sick because you’re uncomfortably full?
Do you worry that you’ve lost Control over how much you eat?
Have you recently lost more than 6kg (about One stone) in 3 months?
Do you believe you’re Fat when others say you’re thin?
Would you say that Food dominates you r life?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What questions should you ask in an anorexia history?

A

Ask about over-valued ideation of body shape and weight - intense fear of becoming fat
Active maintenance of low body weight < 85% expected weight
Amenorrhoea in post-pubertal females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What clinical signs might suggest anorexia?

A 
Dry skin
Lanugo hair
Orange skin and palms
Cold hands and feet
Bradycardia
Drop in BP on standing
Oedema
Weak proximal muscles - squat test
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Who assesses an anorexia patient in CAMHS?

A 
Psychiatrist
Psychologist
Family therapist
Paediatrician
Dietician
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What decisions need to be made by the MDT?

A

Whether to treat in community or as an inpatient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How common is ADHD?

A

Common condition in people of all ages
Associated with impaired QoL
- Reduced educational attainment, higher unemployment
- Increased risk of poor peer relationships and relationship breakdown
- Association with substance misuse and mental health problems
- Increased offending behaviours
- Increased mortality
Early diagnosis and treatment reduces morbidity
3-4% of all school-aged children
5.3% under-18s worldwide and 3.4% adults
Male to female 4:1 in childhood
Equally common in adulthood
Girls tend to present in masked way
Occurs in all cultures, higher prevalence in Western cultures
Often have co-existing conditions eg ASD, attachment disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the main symptoms of ADHD?

A

Inattention
Hyperactivity
Impulsivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the symptoms of inattention?

A

Decreased concentration, lack of persistent focus/attention, easily distractible, forgetful, disorganised, not following instruction, careless mistakes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the symptoms of hyperactivity?

A

Not able to sit still, constantly on the go, fidgety, not able to queue, loud/noisy play

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the symptoms of impulsivity?

A

Poor sense of danger, blurts out answers, interrupts or intrudes into others - when someone is talking, during activities, games

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How is ADHD diagnosed?
``` MDT clinical assessment Good clinical history - interview with child, parents, teachers - Presenting issues/difficulties - Birth and developmental history - Social history - Our observations in different settings - School observations - Feedback from school - Degree of impairment - Behaviour rating scales by parents and teacher Physical examination Scales - Connors Tests - Ob test, TEACH, cognitive assessment ```
26
What is the DSM-V criteria for ADHD?
Under age 17 6 or more hyperactivity or impulsivity symptoms OR 6 or more inattention symptoms Symptoms for more than 6 months before the age of 12 Interferes with functioning or development - interferes/reduces quality of social/academic/occupational function Must not be due to another mental illness Developmentally inappropriate Several symptoms in 2/more settings
27
What could be differential diagnoses for ADHD?
``` ASD Anxiety disorder Attachment difficulties Learning difficulties or learning disability Sensory issues Epilepsy Drug S/E ```
28
What causes ADHD?
Not known Suggestions - reduced/abnormal frontal lobe function, reduced dopamine levels in brain Genetic component - twin studies suggest 76% heritability Environment acting through gene-environment interactions Dietary factors idiosyncratic
29
What can increase the risk of ADHD?
``` Maternal smoking Foetal O2 deprivation Low birth weight Prematurity Heroin use during pregnancy ```
30
How is ADHD managed?
Parent training first line for most cases unless severe Support offered to school CBT - supports emotional regulation, problem-solving, social skills Medication not advocated for pre-school children Stimulants Non-stimulant Combined
31
What advice is offered to parents with a child with ADHD?
``` Regular routine Set clear boundaries Positive reinforcement Brief and specific instructions Incentive schemes Regular exercise and healthy diet Bedtime routine Short and sweet social interactions ```
32
Give an example of a stimulant medication used to treat ADHD
Methylphenidate Amphetamines - Long-acting - lisdexamphetamine - Short-acting - dexamphetamine
33
Give an example of a non-stimulant medication used to treat ADHD
Atomoxetine (SNRI) | Guanfacine
34
What are the S/E of stimulants?
Hypertension Loss of appetite Psychiatric symptoms Diversion
35
Which of stimulants/non-stimulants is better for ADHD treatment?
Stimulants - good if only require at certain times, more effective Non-stimulants - need to take all the time, different S/E
36
How do stimulants work?
Increased amount of dopamine released by brain
37
What is the prognosis of ADHD?
30% exhibit full remission of symptoms by adolescence 15% meet full ADHD criteria aged 25 (but many still meet some) School drop-out rate high Chronic pattern of symptoms throughout adulthood may lead to broken marriages and friendships, incomplete college degrees, unsteady jobs Prognosis in adulthood dependant on severity of symptoms, efficacy of treatment, and presence of comorbidity
38
What is self harm?
Act with intent to hurt self Includes cutting, burning with ice, hitting self, and overdose No intention to kill slef
39
Why do people self harm?
May want to release tension, make feel self, others to see distress (cry for help)
40
What are the most common methods of self harm?
Cutting, swallowing small amounts of toxic substances
41
What are some other methods of self harm?
Burning, scalding, hitting, scratching, hair pulling
42
What is a suicidal act?
Act with intent to kill self Includes overdose, attempted hanging Intention includes desire to be dead Important to assess severity and whether ongoing
43
How common is self harm?
1 in 10 young people will self-harm at some point, it can occur at any age More common in young women than men 4:1 Rates highest in those groups with highest level of poverty Gay and bisexual people more likely to self harm Sometimes do it in groups - having a friend who self-harms may increase your chances of doing it too More common in some sub-cultures eg goths More likely to have experienced physical, emotional, or sexual abuse during childhood Rates have increased over the past decade and in UK amongst highest in Europe In subsequent 12 months following an episode of self-harm - 20% will repeat and approx 1% will die of suicide Around half patients with DSH consulted GP in 4 weeks following episode
44
What risk factors can increase the risk for self harm?
``` Depression Bullying Sexual abuse Family/friend conflict Subculture Drugs and alcohol Family history ```
45
How do you assess self harm?
Check for associated suicidal attempt/ideas Social factors eg family, school, abuse, drugs, and alcohol Frequency, severity, measures Reason - eg relief of distress
46
How is suicide assessed?
``` Circumstances eg alone, did they tell anyone Planned or impulsive Left letter Continuing ideas What would stop a further episode Future ```
47
What questions should you ask about family in suicide and self harm assessment?
Family history of mental illness/self-harm | Family stress, bereavement ect
48
What questions should you ask about school and social in suicide and self harm assessment?
Social support | Educational difficulties
49
What factors can increase risk of suicide?
Presence of psychiatric disorder Previous suicide attempt Alcohol or substance misuse
50
How is self harm treated?
Alternative strategies eg talk with friend, distractions, soothing eg music Manage/treat underlying cause eg family therapy for family conflict, bullying
51
How is suicide treated?
Manage immediate risk Tell parents - plan for young people to tell parents if have further thoughts Manage any underlying mental health condition eg depression If too severe - hospital/intensive home treatment If parents unable - consider social care
52
How common is depression?
2.7% 11-16 year olds 0.3% 5-10 year olds 25% detected and treated
53
What can cause depression?
School - bullying, learning difficulties, family history, thyroid disorder, steroids, chronic physical illness Psychological - low self esteem Previous history of depression Family - abuse/neglect, domestic violence Drugs and alcohol - alcohol is depressant, speed
54
What protective factors are there for depression?
Friendships | Close family
55
What are the key symptoms of depression?
Persistent sadness or low mood Loss of interest or enjoyment Fatigue or low energy
56
What are the associated symptoms of depression?
``` Poor or increased sleep Poor or increased appetite Poor concentration or indecisiveness Low self-confidence Agitation or slowing of movements Guilt or self blame ```
57
What are the types of depression?
Mild up to 4 symptoms Moderate 5-6 symptoms Severe 7-8 symptoms
58
How is depression treated?
``` Information Community CBT therapists Specialist CBT IPT - interpersonal therapy Family therapy Antidepressants - fluoxetine, sertraline, citalopram ```
59
What might children with ADHD have difficulty with before school?
Waking up Getting ready for school Struggling excessively with parents
60
What might children with ADHD have difficulty with at school?
Lower grades Lack of focus Disruptive Difficulty with friendships
61
What might children with ADHD have difficulty with after school?
Sports/clubs Completing homework Risky behaviour and injuries Sitting through dinner
62
What might children with ADHD have difficulty with at bedtime?
Homework Sibling interactions Bedtime prep Settling down and falling asleep
63
How might a 6-12 year old present with ADHD?
``` Distractibility Motor restlessness Impulsive and disruptive behaviour Associated problems and implications - Specific learning disorders - Aggressive behaviour - Low self-esteem - Repetition of classes/grades - Rejection by peers - Impaired family relationships ```
64
How might a 13-17 year old with ADHD present?
``` Difficulty in planning and organisation Persistent inattention Reduction of motor restlessness Associated problems - Aggressive, antisocial, and delinquent behaviour - Alcohol and drug problems - Emotional problems - Accidents ```
65
How might an adult with ADHD present?
``` Residual symptoms in around 70% Associated problems - Other mental disorders - Antisocial behaviour/delinquency - Lack of achievement in academic and professional career ```
66
How far behind can people with ADHD be in terms of socially and emotionally?
1/3 behind those of their age | Catches up in adulthood
67
How is ADHD investigated?
Clinical interview ADHD nurse classroom observation QB test - performance test to control impulsivity Questionnaires
68
What can cause ADHD?
Neuroanatomic/neurochemical Genetics CNS insults Environmental factors
69
How is ADHD treated?
``` Education ADHD parenting programme School support and liaison Medication Stress importance of balanced diet and exercise Mental health ```
70
What should you check before prescribing stimulants for ADHD?
Cardiac assessment
71
What should you check for in a pre-treatment cardiac assessment in ADHD?
``` Hx of cardiac disease FHx of sudden death Symptoms of cardiac death - Effort intolerance - Palpitations - Syncope (exercise, frequent) Other medications Dysmorphic features Pulse BP HS Femoral pulses ```
72
How common is ASD?
1:100 1/2 million in UK Boys 4x than girls
73
What is the cause of ASD?
Exact cause unknown | Genetics important
74
What are the symptoms of ASD?
Social communication and repetitive behaviour and sensory interests Sleeping difficulties Eating difficulties Obsessions Rituals Fears and phobias Overlap with other developmental disorders
75
What symptoms of communication difficulties might you get in ASD?
Lack of desire to communicate Communicating needs only Disordered or delayed language Repeats speech/echolalia Poor non-verbal communication, gesture, body language Good language No social awareness Unable to start up or keep a conversation Pedantic language, very literal, poor or no understanding of idioms or jokes
76
What symptoms of social interaction problems might ASD present with?
No desire to interact with others Being interested in others to have needs met Lack of motivation to please others Affectionate on own terms Friendly but with odd interactions No understanding of unspoken social rules Limited interaction with unfamiliar people in unfamiliar circumstances
77
What behaviour, imagination, or rigidity problems might someone with ASD present with?
``` Using toys as objects Inability to play or write imaginatively Resisting change Playing same game over and over Obsessions/rituals - helps with anxiety, relaxation - really enjoy these Learning by rote, no understanding Inability to see others point of view or wider picture Follows rules exactly Asks same question even when answered ```
78
What other developmental disorders might someone with ASD present with?
``` ADHD Dyspraxia Tics Anxiety Depression Epilepsy Learning disability/difficulty Dyslexia ```
79
How is ASD managed?
``` Education and information ASD parenting workshops School liaison/support Manage comorbidity Communication temptations - play based techniques Picture exchange communication system Written instructions/visual cues Timetables/schedules Visual behaviour support Pull out talents ```
80
How is ASD diagnosed?
Questionnaires | Play with them - multiple specialists involved

Paediatrics (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions