FPC: child psychiatry I Flashcards
(32 cards)
What can be useful tools when interviewing children?
Having them draw pictures, toys like chalkboard or soft blocks. These can help build rapport and help the child feel safe and relaxed.
What behavior elements in adolescents are best reported by the patient themselves?
Mood, motivation, thought process/content.
What behavior elements in adolescents are best reported by others?
Changes in socialization, attention, behaviors, and performance.
What is different about an adolescent vs child interview?
More time is spent alone with the adolescent.
What are the criteria for depression in kids?
Depressed mood (or irritability in kids) most of the day, nearly every day for at least 2 weeks, indicated by subjective report from the patient or observations made by others. There may also be significant weight loss or gain or changes in appetite.
What is true of self-reported feelings a lot of times in kids with depression?
They are more likely than adults to deny depressed mood, and may report more irritability or boredom.
Do boys or girls experience higher levels of depression after puberty?
Girls.
What is true of timing of depression diagnosis and prognosis?
An earlier onset indicates worse prognosis.
What is the first identified episode of bipolar disorder?
A depressive episode.
What are criteria for persistent depressive disorder in kids?
Depressed mood for most of the day, more days than not, for at least 2 years.
Describe disruptive mood dysregulation disorder.
Diagnosis for kids over 12 featuring chronic, persistent, severe irritability.
Describe criteria for disruptive mood dysregulation disorder.
They have outbursts that are disproportionate to the situation or inconsistent with developmental level that occur at least 3 times per week in at least 2 settings (home and school, for ex). They will also be generally irritable outside of these outbursts.
What is the typical onset of bipolar disorder?
Late adolescence.
Are boys or girls more likely to get bipolar disorder?
Equal likelihood.
Describe bipolar disorder.
Mood disorder with a huge genetic link that features high highs and low lows; often presents with irritability in kids as opposed to euphoric episodes.
How can we do safety planning for suicide?
Directly inquire about suicidal thoughts, assess for ideation/plan/means, identify risk factors and protective factors, remove access to weapons to dangerous objects/substances, increase observation.
What makes safety planning for suicide easier in kids than adults?
Kids naturally have a built-in system of someone looking out for them. This can be parents, teachers, etc.
What is a common comorbidity with anxiety?
ADHD.
What are forms of OCD disorders?
Body dysmorphia, hoarding, trichotillomania, excoriation (skin picking).
What are trauma and stressor related disorders?
Adjustment disorders, reactive attachment disorder, disinhibited social engagement disorder, PTSD.
Describe reactive attachment disorder.
Pattern of withdrawn behavior toward caregivers, persistent social-emotional disturbances, and often pattern of insufficient care like social neglect, bounding around between different caregivers, and limited opportunity to form selective attachments.
Describe disinhibited social engagement disorder.
Children are overly friendly or interactive with people they don’t know. There is often a pattern of insufficient care like social neglect, bounding around between different caregivers, and limited opportunity to form selective attachments.
Describe PTSD.
Recurrent, involuntary and intrusive distressing memories of traumatic events. May have dissociative episodes or dreams in which it feels like they’re reliving the event.
What things do ACE’s increase risk of?
Heart disease, obesity, suicide, depression, alcoholism, etc. basically, medical and psychiatric conditions.
