Mental health - paeds & adolescent Flashcards

1
Q

Assessment of child development?

A
  • are the behaviours limited OR persistent ?
    • diagnosis from a temporal assessment
    • Based on the level of disruption to family and child’s development e.g. school progress
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2
Q

What are the two types of mental health problems and mental disorders in childhood?

A
  1. Internalising disorders

2. Externalising disorders ( disruptive behaviour disorders)

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3
Q

What are internalising disorders?

A

= over controlled behaviours such as anxiety and depression

  • Feelings of loneliness, sadness, low self-esteem anxiety, general fears
  • Separation anxiety
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4
Q

What are externalising disorders?

A

= antisocial behaviours such as delinquency or aggression
- Break rules, bulling, fighting, tantrums
- ADHD/ADD
Conduct disorder
- Disruptive with severe and persistent behaviour problems
Autism spectrum disorder
- Lifelong developmental disability
- Characterised by deficits in social communication and fixated interest

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5
Q

What are the treatment options for mental disorders in childhood?

A
  • Adequate assessment
  • psychological interventions
  • pharmacological interventions
  • educational interventions
  • reward dominance
  • family interventions
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6
Q

Nursing goals of childhood mental health disorders?

A

Nursing goals
- being loved and safe, having strong relationships, positive experiences and supportive environments, actively participating in
community and social activities
- building an adaptive capacity allows the child to manage the transition and stresses they will experience in childhood/life

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7
Q

List 5 common mental health disorders in children:

A
  1. depression
  2. suicide
  3. Psychotic disorders
  4. Substance use disorders (SUD)
  5. Trauma
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8
Q

What is the overview and symptoms of depression in children ?

A
  • Different in adolescence to adults
  • More agitation and less melancholy

Symptoms
• Unusually sad or irritable mood that doesn’t go away
• Loss of enjoyment and interest in loved activities
• Lack of energy and tiredness
• Feeling worthless
• Thinking about death
• Difficult concerntation, moving slowly, Difficulties sleeping, Loss of interest in food

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9
Q

What is the treatment for depression in children?

A
First line: therapy 
•	Cognitive behaviour therapy 
•	Acceptance and commitment therapy 
•	Psychodynamic therapy 
•	Family therapy 
•	Medication considered if needed 
•	Antidepressants
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10
Q

What are the symptoms of Suicide in children ?

A
  • Threatening to hurt or kill themselves
  • Seeking access to things to kill themselves
  • Talking or writing about death
  • Hopelessness
  • Rage, anger
  • Engaging in risky activities
  • Feeling trapped
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11
Q

What is the treatment for suicide in children

A
Preventing 
Assessing for risk: 
•	Asking does not give them ideas
•	Are you having thoughts of suicide? 
•	Are you thinking of killing yourself? 
•	Do not leave a young person alone if they disclose thoughts of suicide
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12
Q

What is the overview and symptoms of psychotic disorders in children ?

A
  • Schizophrenia
  • Bipolar disorder with psychosis
  • Drug induced psychosis
  • Schizoaffective disorder

Symptoms
• Changes in thinking, perception. Behaviour, mood, and motivation
Symptoms when psychosis is present
• Delusions, hallucinations, thinking difficulties, loss of drive, blunted emotions, social withdrawal

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13
Q

What is the treatment for psychotic disorders?

A

Medication is first line
• Antipsychotic medication (1st & 2nd generation)
• Therapy is also important
• Management of physical health

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14
Q

What is the overview for substance use disorders in children?

A
  • Dependence on alcohol or other drugs Needing more, craving and withdrawal symptoms
  • Leads to Love, liver, livelihood, and law
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15
Q

What is the treatment for substance use disorders in childhood?

A

Motivational interviewing
• Treatment of any underlying MH condition
• Psychoeducation around harm minimisation

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16
Q

What is the overview of trauma during childhood?

A
•	DV screening 
•	All disclosures need to be taken seriously 
•	Ensure they are safe 
•	All HC workers are mandatory reporters
•
17
Q

What is the treatment for trauma in childhood?

A

Therapy is not possible while still in unsafe environment
• Establishing safety first
• Building rapport and creating a therapeutic relationship
• Trauma informed care
• Non-talking therapies
• Narrative therapy
• Supportive counselling

18
Q

What is community treatment for MH in childhood?

A

GP or paediatrician (first call)

- services available: school counsellor, youth services, headspace etc

19
Q

What are the early interventions for MH in children?

A

= aim to avoid disruption to development

  • cognitive, social, psycholgical, physical,
  • longer the illness is left the harder it is to treat
20
Q

What are the nursing goals for children with MH disorders?

A
  • engage patient and make them feel like you are safe to speak to
  • feel confident to assess for risk
  • speak to them about strategies they may already have