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  • Before treatment is initiated, it is necessary to obtain a diagnosis of ADHD by a qualified professional. There are no specific physical tests for ADHD. Neuropsychological testing has a role in specific cases. A diagnosis of ADHD requires evaluation by different raters in multiple settings – a complete process. Parent – reports non-compliance with daily routine, overall functioning. Teacher – reports academic performance failure/disruption of classroom/fighting during lesson breaks. Child – has self-esteem issues: “I’m too stupid.” Peers – has few friends; rejected by peers.

Childhood psychiatry Childhood psychiatry Presentation Transcript

  • CHILDHOOD PSYCHIATRIC PROBLEMSASHRAF TANTAWY Professor of Psychiatry Suez Canal University Ismailia, Egypt.
  • OVERVIEWPART I: MH of Children.PART II: Classifications ofChildhood Disorders.PART III: Caregivers.
  • PART IMental Health of Children
  • 1- BackgroundIt was not until the 1980’s that thescientific community believed childrencould be depressed.Psychiatric symptoms in childhoodoften predict psychiatric symptomslater in life.Symptoms must be viewed in adevelopmental framework.
  • 2- Child DevelopmentChild development is more than height& weight.We have to observe how childrenplay, learn, speak & act.We have to chick different areas ofdevelopment: Social, Communication,Cognitive, Motor & Adaptive.Monitoring milestones can offer earlysigns of delay including signs of ASD.
  • A- By The End of 7 MonthsRed Flags• No big smiles or other warm Joyful expressions by six months or thereafter.• No back sharing of sounds, smiles or other facial expressions by nine months or thereafter.
  • B- By The End of 12 MonthsRed Flags• No back gestures (Pointing, Showing, Reaching or Waving Bye Bye).• Not answering to one’s name when called.• No babbling – Mama, Dada & Baba.
  • C- By The End of 18 MonthsRed Flags• No single words.• No simple pretend play.
  • D- By The End of 2 Years Red Flags • No two-word meaningful phrases (without imitating or repeating). • Lack of interest in other children. • Any loss of speech or babbling or social skills.
  • 3- Early Treatment• Children with acute symptoms are often more resilient than adults.• Early diagnosis give us insight into the pathophysiology of adult illness.• Early intervention may improve prognosis.
  • 4- Parental Involvement• Family history of mental illness.• Parents may show similar symptoms in many disorders.• Parents are obviously a key part of the assessment & treatment of childhood disorders.
  • 5- Childhood Psychopathology A- Epidemiology 5 - 15% with clinically significant disorders. Boys outnumber girls, below age 12 years, Higher rates of Behavioral, Learning & Developmental disorders. Girls outnumber boys, 12 to 18 years, Higher rates of Anxiety & Mood disorders.
  • Childhood Psychopathology B- Diagnostic Issues Developmental Issues. Multiple Sources of Information. Comorbidity. Categorical vs. Dimensional Models.
  • Input Needed to Make A DiagnosisTeacher Diagnosis Parent Child
  • Childhood Psychopathology C- Risk Factors Individual Characteristics: - Temperament. - Low IQ & Learning Disorders. - Brain Damage. Familial Characteristics: – Parental Psychopathology. – Parental Antisocial Behavior. – Poor Parenting & Marital Discord. Child Abuse/ Neglect. Low Socio-Economic Status.
  • Childhood Psychopathology D- Treatment Issues• Multimodal Therapy is Always Indicated: - Symptomatic Relief. - Individual & Developmental Needs. - Family Issues. - Academic Performance. - Cultural & Community Issues.• Specific vs. Nonspecific Therapies.
  • PART II ClassificationChildhood Disorders
  • Childhood Disorders ClassificationBehavior Disorders.Emotional Disorders.Elimination Disorders.Developmental Disorders.
  • A- Behavior Disorders Attention-Deficit Hyperactivity Disorder. Oppositional Defiant Disorder. Conduct Disorder.
  • B- Emotional DisordersAnxiety Disorders.Mood Disorders.– Same diagnoses as adults.
  • C- Elimination Disorders Enuresis. Encopresis. – Primary. – Secondary.
  • D- Developmental DisordersLearning Disorders.Communication Disorders.Motor Skills Disorder:Pervasive Developmental Disorders.Mental Retardation.
  • PART IIICaregivers
  • Caregiving Burden Signs of Caregiver Burnout1- Physical Burden.2- Financial Burden.3- Time Burden.4- Role Burden.5- Emotional Burden.6- Caregivers Psychiatric Disorders: Depression, Anxiety disorders, Unexplained Somatic Complaints, Adjustment disorders & Sleep disorders.
  • Conclusion• Child Psychiatry: is a rapidly expanding field with research in Treatment, Pathophysiology, Neuroimaging, Inheritance, Molecular & Neuro-Metabolic Studies.• Child psychiatry: combines roles in Medicine, Science & Psychology.