Childhood psychiatry

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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

    1. 1. CHILDHOOD PSYCHIATRIC PROBLEMSASHRAF TANTAWY Professor of Psychiatry Suez Canal University Ismailia, Egypt.
    2. 2. OVERVIEWPART I: MH of Children.PART II: Classifications ofChildhood Disorders.PART III: Caregivers.
    3. 3. PART IMental Health of Children
    4. 4. 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.
    5. 5. 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.
    6. 6. 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.
    7. 7. 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.
    8. 8. C- By The End of 18 MonthsRed Flags• No single words.• No simple pretend play.
    9. 9. 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.
    10. 10. 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.
    11. 11. 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.
    12. 12. 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.
    13. 13. Childhood Psychopathology B- Diagnostic Issues Developmental Issues. Multiple Sources of Information. Comorbidity. Categorical vs. Dimensional Models.
    14. 14. Input Needed to Make A DiagnosisTeacher Diagnosis Parent Child
    15. 15. 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.
    16. 16. 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.
    17. 17. PART II ClassificationChildhood Disorders
    18. 18. Childhood Disorders ClassificationBehavior Disorders.Emotional Disorders.Elimination Disorders.Developmental Disorders.
    19. 19. A- Behavior Disorders Attention-Deficit Hyperactivity Disorder. Oppositional Defiant Disorder. Conduct Disorder.
    20. 20. B- Emotional DisordersAnxiety Disorders.Mood Disorders.– Same diagnoses as adults.
    21. 21. C- Elimination Disorders Enuresis. Encopresis. – Primary. – Secondary.
    22. 22. D- Developmental DisordersLearning Disorders.Communication Disorders.Motor Skills Disorder:Pervasive Developmental Disorders.Mental Retardation.
    23. 23. PART IIICaregivers
    24. 24. 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.
    25. 25. 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.

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