Child psychiatry is a branch of psychiatry that focuses on behavioral, emotional, and developmental disorders in children and adolescents under age 18. It involves treating conditions like autism, ADHD, anxiety disorders, depression, adjustment disorders, schizophrenia, and effects of abuse or trauma. Child psychiatrists conduct evaluations of a patient's history, mental status, family relationships, and functioning at home and school to diagnose conditions and formulate treatment plans. Common approaches include medication management and therapies that are modified for children compared to adult patients. Childhood disorders have multiple contributing factors including genetics, temperament, medical issues, family dynamics, and environment.

1. ZEINAB EL NAGAR
CLASSIFICATION OF
CHILD PSYCHIATRY

2. WHAT IS CHILD PSYCHIATRY?
A branch of Psychiatry.
The central focuses of the subject are behavioral and
emotional disorders of childhood, but many would
include physical symptoms such as non-organic
headache and stomach pain in which stress or other
environmental factors appear to play an important
causative role.
Delays and deviations in development, as well as general
and specific learning problems lie within the practice of
child psychiatry.
Childhood period extends averagely up to age of 18
years.

3. THE PRACTICE OF CHILD PSYCHIATRY
DIFFERS FROM THAT OF ADULT
PSYCHIATRY IN SEVERAL IMPORTANT
WAYS:
1. Initiation of the consultation with the clinician.
2. The stage of the development of the patient.
3. Psychological problems in a child may be a
manifestation of disturbance in other members of
the family.
4. Evidence of disturbance is based more on observation
of behavior made by parents, teachers and others.
5. Treatment of children makes less use of medication
and other methods of individual therapies.

4. Disorders usually first diagnosed in infancy,
childhood or adolescence (DSM V)
 Mental Retardation
 Learning disorders
 Motor skills disorders
 Autism Spectrum Disorder , Asperger’s disorder, childhood
disintegrative disorder
 Social Communication disorders
 Pervasive developmental disorders
 Attention deficit & disruptive disorders
 Feeding and eating disorders of infancy & early childhood
 Tic disorders
 Elimination disorders
 Other disorders of infancy, childhood & adolescence.

5. Aetiology
 The determinants of childhood disturbance are
usually multiple.
 Developmental aspects are important (their
disorders reflect psychological & social
maturation).

6. Aetiology
 interacting group of factors are important:
1. genetic factors,
2. temperament & individual differences,
3. physical problem especially brain damage, chronic physical
diseases
4. environmental,
5. family,
6. social and cultural causes physical, & emotional maltreatment

7. Child Psychiatric Evaluation
• Identifying data
Identified patient and family members
Source of referral
Informants
- History
Chief complaint
History of present illness
Developmental history and milestones
Psychiatric history
Medical history, including immunizations
Family social history and parents' marital status

8. Child Psychiatric Evaluation
- History
Family social history and parents' marital status
Educational history and current school functioning
Peer relationship history
Current family functioning
Family psychiatric and medical histories
Current physical examination
- Mental status examination
- Neuropsychiatric examination (when applicable)
- Developmental, psychological, and educational testing
- Formulation and summary
- DSM V diagnosis

9. Autistic Disorder:
1. Abnormalities of communication,
2. abnormalities of social relationships
3. restriction of behavior & interest.

10. Attention Deficit Hyperactivity
Disorder:
1. Extreme and persistent restlessness
2. sustained & prolong motor activity,
3. difficulty in maintaining attention
4. impulsivity.

11. Anxiety Disorders:
 Normal anxiety in childhood.
 Separation anxiety disorder 
fear of separation from people to whom the child
is attached which is clearly greater than normal
separation anxiety of toddlers or preschool period
and associated with significant problem in social
functioning.
 Generalized anxiety disorders.
 Phobic disorders.

12. SCHIZOPHRENIA
• Schizophrenia subtypes have been dropped
• Individual must have at least one of the
following:
delusions,
hallucinations,
disorganized speech
Bizarre delusions
or “first rank” hallucinations no longer given
special weight

13. Affective Disorders:
 Depressive symptoms
 Normal form of unhappiness
 Depressive disorder
 Bipolar affective disorder: “Mixed Episode” has been
removed; replaced with specifier “with mixed
features” (can also be applied to MDD) . A specifier
for “anxious distress” has also been added

14. Affective Disorders:
Disruptive Mood Dysregulation
Disorder*
 For children 6-18 years old who exhibit:
persistent irritability
frequent episodes of extreme behavioral dyscontrol (temper
outbursts)
Symptoms present for at least 12 months in at least 2 settings

15. Adjustment Disorders:
 Divorce
 Death of a parent
 Birth of a sibling
 Acquired physical disease or injury
 School issues

16. School Refusal:
 It is not a psychiatric disorder.
 A pattern of behavior that can have many
causes Repeated absence from school:
1. Physical illness
2. Deliberately kept at home by parents to help with
domestic work or for company.
3. School refusal:
- separation anxiety disorder
- school phobia
- failure to do well in the class
- depression
- truancy

17. Child Abuse:
 physical
 emotional maltreatment
sexual abuse
neglect.

18. DISINHIBITED SOCIAL ENGAGEMENT
DISORDER*
Once a subtype of reactive attachment disorder
(indiscriminately social/disinhibited vs emotionally
withdrawn/inhibited),
now a separate diagnosis

19. GENDER DYSPHORIA IN
CHILDREN
1. Replaces term Gender Identity Disorder
2. Gender non-conformity not in itself a
mental disorder
3. Must be associated with significant distress
4. Marked difference between a child’s
experienced gender and the gender
others would assign to him or her
5. The desire to be of the other gender must
be verbalized

20. behavioral problems

21. OPPOSITIONAL DEFIANT DISORDER-
THREE SUBTYPES:
1. angry/irritable
2. vindictiveness
3. argumentative/defiant
4. conduct disorder exclusion removed

22. :
Intermittent Explosive Disorder-physical aggression
was required in DSM IV
whereas verbal aggression and non-
destructive/non injurious physical aggression now
suffice

23. Other disorders
 Mental Retardation
 Learning disorders
 Elimination disorders
 borderline intelligence
 Speech problems
 substance related and addictive disorders

24. Thank
you