1. The document provides guidance on taking history for childhood and adolescent psychiatric disorders. It emphasizes interviewing parents and children separately and getting details on symptoms, development, family, social, and medical history.
2. Specific questions are outlined to assess conditions like ADHD, autism, depression, conduct disorder, and oppositional defiant disorder. Developmental milestones, school performance, substance use, trauma history should be covered.
3. The mental status and relationships within the family and with peers need to be examined to understand the full clinical picture.
This slide contains information regarding assessment in psychiatry. This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated.
This slide contains information regarding assessment in psychiatry. This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated.
Mental Health Nursing
Psychiatric Nursing
Dr. Rahul Sharma
Associate Professor
H.O.D. of Mental Health Nursing
Ph. D Coordinator
Seedling School of Nursing,
Jaipur National University, Jaipur
mental retardation power point presentationjagan _jaggi
Intellectual disability (ID), once called mental retardation, is characterized by below-average intelligence or mental ability and a lack of skills necessary for day-to-day living. People with intellectual disabilities can and do learn new skills, but they learn them more slowly.
The DSM-IV definition utilizes four degrees of severity that reflect the level of intellectual impairment: IQ levels between 50–55 to approximately 70 characterize mild mental retardation, 35—40 to 50–55 characterize moderate mental retardation, 20–25 to 35–40 characterize severe mental retardation,
Workshop presented by Jeanne Hopkins, Department Chair & Professor of Early Childhood Development, Tidewater Community College, and Amanda Raymond, Disability Awareness Advocate, published author, parent of two children with autism. For more information e-mail jehopkins@tcc.edu.
Mental Health Nursing
Psychiatric Nursing
Dr. Rahul Sharma
Associate Professor
H.O.D. of Mental Health Nursing
Ph. D Coordinator
Seedling School of Nursing,
Jaipur National University, Jaipur
mental retardation power point presentationjagan _jaggi
Intellectual disability (ID), once called mental retardation, is characterized by below-average intelligence or mental ability and a lack of skills necessary for day-to-day living. People with intellectual disabilities can and do learn new skills, but they learn them more slowly.
The DSM-IV definition utilizes four degrees of severity that reflect the level of intellectual impairment: IQ levels between 50–55 to approximately 70 characterize mild mental retardation, 35—40 to 50–55 characterize moderate mental retardation, 20–25 to 35–40 characterize severe mental retardation,
Workshop presented by Jeanne Hopkins, Department Chair & Professor of Early Childhood Development, Tidewater Community College, and Amanda Raymond, Disability Awareness Advocate, published author, parent of two children with autism. For more information e-mail jehopkins@tcc.edu.
Learning disability and its homeopathy treatmentShewta shetty
"Treatment & remedies for learning disability find its promising homeopathy treatment.Personalised online consultancy & treatments provided at our clinic by efficient panel of doctors in our center at mumbai,Bombay,Chembur, India.Contact us."
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Learning disability and its homeopathy treatment in Chembur, Mumbai, India.Shewta shetty
"Treatment & remedies for learning disability find its promising homeopathy treatment.Personalised online consultancy & treatments provided at our clinic by efficient panel of doctors in our center at mumbai,Bombay,Chembur, India.Contact us."
"/>
Learning disability and its homeopathy treatment in Chembur, Mumbai, India.Shewta shetty
"Treatment & remedies for learning disability find its promising homeopathy treatment.Personalised online consultancy & treatments provided at our clinic by efficient panel of doctors in our center at mumbai,Bombay,Chembur, India.Contact us."
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"Treatment & remedies for learning disability find its promising homeopathy ...Shewta shetty
"Treatment & remedies for learning disability find its promising homeopathy treatment.Personalised online consultancy & treatments provided at our clinic by efficient panel of doctors in our center at mumbai,Bombay,Chembur, India.Contact us."
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CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
History taking on childhood and psychiatric disorders
1. History taking on Childhood and adolescent
Psychiatric Disorders
Presented by,
Sudipta Debnath
Junior Lecturer
CON,CMC,Vellore
2. Whom should I talk to first???
• For young children:
– 1 or >1 initial interviews of parents without the
child may be appropriate
– But child should be interviewed alone also at some
point of time .
• Adolescents:
– Include them from the starting with/without
parents
4. Intellectual disability
• Conceptual skills:
– language; reading and writing; and money, time and
number concepts;
• Social skills:
– interpersonal skills, social responsibility, self-
esteem, gullibility, naivety (i.e. wariness), follows
rules/obeys laws, avoids being victimized, and
social problem-solving;
• Practical skills:
– activities of daily living (personal care),
occupational skills, use of money, safety, health
care, travel/transportation, schedules/routines.
5. • Assessment of
– Nonsymbolic (e.g., gestures, vocalizations,
problem behaviors) and/or symbolic (e.g., words,
signs, pictures) communication;
– Play;
– Social interaction and social communication;
– speech production;
– Safe swallowing;
• Impairment in vision, hearing, speech or mobility
should be mentioned
• History of medical, educational, and vocational status
as well as caregiver and client/patient perspectives on
the problem.
6. ADHD (Attention Deficit Hyperactivity
Disorder)
• Inattentive, (often):
– Fails to give close attention to details or makes
careless mistakes in schoolwork, work, or other
activities
– Difficulty sustaining attention in tasks or play
activities
– Does not seem to listen to what is being said
– Does not follow through on instructions and fails
to finish schoolwork
– Has difficulties organizing tasks and activities
7. • Hyperactivity :
–Fidgeting with or tapping hands or feet,
squirming in seat
–Leaving seat in classroom or in other
situations in which remaining seated is
expected
–Running about or climbing excessively in
situations where this behavior is
inappropriate (in adolescents, this may be
limited to subjective feelings of restlessness)
–Difficulty playing or engaging in leisure
activities quietly
8. –Unable to be or uncomfortable being still for
extended periods of time (may be
experienced by others as “on the go” or
difficult to keep up with)
–Excessive talking
–Blurting out answers to questions before the
questions have been completed
–Difficulty waiting in lines or awaiting turn
in games or group situations
–Interrupting or intruding on others (for
adolescents may intrude into or take over
what others are doing)
9. • Other
– Amount of distress or impairment in social, academic,
or occupational functioning
– Often avoids or strongly dislikes tasks (such as
schoolwork or homework) that require sustained mental
effort
– Often loses things necessary for tasks or activities
(school assignments, pencils, books, tools, or toys)
– Often is easily distracted by extraneous stimuli
– Often forgetful in daily activities
11. Depression
• Depressed mood - For children and adolescents, can be an
irritable mood
• Diminished interest or loss of pleasure
• Weight change or appetite disturbance ( / )- For children,
this can be failure to achieve expected
• Sleep disturbance
• Psychomotor agitation or retardation
• Fatigue or loss of energy
• Feelings of worthlessness or inappropriate guilt
• Decreased concentration or indecisiveness
• Refusing to attend school or poor school performance
• Suicidal ideation or thoughts of death
12. • Impulsive, risk-taking, or self-injurious behaviour.
• Somatic complaints (e.g., headaches and
stomachaches), particularly for younger children
• Early and recent negative life events
• Psychosocial and academic problems (including
bullying, social withdrawal, avoiding school)
• Neglect of the child or sibs
• Physical, sexual and psychological abuse
• Harassment by peers
• Substance use/abuse (including nicotine)
13. Conduct disorder
• History of sibling violence, abuse of family pets, and
cruelty to animals outside of family
• Age of onset
• History of symptoms
• Difficulties during infancy, including temperament
• Behavior during the preschool years, especially
– oppositional and/or aggressive behaviour,
– attention and impulse control (ADHD symptoms),
– attachment problems involving parent or caregiver
14. • Context in which the child exhibits the problem
behaviour (alone or in a group)
• Specific events associated with the onset of the
behaviour problems, including injury or illness
• Corporal punishment of the child
• Physical and sexual abuse history (as victim and/or
perpetrator)
• Legal history
• Treatment history of child, history of hospitalizations,
adoptions and placements in foster care and out-of-
family care
• Parents' perception of the child's strengths and
weaknesses
15. To the child:
• Specific questions about changes in mood, with
special attention for signs of depression or anxiety
disorder and level of self-esteem
• Peer relationships
• Evidence of self-injury, suicidal and homicidal
thoughts and behaviour
• Specific questions about sexual or physical abuse,
sexual behaviour and promiscuity, substance abuse
16. Oppositional defiant disorder
• History of temper tantrums for his or her
developmental level
• Argumentativeness
• Often actively refuses adults’ requests or defies rules
• Often apparently deliberately, does things that annoy
other people
• Often blames others for his or her own mistakes or
misbehaviour
• Is often ‘touchy’ or easily annoyed by others
• Is often angry or resentful
• Is often spiteful or resentful.
17. Past history
• Onset of symptoms
• Pattern and duration
• Impact in functioning
• RED Flags
– h/o seizure
– Regression in development
– >97th or <3rd percentile in any of growth curve
– Sudden onset
– Altered LOC, severe fatigue, cognitive changes,
headache, nausea and weight changes
– Acute onset of OC symptoms or tics...particularly
following pharyngitis (PANDAS)
18. Birth history
• Consanguinity
• Planned/unplanned pregnancy
• Use of assistive reproductive technologies
• Pregnancy : exposure to
– Teratogens
– Alcohols, tobacco, illicit substance
– Medications
– h/o rashes, fever
• Previous neonatal deaths or acute life threatening
episodes in siblings
• Previous spontaneous abortions (>2)
19. Developmental history
• Early developmental history
– Fine and gross motor development
– Coordination: age of
• Neck holding
• Tooth eruption
• Sitting
• Standing and
• Walking
– Speech and language: age of
• First words
• First sentences
• Receptive and expressive languages
• Bowel and bladder control
• Type of play
• Any regression
20. Emotional development and
temperament
• Few questions that can be asked for inquiring about this
are:
– In the first few weeks & months of his/her life, how
was he like?
– Was he a very quiet/ moderably so?
– How did the child respond to changed circumstances?
– How would you know that the baby liked/disliked
something?
– Could you divert him easily & stop him crying?
• Also ask the adolescent about any antisocial/delinquent
behavior:
– Have you done anything that you now look back on
and think was pretty dangerous?
21. School history
• Age of beginning
• School changes: if any, reason
• Attendance
• academic strength and weaknesses
• Motivation to learn
• Attitude towards authority
• IPR with peers/teachers
• WARNING signs of school violence
– Social withdrawal
– Excessive feelings of isolation, rejection
– Feelings of being persecuted
– Expression of violence in writings /drawings
– Uncontrolled anger
22. –Substance abuse
–Severe destruction of property
–SIBs/ suicidal threats
–Severe rage for minor reasons
–Patterns of impulsive and chronic hitting,
intimidating & bullying behaviors
–Physical fights
23. Personal history
• Peer relations
• Hobbies and interests
• Conscience and values
• Substance abuse
• Unusual and traumatic life events
– Sexual/physical abuse
– Domestic violence
– Exposure to any disaster
– Any life changes
24. Family history
• h/o any neuropsychiatric illness
• Family functioning
– Coping styles
– Communication patterns
• Parent-child interactions
• Parental functioning
– Parental attitude, hope, fear, expectation regarding child
– Attachment towards child
– Boundaries and alliances within the family
– Child’s way of fitting in the system
• Social & environmental conditions