Child and Adolescent Psychiatry An Overview

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Child and Adolescent PsychiatryAn Overview

• Alan Apter
• Child Study Center
• Schneider Childrens Medical Center of Israel

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5 Groups of Disorders

• Developmental
• Emotional
• Conduct
• Physical symptoms
• Intellectual

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Developmental Disorders

• PDD
• Pervasive Developmental Disorders
• Autism
• Schizophrenia
• Dementia

• SDD
• Specific Developmental Disorders
• Dyslexia...

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Emotional Disorders

• Anxiety
• OCD
• PD
• Social Phobia
• PTSD
• Strangers Anx., Seperation Anx., Phobia...

• Depression
• Unipolar
• Bipolar
• Dysthymia
• Atypical
• Seasonal
• Suicidal Behavior

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Mood Disorders

• Unipolar
• 1 Parent -gt 10
• 2 Parents -gt 25
• MZ50, DZ25
• Bipolar
• 1 Parent -gt 25
• 2 Parents -gt 50-75
• MZ33-90
• DZ5-25

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Depressionin Children Adolescents

• 1970 Depression in children as entity
• Preschool 0.9
• School 1.9
• Adolescents 4.7
• Age and developmental stage gtclinical picture

• Spitz, Bowlby anaclytic depression
• Difficult to diagnose before 7y
• body language, posture, face

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Conduct Disorders

• CD/ODD
• Violating rights of others

• ADD/ADHD
• Attention Deficit with/without Hyperactivity

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SEROTONIN RELATED BEHAVIORS

• Violence
• Aggression
• Impulsivity
• Suicidality
• Low CSF 5H-T
• (Coccaro 1989)

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Attention Deficit Hyperactivity Disorder

• Epidemiology
• 3-5 School Child.
• MaleX3, 1st Child
• Parents Psychopath. Etiology
• MBD? Frontal?
• Dopamine NE
• Psychosocial
• Environment
• Final Common Pathway

• Diagnosis
• Inattention- 6
• Hyperactivity
• Impulsivity 6 total
• Before 7y, 2 settings
• Functional, not PDD
• Clinical
• From infancy
• School!!!

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Psychological Disorders with Physical Symptoms

• TICS/TS
• EATING DISORDERS
• SLEEP DIS.
• ENURESIS
• ENCOPRESIS

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Intellectual Disorders

• MENTAL RETARDATION

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Mental Retardation

• Multiple causes (Basket)
• Medical and Pedagogic
• Definition (DSM IV) lt 70
• Functional deficits, lt18y
• Axis II

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Mental Retardation

• B.L I.Q 71-84
• MILD 50-70
• MODERATE 35-50
• SEVERE 20-35
• PROFOUND lt20
• No simple correlation to adaptive functioning

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5 Groups of Disorders

• Developmental
• Emotional
• Conduct
• Physiological
• Intellectual