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Medicine Notes Psychiatry Notes

Child Psychiatry Notes

Updated Child Psychiatry Notes

Psychiatry Notes

Psychiatry

Approximately 43 pages

Clinically-relevant notes for medical finals. Includes all the common psychiatric conditions along with notes on dementia and child psychiatry. Colour coded per topic. Easy to follow and breaks down the main presenting features and treatments (both drugs, psychological therapies and ECT)
Very useful for finals revision....

The following is a more accessible plain text extract of the PDF sample above, taken from our Psychiatry Notes. Due to the challenges of extracting text from PDFs, it will have odd formatting:

Child Psychiatry

Conduct Disorder

Main features

  • Persistent antisocial behaviours (fighting, bullying, starting fires, stealing, truancy)

  • Persistent + defiant disobedience

  • 1/3 cases have specific reading disorder

  • Considerable overlap with ADHD

  • Common in boys 12-16

Two types

Socialised

  • Able to make friends who usually also behave in an antisocial way

  • Bad behaviour most evident away from home

  • Relationships with adults may be good but often difficulties with authority figures

Unsocialised

  • Children do not have friends

  • Usually some degree of emotional disorder

Aetiology

Parenting = major factor

Improving parenting skills likely to improve behaviour

Other approaches

  • Family therapy

  • Behavioural therapy

  • Remedial teaching

  • Provision of alternative peer group activities

Outcome is better for socialized group

2/3 of unsocialised will have persisting dissocial behaviour into adulthood

Attention deficit hyperactivity disorder (ADHD)

Epidemiology

  • 1% of population

  • M>F

  • Increased incidence in lower socioeconomic class + inner city areas

  • Commonly diagnosed aged 6-9 years

Aetiology

  • Genetic factors

  • Neurochemical balance theory

    • Increased dopamine receptors causes dopamine to be drained from nerve terminals – therefore decreased inhibitory effect on brain

  • Associated with low birth weight

    • Cannabis, heroin or smoking during pregnancy

Clinical features

  • A triad of symptoms

    • Inattention

      • Poor attention to detail, unable to concentrate on task, appears not to listen, unable to follow instructions

    • Hyperactivity

      • Fidgeting, leaves seat in classroom, runs/climbs excessively in inappropriate places, unduly noisy playing

    • Impulsivity

      • Blurts out all answers before questions completed, fails to wait in line, interrupts

  • Symptoms must be present in >1 setting and last > 6 months

  • Symptoms must cause significant functional impairment

  • Onset no later than 7 years old

Management

  • Adjust environment to decrease distraction

  • Restricting stimulants e.g additives in diet

  • Help parents with advice re setting boundaries for behaviour

  • Medication

    • Stimulants e.g methylphenidate (block dopamine transporters therefore increase inhibition and decrease activity, and increase attention) ADR = weight loss. Only works in the day time

    • Atomoxitine - Acts on Noradrenaline system a(nalogous to antidepressants) 2 months to become effective. ADR = GI disturbances

Prognosis

Typically resides in adolescence (but no cure)

May carry through into adulthood

  • Underachievement

  • Substance misuse

  • Antisocial personality disorder

Autistic Spectrum Disorders (Autism/Aspergers)

M:F 1:100

Genetic predisposition

Triad of impairments in;

  • Social...

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