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64 Cards in this Set

  • Front
  • Back
What is rumination disorder? When is is it often seen? How do you dx?
- repeated regurgitation and rechewing of food for a period of at least 1 month following a period of normal functioning
- often seen in babies who have a variety of caretakers in an unstable environment
- r/o other medical disorders like esophageal reflux
what is the most common psychiatric emergency in children and adolescents?
- suicidal behavior
what is the most common cause of visual hallucinations in a child?
substance-induced psychotic disorder
- note: schizophrenia rarely presents in young children; if it does it's usually auditory hallucinations
What is the approximate comorbidity of childhood anxiety disorrder and MMD?
50%
What is the comorbidity of childhood anxiety disorder and ADHD?
30%
What is the age of onset for Rett's disorder?
between 5 and 48 months: loss of previous learned skills with stereotyped hand movements
What is the prognosis of Rett's disorder?
Cognitive development never progresses beyond first year of life.
What is the age of onset for Childhood Disintegrative Disorder?
between age 2 to 10 years old
What is the diagnostic criteria for Childhood Disintegrative Disorder?
- Loss of skills in two of the following: language,social skills, bowel or bladder control, play, mototr skills
- at least 2 of the following: impaired social interaction, impaired use of language, restricted and repetitive and stereotyped behaviors and interests
What is the incidence of Childhood Disintegrative Disorder for boys vs girls?
4-8x higher in boys than girls
What is the diagnostic time period for conduct disorder?
1 or more years
What is the diagnostic time period for oppositional defiant disorder?
6 or more months
What is the diagnostic time period for ADHD?
6 or more months
What is the diagnostic criteria for Tourett'e syndrome?
- must have multiple motor tics and at least one vocal tic; don't have to have them at the same time
- multiple times per day for more than 1 year; can't be sx free for more than 3 months
- onset is prior to age 18 years old
- causes distress or impairment in social/occupational functioning
What is the diagnostic criteria for bulimia nervosa?
twice a week for 3 months
At what age does ADHD usually present? At what age must some sx be present?
3-13 years old and some sx must be present before age 7
When does autism usually present?
less than age 3
Following a dx of DM1, what percentage of children develop sx of adjustment disorder?
33%
What is the first line tx for Tourette?
- clonidine! w/ additional effects on ADHD and OCD which are comorbid with tourette!
- note: high potency antipsychotics e.g. haloperidol, used to be first line
- newer atypical antipsychotics are not helpful at all
What is the best way to interview a child?
- give the child toys and allow him to play with it
- encouraging talk still probably won't get them to talk
What are the most common initial presenting sx of tourettes?
eye tics: blinking, eye rolling
- next most common are facial tics and vocal tics
When is the usual age of onset for Tourette's?
between ages 7 and 8
What is the incidence of tourettes for boys compared to girls?
3x more common in boys
List the etiology of mental retardation
- 30-40% no clear etiology
- 30% early alterations in embryonic development (e.g. chromosomal changes, alcohol consumption)
- 15-20% environmental influences
- 10% pregnancy and perinatal problems
- 5% hereditary
What is the dx criteria for ADHD?
- see notes :x
What drug should be used to tx ADHD and a fhx of tics?
- still use methylphenidate, does not worsen tics, just unmasks them i guess
- TCA can be used but don't b/c of overdose
What percentage of kids in school suffer from learning disorder? What percentage of those kids drop out?
5%
40%
What group of kids does enuresis normally occur?
normal boys
- no increase incidence with mental retardation, autism, OCD, etc
what is the dx criteria for enuresis and encopresis?
enuresis:
- older than 5 years old
- occurs at least 2x/week for 3 months or with marked impairment

encopresis
- involuntary or intentional passage of feces in inappropriate places
- must be at least 4 years of age
- 1/month for 3 months
What is the incidence of enuresis and encopresis?
enuresis: 7% of 5 year olds
encopresis: 1% of 5 year olds
What disorders is encopresis associated with?
conduct d/o and ADHD
what psychiatric medication can be used to tx enuresis
TCA
but usually use behavior modification and antidiuretics
how effective is methylphenidate in treating ADHD?
70%
quick and dirty child development ages 2, 3, 5
age 2: copy a circle
age 3: ride a tricycle, tell age, tell gender
age 5: copy a square, identify left hand
autistic disorder dx critiera
six sx:
1. at least 2 problems with social interaction
2. at least 1 impairment in communication
3. at least 1 repetitive stereotypes patterns of behavior and activities
what is the incidence of autism? boys versus girls?
0.02%-0.05%
boys = 3-5xgirls
what is comorbid with autism?
fragile x, tuberous sclerosis, mental retardation, seizures
what percentage of autistic kids are mentally retarded?
70%
what percentage of autistic children can function independently as adults?
1-2%
At what age is separation anxiety normal? In which disorder does separation anxiety not occur?
1. 7-8 months
2. autistic children
What is associated with a poor outcome outcome for schizophrenia? better outcome?
poor: the younger you are
better:
1. acute onset
2. no fhx
3. well differentiated sx
4. good premorbid functioning
5. more affective sx
what is the most likely adverse affect of clonidine?
sedation
how do you ddx mania from ADHD?
ADHD kids have low self esteem
- pressured speech, distractibility, motor overactivity, impulsivity are seen in both
at what age does a child realize that death is irreversible?
7-8 years old
at what age does conduct disorder have to be dx for the person to be eligible for antisocial personality?
15y.o.
define the following:
1. alexia
2. anomia
3. aphasia
4. agnosia
5. apraxia
1. inability to read
2. can recognize an object but can't name it
3.problems with expression or comprehension of language
4. inability to recognize objects
5. can't perform motor skills
stereotypic movment disorder
- can present with self-inflicted body injury that may need medical attention
- can cause rectal bleeding severe enough to cause anemia
when does trichotillomania usually occur?
between 5-8 years old or age 13
what are the IQ ranges?
hints: 25-15-15-15
profound: below 25
severe: 25-39
mod: 40-54
mild: 55-70
Kaufman assessment battery for children
intelligence test for ages 2.5-12y.o
Weschler Intelligence Scale for Children-Revised
determines IQ for ages 6-16
Peabody Individual Achievement Test
tests academic achievement
Epi of reading disorder
4% school age kids
- boys = 3-4x girls
Epi of math disorder
5% school age kids
more common in girls
epi of disorder of written expression
3-10%
conduct disorder dx criteria
in past year, 3/4:
1. aggression towards people and animals
2. destruction of property
3. decitfulness
4. serious violation of rules
epi of conduct disorder
6-16% boys
2-9% girls
40% develop antisocial PD
comorbid disorders with conduct disorder?
ADHD, learning disorder, mood disorders, substance abuse
tx for conduct disorder
structure environment with rules, psychotherapy
- antipsychotics or lithium for aggression
SSRI for impulsivity, irritabililty, mood lability
oppositional defiant disorder dx criteria
6 months of defiant behavior with 4/8:
1. frequent loss of temper
2. arguments with adults
3. defying adults rules
4. deliberately annoying people
5. easily annoyed
6. anger and resentment
7. spiteful
8. blaming others for mistakes or misbehaviors
oppositional defiant disorder epi
6-22% in children > age 6
usually begins by age 8
onset before puberty more in boys, equal after puberty
oppositional defiant disorder comorbid disorders
substance abuse, mood, ADHD
oppositional defiant disorder prognosis
remits in 25% of children, may progress to conduct disorder
oppositional defiant disorder tx
individual psychotherapy, focus on behavior modification, problem solving skills, parenting skills training