psychiatric disorders in childhood and adolescence
DESCRIPTION
PSYCHIATRIC DISORDERS IN CHILDHOOD AND ADOLESCENCE. Robert L. Hendren, D.O. Professor of Psychiatry and Pediatrics UMDNJ-RWJMS. Developmental Model of Psychopathology. 2 4-5 6-7 12 14 21. 6. MOS. 0. Eating Disorder Identity Disorder. - PowerPoint PPT PresentationTRANSCRIPT
PSYCHIATRIC DISORDERS PSYCHIATRIC DISORDERS IN CHILDHOOD AND IN CHILDHOOD AND
ADOLESCENCEADOLESCENCERobert L. Hendren, D.O.
Professor of Psychiatry and Pediatrics
UMDNJ-RWJMS
Developmental Model of Psychopathology
2 4-5 6-7 12 14 21
0
Autism SchizoidReactiveAttachmentSeparationAnxiety
ODDConductDisorder
TourettesPDDMentalRetardationAnxiety
ODDADHDSeparationAnxietyOveranxious
ConductDisorder
EatingDisorderSchizophreniaDepression
EatingDisorderIdentityDisorder
6MOS
Mental Retardation Retardation
• Mild (50-55 to 70)• Moderate (35-40 to 50-55)• Severe (20-25 to 35-40)• Profound (<20-25)
Etiology Etiology Unknown 30-40%Genetic 5%Prenatal 30%Perinatal medical conditions
and complications -15%Environmental influences 15 -
20%
Learning, Motor Skills, Communication Disorders
Reading disorder 7-9% Mathematics disorder Disorder of Written Expression 2-8% Developmental Coordination Disorder 6% Expressive Language Disorder 3-10% Mixed Receptive - Expressive Language Disorder 3-
10% Phonological Disorder 5-10% Stuttering
Pervasive Developmental Pervasive Developmental DisordersDisorders
Asperger’s DisorderRett’s DisorderChildhood Disintegrative
DisorderPDD NOS
Attention Deficit Hyperactivity Attention Deficit Hyperactivity DisorderDisorder
Over vs. under diagnosis controversy
Subtypes include inattentive, impulsive/hyperactive and combined
Similar life cycle except hyperactivity and co-morbidity
ADHD PrevalenceADHD Prevalence
•3 - 5% school-aged children•Boys more than girls, but may be under-diagnosed in girls
ADHD Biologic EtiologyADHD Biologic EtiologyGenetic riskPrenatal stress and toxinsFrontal lobe, basal ganglia and RAS implicatedNorepinepherine - inattentionSerotonin - impulsivity
ADHD Psychosocial ADHD Psychosocial EtiologyEtiology
Poor social relatednessPeer/Authority rejectionGoodness of fit
ADHD AssessmentADHD Assessment
Context and developmentLife cycle issuesFamily issuesRule out medical causes
Rating Scales - ADHDRating Scales - ADHD
ConnorsAcTERSContinuous PerformanceWender Utah Rating Scale for
retrospective diagnosis
ADHD Co-morbidityADHD Co-morbidity
DepressionTics and TourettesConduct DisorderSubstance Use DisorderLearning Disability
Conduct DisorderConduct DisorderRepetitive persistent pattern of
violation
Childhood vs. adolescent onset9% males; 2% femalesCo-morbidity
CD - Biologic EtiologyCD - Biologic Etiology
Temperament
GeneticsSerotonin
•Developmental instability
CD - Psychosocial CD - Psychosocial EtiologyEtiology
•Cognitive factors•Family factors•Peer group•SES•Culture
Oppositional Defiant Oppositional Defiant DisorderDisorder
Recurrent pattern greater than 6 months
Evident by age 8Non-aggressive grow out