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CHILDHOOD PSYCHIATRIC
      PROBLEMS

ASHRAF TANTAWY
 Professor of Psychiatry
  Suez Canal University
     Ismailia, Egypt.
OVERVIEW
PART I: MH of Children.
PART II: Classifications of
Childhood Disorders.
PART III: Caregivers.
PART I
Mental Health of
   Children
1- Background
It was not until the 1980’s that the
scientific community believed children
could be depressed.
Psychiatric symptoms in childhood
often predict psychiatric symptoms
later in life.
Symptoms must be viewed in a
developmental framework.
2- Child Development
Child development is more than height
& weight.
We have to observe how children
play, learn, speak & act.
We have to chick different areas of
development: Social, Communication,
Cognitive, Motor & Adaptive.
Monitoring milestones can offer early
signs of delay including signs of ASD.
A- By The End of 7 Months

Red Flags
• No big smiles or other warm
  Joyful expressions by six
  months or thereafter.
• No back sharing of sounds,
  smiles or other facial
  expressions by nine months
  or thereafter.
B- By The End of 12 Months
Red Flags
• No back gestures
  (Pointing, Showing,
  Reaching or Waving Bye
  Bye).
• Not answering to one’s
  name when called.
• No babbling – Mama,
  Dada & Baba.
C- By The End of 18 Months

Red Flags
• No single words.
• No simple
  pretend play.
D- By The End of 2 Years

 Red Flags
 • No two-word meaningful
   phrases (without imitating or
   repeating).
 • Lack of interest in other
   children.
 • Any loss of speech or babbling
   or social skills.
3- Early Treatment
• Children with acute symptoms are
  often more resilient than adults.
• Early diagnosis give us insight
  into the pathophysiology of adult
  illness.
• Early intervention may improve
  prognosis.
4- Parental Involvement
• Family history of mental illness.
• Parents may show similar
  symptoms in many disorders.
• Parents are obviously a key part of
  the assessment & treatment of
  childhood disorders.
5- Childhood Psychopathology
          A- Epidemiology
 5 - 15% with clinically significant disorders.

 Boys outnumber girls, below age 12 years,
  Higher rates of Behavioral, Learning &
  Developmental disorders.

 Girls outnumber boys, 12 to 18 years,
  Higher rates of Anxiety & Mood disorders.
Childhood Psychopathology
    B- Diagnostic Issues

 Developmental Issues.
 Multiple Sources of Information.
 Comorbidity.
 Categorical vs. Dimensional Models.
Input Needed to Make
     A Diagnosis
Teacher   Diagnosis   Parent


          Child
Childhood Psychopathology
              C- Risk Factors
 Individual Characteristics:
 - Temperament.
 - Low IQ & Learning Disorders.
 - Brain Damage.
 Familial Characteristics:
  –   Parental Psychopathology.
  –   Parental Antisocial Behavior.
  –   Poor Parenting & Marital Discord.
 Child Abuse/ Neglect.
 Low Socio-Economic Status.
Childhood Psychopathology
   D- Treatment Issues
• Multimodal Therapy is Always Indicated:

  - Symptomatic Relief.
  - Individual & Developmental Needs.
  - Family Issues.
  - Academic Performance.
  - Cultural & Community Issues.

• Specific vs. Nonspecific Therapies.
PART II
   Classification
Childhood Disorders
Childhood Disorders
    Classification
Behavior Disorders.
Emotional Disorders.
Elimination Disorders.
Developmental Disorders.
A- Behavior Disorders

 Attention-Deficit Hyperactivity Disorder.

 Oppositional Defiant Disorder.

 Conduct Disorder.
B- Emotional Disorders
Anxiety Disorders.
Mood Disorders.

– Same diagnoses as adults.
C- Elimination Disorders
     Enuresis.
     Encopresis.

     – Primary.
     – Secondary.
D- Developmental Disorders
Learning Disorders.

Communication Disorders.

Motor Skills Disorder:

Pervasive Developmental Disorders.

Mental Retardation.
PART III
Caregivers
Caregiving Burden
     Signs of Caregiver Burnout
1- Physical Burden.
2- Financial Burden.
3- Time Burden.
4- Role Burden.
5- Emotional Burden.
6- Caregivers Psychiatric Disorders:
   Depression, Anxiety disorders,
   Unexplained Somatic Complaints,
   Adjustment disorders & Sleep disorders.
Conclusion
• Child Psychiatry: is a rapidly
  expanding field with research in
  Treatment, Pathophysiology,
  Neuroimaging, Inheritance, Molecular
  & Neuro-Metabolic Studies.
• Child psychiatry: combines roles in
  Medicine, Science & Psychology.
Childhood psychiatry

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Childhood psychiatry

  • 1. CHILDHOOD PSYCHIATRIC PROBLEMS ASHRAF TANTAWY Professor of Psychiatry Suez Canal University Ismailia, Egypt.
  • 2. OVERVIEW PART I: MH of Children. PART II: Classifications of Childhood Disorders. PART III: Caregivers.
  • 3. PART I Mental Health of Children
  • 4. 1- Background It was not until the 1980’s that the scientific community believed children could be depressed. Psychiatric symptoms in childhood often predict psychiatric symptoms later in life. Symptoms must be viewed in a developmental framework.
  • 5. 2- Child Development Child development is more than height & weight. We have to observe how children play, learn, speak & act. We have to chick different areas of development: Social, Communication, Cognitive, Motor & Adaptive. Monitoring milestones can offer early signs of delay including signs of ASD.
  • 6. A- By The End of 7 Months Red Flags • No big smiles or other warm Joyful expressions by six months or thereafter. • No back sharing of sounds, smiles or other facial expressions by nine months or thereafter.
  • 7. B- By The End of 12 Months Red Flags • No back gestures (Pointing, Showing, Reaching or Waving Bye Bye). • Not answering to one’s name when called. • No babbling – Mama, Dada & Baba.
  • 8. C- By The End of 18 Months Red Flags • No single words. • No simple pretend play.
  • 9. D- By The End of 2 Years Red Flags • No two-word meaningful phrases (without imitating or repeating). • Lack of interest in other children. • Any loss of speech or babbling or social skills.
  • 10. 3- Early Treatment • Children with acute symptoms are often more resilient than adults. • Early diagnosis give us insight into the pathophysiology of adult illness. • Early intervention may improve prognosis.
  • 11. 4- Parental Involvement • Family history of mental illness. • Parents may show similar symptoms in many disorders. • Parents are obviously a key part of the assessment & treatment of childhood disorders.
  • 12. 5- Childhood Psychopathology A- Epidemiology  5 - 15% with clinically significant disorders.  Boys outnumber girls, below age 12 years, Higher rates of Behavioral, Learning & Developmental disorders.  Girls outnumber boys, 12 to 18 years, Higher rates of Anxiety & Mood disorders.
  • 13. Childhood Psychopathology B- Diagnostic Issues  Developmental Issues.  Multiple Sources of Information.  Comorbidity.  Categorical vs. Dimensional Models.
  • 14. Input Needed to Make A Diagnosis Teacher Diagnosis Parent Child
  • 15. Childhood Psychopathology C- Risk Factors Individual Characteristics: - Temperament. - Low IQ & Learning Disorders. - Brain Damage. Familial Characteristics: – Parental Psychopathology. – Parental Antisocial Behavior. – Poor Parenting & Marital Discord. Child Abuse/ Neglect. Low Socio-Economic Status.
  • 16. Childhood Psychopathology D- Treatment Issues • Multimodal Therapy is Always Indicated: - Symptomatic Relief. - Individual & Developmental Needs. - Family Issues. - Academic Performance. - Cultural & Community Issues. • Specific vs. Nonspecific Therapies.
  • 17. PART II Classification Childhood Disorders
  • 18. Childhood Disorders Classification Behavior Disorders. Emotional Disorders. Elimination Disorders. Developmental Disorders.
  • 19. A- Behavior Disorders  Attention-Deficit Hyperactivity Disorder.  Oppositional Defiant Disorder.  Conduct Disorder.
  • 20. B- Emotional Disorders Anxiety Disorders. Mood Disorders. – Same diagnoses as adults.
  • 21. C- Elimination Disorders Enuresis. Encopresis. – Primary. – Secondary.
  • 22. D- Developmental Disorders Learning Disorders. Communication Disorders. Motor Skills Disorder: Pervasive Developmental Disorders. Mental Retardation.
  • 24. Caregiving Burden Signs of Caregiver Burnout 1- Physical Burden. 2- Financial Burden. 3- Time Burden. 4- Role Burden. 5- Emotional Burden. 6- Caregivers Psychiatric Disorders: Depression, Anxiety disorders, Unexplained Somatic Complaints, Adjustment disorders & Sleep disorders.
  • 25. Conclusion • Child Psychiatry: is a rapidly expanding field with research in Treatment, Pathophysiology, Neuroimaging, Inheritance, Molecular & Neuro-Metabolic Studies. • Child psychiatry: combines roles in Medicine, Science & Psychology.

Editor's Notes

  1. Before treatment is initiated, it is necessary to obtain a diagnosis of ADHD by a qualified professional. There are no specific physical tests for ADHD. Neuropsychological testing has a role in specific cases. A diagnosis of ADHD requires evaluation by different raters in multiple settings – a complete process. Parent – reports non-compliance with daily routine, overall functioning. Teacher – reports academic performance failure/disruption of classroom/fighting during lesson breaks. Child – has self-esteem issues: “I’m too stupid.” Peers – has few friends; rejected by peers.