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12.09.17 Child psychiatry notes

Conduct disorder
  • Psychological disorder diagnosed in childhood that presents itself through a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate norms are violated
  • DSM IVCriteria:
    • A repetitive and persistent pattern of behavior in which the basic rules of others or major age-appropriate societal norms or rules are violated
    • Manifested by the presence of three (or more) of the following criteria in the past 12 months, with at least one criterion present in the past 6 months:
      • Aggression to people and animals
        • Often bullies, threatens, or intimidates others
        • Often initiates physical fights
        • Has used a weapon that can cause serious physical harm to others
        • Has been physically cruel to people
        • Has been physically cruel to animals
        • Has stolen while confronting a victim
        • Has forced someone into sexual activity
      • Destruction of property
        • Has deliberately engaged in fire setting with the intention of causing serious damage
        • Has deliberately destroyed others' property (other than by firesetting)
      • Deceitfulness or theft
        • Has broken into someone else's house, building, or car
        • Often lies to obtain goods of favors or to avoid obligations
        • Has stolen items of nontrivial value without confronting a victim
      • Serious violations of rules
        • Often stays out at night despite parental prohibitions, beginning before age 13 years
        • Has run away from home overnight at least twice while living in parental or parental surrogate home (or once without returning home for a lengthy period of time)
        • Is often truant from school, beginning before the age 13 years
    • The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.
    • If individual is age 18 years or older, criteria are not met for antisocial Personality Disorder
  • Precursor to antisocial personality disorder
  • May be:
    • Socialised
      • Apparent when in a group
      • cf Herd mentality
    • Unsocialised
      • Apparent when alone
      • Much more serious


ADHD Diagnosis

  • IA. Six or more of the following signs of inattention have been present for at least 6 months to a point that is disruptive and inappropriate for developmental level:
    • Inattention:
      • Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities.
      • Often has trouble keeping attention on tasks or play activities.
      • Often does not seem to listen when spoken to directly.
      • Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
      • Often has trouble organizing activities.
      • Often avoids, dislikes, or does not want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).
      • Often loses things needed for tasks and activities (such as toys, school assignments, pencils, books, or tools).
      • Is often easily distracted.
      • Often forgetful in daily activities.
  • IB. Six or more of the following signs of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for developmental level:
    • Hyperactivity:
      • Often fidgets with hands or feet or squirms in seat.
      • Often gets up from seat when remaining in seat is expected.
      • Often runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless).
      • Often has trouble playing or enjoying leisure activities quietly.
      • Is often "on the go" or often acts as if "driven by a motor".
      • Often talks excessively.
    • Impulsiveness:
      • Often blurts out answers before questions have been finished.
      • Often has trouble waiting one's turn.
      • Often interrupts or intrudes on others (example: butts into conversations or games).
  • II. Some signs that cause impairment were present before age 7 years.
  • III. Some impairment from the signs is present in two or more settings (such as at school/work and at home)
  • IV. There must be clear evidence of significant impairment in social, school, or work functioning.
  • V. Exclusions:


Notes

  • Abuse types
    • Physical
    • Emotional
    • Sexual
    • Neglect
  • Dad has full parental responsibility if he is named on the birth certificate, even if separated
  • Connor's questionnaire for ADHD
  • ABCDE
    • Asymmetry
    • Border
    • Colour
    • Diameter
    • Elevation
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