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