Mental Health Nursing

open access articles on mental health nursing

Child Psychiatric Disorders

Introduction

Historical developments in Child Psychiatry

Differences of Child psychiatry from adult psychiatry

Etiological factors

Important factors contribute to mental illness in children are:

Constitutional

Environmental

Physical damage or illness

Family discord

Parental deviance

Social disadvantage

Schooling

Classification & Prevalance

Child Psychiatric Assessment

Assessment is more time consuming in child psychiatry than in other branches of psychiatry or medicine. Child mental health assessment is distinctive.

Psychiatric Assessment

History Taking
Mental Health Examination

Treatment in child and adolescent psychiatry

Drug treatment

Drug

Usage

Comment.

Anxiolytics

Anxiety /phobic conditions

  • Short term adjunct to behavior treatment

Neuroleptics

Schizophrenia/hyperkinetic syndrome

Complex tics/ Tourette’s syndrome

 

Phenothiazines eg. chlorpromazine

Butyrophenones, eg. Haloperidol

  • Extrapyramidal side effects common

Tricyclic antidepressants

 

 

Imipramine/amitriptyline Clomipramine

Enuresis

Major affective disorder

  • Effective, but high relapse rate
  • Most useful with persistent
  • and sustained mood disturbance

Stimulants

Hyperkinetic syndrome

  • Effective in the short term.
  • Long term effects on growth.
  • steep and appetite

Methylphenidate

Fenfluramine

Pervasive developmental disorder

  • Effectiveness not established. Side effects
  • include irritability, anorexia
  • and weight loss

Hypnotics, eg.

trimeprazine/promethazine

Persistent. sleep disorder in preschool children

  • Only short term

Lithium

Recurrent bipolar affective disorder

Close supervision of blood

levels for signs of toxicity

Laxatives, e.g. bulkforming

(methylecellulose) Stimulants (senna) softener (dioctyl)

Encopresis with constipation

 

Facilities formation and Passage of feces

Central alpha agonist. e.g. clonidine

Unresponsive Tourette's syndrome

Sedation and rebound

hypertension

Behavioral psychotherapy

Behavioral techniques

Applications of Behaviour techniques

Disorder

Technique

Anxiety and phobic

Desensitization, flooding, relaxation

Obsessivecompulsive

Relaxation

Relapseprevention

Depressive disorder

Cognitive behavioural

Relaxation

Conduct disorders

Positive reinforcement

Extinction

Hyperactivity syndromes

Time out

Positive reinforcement

Extinction

Pervasive developmental disorders

Timeout

Positive reinforcement

Extinction

Time out

Aversive techniques

Encopresis/enuresis

Positive reinforcement

Mental retardation

Positive reinforcement

Extinction and timeout

Prompting and shaping

Aversive techniques

Tics

Massed practice.

Research

Shastri PC, Shastri JP, Shastri D. Research in child and adolescent psychiatry in India. Indian J Psychiatry [serial online] 2010 [cited 2010 Nov 24];52:219-23. 

Conclusion

References

  1. Kaplan HI, Sadock BJ. Synopsis of Psychiatry , Behavioral Sciences/ Clinical Psychiatry. 9th ed. Hong Kong :William and Wilkinson Publishers ;1998.

  2. Friedman ES, Thase ME, Wright JH. Cognitive and behavioral therapies, in Psychiatry, Third Edition. Edited by Allan Tasman, Jerald Kay, Jeffrey A. Lieberman, Michael B. First and Mario Maj. John Wiley & Sons, Ltd, 2008.

  3. Hoare P. Essential child psychiatry. Churchill Livingstone.1993.

This page was last updated on: 08/12/2020