2.  The branch of psychiatry that
specializes in the
study, diagnosis, treatment, a
nd prevention of
psychopathological disorders
of children, adolescents, &
their families (Kaplan & Saddock)
 Clinical investigation of
phenomenology, biologic
factors, psychosocial
factors…. & response to
interventions of child and
adolescent psychiatric
disorders (Kaplan & Saddock)

3.  1883: Emil Kreapelin: Ignored
 1933: Moritz Tramer: Swiss
psychiatrist
 1st Journal: Zeitschrift für
Kinderpsychiatrie = Acta
Paedopsychiatria
 1st academic child
psychiatry department in the
world was founded by Leo
Kanner in Baltimore
 1953: AACP
 1959: Board certified
speciality

4.  Where does the medical term “rounds”
originate from?
 Who stated “Listen to your patient, he is
telling you the diagnosis,“
 Who 1st developed the concept of
Medical residency ?
 Hint: Rendu-Osler-Weber disease

6. ADULT D/O seen in kids Starting in childhood
 Anxiety Disorders  Disruptive Behavior d/o
 Mood Disorders  Pervasive
 Substance Abuse developmental d/o
 Sleep disorders  Elimination disorders
 Eating disorders  Feeding disorders
 Schizophrenia  Tourette’s/Tics
 Adjustment disorder  Selective Mutism
 Seperatation Anxiety d/o
 RAD

8.  Panic disorder
 Specific & Social Phobias
 GAD
 PTSD/Acute Stress d/o
 Obsessive Compulsive Disorder

9.  What is the phobia of needles/injections
called
 What is the fear of night/darkness
 What is Triskaidekaphobia

10.  Trypanophobia
 Nyctophobia

11.  Substance abuse
 Substance dependence

12.  Major depressive disorder
 Bipolar disorder
 Substance induced mood disorder
 Mood disorder NOS

13. Catatonic
Paranoid
Disorganized
Undifferentiated
Residual

14.  Dyssomnias:
disturbance in
initiation or
maintenance of Parasomnias: involve abnormal and
sleep unnatural
- Insomnia movements, behaviors, emotions, per
- Hypersomnia ceptions, and dreams that occur
- Narcolepsy while falling
asleep, sleeping, between sleep
- Sleep apnea, stages, or during arousal from sleep
- ASPS, DSPS - Nightmares
- Jetlag, - Sleep Terror
- Shift sleep disorder. - Bruxism
- Somnambulism

15. Anorexia
• Refusal to maintain body weight
• Intense fear of gaining weight
• Preoccupation: body shape
• Amenorrhea (at least 3 consecutive
menstrual cycles)
• 0.5-1% of adolescent girls
• Restricting type vs. binge
eating/purging type
Bulimia
• Binge eating 2/week for 3 mo
• Binges accompanied by a sense
of lack of control
• Inappropriate compensatory
behavior
(purging, laxatives, exercise, ene
mas)
• Self-evaluation is unduly based
on body shape and weight
• 1-3% of young women

17.  ADHD
 Opositional defiant disorder
 Conduct disorder

18.  Mental Retardation
 Learning Disorders
 Pervasive developmental disorders
- Autism
- Aspergers Syndrome
- Retts Syndrome
- Childhood disintegrative disorder
- PDD NOS
 Stuttering

19. • IQ < 70
• Onset before age 18
Mild • At least 2 areas of deficit
in adaptive functioning
(communication, self-care, home
Moderate
living, social skills, use of community
resources, self-
direction, academics,work, leisure, he
alth, safety)
Severe • Epidemiology
prevalence of 1-3%
M/F ~2:1
Profound • Comorbidity: 30-70%
psych disorders

20. What is the most common genetic cause of ID/MR?
What is the most common heritable cause of ID/MR?
What is the most common preventable cause of
ID/MR?

21.  Genetic: Down’s Syndrome
 Heritable: Fragile X
 Preventable: Fetal Alcohol Syndrome

22.  Eneuresis
- voiding of urine in inappropriate places
- > 2 times per week for 3 months
- 5 years of age or older
- seen in 7% 5 year old boys & 3% 5 year old girls
- can run in families
- first line treatment: Reward/Behavioral
therapy, Imipramine or ddAVP (vasopressin) are
also used
 Encopresis
-lack of bowel control & passage of feces in
inappropriate places
- > 1 time per month for 3 months
- 4 years of age or older
- seen in 1% of 5 year olds
- higher in males
- treat with supportive and behavioral therapy

23.  Markedly disturbed and developmentally
inappropriate social relatedness in most
contexts
 The disturbance is not accounted for solely
by developmental delay and does not
meet the criteria for pervasive
developmental disorder
 Onset before five years of age
 A history of significant neglect
 An implicit lack of identifiable, preferred
attachment figure.

24. Symptoms of Separation Anxiety
- Distress : separated from caregiver/home
- Persistent worry : losing caregiver
- Persistent worry about separation due to
untoward event
- Refusing to go to school
- Frequent physical complaints
- Fear of being alone
- Fear of sleeping away from caregiver
- Panic/tantrums at times of separation
- Nightmares about separation
 Developmentally inappropriate anxiety
Normal 8 mo to pre-school
 >3 symptoms for > 4 weeks
 Common ages 5-7 and 11-14, when kids
deal with change at school
 up to 4% prevalence in children & young
adolescents
 Treatment: Keep in school , CBT, SSRI’s

25.  Do not speak in 1 or >
important settings
despite ability to
comprehend
 <1% b/w 3-8 yrs F:M 2:1
 Etiology: trauma vs.
anxiety vs. temperament
 Rx: CBT Behavioral
Parental-Training
Speech-lang

26. A large, community-based study Tourette’s: Motor and/or vocal tics
suggested that over 19% of -
school-age children have tic sudden, rapid, recurrent, nonrhyt
disorders (Kurlan et.al.* ) hmic, stereotyped motor
movement or vocalization-occur
Transient tic disorder consists of at least 1 year with no tic free
multiple motor and/or phonic period for greater than 3 months
tics with duration of at least 4 -onset before 18 yrs
weeks, but less than 12 Epidemiology
months. -0.04% M:F 3:1
Chronic tic disorder is either single Associations: genetic
or multiple motor or phonic basis, ADHD, OCD, & PANDAS
tics, but not both, which are
present for more than a year. Treatment
Tourete’s (see right side for -behavioral therapy:CBIT
description) -antipsychotics, alpha agonists:
Tic d/o NOS
*Kurlan R, McDermott MP, Deeley C, et al. "Prevalence
of tics in schoolchildren and association with
placement in special education". Neurology Oct-
2001

27. Oral
- 0-18 months
- focus of gratification is on the mouth
Anal
- 18-36 months
- child learns to toilet train
Phallic
- 3-6 years
- Oedipal conflict
Latency
- 6 years-puberty
- drives of id are suppressed
Genital
- puberty and beyond
- detachment from parents
- adult sexuality

28. Sensorimotor
- birth-2 years
- child explores objects & their spatial relationships
- object permanence
Preoperational thought
- 2-7 years
- symbolic activity & play
- “animistic thinking” -- assigns living attributes to inanimate
objects,
- between ages 4-7 “decentration “ -- child starts to recognize
other points of view
Concrete operations
- 7 years-adolescence
- child develops understanding of conservation & reversibility
- can apply basic logical principles without being bound by his/her
own perceptions
Formal operations
- adolescence
- child can manipulate ideas & theorize
- abstract thinking

29. Trust/mistrust Identity vs. role confusion
- birth-18 months - teens-20s
Autonomy vs. shame Intimacy vs. isolation
and doubt - 20s-40s
-18 months-3 years Generativity vs. stagnation
Initiative vs. guilt - 40-60
- 3-5 years Ego integrity vs. despair
Industry vs. inferiority - 60-death
- 6-teens