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Child and Adolescent Psychiatry An Overview. Alan Apter Child Study Center Schneider Children’s Medical Center of Israel. Developmental Emotional Conduct Physical symptoms Intellectual. 5 Groups of Disorders. PDD : Pervasive Developmental Disorders Autism Schizophrenia Dementia.
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Child and Adolescent PsychiatryAn Overview Alan Apter Child Study Center Schneider Children’s Medical Center of Israel
Developmental Emotional Conduct Physical symptoms Intellectual 5 Groups of Disorders
PDD: Pervasive Developmental Disorders Autism Schizophrenia Dementia SDD: Specific Developmental Disorders Dyslexia... Developmental Disorders
Depression: Unipolar Bipolar Dysthymia Atypical Seasonal Suicidal Behavior Anxiety: OCD PD Social Phobia PTSD Strangers Anx., Seperation Anx., Phobia... Emotional Disorders
Mood Disorders Unipolar • 1 Parent -> 10% • 2 Parents -> 25% • MZ=50%, DZ=25% Bipolar • 1 Parent -> 25% • 2 Parents -> 50-75% • MZ=33-90% • DZ=5-25%
1970: Depression in children as entity Preschool: 0.9% School: 1.9% Adolescents: 4.7% Age and developmental stage =>clinical picture Spitz, Bowlby: anaclytic depression Difficult to diagnose before 7y body language, posture, face Depressionin Children & Adolescents
CD/ODD Violating rights of others ADD/ADHD Attention Deficit with/without Hyperactivity Conduct Disorders
“SEROTONIN RELATED” BEHAVIORS • Violence • Aggression • Impulsivity • Suicidality ~ Low CSF 5H-T (Coccaro 1989)
Epidemiology 3-5% School Child. MaleX3, 1st Child Parents Psychopath. Etiology MBD? Frontal? Dopamine +NE Psychosocial Environment Final Common Pathway Diagnosis Inattention- 6 Hyperactivity Impulsivity: 6 total Before 7y, 2 settings Functional, not PDD Clinical From infancy School!!! Attention Deficit Hyperactivity Disorder
TICS/TS EATING DISORDERS SLEEP DIS. ENURESIS ENCOPRESIS Psychological Disorders with Physical Symptoms
MENTAL RETARDATION Intellectual Disorders
Mental Retardation Multiple causes (“Basket”) Medical and Pedagogic Definition (DSM IV): < 70 Functional deficits, <18y Axis II
Mental Retardation • B.L I.Q: 71-84 • MILD 50-70 • MODERATE 35-50 • SEVERE 20-35 • PROFOUND <20 No simple correlation to adaptive functioning
Developmental Emotional Conduct Physiological Intellectual 5 Groups of Disorders