* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Slides 25 - Association for Academic Psychiatry
Mental status examination wikipedia , lookup
Emergency psychiatry wikipedia , lookup
History of psychiatry wikipedia , lookup
Reactive attachment disorder wikipedia , lookup
Controversy surrounding psychiatry wikipedia , lookup
Excoriation disorder wikipedia , lookup
Abnormal psychology wikipedia , lookup
Autism spectrum wikipedia , lookup
Posttraumatic stress disorder wikipedia , lookup
Classification of mental disorders wikipedia , lookup
Mental disorder wikipedia , lookup
Panic disorder wikipedia , lookup
Depersonalization disorder wikipedia , lookup
Selective mutism wikipedia , lookup
Antisocial personality disorder wikipedia , lookup
History of mental disorders wikipedia , lookup
Schizoaffective disorder wikipedia , lookup
Diagnostic and Statistical Manual of Mental Disorders wikipedia , lookup
Conversion disorder wikipedia , lookup
Postpartum depression wikipedia , lookup
Behavioral theories of depression wikipedia , lookup
Major depressive disorder wikipedia , lookup
Narcissistic personality disorder wikipedia , lookup
Bipolar disorder wikipedia , lookup
Spectrum disorder wikipedia , lookup
Conduct disorder wikipedia , lookup
Causes of mental disorders wikipedia , lookup
Bipolar II disorder wikipedia , lookup
Asperger syndrome wikipedia , lookup
Anxiety disorder wikipedia , lookup
Dissociative identity disorder wikipedia , lookup
Biology of depression wikipedia , lookup
Child psychopathology wikipedia , lookup
Separation anxiety disorder wikipedia , lookup
“I guess what I miss most is being drunk.” SUD Assessment Parental values Genetics Culture Individual Peer group characteristics Suicide Epidemiology Impulse control risk factors Biopsychosocial etiology Gender differences Tic Disorders Sudden, rapid, recurrent nonrhythmic, stereotyped, motor movement or vocalization Tourette’s Disorder motor before vocal autosomal dominant Symptoms of Depression in Young People Irritability Denial of depression Low self-esteem Somatic Complaints Depressed appearance Diagnosis of Dysthymia Depressed or irritable mood lasting a year or longer Never symptom free for longer than 2 months Diagnosis of Dysthymia (Cont’d.) Symptoms –poor –pessimism concentration –social –hopelessness withdrawal –sleep and –decreased appetite changes energy –low self-esteem Risk Factors for MDD and Dysthymia Stressful life events Parental dysfunction and loss Boys - neonatal health problems Girls - perceived unpopularity, anxiety Early Onset Bipolar Disorder Changes in mood, sleep pattern and energy Hyperactivity and irritability Distractibility Pressured speech Early Onset Bipolar Disorder (Cont’d.) Affective symptomatology Visual hallucinations Unreasonable irritability and anger Epidemiology of Depression Incidence increasing 4.7% Mean MDD among adolescents age of onset 11 years 0.7% bipolar among adolescents “Son, it’s important to remember that its O.K. to be depressed.” Depression Biologic Etiology Genetic influences Structural and functional changes Serotonin and norepinepherine Cortisol and growth hormone Attachment experience Depression Psychosocial Etiology Developmental dynamics Life stress Family dysfunction Cultural support Depression DDX and Co-mobidity Bipolar Disorder ADHD Anxiety and PTSD •Medical causes Separation Anxiety Disorder Excessive anxiety about separation from the home or from significant others Differential Diagnosis Phobia Conduct Disorder LD Depression Selective Mutism Failure to speak in specific social situations despite speaking in other situations. Reactive Attachment Disorder of Infancy or Early Childhood Developmentally inappropriate social relatedness beginning before age 5 associated with pathological care. Inhibited and Disinhibited Type Generalized Anxiety Disorder Excessive anxiety and worry for at least 6 months Worry about performance at school and sports DSM IV criteria less stringent Phobias Most common disorder in childhood Fears and anxieties decrease with age. About 2 - 3% of adolescents have significant fears. Phobias (Cont’d.) Fear of loud noises, the dark, animals, or imaginary creatures are common in younger children. In older children, fears are more focused on health, social and school problems. Obsessive-Compulsive Disorder High incidence in Tourettes Age of onset younger in males Basal ganglia disorders (PANDAS) PTSD Fear of separation, withdrawal, reenactment, sleep disturbance, regression, impulsivity Anxiety, psychosis Physical symptoms, nightmares Response to Traumatic Events The effect of trauma depends on the mediating processes – developmental level – biology of the trauma experience – social context – coping skills, protective factors, resilience Childhood Trauma Type I – full detailed memories – “omens” and misperceptions Type II – denial and numbing – self-hypnosis, dissociation, rage Dissociative experiences both during the trauma and afterward is related to the later development of PTSD Biologic Response to Stress Genetics Fight or flight Norepinepherine linked to immediate and prolonged response Serotonin linked to anxiety and panic in PTSD Biologic Response to Stress (Cont’d.) Brain regions involved include locus coeruleus, ventral tegmental region, and amygdala Increase glucocorticoid release results in loss of neurons and decreased dendritic branching in hippocampus and cognitive dysfunction. The Child Interview (Pynoos) Stage I – focus and traumatic reference Stage 2 – relive experience – coping themes – closure, recapitulation, courage/strengths Associated Problems Co-morbid Substance psychiatric disorders abuse Sexual/intimacy problems