Child and Adolescent Psychiatry: A Practical Guide by Dorothy Stubbe

By Dorothy Stubbe

Written through the learning director of Yale baby learn Center's world-renowned psychiatry application, this sensible guide is a brief, concise consultant for pros at the entrance traces of kid and adolescent psychological overall healthiness care. utilizing the conversational variety and medical vignettes present in all "Practical courses in Psychiatry" titles, Dr. Stubbe takes clinicians via each one step of the psychiatric care method, providing crucial quick proof and potent sufferer care options. Sections disguise psychiatric review; issues noticeable in babies, kids, and youngsters; therapy modalities and therapy making plans; and targeted situations together with psychiatric emergencies, baby forget and abuse, and family members matters. Easy-to-use appendices contain score scales and source information."The functional courses in Psychiatry" sequence presents speedy, concise info for pros at the entrance strains of psychological healthiness care. Written in an easy-to-read, conversational type, those valuable assets take you thru every one step of the psychiatric care procedure, offering quickly proof and worthwhile innovations that assist you offer potent and compassionate care for your patients.

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Consider overall family functioning, problem-solving abilities, intrafamily communications and boundaries, behavioral control, affective processes, and family cohesion and adaptability as areas that impact each family member. Patient Interview: The Mental Status Examination For children and adolescents, the mental status examination components may be gathered through direct questioning, play activities, or observations during the session. qxd 8/11/06 6:30 PM Page 27 Chapter 2 / The Psychiatric Evaluation 27 • Appearance and behavior: grooming, size, type of dress, dysmorphic features, bruises, scars or injuries, eye contact • Ability to cooperate and engage with assessment • Social relatedness • Speech and language: fluency, volume, rate, and language skills (appropriateness for developmental level, articulation issues, social speech) • Motor function: activity level, coordination, attention, frustration tolerance, impulsivity, tics and mannerisms • Mood and affect: neurovegetative symptoms, manic symptoms, range and appropriateness of affects • Thought process and content: psychotic symptoms (hallucinations, delusions, thought disorder) • Anxiety: fears and phobias, obsessions or compulsions, post-traumatic anxiety, separation difficulties • Conduct symptoms: oppositionality, conduct symptoms, aggression (verbal or physical) • Trauma history: physical or sexual abuse, neglect • Assessment of risk: suicidal thoughts or behavior, selfabusive behavior, thoughts or plans to harm others, risktaking behaviors, sexual behaviors, internet usage, legal issues, cigarette, substance or alcohol experimentation/use • Cognitive functioning: overall assessment of developmentally appropriate vocabulary, fund of knowledge, drawings • Insight and judgment: acknowledgment of having a problem, judgment for hypothetical situations Rating Scales/Assessment Instruments Rating scales range from systematized questionnaires that assess psychiatric symptoms in general to those that probe specific areas of difficulty in depth.

Family theorists vary on the type of approach used to assess family functioning. I find the following most useful. Family genogram. In the initial meeting with the parents I ask about a basic family history. This may be most efficiently done in a genogram. The genogram, as presented by McGoldrick, is a practical and useful framework for understanding family patterns and mapping out how family members are biologically and legally related to one another over a series of several generations. I include any psychiatric, learning, medical or substance use issues, history of abuse or neglect, and legal issues next to each circle (female) or square (male) person in the genogram.

Psychiatrists work within a system of care to provide needed services for a child and his or her family. qxd 8/12/06 12:26 PM Page 47 Chapter 5 / Pervasive Developmental Disorders 47 BASIC PRINCIPLES From the earliest description of autism by Leo Kanner in 1943, the disorder has been studied widely to ascertain the etiology and effective treatments. Some initial descriptions of “refrigerator mothers” as the cause has been long since dispelled. A neurological insult of multiple etiologies (genetic, intrauterine, neurotransmitter, or neurophysiological abnormalities) is posited.

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