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Book Details
Abstract
Get a quick, expert overview of complex childhood psychiatric disorders from Drs. David I. Driver and Shari Thomas of Healthy Foundations Group. This practical resource presents a summary of today’s current knowledge and best approaches to topics from gender dysphoria to childhood onset schizophrenia and other complex psychiatric disorders.
- Comprehensive guide for any professional working with children.
- Consolidates today’s evidence-based information on complex childhood psychiatric disorders into one convenient resource.
- Provides must-know information on evaluation and management.
- Covers a range of psychiatric disorders of children including drug-induced mania and psychosis, concussions, ADHD, technology addiction, sleep disorders, and eating disorders.
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Front Cover | Cover | ||
Complex Disorders in Pediatric Psychiatry: A Clinician’s Guide | i | ||
Complex Disorders in Pediatric Psychiatry: A Clinician’s Guide | iii | ||
Copyright | iv | ||
List of Contributors | v | ||
Preface | ix | ||
Contents | xi | ||
List of Tables and Boxes | xiii | ||
LIST OF TABLES | xiii | ||
LIST OF BOXES | xiv | ||
1 - Gender Dysphoria in Childhood and Adolescence | 1 | ||
DEVELOPMENT OF GENDER IDENTITY | 1 | ||
DIAGNOSTIC CRITERIA FOR GENDER DYSPHORIA IN CHILDHOOD AND IN ADOLESCENCE | 2 | ||
EPIDEMIOLOGY AND ETIOLOGY | 2 | ||
SCREENING/DIAGNOSIS | 3 | ||
PSYCHOTHERAPY | 5 | ||
MEDICAL INTERVENTIONS | 5 | ||
COOCCURRING MENTAL ILLNESS | 7 | ||
PROTECTIVE FACTORS AND CLINICAL IMPLICATIONS | 7 | ||
REFERENCES | 8 | ||
2 - School Refusal | 11 | ||
INTRODUCTION | 11 | ||
DIAGNOSTIC ASSESSMENT | 12 | ||
DIMENSIONAL ASSESSMENT | 13 | ||
FUNCTIONAL ASSESSMENT | 15 | ||
COGNITIVE BEHAVIORAL TREATMENT | 15 | ||
PHARMACOTHERAPY | 15 | ||
COMPREHENSIVE TREATMENT DESIGN | 15 | ||
CHILD GROUP THERAPY FOR SCHOOL REFUSAL | 17 | ||
PARENT MANAGEMENT TRAINING | 18 | ||
SCHOOL CONSULTATION | 18 | ||
CONCLUSION | 19 | ||
REFERENCES | 19 | ||
3 - Attention Deficit Hyperactivity Disorder and Anxiety | 23 | ||
INTRODUCTION | 23 | ||
BACKGROUND | 23 | ||
PREVALENCE | 23 | ||
AGE AND DEVELOPMENT | 23 | ||
GENDER | 24 | ||
SCREENING | 26 | ||
DIAGNOSIS | 26 | ||
CLINICAL WORKUP | 27 | ||
NEUROPSYCHOLOGIC TESTS | 27 | ||
PATHOPHYSIOLOGY/ETIOLOGY | 27 | ||
Is Comorbidity Due to Overlapping Symptoms? | 27 | ||
Does Anxiety Modulate Attention Deficit Hyperactivity Disorder Symptoms or Vice Versa? | 28 | ||
GENETICS | 28 | ||
SIGNALING PATHWAYS | 29 | ||
TREATMENTS | 29 | ||
Behavioral Interventions | 29 | ||
PHARMACOTHERAPY | 29 | ||
Stimulants: Effect on Attention Deficit Hyperactivity Disorder | 29 | ||
Stimulants: Effect on Anxiety | 30 | ||
Multimodal Therapy+Stimulants | 31 | ||
ATOMOXETINE | 31 | ||
ATTENTION DEFICIT HYPERACTIVITY DISORDER MEDICATIONS+ANTIANXIETY MEDICATIONS | 31 | ||
Stimulant+Selective Serotonin Reuptake Inhibitor | 31 | ||
Atomoxetine+Selective Serotonin Reuptake Inhibitor | 32 | ||
IMPLICATIONS FOR CLINICAL PEDIATRIC PRACTICE | 32 | ||
SUMMARY | 33 | ||
REFERENCES | 33 | ||
4 - Tourette Syndrome | 37 | ||
INTRODUCTION | 37 | ||
BRIEF HISTORY | 37 | ||
CLINICAL PRESENTATION | 38 | ||
PATHOPHYSIOLOGY | 40 | ||
COMORBIDITIES WITH FOCUS ON ATTENTION DEFICIT HYPERACTIVITY DISORDER AND OBSESSIVE-COMPULSIVE DISORDER | 40 | ||
TREATMENT OF TOURETTE SYNDROME—GENERAL COMMENTS | 41 | ||
PHARMACOLOGIC TREATMENT OF TICS | 41 | ||
TREATMENT OF TICS AND ATTENTION DEFICIT HYPERACTIVITY DISORDER | 43 | ||
TREATMENT OF TICS AND OBSESSIVE-COMPULSIVE DISORDER | 44 | ||
DIFFERENTIAL DIAGNOSIS | 44 | ||
CONCLUSIONS: COMMUNICATION AND COUNSELING | 45 | ||
REFERENCES | 45 | ||
5 - Management of ADHD in Youth With Comorbid Epilepsy | 49 | ||
INTRODUCTION | 49 | ||
Attention Deficit Hyperactivity Disorder | 49 | ||
Epilepsy | 51 | ||
COMORBIDITY OF ATTENTION DEFICIT HYPERACTIVITY DISORDER AND EPILEPSY9 | 51 | ||
PATHOLOGY | 52 | ||
Other Pathogenic Mechanisms | 52 | ||
Effect of subclinical epileptiform activity | 52 | ||
CLINICAL PRESENTATION | 54 | ||
TREATMENT | 55 | ||
Case Report | 59 | ||
DISCLOSURE STATEMENT | 60 | ||
REFERENCES | 61 | ||
6 - Evolution From Feeding Disorders to Avoidant/Restrictive Food Intake Disorder | 63 | ||
INTRODUCTION | 63 | ||
DEFINITIONS OF FEEDING DISORDERS | 63 | ||
HISTORY AND COMPARATIVE NOSOLOGY | 63 | ||
SPECIFIC FEEDING DISORDERS SUBTYPES OF AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDER (DSM-5) | 64 | ||
I. ARFID Subtype: “Apparent Lack of Interest in Eating or Food” (DSM-5) | 64 | ||
Clinical features | 64 | ||
Risk factors | 65 | ||
Differential diagnosis | 65 | ||
Etiology and course | 65 | ||
Treatment | 67 | ||
II. ARFID Subtype: Avoidance Based on the Sensory Characteristics of Food (DSM-5) | 68 | ||
Clinical features | 68 | ||
Risk factors | 69 | ||
Differential diagnosis | 69 | ||
Etiology and course | 70 | ||
Treatment | 70 | ||
III. ARFID Subtype: Concern About the Aversive Consequences of Eating (DSM-5) | 71 | ||
Clinical features | 72 | ||
Risk factors | 72 | ||
Differential diagnosis | 72 | ||
Etiology and course | 72 | ||
Treatment | 73 | ||
COMORBIDITIES OF FEEDING DISORDERS | 74 | ||
COMORBIDITIES OF FEEDING, SLEEP, AND ANXIETY DISORDERS | 74 | ||
TREATMENT OF COMORBID ANXIETY AND SLEEP DISORDERS | 74 | ||
CONCLUSION | 74 | ||
REFERENCES | 75 | ||
7 - Eating Disorders | 77 | ||
DIAGNOSTIC CRITERIA AND EPIDEMIOLOGY | 77 | ||
Anorexia | 77 | ||
Bulimia | 78 | ||
Binge Eating Disorder | 78 | ||
Avoidant-Restrictive Food Intake Disorder | 79 | ||
Differentiating avoidant-restrictive food intake disorder from anorexia | 79 | ||
DIFFERENTIAL DIAGNOSIS OF EATING DISORDERS AND DIAGNOSTIC DILEMMAS | 79 | ||
Obsessive-Compulsive Disorder Differential | 80 | ||
Social Anxiety | 80 | ||
Clinical Implications | 80 | ||
Medical Differential | 81 | ||
TREATMENT OF EATING DISORDERS | 81 | ||
TREATMENT OF ANOREXIA NERVOSA | 82 | ||
Behavioral Treatments | 82 | ||
Psychopharmacology | 83 | ||
TREATMENT OF BULIMIA NERVOSA | 85 | ||
Behavioral Treatments | 85 | ||
Psychopharmacology | 85 | ||
TREATMENT OF AVOIDANT-RESTRICTIVE FOOD INTAKE DISORDER | 85 | ||
Behavioral Treatment | 86 | ||
8 - Childhood Stress and Trauma | 93 | ||
INTRODUCTION | 93 | ||
CLARIFICATIONS | 93 | ||
PATHOPHYSIOLOGY: THE INJURY PARADIGM | 93 | ||
STRESS-RELATED DIAGNOSES | 94 | ||
Posttraumatic Stress Disorder Changes in Diagnostic and Statistical Manual of Mental Disorder-5 | 94 | ||
Diagnostic Dilemmas—Trauma Syndrome Continuum | 95 | ||
Complex Trauma | 96 | ||
PREVALENCE AND EPIDEMIOLOGY | 96 | ||
PREVENTION | 97 | ||
CONCEPTUALIZING TRAUMA AND THE CLINICAL WORKUP | 98 | ||
Trauma Assessment | 98 | ||
TREATMENT | 98 | ||
Pharmacology | 99 | ||
REFERENCES | 100 | ||
9 - Factitious Disorder Imposed on Another | 105 | ||
INTRODUCTION | 105 | ||
DEFINITION/SYMPTOM CRITERIA | 105 | ||
EPIDEMIOLOGY | 106 | ||
ETIOLOGY | 106 | ||
SCREENING | 106 | ||
DIFFERENTIAL DIAGNOSIS | 107 | ||
Additional Somatic Symptom and Related Disorders | 107 | ||
Malingering | 107 | ||
Schizophrenia Spectrum and Other Psychotic Disorders | 108 | ||
Anxiety Disorders | 108 | ||
Neurodevelopmental Disorders | 108 | ||
COMMON COMORBID DIAGNOSES | 108 | ||
ASSESSMENT | 108 | ||
The Record Review | 109 | ||
Mental Health Assessment | 109 | ||
Collateral Interviews | 111 | ||
The Separation Test | 111 | ||
Clinical Evaluation of Suspected Victim | 112 | ||
Profiling Abusers | 112 | ||
CASE MANAGEMENT, TREATMENT, AND RECOMMENDATIONS | 112 | ||
Working as a Team | 112 | ||
Placement | 112 | ||
Supervised Visitation | 113 | ||
Medical Care for Child | 113 | ||
School | 113 | ||
Psychotherapy for Abuser, Spouse, and Child Victim | 113 | ||
Reunification | 114 | ||
CONCLUSION | 114 | ||
DISCLOSURE STATEMENT | 114 | ||
REFERENCES | 114 | ||
10 - Pediatric Sleep Disorders | 117 | ||
INTRODUCTION | 117 | ||
NORMAL SLEEP DEVELOPMENT | 117 | ||
Newborns (0–2Months) | 117 | ||
Infants (2–12Months) | 118 | ||
Toddlers (12Months–3Years) | 118 | ||
Preschoolers (3–5Years) | 118 | ||
School-Aged Children (6–12Years) | 119 | ||
Adolescents (12–18Years) | 119 | ||
PEDIATRIC SLEEP DISORDERS | 119 | ||
Clinical Evaluation | 120 | ||
Partial arousal parasomnias | 122 | ||
Rhythmic movement disorders | 123 | ||
Restless legs syndrome | 123 | ||
Common Pediatric Disorders in Children in Preteens and Young Adolescents | 123 | ||
Circadian rhythm disorders—delayed sleep phase syndrome | 124 | ||
Pediatric narcolepsy | 124 | ||
Insomnia | 125 | ||
Sleep bruxism | 125 | ||
PEDIATRIC PSYCHIATRIC DISORDERS AND SLEEP | 125 | ||
Sleep Disturbance in Attention Deficit Hyperactivity Disorder | 125 | ||
Sleep Disturbance in Autism | 126 | ||
Sleep Disturbance in Generalized Anxiety Disorder | 126 | ||
Sleep Disturbance in Posttraumatic Sleep Disorder | 126 | ||
Sleep Disturbance in Panic Disorder | 127 | ||
Bipolar disorder | 127 | ||
SUMMARY | 128 | ||
REFERENCES | 128 | ||
11 - Concussion in Children and Adolescents | 129 | ||
INTRODUCTION | 129 | ||
DEFINITION/SYMPTOM CRITERIA | 129 | ||
PREVALENCE/EPIDEMIOLOGY | 129 | ||
ETIOLOGY/PATHOPHYSIOLOGY | 130 | ||
SCREENING/DIAGNOSIS | 130 | ||
Baseline Testing | 131 | ||
DIFFERENTIAL DIAGNOSES | 131 | ||
WORKUP/CLINICAL FINDINGS | 132 | ||
Physical Examination | 132 | ||
TREATMENT | 132 | ||
REFERENCES | 133 | ||
12 - Pediatric Delirium | 135 | ||
INTRODUCTION | 135 | ||
DEFINITION/SYMPTOM CRITERIA | 135 | ||
PREVALENCE/EPIDEMIOLOGY | 136 | ||
PATHOPHYSIOLOGY/ETIOLOGY | 137 | ||
Neurotransmitter Deficiency/Dysregulation | 137 | ||
Neuroinflammation | 138 | ||
Oxidative Stress | 138 | ||
ASSESSMENT | 138 | ||
Screening | 138 | ||
Electroencephalogram Findings | 141 | ||
Developmental Concerns | 141 | ||
DIAGNOSTIC DILEMMAS | 141 | ||
Delirium Versus Catatonia | 141 | ||
Delirium Versus Psychiatric Illness | 143 | ||
TREATMENT | 143 | ||
Nonpharmacologic Management | 143 | ||
Pharmacologic Management | 144 | ||
Benzodiazepine Withdrawal–Induced Delirium | 145 | ||
Treatment of Behavioral Symptoms With Medications | 145 | ||
Pharmacologic Strategies to Reduce the Incidence of Delirium | 147 | ||
Integrative Management | 147 | ||
SEQUELAE | 148 | ||
Cognitive Outcomes | 148 | ||
Psychiatric Outcomes | 148 | ||
CLOSING | 149 | ||
REFERENCES | 149 | ||
13 - Pediatric Catatonia | 155 | ||
INTRODUCTION | 155 | ||
BACKGROUND | 155 | ||
PREVALENCE | 155 | ||
SCREENING | 155 | ||
DIAGNOSIS | 155 | ||
LABORATORY TESTS | 156 | ||
ELECTROENCEPHALOGRAM | 157 | ||
BRAIN IMAGING | 157 | ||
PATHOPHYSIOLOGY/ETIOLOGY | 159 | ||
Animal Models | 159 | ||
Neurotransmitters Imbalances | 159 | ||
Glutamatergic | 159 | ||
Dopaminergic | 159 | ||
Serotonergic | 159 | ||
Cholinergic | 159 | ||
Infectious/Autoimmune | 160 | ||
Oxidative Damage | 160 | ||
Genetic Risks | 160 | ||
Physical and Psychological Trauma | 160 | ||
TREATMENTS | 160 | ||
TREATMENTS FOR CATATONIA | 160 | ||
MEDICATIONS | 160 | ||
ELECTROCONVULSIVE THERAPY | 161 | ||
Implications for Clinical Pediatric Practice | 162 | ||
SUMMARY | 162 | ||
REFERENCES | 163 | ||
14 - Pediatric Inflammatory Brain Disease | 169 | ||
INTRODUCTION | 169 | ||
BRAIN IMMUNOLOGY | 169 | ||
CLINICAL PRESENTATION OF INFLAMMATORY BRAIN DISEASE | 170 | ||
DIAGNOSTIC EVALUATION | 170 | ||
Physical Examination Findings | 170 | ||
Laboratory Studies | 171 | ||
Imaging | 173 | ||
Electroencephalogram | 173 | ||
Neuropsychiatric Testing | 173 | ||
Diagnosis | 173 | ||
DIFFERENTIAL DIAGNOSIS | 173 | ||
OVERVIEW OF INFLAMMATORY BRAIN DISEASES | 175 | ||
Immune-Mediated Causes | 177 | ||
Autoimmune encephalitis | 177 | ||
Limbic Encephalitis (N-Methyl-d-Aspartate Receptor and Others) | 177 | ||
Basal Ganglia Encephalitis | 178 | ||
Steroid-Responsive Encephalitis Associated With Thyroiditis (Hashimoto’s Encephalitis) | 178 | ||
Demyelinating inflammatory brain disease | 179 | ||
Central nervous system vasculitis and rheumatologic diseases associated with central nervous system inflammation | 179 | ||
Central Nervous System Vasculitis | 179 | ||
Systemic Lupus Erythematosus and Antiphospholipid Antibody Syndrome | 180 | ||
Behcet’s Disease | 180 | ||
Sjogren’s Syndrome and Sarcoidosis | 180 | ||
Cytokine-associated encephalopathy | 180 | ||
Infection-associated relapsing/remitting central nervous system disorder: neuropsychiatric symptoms that follow infections outsi... | 180 | ||
TREATMENT | 181 | ||
THREE PEDIATRIC ACUTE-ONSET NEUROPSYCHIATRIC SYNDROME CONSENSUS GUIDELINES: A POSSIBLE MODEL FOR PEDIATRIC INFLAMMATORY BRAIN DI... | 181 | ||
ROLE OF PSYCHIATRIST IN MANAGING INFLAMMATORY BRAIN DISORDER | 182 | ||
Recognition | 182 | ||
Psychiatric Evaluation | 182 | ||
REFERENCES | 184 | ||
15 - Disruptive Mood Dysregulation Disorder | 189 | ||
INTRODUCTION | 189 | ||
DEFINITION/SYMPTOM CRITERIA | 190 | ||
PREVALENCE/EPIDEMIOLOGY | 190 | ||
ETIOLOGY/PATHOPHYSIOLOGY | 190 | ||
DIFFERENTIAL DIAGNOSES AND DIAGNOSTIC DILEMMAS | 191 | ||
WORKUP | 191 | ||
TREATMENT | 192 | ||
RISK FACTORS | 193 | ||
POTENTIAL OUTCOMES | 193 | ||
COMORBIDITIES | 194 | ||
IMPLICATIONS FOR CLINICAL PRACTICE | 194 | ||
REFERENCES | 195 | ||
16 - Pediatric Bipolar Disorder | 199 | ||
INTRODUCTION | 199 | ||
DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS, FIFTH EDITION DEFINITION | 199 | ||
DIFFERENTIAL DIAGNOSIS | 200 | ||
EPIDEMIOLOGY AND GENETICS | 200 | ||
COMMON COMORBIDITY | 200 | ||
Substance Use Disorders | 200 | ||
Anxiety Disorders | 201 | ||
Attention Deficit Hyperactivity Disorder and Disruptive Behavior Disorders | 201 | ||
Learning Disabilities | 201 | ||
Suicide | 201 | ||
Medical Comorbidity | 202 | ||
Treatment | 202 | ||
Pharmacology, immediate and long-term | 202 | ||
Failed or Negative Trials | 202 | ||
Positive Double-Blind Trials | 204 | ||
Positive Open-Label Trials | 205 | ||
Federal Treatment Trials | 205 | ||
Combination Trials | 206 | ||
Long-term trial | 206 | ||
Psychotherapy | 206 | ||
CONCLUSIONS | 207 | ||
REFERENCES | 207 | ||
17 - Childhood-Onset Schizophrenia | 211 | ||
INTRODUCTION | 211 | ||
DEFINITION/SYMPTOM CRITERIA | 211 | ||
EPIDEMIOLOGY | 213 | ||
SCREENING/DIAGNOSIS | 213 | ||
Differential Diagnoses | 213 | ||
EVALUATION AND WORKUP | 213 | ||
Screening and Diagnostic Tools | 214 | ||
Comorbidity | 214 | ||
INTERVENTION | 216 | ||
Nonpharmacologic | 216 | ||
Pharmacologic | 216 | ||
IMPLICATIONS FOR CLINICAL PRACTICE | 218 | ||
REFERENCES | 218 | ||
Clinical Pearls Appendix | 225 | ||
Index | 231 | ||
A | 231 | ||
B | 231 | ||
C | 232 | ||
D | 233 | ||
E | 233 | ||
F | 233 | ||
G | 234 | ||
H | 234 | ||
I | 234 | ||
K | 234 | ||
L | 234 | ||
M | 234 | ||
N | 234 | ||
O | 235 | ||
P | 235 | ||
R | 236 | ||
S | 236 | ||
T | 237 | ||
U | 237 | ||
V | 237 | ||
W | 237 | ||
Z | 237 |