1. Introduction to Child and Adolescent Psychiatry Dr. Oğuzhan Zahmacıoğlu 2015

2. AIMS a) Learning about the issues of child and adolescent psychiatry b) Understanding the importance of child and adolescent psychiatry as a preventive discipline for promoting community mental health. c) Learning about common childhood psychiatric problems.

3. Child and Adolescent Psychiatry: Considers childhood mental disorders as developmental variations/deviations. Needs to know normal development Needs to consider child with his/her environment (family/community) Needs to find ways to promote healthy development as well as treating mental problems so it is a preventative discipline of medicine Child advocacy is part of child psychiatry

4. We need to know Normal motor and mental development Family system Education system the child is in Health system Legal issues Factors that are related to child mental health e.g: child abuse and neglect, violence, bullying

5. How do we relate to the child How do we relate to the family History taking Psychologic tests Follow up

6. Observation Does he/she look at his/her age-gender Does he/she behave approapriate to the age- gender Is he/she dressed appropriately to the age- gender How does the parents relate to the child How does the child relat to parents How does the child relate to us

7. Forming a positive relationship Respectful manners Trust forming Language should be appropriate to culture, age, clear, not using medical jargon. Warmth Setting: appropriate for the family and child Non-judgemental approach Honesty

8. History Taking 1. What is the main problem at this moment: 2. When did this problem begin, how does it affect the child’s life and family life. 3. What other problems accompany this problem. 4. What did the family do to solve this problem. 5. Previous psychiatric help seeking.

9. Developmental History of the Child Pregnancy Birth problems Temperamental characteristics as a baby Attachment Motor developmental milestones: when did the child sit,walk Language development Toilet training Social development, friendship patterns Educational history and current school functioning Achievements

10. Mental Status Examination Physical appearence Parent-child interaction Seperation and reunion Orientation to time, place, person Speech and language Mood and affective expression style Thought process and content Attention Motor behavior Social relatedness Memory Judgemenet and insight IQ

11. Commonly used tests Good-Enough Draw a Person Test Beier Sentence Completion Test Bender Gestalt Test Kovacs Children’s Depression Inventory ADHD Scales WISC-R (Wechsler Intelligence Scale for Children-Revised) Stanford Binet Test Developmental screening tests: AGTE, Vineland, Denver

12. Formulation Define the problem (e.g: difficult child, temper tantrums) Define precipitating factors for the problem (e.g: uncontrollable since his sister born) Perpetuating factors (e.g: mother less tolerant, tired, parental conflict) Predisposing factors: (e.g: difficult child since birth, always on the move)

13. Diagnosing Diagnostic Systems: DSM V: Diagnostic and Statistical Manual of Mental Disorders; (APA) ICD 10: International Classification of Disease (WHO) Multiaxial Systems

14. ICD 10 Axis I: Behavioral and emotional disorders with onset usually occuring in childhood and adolescence Axis II: Developmental disorders Axis III: Intellectual level Axis IV: Medical Condition Axis V: Associated abnormal psychosocial situations

15. END OF SESSION Treatment planning: Psychopharmacological Advice and directives Therapy planning Academic planning Giving feedback to the family