2. Child and Adolescent Psychiatry An Overview Child and Adolescent Psychiatry An Overview Alan Apter Child Study Center Schneider Children’s Medical Center of Israel

3. 5 Groups of Disorders n Developmental n Emotional n Conduct n Physical symptoms n Intellectual

4. Developmental Disorders PDD PDD: Pervasive Developmental Disorders n Autism n Schizophrenia n DementiaSDD: Specific Developmental Disorders n Dyslexia...

5. Emotional Disorders Depression Depression: n Unipolar n Bipolar n Dysthymia n Atypical n Seasonal n Suicidal Behavior Anxiety: n OCD n PD n Social Phobia n PTSD n Strangers Anx., Seperation Anx., Phobia...

6. Geha Hospital Israe 5 Mood Disorders Unipolar n 1 Parent -> 10% n 2 Parents -> 25% n MZ=50%, DZ=25% Bipolar n 1 Parent -> 25% n 2 Parents -> 50-75% n MZ=33-90% n DZ=5-25%

7. Geha Hospital Israe 6 Depression in Children & Adolescents 1970: Depression in children as entity Preschool: 0.9% School: 1.9% Adolescents: 4.7% n Age and developmental stage =>clinical picture n Spitz, Bowlby: anaclytic depression n Difficult to diagnose before 7y n body language, posture, face

8. Conduct Disorders CD/ODD Violating rights of others ADD/ADHD Attention Deficit with/without Hyperactivity

9. Geha Hospital Israe 8 “SEROTONIN RELATED” BEHAVIORS n Violence n Aggression n Impulsivity n Suicidality ~ Low CSF 5H-T (Coccaro 1989)

10. Geha Hospital Israe 9 Attention Deficit Hyperactivity Disorder Epidemiology n 3-5% School Child. n MaleX3, 1st Child n Parents Psychopath. Etiology n MBD? Frontal? n Dopamine +NE n Psychosocial n Environment n Final Common Pathway Diagnosis n Inattention- 6 n Hyperactivity Impulsivity: 6 total n Before 7y, 2 settings Functional, not PDD Clinical n From infancy n School!!!

11. Psychological Disorders with Physical Symptoms n TICS/TS n EATING DISORDERS n SLEEP DIS. n ENURESIS n ENCOPRESIS

12. Intellectual Disorders MENTAL RETARDATION

13. Geha Hospital Israe 12 Mental Retardation n Multiple causes (“Basket”) n Medical and Pedagogic n Definition (DSM IV): < 70 Functional deficits, <18y Axis II

14. Geha Hospital Israe 13 Mental Retardation n B.L I.Q: 71-84 n MILD50-70 n MODERATE 35-50 n SEVERE 20-35 n PROFOUND <20 No simple correlation to adaptive functioning

15. 5 Groups of Disorders n Developmental n Emotional n Conduct n Physiological n Intellectual