1. Psychiatric Assessment of Child and Adolescent Patient
Dr.Oğuzhan Zahmacıoğlu
2015

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

3. 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

4. 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

5. 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.

6. 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

7. 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

8. 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

9. 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)

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

11. DSM IV
Axis I Diagnosis: Clinical disorders and other conditions that may be a focus of clinical attention
Axis II: Personality Disorders, Developmental Disorders, Mental Retardation
Axis III: General Medical Condition
Axis IV: Psychosocial and Environmental Problems.
Axis V: Global Assessment of Functioning

12. 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

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