Psychiatric Disorders of Childhood and Adolescence
Psychiatric disorders of childhood and adolescence
Candidates must know the defining features, age of onset, course, and differential for major youth disorders: ADHD, autism spectrum disorder, disruptive behavior disorders, anxiety disorders, OCD, major depression, bipolar disorder, DMDD, tics/Tourette, eating disorders, trauma-related disorders, and early psychosis. Key distinctions: episodic mania with elevated mood/energy versus chronic nonepisodic irritability (DMDD); OCD rituals versus ASD repetitive behavior (ego-dystonic and intrusive versus comforting); tics versus stereotypies (variable, suppressible urges versus fixed, rhythmic); and depression versus irritability in youth. Eating disorders require medical risk assessment. Psychosis must be distinguished from fantasy, trauma-related dissociation, and cultural beliefs.
Traps: overdiagnosing bipolar disorder in irritable children; missing OCD because the child hides rituals; attributing weight loss to depression when an eating disorder is present; and calling tantrums "DMDD" without persistent irritability between outbursts. Age and duration criteria matter-many diagnoses require symptoms for specified periods and impairment.
Worked example/rule of thumb: A 9-year-old has severe tantrums most days for a year and is angry between outbursts, with no distinct elevated-mood episodes. This suggests DMDD rather than bipolar disorder. Rule: mania is episodic with a change in mood and energy; chronic irritability is not mania.