Child and Adolescent Psychiatry
Core concepts
Know developmental milestones and their red flags. Autism spectrum disorder: persistent deficits in social communication + restricted/repetitive behaviours, early onset. ADHD: developmentally inappropriate inattention and/or hyperactivity-impulsivity, ≥6 months, present before age 12, across ≥2 settings. Disruptive mood dysregulation disorder (chronic irritability, severe temper outbursts) vs bipolar (episodic). Conduct disorder vs oppositional defiant disorder (ODD = argumentative/defiant without serious rights violations). Separation anxiety disorder and school refusal. Tic disorders including Tourette syndrome (motor + vocal tics ≥1 year). Eating disorders: anorexia nervosa (low weight, fear of weight gain, body image disturbance), bulimia (binge-purge), ARFID. Treatment: behavioural parent training, CBT, family-based treatment for anorexia, stimulants for ADHD with growth monitoring.
Traps
Do not diagnose bipolar in children with chronic irritability - consider DMDD. ADHD requires cross-setting impairment; classroom-only problems may reflect other issues. Anorexia has the highest mortality of psychiatric disorders. Distinguish normal developmental fears from anxiety disorders.
Rule of thumb
In children, chronic non-episodic irritability = DMDD; episodic mood swings = consider bipolar. Always assess across settings (home and school).