Child and Adolescent Psychiatry
Core concepts
Know the presentation of autism spectrum disorder (social communication deficits, restricted/repetitive behaviours), ADHD (inattention, hyperactivity, impulsivity across settings), oppositional defiant disorder, conduct disorder, separation anxiety, and paediatric depression. Developmental milestones and their deviations are commonly tested.
Treatment
- ADHD: behavioural parenting interventions first in young children; stimulants (methylphenidate) or atomoxetine first-line pharmacotherapy; monitor growth and cardiovascular status.
- Autism: early behavioural intervention; treat comorbid conditions.
- Depression: psychological therapy first-line; fluoxetine is the best-evidenced SSRI in adolescents.
- Anxiety: CBT first-line.
Traps
- Diagnosing ADHD without evidence of cross-situational symptoms.
- Missing comorbidity (e.g., tics, anxiety, learning disorders).
- Overlooking safeguarding concerns and school context.
- Forgetting that bipolar disorder is rare in prepubertal children; irritability is often misattributed.
Rule of thumb
Always gather information from multiple informants (parent, teacher, child) and consider developmental stage before diagnosing.