Child and Adolescent Psychiatry
Developmental context
Symptoms must be interpreted against developmental stage. Know attachment theory, developmental milestones, and the impact of adverse childhood experiences.
Key disorders
Neurodevelopmental: autism spectrum disorder, ADHD, intellectual disability, tic disorders. Emotional: separation anxiety, school refusal, depression, self-harm. Behavioural: oppositional defiant disorder, conduct disorder. Eating disorders (anorexia, bulimia, ARFID). Psychosis is rare before adolescence.
Assessment
Multiple informants (parent, school), developmental history, observation, and screening tools. Consider safeguarding, looked-after children, and transition to adult services.
Traps
Overdiagnosing ADHD without cross-setting impairment; missing autism in a child labelled as naughty; attributing self-harm to attention-seeking; forgetting that depression can present as irritability.
Worked rule of thumb
ADHD requires symptoms in more than one setting, onset before age 12, and functional impairment. If impairment is confined to school or home alone, look for environmental or other explanations.