Clinical Child Psychiatry E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 1823

Veröffentlichungsjahr: 2012

Beschreibung

Clinical Child Psychiatry
THIRD EDITION

Making a psychiatric diagnosis in children can be challenging: some clinicians say the incidence of some childhood disorders, such as bipolar disorder and ADHD, is over-diagnosed while others say they are undiagnosed, undertreated, and are a large burden on society. The drug treatment of child psychiatric disorders can also be controversial in children and adolescents. This book fulfills the need for an objective, clinically relevant source to dispel this confusion.

Clinical Child Psychiatry is a textbook of current clinical practice in child and adolescent psychiatry. It is designed as a reference for clinicians that is both easily usable and authoritative, a "chairside" reference for the consultation room.

This book addresses a defined series of clinical entities that represent the bulk of current treatment modalities and disorders encountered in 21st century practice. It is authoritative in the areas addressed while at the same time being rapidly accessible in format. To facilitate access, it presents disorders in declining order of frequency. The authors believe that worthwhile clinical work must be informed by both evidence-based practice and by psychiatry's traditional attention to internal and interpersonal dynamics. They are committed to an approach that is broadly biopsychosocial while based on current clinical evidence for a pragmatic, clinical focus. The book is divided into four sections. The first, Fundamentals of Child and Adolescent Psychiatric Practice, addresses assessment, treatment modalities, and planning. Common Child and Adolescent Psychiatric Disorders and Developmental Disorders cover the diagnosis and treatment of the large majority of disease entities encountered in practice. The final section, Special Problems in Child and Adolescent Psychiatry, includes a variety of topics such as foster care and adoption, loss and grief, and forensics.

• New evidence relating to the areas of depression, psychosis, trauma.
• New insights from genetics, genomics, and proteomics cleverly integrated into chapters on the individual disease with focus on their clinical application.
• New chapter on consultation and collaboration within systems of care.

The book addresses a need for clinicians, many of whom are beginners, non-psychiatrists, or psychiatrists entering unfamiliar territory, to come up to speed rapidly in providing more than perfunctory service to needy populations. This challenge grows ever greater.

Leseprobe

Contents

Cover

Series Page

Title Page

Copyright

Dedication

List of Contributors

Preface to Clinical Child Psychiatry, Third Edition

Section I: The Fundamentals of Child and Adolescent Psychiatric Practice

Chapter 1: The Initial Psychiatric Evaluation

Referral Sources

Elements of the Evaluation

Outcome of the Evaluation

Conclusion

Appendix 1.1

References

Chapter 2: Psychological Assessment of Children

Parent/Teacher Questionnaires

Cognitive Assessment

Drawings

Projective Testing

Child Questionnaires

Behavioral Assessment

Play Observations

Family Interaction

Special Issues

Conclusion

References

Chapter 3: Neurobiological Assessment

Introduction

Pharmacogenomics

Fluorescence In Situ Hybridization

Polymerase Chain Reaction

Microarray Analysis

Promising Technologies for Neurobiological Assessments

Measurement of Cortisol and its Importance in Mental Health Disorders

Conclusion

Glossary

References

Chapter 4: Educational Assessment and School Consultation

The Evaluation Process

When Should a Referral be Made?

Legislation and Rights

The Educational Evaluation

Consultation, Collaboration, and Educational Planning

References

Chapter 5: Psychiatric Assessment in Medically Ill Children

Introduction

Epidemiology

The Consultative Process and Assessment

Psychiatric Aspects of Chronic Medical Illness

Pediatric Hospital Consultation Today

Integrated Mental Health Care in the Medical Home

Summary

References

Chapter 6: How to Plan and Tailor Treatment: An Overview of Diagnosis and Treatment Planning

Models of Diagnostic Classification

Patterns of Child and Adolescent Psychotherapy

Commonly Described Forms of Psychotherapy

Therapeutic Interventions: Models for Selection and Utilization of Different Forms of Child and Adolescent Psychotherapy

Summary

References

Chapter 7: Assessment of Infants and Toddlers

Fundamental Aspects of an Infant Assessment

Models of Infant Assessment

Conducting an Infant Assessment

Conclusion

References

Chapter 8: Play Therapy

History

Play and Play Therapy

Conducting Child Psychotherapy

Conclusion

References

Chapter 9: Cognitive Behavioral Therapy

Introduction

Special Issues

Principles of Cognitive Behavioral Therapy

The Model

Adaptations

Developing the Conceptualization

Treatment

Examples of Treatment

Guidelines for CBT-Oriented Treatment

Concluding Remarks

References

Section II: Common Child and Adolescent Psychiatric Disorders

Chapter 10: Attention-Deficit Hyperactivity Disorder

Introduction

History

Core Clinical Criteria

Epidemiology of ADHD

Etiology of ADHD

Differential Diagnosis

Assessing Comorbidity

Diagnosis and Assessment

Treatment of ADHD

Summary and Conclusions

Appendix 10.1 Approach to Assessment and Treatment of ADHD

I. Initial Evaluation

II. Psychiatric Differential Diagnosis

III. Diagnosis

Treatment

Children Aged 3 to 5 Years

Adolescents

Appendix 10.2 Readings for Parents, Patients, and Teachers

Books

Websites

References

Chapter 11: Disruptive Behavior Disorders

Introduction

Definitions and Nosology

Epidemiology

Etiology

Diagnosis

Comorbidity and Differential Diagnosis

Course and Pattern

Treatment

Prognosis

Future Directions

References

Chapter 12: Child and Adolescent Affective Disorders and their Treatment

Introduction

Depressive Disorders

Bipolar Disorders

Conclusion

References

Chapter 13: Anxiety Disorders in Childhood and Adolescence

Introduction

Separation Anxiety

School Refusal

Generalized Anxiety Disorder

Specific Phobia

Social Phobia (Social Anxiety Disorder)

Panic Disorder

Obsessive-Compulsive Disorder

Selective Mutism

Summary

References

Chapter 14: Substance Use in Adolescents

Introduction

Epidemiology

Risk Factors

Comorbidity

Assessment

Medical Concerns

Treatment

Prevention

Conclusion

References

Chapter 15: Childhood Trauma

Introduction

History of Trauma-Related Diagnosis

Epidemiology

Developmental Traumatology

Neurobiological Processes Involved in the Stress Response

The Workup

Treatment

Conclusion

References

Chapter 16: Attachment and its Disorders

The History of Attachment Theory

Core Concepts of Attachment Theory

The Developmental Significance of Attachment

Attachment Theory Research

Neurobiological Aspects of Animal Attachment

Neurobiological Aspects of Human Attachment

Attachment Disorganization and Psychopathology

Treatment Implications of Disorganized Attachment

Conclusion

References

Chapter 17: The Eating Disorders

Introduction

Epidemiology

Etiology

Diagnosis

The Eating Disorder Assessment

Medical Complications

Treatment

Outcome

Binge Eating Disorder

Conclusions

References

Chapter 18: Elimination Disorders: Enuresis and Encopresis

Introduction

Enuresis

Encopresis

Acknowledgement

References

Chapter 19: Sexual Development and the Treatment of Sexual Disorders in Children and Adolescents

Sex and Gender Development

Sex And Gender Disorders

Paraphilias

The Effect of Sexual Abuse on Sexual Development and Behavior

References

Section III: Developmental Disorders

Chapter 20: Learning and Communications Disorders

Introduction

Diagnostic Categories

Specific Learning Disabilities

Communication Disorders

Diagnostic Comorbidity

References

Chapter 21: The Autistic Spectrum Disorders

Epidemiology

Etiology and Pathophysiology

Diagnosis

Course and Natural History

Goals of Treatment

Approach to Treatment

Summary and Future Considerations

References

Chapter 22: Intellectual Disability (Mental Retardation)

Introduction

Definition of Intellectual Disability

Epidemiology

Etiological Considerations

Behavioral Phenotypes

Intellectual Disability and Comorbid Psychopathology

Approach to Maladaptive Behavior

Treatment

The Child Psychiatrist as Consultant

References

Chapter 23: Movement Disorders: Tics and Tourette's Disorder

Introduction

Classification and Clinical Phenomenology

Clinical Course

Epidemiology

Psychiatric Comorbid Disorders

Genetic Findings

Etiology and Pathophysiology

Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus (PANDAS)

Differential Diagnosis

Clinical Evaluation

Treatment

Summary

References

Chapter 24: Psychotic Disorders

Introduction

Historical Perspective

Prevalence and Epidemiology

Clinical Description: Premorbid Functioning

Symptoms of Schizophrenia

Etiology

Assessment

Differential Diagnosis

Treatment

Outcome

Ultra-High-Risk Syndrome

References

Chapter 25: Neuropsychological Assessment and the Neurologically Impaired Child

Introduction

General Principles

Methods of Assessment

Childhood Neurological Disorders

Neuropsychological Management

Summary

References

Chapter 26: The Somatoform Disorders

Overview

Pain Disorders

Conversion Disorders

Somatization and Undifferentiated Somatoform Disorders

Body Dysmorphic Disorder

Treatment of Somatoform Disorders

Conclusion

References

Chapter 27: Sleep Disorders

Introduction

Normal Sleep

Dreams

Sleep Hygiene

Problems of Childhood Sleep

Sleeplessness in Childhood and Adolescence: Cognitive and Emotional Consequences

References

Section IV: Special Problems in Child and Adolescent Psychiatry

Chapter 28: Loss: Divorce, Separation, and Bereavement

Introduction

Separation/Divorce

Bereavement

Differential Diagnosis

Treatment

References

Chapter 29: Foster Care and Adoption

Foster Care

Adoption

Controversies in Foster Care and Adoption

Conclusion

Acknowledgement

References

Chapter 30: Child Psychiatry and the Law

Introduction

Legal Issues in the Treatment of Minors

Child Abuse and Neglect

Disabled Children

Children as Plaintiffs and Witnesses

Divorce and Child Custody

Juvenile Courts and Juvenile Delinquency

The Child Psychiatrist in Court

References

Index

Companion website

The book is accompanied by a companion resources site:

clinicalchildpsychiatry.com

With interactive multiple-choice questions for each chapter.

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Library of Congress Cataloging-in-Publication Data

Clinical child psychiatry / editors, William M. Klykylo and Jerald L. Kay. – 3rd ed.

p.; cm.

Includes bibliographical references and index.

ISBN 978-1-119-99334-6 (pbk.) – ISBN 978-1-119-96221-2 (ePDF) – ISBN 978-1-119-96222-9 (oBook) – ISBN 978-1-119-96770-5 (ePub) – ISBN 978-1-119-96771-2 (Mobi)

I. Klykylo, William M. II. Kay, Jerald.

[DNLM: 1. Adolescent Psychiatry–methods. 2. Child Psychiatry–methods. 3. Adolescent. 4. Child. 5. Developmental Disabilities. 6. Infant. 7. Mental Disorders. WS 350]

616.8900835–dc23

2011038027

Dedication

To our teachers, our students, our patients, and our families.

Contributors

Rick T. Bowers, South Community Behavioral Healthcare, 3095 Kettering Blvd, Dayton, OH 45439, USA

L. Lee Carlisle, Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Child Study and Treatment Center, 8805 Steilacoom Boulevard SW, W27-25, Lakewood, WA 98498-4771, USA

Christina C. Clark, Psy.D., LLC, 666 High Street, Suite 200D, Worthington, OH 43085-4135, USA

Barbara J. Coffey, Child Study Center, New York University School of Medicine, 577 First Avenue, New York, NY 10016, USA

Antoinette S. Cordell, PhD and Associates, 5045 N. Main Street, Suite 223, Dayton, OH 45415, USA

Jacqueline Countryman, Department of Psychiatry, Wright State University School of Medicine, 627 S. Edwin C Moses Blvd, P.O. Box 927, Dayton, OH 45401-0927, USA

Jennifer Couturier, Department of Psychiatry & Behavioural Neurosciences, McMaster University, 200 Main Street W., Hamilton, Ontario, L8N 3Z5, Canada

Sergio V. Delgado, Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA

David Ray DeMaso, Department of Psychiatry, Children's Hospital of Boston, Hunnewell 121, 300 Longwood Ave., Boston, MA 02115, USA

Craig L. Donnelly, Section of Pediatric Psychopharmacology, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756-0001, USA

Martin J. Drell, LSUHSC, Department of Psychiatry, Room A 236, 1542 Tulane Avenue, New Orleans, LA 70112, USA

James H. Duffee, Rocking Horse Center, 651 South Limestone Street, Springfield, OH 45505, USA

Jennifer P. Edidin, Department of Psychiatry & Behavioral Neuroscience, The University of Chicago, 5841 S. Maryland Avenue., MC 3077, Chicago, IL 60637, USA

Sidney Edsall, Department of Psychiatry, Stanford University, 401 Quarry Road, Palo Alto, CA 94305

Dorothyann Feldis, College of Education, 600 E Teacher's College, University of Cincinnati, PO Box 210022, Cincinnati, OH 45221-0022, USA

Scott D. Grewe, Sage View Youth Psychology, 1950 Keene Road, Bldg. O, Richland, WA 99352, USA

Pamela A. Gulley, 640 Concord Village Circle, Johnston, OH 43031, USA

Julia Huemer, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria

Scott J. Hunter, Department of Psychiatry & Behavioral Neuroscience, The University of Chicago Medical Center, 5841 S. Maryland Avenue, MC 3077, Chicago, IL 60637, USA

Patricia I. Ibeziako, Department of Psychiatry, Children's Hospital of Boston, Hunnewell 121, 300 Longwood Ave., Boston, 02115, USA

Julia Jackson, Department of Psychiatry, Wright State University, School of Medicine, PO Box 927, Dayton, OH 45401-0927, USA

Niranjan S. Karnik, Department of Psychiatry and Behavioral Sciences, The University of Chicago, 5841 S. Maryland, MC 3077, Chicago, IL 60637, USA

Tejal Kaur, Division of Cognitive Neuroscience, Columbia University, 622 W. 168th Street, PH1291, New York, NY 10032, USA

Jerald Kay, Department of Psychiatry, Wright State University School of Medicine, P.O. Box 927, Dayton, OH 45401-0927, USA

Young Shin Kim, Associate Professor, Yale University Child Study Center, Nieson-Irving Harris Blvd., 230 S. Frontage Road, I-379, New Haven, CT 06519, USA

Bryan H. King, University of Washington and Seattle Children's Hospital, 4800 Sand Point Way, NE, PO Box 5371/M1-1, Seattle, WA 98105, USA

Bonnie Klimes-Dougan, University of Minnesota, N414 Elliott Hall, 75 East River Road, Minneapolis, MN 55455-0344, USA

William M. Klykylo, Department of Psychiatry, Wright State University School of Medicine, 627 S. Edwin C Moses Blvd, P.O. Box 927, Dayton, OH 45401-0927, USA

Kevin Lam, NYU Child Study Center and Bellevue Hospital Center, 577 First Avenue, New York, NY 10016, USA

Bennett L. Leventhal, Deputy Director, Nathan Kline Institute for Psychiatric Research (NKI), 140 Old Orangeburg Road, Bldg 35, Orangeburg, NY 10962, USA

James Lock, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, MC 5719, Stanford, CA 94305-5719, USA

Arthur Maerlender, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03757, USA

Ryan C. Mast, Department of Psychiatry, Wright State University School of Medicine, 627 S. Edwin C Moses Blvd, P.O. Box 927, Dayton, OH 45401-0927, USA

Jill D. McCarley, East Tennessee State University, Quillen College of Medicine, PO Box 70567, Johnson City, TN 37614, USA

Brian J. McConville, Department of Psychiatry, University of Cincinnati College of Medicine, 2444 Madison Road, #1105, Cincinnati, OH 45208-1225, USA

Douglas Mossman, University of Cincinnati College of Medicine, Dept. of Psychiatry, 260 Stetson Street, Suite 3200, PO Box 670559, Cincinnati, OH 45267-0559, USA

Susan C. Mumford, Department of Psychiatry, Wright State University School of Medicine, 627 S. Edwin C Moses Blvd, P.O. Box 927, Dayton, OH 45401-0927, USA

Thomas B. Owley, Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, 1747 W. Roosevelt Road, Chicago, IL 60608, USA

George Realmuto, Department of Psychiatry, University of Minnesota, F256/2B West, 2450 Riverside Avenue, Minneapolis, MN 55454-1495, USA

Jesse C. Rhoads, Section of Pediatric Psychopharmacology, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756-0001, USA

David M. Rube, Queen's Children's Psychiatric Center, 74-03 Commonwealth Blvd, Bellrose, NY 11426, USA

Lori A. Sansone, Wright-Patterson Air Force Base, 88 MDOS/SGOPC, 4881 Sugar Maple Drive, WPAFB, OH, 45433, USA

Randy A. Sansone, Sycamore Primary Care Center, 2115 Leiter Road, Suite 300, Miamisburg, OH 45342-3659, USA

Martin B. Scharf, Center for Research in Sleep Disorders, 1275 East Kemper Road, Cincinnati, OH 45237, USA

Andrew B. Smith, Department of Psychiatry, Wright State University School of Medicine, 627 S. Edwin C Moses Blvd, P.O. Box 927, Dayton, OH 45401-0927, USA

Jamie Snyder, Child and Adolescent Psychiatry and Post-Pediatric Portal Program, Creighton University/University of Nebraska Training Programs, 3500 S. 91st Street, Lincoln, NE 69520-1429, USA

Michael T. Sorter, Cincinnati Children's Hospital Medical Center, University of Cincinnati, 3333 Burnet Avenue, M.L. 3014, Cincinnati, OH 45229, USA

Hans Steiner, Department of Psychiatry and Behavioral Sciences; Child and Adolescent Psychiatry Clinic, Stanford University School of Medicine, 401 Quarry Road, MC 5719, Stanford, CA 94305-5719, USA

Russell Tobe, Medical Director, Outpatient Research Department, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA

Daniel A. Vogel, Cincinnati Children's Hospital Medical Center, 3333 Burnet avenue, MI 3014, Cincinnati, OH 45229-3014, USA

Christine V. Wellborn, Education Director, Tri-State Sleep Disorders Center, 1275 East Kemper Road, Cincinnati, Ohio 45246, USA

Christina G. Weston, Department of Psychiatry, Wright State University, School of Medicine, PO Box 927, Dayton, OH 45401-0927, USA

Keith Owen Yeates, Department of Psychology, The Ohio State University, and Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, 700 Children's Dr., Columbus, OH 43205, USA

Preface To Clinical Child Psychiatry, Third Edition

In the preface to the first edition of this work, we stated that the changes in child psychiatry occurring then would have been barely imaginable 15 years earlier. In the preface to the second edition, we remarked that we could not have predicted then how much the whole world would change thereafter. The subsequent world crises have only intensified the demands placed upon child and adolescent psychiatry. We have ever growing demands for service to our patients, whose stressors and pathology become more severe and pervasive. We are fortunate that our understanding of disease and our armamentarium of treatments also continue to increase. Regrettably, the resources allocated for those treatments have not always grown apace; so we must continue to do more with less and do so ever more quickly and efficiently.

The welcome growth of knowledge in our field continues to change clinical practice, creating a need for an update of this book. Like its predecessors, Clinical Child Psychiatry, Third Edition is presented neither as a comprehensive textbook covering the entire field, nor as a brief introduction. It still attempts to serve as a focused study of major problems, challenges, and practices commonly encountered in clinical work. It remains directed toward experienced clinicians encountering new areas of practice, as well as to students and residents entering the field. We especially hope that pediatricians and family physicians, who throughout the world provide the preponderance of child psychiatric services, will find this volume useful. We also wish it to be informative to professionals outside of medicine as an overview of what child psychiatry can – and should – do today. As always, but in these times especially, we must work together as best we can.

Whatever its merits, Clinical Child Psychiatry, Third Edition is the product of the individuals' efforts. We have been well served by our publisher John Wiley & Sons, Ltd, and especially by our Project Editor Fiona Seymour, our Associate Editor Robyn Lyons, and our Publisher Joan Marsh. They bring to their work an enviable combination of knowledge, experience, patience, and good humor that has encouraged and sustained us. We could not have assembled this book without the support of our staff at Wright State University Boonshoft School of Medicine, most notably Laura Johnson and Megan McKenzie. Our contributors are the ultimate source of this volume's content and value, and we are in their debt. Finally, our families continue to support us with their affection and patience.

William M. KlykyloJerald Kay

Section I

The Fundamentals of Child and Adolescent Psychiatric Practice

1

The Initial Psychiatric Evaluation

William M. Klykylo

This chapter is an introduction both to this textbook and to the approach of patients and families in child and adolescent psychiatric practice. Child and adolescent psychiatrists should be broadly trained clinicians able to address a variety of somatic, psychologic, and social needs of the patient and family. Their approach should combine the caution and competence required of a physician treating an individual patient with a broad concern for that patient's development in the context of family, school, and society. This textbook provides an overview of child and adolescent psychiatric practice while focusing on the more common areas of clinical practice. As such, it should serve the established practitioner as a rapid and accessible introduction to unfamiliar areas by taking into account the ever-expanding breadth of clinical practice. For general readers or students in professions other than medicine, this book will serve as an introduction to both the assessment and management of some commonly encountered clinical entities and to the range and standards of practice expected of a contemporary child and adolescent psychiatrist. There are currently about 6000 child psychiatrists in some sort of clinical practice in the United States, whereas there are between 7 and 12 million children with psychiatric illnesses, as identified by Diagnostic and Statistical Manual, Fourth Edition, Text Revision (DSM-IV-TR) criteria [1, 2]. The median prevalence estimate of functionally impairing child and adolescent psychiatric disorders is 12%, although the range of estimates is wide. Disorders that often appear first in childhood or adolescence are among those ranked highest in the World Health Organization's estimates of the global burden of disease [3]. Most of these children will not see a child and adolescent psychiatrist and, in many instances, the parents, teachers, and other professionals attempting to serve them may be unaware of the contribution that child and adolescent psychiatry can make to the child's care.

The traditional roles of child and adolescent psychiatrists are those of diagnostician, therapist, and consultant. First, child and adolescent psychiatrists should offer a child and family a comprehensive diagnostic assessment that addresses the medical condition of the child; delineates the child's emotional, cognitive, social, and linguistic development; and identifies the nature of the child's relationship with his or her family, school, and social milieu.

Second, child and adolescent psychiatrists as physicians treat illnesses, using an armamentarium of somatic treatments and the more traditional skills of individual, family, and group psychotherapists. Because of the breadth of training they receive, child and adolescent psychiatrists should have special skill in appreciating the interaction among these therapies and their effects on one another and on the child and family.

Finally, in many cases, child and adolescent psychiatrists will serve as consultants. This role is more developed in our specialty than in most other areas of medicine because of the constant disproportion between the number of patients and the number of clinicians. Inevitably, we consult and collaborate with parents, educators, and other professionals who may see the child and family more frequently and intensively than we do; because of the breadth of our training, we should offer a special competence in coordinating these efforts. Concurrent with this role, we often must serve as advocates for children and their families in today's environment of great clinical needs and comparatively limited resources.