- Last edited on April 30, 2020
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teaching:child-adol-psych-interview [on April 25, 2020] |
teaching:child-adol-psych-interview [on October 19, 2020] (current) |
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{{INLINETOC}} | {{INLINETOC}} | ||
===== Primer ===== | ===== Primer ===== | ||
- | == Key Questions == | + | The **Child and Adolescent Psychiatry Interview** is a specialized [[teaching:1-psych-interview|psychiatric interview]] tailored to children and adolescents. It requires a particular focus on psychosocial factors. |
- | * Who are the family members present? | + | |
- | * Does the child have any Individualized Education Plans? | + | ===== Timeline of Childhood Disorders ===== |
- | * Have they had a psychoeducational assessment? When? By whom? | + | When doing a child and adolescent assessment, it is very important to keep in mind the age of the child, and the likelihood disorders occurring at that particular age. |
- | * Report card comments? | + | |
- | <WRAP group> | + | <imgcaption image1|>{{:teaching:core:emergence-childhood-disorders.png?direct&900|Timeline of the emergence of childhood psychiatric disorders by age}}</imgcaption> |
- | <WRAP half column> | + | |
- | ==== HPI ==== | + | ===== Patient ID ===== |
+ | * Age | ||
+ | * Home/Living with | ||
+ | * Grade/School | ||
+ | * Part time jobs | ||
+ | * Religious affiliation | ||
+ | ===== History of Presenting Illness (HPI) ===== | ||
+ | ==== Depression ==== | ||
* Depression | * Depression | ||
* Don't forget to ask about irritability, which is common in children and adolescents | * Don't forget to ask about irritability, which is common in children and adolescents | ||
* When asking about appetite and weight, also ask about body image and intentional weight loss to screen for eating disorders | * When asking about appetite and weight, also ask about body image and intentional weight loss to screen for eating disorders | ||
- | ==== Social History ==== | + | ==== Anxiety and Panic ==== |
- | * **School** | + | <alert icon="fa fa-arrow-circle-right fa-lg fa-fw" type="success">See main article: **[[anxiety:home|]]**</alert> |
- | * Grades | + | |
- | * Favourite Subject | + | |
- | * Homework | + | |
- | * Teachers | + | |
- | * **Social** | + | |
- | * Bullying? | + | |
- | * Friends | + | |
- | * Social Media | + | |
- | * Relationships (Sexual/Romantic) | + | |
- | * **Home** | + | |
- | * Siblings | + | |
- | * Parents | + | |
- | * Are conflicts common? | + | |
- | * **Self** | + | |
- | * Feelings | + | |
- | * "What are the main feelings you usually feel?" (happy, sad, angry, anxious, irritable) | + | |
- | * (lead to) Behaviours | + | |
- | * "What do you do when you have these feelings?" (self-harm, externalized behaviours (e.g. - acting out, truancy, disruptive), internalized behaviours (e.g. - rumination) | + | |
- | * What are your strengths? (Can ask both the parents or the child) | + | |
- | ==== Neurodevelopmental History ==== | + | Anxiety symptoms and disorders are common in children, and are often part of the normal neurodevelopmental history. |
- | * Age of parents at conception | + | |
- | * Illnesses in pregnancy | + | |
- | * Substance use during pregnancy | + | |
- | * Toxin exposure | + | |
- | * Birth term | + | |
- | * Delivery complications | + | |
- | * Growth charts | + | |
- | ==== Pubertal history ==== | + | ==== Psychosis ==== |
- | * Age of menarche | + | |
- | * Regular/irregular menstrual cycles | + | |
- | ==== Medical ==== | + | ==== Mania ==== |
- | * History of seizures, recurrent infections, easy bruising/blood clots, tumours/growth, muscle pains/arthritis, or any other diagnosed medical conditions | + | Childhood bipolar disorder is overdiagnosed. |
- | ==== Family History ==== | + | ==== OCD ==== |
- | * Psychiatric (bipolar disorder, schizophrenia, completed suicide/suicide attempt), seizures/epilepsy, Parkinson's, dementia, other cancers, birth defects, infertility, known genetic conditions | + | <alert icon="fa fa-arrow-circle-right fa-lg fa-fw" type="success">See main article: **[[ocd:1-ocd|]]**</alert> |
- | </WRAP> | + | OCD can present commonly in childhood. |
- | <WRAP half column> | + | |
- | == Oppositional Defiant Disorder == | + | ==== ADHD ==== |
+ | <alert icon="fa fa-arrow-circle-right fa-lg fa-fw" type="success">See main article: **[[child:adhd|]]**</alert> | ||
+ | ==== Oppositional Defiant Disorder ==== | ||
* Loses temper | * Loses temper | ||
* Argues with adults | * Argues with adults | ||
* Defies or refuses | * Defies or refuses | ||
* Deliberately annoys | * Deliberately annoys | ||
- | |||
* Blames others | * Blames others | ||
* Touchy or easily annoyed | * Touchy or easily annoyed | ||
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* Spiteful | * Spiteful | ||
- | == Medical History == | + | ==== Eating Disorders ==== |
- | * Hearing, vision, or cardiac problems? | + | <alert icon="fa fa-arrow-circle-right fa-lg fa-fw" type="success">See main article: **[[eating-disorders:home|]]**</alert> |
+ | It is important to screen for eating disorders in children and adolescents, as there high prevalence and high mortality with eating disorders. | ||
- | == Family Psychiatric History == | + | ==== Safety ==== |
- | * Sudden Unexplained Deaths (SIDS?) | + | * Suicide/homicide |
- | * Congenital Cardiac Malformations? | + | * Cutting and self-harm |
+ | * Trauma or abuse from adults at home/school/other | ||
+ | ===== Social History ===== | ||
+ | In the social history, you need to get an understanding of the child's relationship with their family, school, friends, extracurricular activities, and any ongoing stressors. | ||
- | == Development == | + | ==== School ==== |
- | * Developmental Milestones? | + | * Grades |
- | * How are things with family, school, friends, extracurricular activities, stressors? | + | * Favourite Subject |
+ | * Homework | ||
+ | * Teachers | ||
+ | * Does the child have any Individualized Education Plans? | ||
+ | * Have they had a psychoeducational assessment? When? By whom? | ||
+ | * Report card comments? | ||
+ | |||
+ | ==== Social ==== | ||
+ | * Bullying? | ||
+ | * Friends | ||
+ | * Social Media | ||
+ | * Relationships (Sexual/Romantic) | ||
+ | |||
+ | ==== Home ==== | ||
+ | * Who are the family members present? | ||
+ | * Siblings | ||
+ | * Parents | ||
+ | * Are conflicts common? | ||
+ | * What are the family dynamics at home? | ||
+ | |||
+ | ==== Self ==== | ||
+ | * Ask about feelings | ||
+ | * "What are the main feelings you usually feel?" (happy, sad, angry, anxious, irritable) | ||
+ | * Feelings -> (lead to) Behaviours | ||
+ | * "What do you do when you have these feelings?" (self-harm, externalized behaviours (e.g. - acting out, truancy, disruptive), internalized behaviours (e.g. - rumination) | ||
+ | * What are your strengths? (Can ask both the parents or the child) | ||
+ | |||
+ | ===== Legal History ===== | ||
+ | * Truancy | ||
+ | * Skipping school | ||
+ | |||
+ | |||
+ | ===== Neurodevelopmental History ===== | ||
+ | * Age of parents at conception | ||
+ | * Illnesses in pregnancy | ||
+ | * Substance use during pregnancy | ||
+ | * Toxin exposure | ||
+ | * Birth term | ||
+ | * Delivery complications | ||
+ | * Growth charts | ||
+ | * Developmental Milestones | ||
* What is the child/adolescent’s strengths? | * What is the child/adolescent’s strengths? | ||
- | </WRAP> | ||
- | </WRAP> | ||
- | ===== Timeline of Childhood Disorders ===== | + | ===== Medical ===== |
- | <imgcaption image1|>{{:teaching:core:emergence-childhood-disorders.png?direct&900|Timeline of the emergence of childhood psychiatric disorders by age}}</imgcaption> | + | * History of seizures, recurrent infections, easy bruising/blood clots, tumours/growth, muscle pains/arthritis, or any other diagnosed medical conditions |
+ | * Hearing, vision, or cardiac problems | ||
+ | |||
+ | ==== Pubertal History ==== | ||
+ | * Age of menarche | ||
+ | * Regular/irregular menstrual cycles | ||
+ | |||
+ | |||
+ | ===== Family History ===== | ||
+ | * Psychiatric (bipolar disorder, schizophrenia, completed suicide/suicide attempt) | ||
+ | * Seizures/epilepsy | ||
+ | * Birth defects | ||
+ | * Infertility | ||
+ | * Known genetic conditions | ||
+ | * Sudden Unexplained Deaths (SIDS?) | ||
+ | * Congenital Cardiac Malformations? | ||
===== Resources ===== | ===== Resources ===== | ||
- | * {{ :teaching:core:child_template_new.pdf |Consult Template}} | + | * [[http://www.drcheng.ca/styled-2/|Dr. Michael Cheng: Child and Adolescent Psychiatry for Medical Students]] |
{{tag>interview}} | {{tag>interview}} |