CHILD PSYCHATRIC DISORDERS pptx

CHILD PSYCHATRIC DISORDERS

1. CHILD PSYCHATRIC DISORDERS MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

2. CHILD PSYCHATRIC DISORDERS M ental health problems in children that affect their thinking, emotions, behavior, and social life . They interfere with school performance, friendships, and family life. Child Psychiatric Disorders are- Childhood sc hizophrenia Childhood depression Conversion reaction Posttraumatic stress disorder Autistic spectrum disorder

3. 1-CHILDHOOD SCHIZOPHERNIA MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

4. CHILDHOOD SCHIZOPHERNIA Childhood schizophrenia is a rare but serious mental disorder in children under 13 years of age , where the child has problems in thinking, emotions, and behavior . They lose touch with reality and may see, hear, or believe things that are not real. MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

5. CAUSES 1. Genetic factors If parents or close relatives have schizophrenia, the child has a higher risk . Genes affect the way the brain chemicals (like dopamine) work. This imbalance makes it harder for the child to think clearly → may lead to schizophrenia. MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

6. 2. Drug abuse- Harmful drugs (like cannabis, LSD ( Lysergic acid diethylamide ) , or other hallucinogens) disturb brain chemicals . In some children, this can trigger abnormal thinking and hallucinations , especially if they already have a family history of schizophrenia. MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

7. 3. Obstetric complications- Problems during pregnancy or birth (e.g., lack of oxygen, low birth weight, maternal infection). These can damage brain development in the baby. Later, the child may develop schizophrenia because the brain didn’t grow normally. MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

8. 4. Parents & family characteristics- A stressful or unhealthy home environment (violence, neglect, constant fights). This stress can make symptoms worse in a child who is already at risk. Doesn’t directly “cause” schizophrenia, but acts as a trigger . MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

9. 5. Brain structure problems- Some children have abnormalities in brain areas like the frontal lobe, hippocampus, or amygdala. These areas control thinking, memory, and emotions . If they don’t work properly → the child may lose touch with reality. MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

10. SIGN AND SYMPTOMS Hearing voices or seeing things not real ( hallucinations ) Strange beliefs or confused thinking ( delusions ) Odd or unusual behavior, lack of emotions Poor school performance Trouble making friends Difficulty in daily activities MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

11. DIAGNOSTIC TEST 1. Medical Evaluation- Physical exam → to check overall health. Blood tests & urine tests → to rule out drug use or other illnesses. Brain scans (CT or MRI) → to see if there are brain structure problems or tumors. 2-Psychological Tests- Tests for thinking, memory, attention, and learning ability . Helps to find out if symptoms match schizophrenia or another disorder. 3-Ruling out Other Disorders- Autism spectrum disorder Depression or bipolar disorder ADHD or conduct disorder Substance/drug use MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

12. MANAGEMENT 1-Medical Management (Medications)- Antipsychotic medications are the main treatment. Examples: Risperidone, Aripiprazole (commonly used in children). Goals: Reduce hallucinations, delusions, disorganized thinking, aggression . 2-Psychosocial Interventions- Cognitive Behavioral Therapy (CBT) Helps children cope with hallucinations or unusual thoughts. Social skills training Improves interaction with peers and adults. Family therapy Teaches family how to manage symptoms, reduce stress, and improve communication . MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

13. 3-Monitoring and Follow-Up- Regular follow-up with psychiatrist to adjust medications . Monitor growth, development, and social progress. Watch for relapse signs : withdrawal, aggression, unusual thoughts. 4-Supportive Measures- Encourage hobbies and interests. Build friendships and peer support gradually. Educate parents about realistic expectations and self-care. MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

14. 2-CHILDHOOD DEPRESSION MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

15. CHILDHOOD DEPRESSION Childhood depression is a mental health disorder in which a child has a persistent sad or irritable mood, loss of interest in activities, and changes in behavior, sleep, or appetite that interfere with daily life.” MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

16. CAUSES 1- Genetic – i f parents or close relatives have depression, the child is at higher risk because of inherited genes. The child’s body may also not balance “happy chemicals” (like serotonin, dopamine) properly. MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

17. 2-Neurostructural – Structural or functional changes in the child’s brain. Abnormalities in the frontal lobe, hippocampus, affect emotions and thinking. Frontal lobe → controls thinking and decision-making . If it doesn’t work well → child has confused or negative thoughts . Hippocampus → stores memories . If affected → child remembers sad events more and feels low. MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

18. 3-Psychological – p roblems related to thoughts, emotions, and past experiences. Stress (exam pressure, bullying, rejection) → makes the child feel helpless or hopeless. Low self-esteem → child thinks “I’m not good enough,” leading to constant sadness. Trauma (loss of parent, abuse, neglect) → leaves emotional scars and feelings of fear, loneliness, or worthlessness . MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

19. 4-Environmental – Family problems (divorce, constant fights, domestic violence) make the child feel insecure. School pressure (too much study load, bullying, peer rejection) leads to stress and sadness MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

20. SIGN AND SYMPTOMS P ersistent sadness or low mood Irritability or anger (child gets upset easily) Feeling worthless or guilty Loss of interest in play, studies, or hobbies Hopelessness (“nothing will get better”) Withdrawal → avoids friends, family, or social activities Poor school performance Crying easily or often Lack of energy or motivation May talk about death or suicide (in severe cases) Changes in sleep (sleeps too much or too little) Changes in appetite/weight (eats more or less than usual) MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

21. DIAGNOSTIC TEST 1-Often underdiagnosed in children- Parents and teachers may think the child is just “moody,” “lazy,” or “naughty,” instead of seeing it as a mental health problem. 2-Children may be unable to express their feelings- Instead of saying “I feel sad,” they may show it through anger, irritability, crying, or poor performance in school . 3-Sometimes misdiagnosed as conduct disorder- Conduct disorder means a child shows aggressive, disobey, or rule-breaking behavior . Depressed children may also behave like this (e.g., refusing to go to school, being irritable, breaking rules). 4-May be masked by other mental illnesses- Depression can occur together with other problems like anxiety, ADHD, or learning disabilities . MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

22. MANAGEMENT 1. Medications – SSRIs (e.g., Fluoxetine / Prozac)- SSRIs are a type of medicine that balances brain chemicals like serotonin. They help reduce sadness, irritability, and hopelessness in depressed children. 2. Psychotherapy (Talk therapy / Cognitive-behavioral therapy)- A trained therapist talks with the child about their feelings and problems . The child learns how to think positively, manage stress, and change negative thoughts . 3. Active Listening- Parents, teachers, or caregivers give the child time and attention . They listen carefully without judging, so the child feels understood and supported . This makes the child feel less lonely and more confident . 4-Family therapy - improves home environment. MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

23. 3-CONVERSION REACTION MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

24. CONVERSION REACTION Conversion reaction happens when stress or emotional problems "convert" into physical problems like blindness, paralysis, or fits — but without actual physical damage. OR A condition in children where emotional stress or psychological conflict shows up as physical problems (like paralysis, fits, or blindness) without any physical disease . MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

25. CAUSES 1-Stress at home or school (strict parents, exams, bullying)- Child feels too much pressure or fear . The mind cannot handle the stress, so it sends the problem to the body. Example: child may faint on exam day or stop talking after being scolded . MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

26. 2-Family conflicts or broken family- Fighting parents or separation makes child feel unsafe and anxious . The child cannot express feelings, so stress comes out as body problems (like paralysis, mutism). MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

27. 3-Desire for attention (from parents/teachers)- If child feels ignored, the mind creates symptoms (fits, fainting) so that everyone gives care. This is not acting — it’s an unconscious way to get love and attention. MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

28. 3-Fear of punishment or failure- Child is afraid of scolding or failing in studies. The body shows illness (like “sudden blindness” or “can’t walk”) to escape the stressful situation. Example:- child gets paralysis-like symptoms before an exam to avoid going. MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

29. 4-Copying behavior (learned from seeing illness in others)- Children learn by watching. If they see someone sick (like seizures or paralysis), their mind may produce the same symptoms during stress. MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

30. SIGN /SYMPTOMS Child suddenly cannot walk, move hand or leg. Cannot speak (mute) or hear. Seizure-like attacks (fits) but test reports normal. Blindness (cannot see) but eyes are healthy. Symptoms mostly start after some stress (like exam or scolding) MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

31. DIAGNOSTIC TEST There is no specific medical test for conversion disorder, because the body is healthy. But doctors do some tests to rule out real physical or neurological disease . 1. History & Clinical Examination- Detailed history of stress, school/family problems. Sudden start of symptoms after stress (exam, scolding). 2. Neurological Tests (to rule out disease)- EEG (Electroencephalogram): Normal in conversion fits (different from epilepsy). CT scan / MRI brain: Normal (rules out tumor, injury, etc.). 3. Physical Examination- Muscle tone, reflexes, vision, hearing checked. No real damage found (e.g., child says “blind,” but eye exam normal) MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

32. MANAGEMENT 1. Reassure the child- Children think something is very wrong with their body. Nurse/doctor should calmly say: “Don’t worry, you will be fine.” This reduces fear and stress immediately. Never say “you are pretending.” MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

33. 2. Counseling / Play therapy- Children cannot always explain feelings with words. Through counseling (talking) and play therapy (games, drawing), they express hidden fears. Example:- a child scared of exams may show it in play. MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

34. 3. Family help- Parents should give love and support instead of scolding. Reduce pressure of studies or expectations. Stop giving extra attention to symptoms (otherwise child may continue). Maintain a peaceful home environment. MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

35. 4. School help- Teachers should be friendly and supportive. Reduce heavy stress from exams or strict punishment. Encourage the child in a positive way. Create a safe, relaxed classroom environment. MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

36. 5. Medicines- Usually not needed because the body has no real disease. Only used if the child also has severe anxiety or depression . In such cases, doctor may give mild antidepressants or anti-anxiety medicines . MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

37. 4-POSTTRAUMATIC STRESS DISORDERS MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

38. POSTTRAUMATIC STRESS DISORDERS PTSD is a mental health problem that happens after a child goes through or sees a very scary, painful, or life-threatening event (such as accident, abuse, disaster, or violence). MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

39. CAUSES Accidents (car crash, burns, serious injury) Natural disasters (earthquake, flood, cyclone) Abuse (physical, sexual, emotional) Witnessing violence or death Loss of parent or close family member MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

40. SYMPTOMS 1-Re-experiencing Nightmares or flashbacks Gets very upset when reminded of trauma 2-Avoidance Avoids places, people, or things that remind of the event Refuses to talk about what happened 3-Negative mood changes Fear, sadness, anger, guilt Feels nobody understands Loses interest in play, friends, or school 4-Increased alertness (Hyperarousal) Trouble sleeping Easily startled (jumps at loud noise) Cannot concentrate in school Irritable, aggressive, or restless MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

41. DIAGNOSTIC TEST 1. Based on history of trauma Doctor/nurse asks about any past traumatic event (accident, abuse, violence, disaster, death in family). Parents, teachers, or child (if able) tell what happened. Important because without a trauma history, PTSD cannot be confirmed . 2. Observation of behavior and emotional changes Child’s actions and feelings are carefully noted. Examples: Nightmares, fearfulness Avoids school or people Aggressive or restless Sudden drop in studies MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

42. 3. Psychological tests may be used Psychologists use special questionnaires or interviews to check child’s thinking, memory, mood, and fears. Examples: Child PTSD Symptom Scale (CPSS) Trauma Symptom Checklist for Children (TSCC) These tests help confirm if symptoms match PTSD. 4. Rule out other conditions Symptoms of PTSD can look similar to other disorders, so doctors make sure it is not something else Depression Anxiety disorders ADHD Careful history and testing help separate PTSD from these . MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

43. MANAGEMENT 1- Reassurance & Support-- Make child feel safe and protected Provide love and stable environment 2-Counseling / Psychotherapy Cognitive Behavioral Therapy (CBT) → helps child talk about fears, change negative thoughts Play therapy → child expresses feelings through play Family therapy → teaches parents how to support child 3-School help- Teachers provide a friendly, stress-free environment Reduce pressure in studies 4-Medicines- Usually not needed in mild cases In severe cases (with depression, anxiety, or sleep problems) – antidepressants or anti-anxiety medicines may be prescribed by doctor MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

44. AUTISM SPECTRUM DISORDER (ASD) MS. ANEETA SHARMA NURSING LECTRUR (CHILD HEALTH NURSING)

45. AUTISM SPECTRUM DISORDER (ASD) Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that affects how a child communicates, behaves, and interacts with others. It is called a spectrum because symptoms and severity vary widely from child to child. MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

46. CAUSES / RISK FACTORS Genetic history – Autism is heritable , meaning it can run in families. If one child has autism, there is a higher chance that siblings may also develop it. SHANK3 → important for synapse structure; mutations cause severe social and communication problems. MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

47. 2. Environmental Factors – Advanced parental age (older mother or father) → increases chances of genetic changes in egg or sperm, which may affect the child’s brain development. Pregnancy complications (infections, exposure to certain drugs, poor nutrition, diabetes, high blood pressure in mother) → can interfere with normal brain growth. Birth complications (lack of oxygen, low birth weight, premature delivery) → may damage brain areas important for language and behavior. MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

48. 3. Brain Development Differences – abnormal connectivity between brain regions. Some areas are over-connected (leading to repetitive behaviors). Others are under-connected (causing poor communication and social skills). MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

49. CLINICAL FEATURES OF ASD A-Early signs (< 3 years): - delayed speech poor response to name lack of eye contact/gestures prefers to play alone. B-School age (3–12 years):- difficulty making friends repetitive behaviors (hand flapping, rocking) insists on routines unusual interests, echolalia. MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

50. C-Adolescence/adulthood: - social communication problems continue restricted interests persist may develop compensatory skills sometimes associated with anxiety/depression. MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

51. DIAGNOSTIC TEST 1. Developmental Screening Tools (early detection)- Doctors watch how the child communicates, plays, and behaves. Parents give information about early milestones (speech, social skills, routines). MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

52. 2-Diagnostic Tools- ADOS (Autism Diagnostic Observation Schedule): Standard test where the child is observed during activities to check social interaction, communication, and play. ADI (Autism Diagnostic Interview): A structured interview with parents about the child’s early development and current behavior. 3-Ruling Out Other Conditions Hearing problems (child may not respond due to deafness, not autism). Intellectual disability (learning delays may look similar). ADHD (inattention or hyperactivity may overlap with autism signs). Anxiety disorders (social withdrawal may be due to anxiety, not autism). MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

53. MANAGEMENT 5 Ts of Autism Management 1-Therapy early – Early intervention gives best results Example: Starting therapy at age 2–3 years → better speech, social skills later. 2-Training (Behavioral therapy – ABA, TEACCH) – Improve social & learning ABA (Applied Behavior Analysis): Rewarding the child for making eye contact or saying a word. TEACCH (Treatment and Education of Autistic and related Communication-handicapped Children): Using visual schedules, structured classroom routines. MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

54. 3-Talking (Speech therapy) – For communication Example: Teaching child to use PECS (Picture Exchange Communication System) , sign language, or improving pronunciation. 4-Touch & daily skills (Occupational/Sensory therapy) – Helps in daily life Example: Practicing how to button a shirt, holding a pencil, brushing teeth, managing sound/light sensitivity. 5-Medicines if needed – Not for core autism, only for associated problems Irritability/aggression: Risperidone, Aripiprazole Hyperactivity/impulsivity: Methylphenidate Anxiety/obsession: SSRIs (e.g., Fluoxetine) MS. ANEETA SHARMA NURSING LECTURER (CHILD HEALTH NURSING)

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