Update in Pediatric Psychiatry
More than 50% of psychiatric illnesses that cause morbidity and mortality in adulthood have their onset in childhood and adolescence. Moreover greater than 20% of children and youth have a diagnosable psychiatric illness at any time with the majority meeting criteria for more than one. Furthermore, many children and youth have identifiable subsyndromal symptoms of illness that cause distress and impairment, warranting attention and heralding the potential for worsening to full blown manifestation of disorder. Recognizing that most psychiatric illnesses are neurodevelopmental in nature and fit within a clinical staging framework is essential. In this framework symptom severity exists on a fluid continuum from normal variant to full manifestation of illness. Understanding where the youth’s presentation fits within this process is essential to fostering accurate and reliable identification of illness manifestation. This new concept underscores the exciting potential for clinicians working in the field of child and adolescent psychiatry for early identification, intervention and possible prevention of morbidity associated with psychiatric illnesses. The new organisation of the DSMV reflects this approach to illness development aiding the curious clinician in making appropriate diagnostic decisions. Outlined are some of the clinical updates regarding psychiatric disorders that present in childhood and adolescence that are in keeping with the new framework. Information presented should be used in conjunction with the DSMV (or other accepted psychiatric diagnostic guide) to enable clinicians to make decisions that foster optimum care for their young patients.
KeywordsChildhood Adolescent Psychiatric illness Early intervention Pharmacotherapy Clinical update Mental health Clinical care Pediatric psychiatry ADHD Anxiety Depression Psychosis Addictions
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