Childhood Mental Health and Development

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Questions and Answers

What are considered positive symptoms in older adults?

Change in financial status and loss of loved ones

Social withdrawal and poor sleep

Hallucinations and delusions (correct)

Impaired motivation and grief

What is a long-term side effect of lithium in older adults with BPAD?

Cardiac illness

Social withdrawal

Decreased kidney function (correct)

Increased risk of stroke

Which group has the highest likelihood of completing suicide among older adults?

Older females

Middle-aged individuals

Older males (correct)

Younger adults

What factor can increase the risk of falls in older adults taking medications?

Increased sedation Signup and view all the answers

What constitutes a diagnosis of dementia?

Significant difficulties in daily life due to cognitive impairment Signup and view all the answers

What condition accounts for 70% of dementia diagnoses?

Alzheimer's disease Signup and view all the answers

Which of the following is NOT considered a negative symptom in older adults?

Hallucinations Signup and view all the answers

What often triggers depression and anxiety in older adults?

Loneliness due to retirement Signup and view all the answers

What age range does the WHO define a child?

10-19 years Signup and view all the answers

Which mental health condition is NOT commonly associated with childhood?

Schizophrenia Signup and view all the answers

What is a significant risk factor for mental health struggles in older adults?

Loss of independence Signup and view all the answers

Which of the following behaviors is associated with adolescence and risk-taking?

Illicit substance use Signup and view all the answers

What is one of the primary indicators of potential mental health struggles in children?

School refusal Signup and view all the answers

Which impact of technology can negatively affect young people?

Exposure to cyberbullying Signup and view all the answers

Which of these conditions is most commonly seen in older adults?

Cognitive impairments Signup and view all the answers

What is a common emotional change during puberty that affects children?

Difficulty regulating emotions Signup and view all the answers

What percentage of people over 60 are predicted to experience a mental disorder?

15% Signup and view all the answers

Which of the following is NOT a feature of schizophrenia?

Depressive disorder Signup and view all the answers

What is the term for the difficulty in language associated with cognitive impairments?

Aphasia Signup and view all the answers

Which symptom is characterized by the inability to remember recent events or information?

Amnesia Signup and view all the answers

What impact does dementia typically have on a person's ability to communicate?

Creates confusion and memory impairment Signup and view all the answers

In providing care for patients with cognitive impairment, why is it important to know their preferences?

To make care planning easier and avoid frustration Signup and view all the answers

What is a key strategy for effective verbal communication with cognitively impaired patients?

Use short, simple sentences Signup and view all the answers

How does knowing your patient help in providing care?

Easier to build trust and rapport Signup and view all the answers

Which of the following is NOT a component of non-verbal communication to be aware of?

Written instructions Signup and view all the answers

What can happen when a cognitively impaired person is offered too many choices?

It leads to confusion Signup and view all the answers

What is a key characteristic of dementia in older adults?

Slow and progressive cognitive decline Signup and view all the answers

Which symptom is commonly associated with delirium?

Fluctuations in agitation Signup and view all the answers

What is essential when providing patient-centered care at the end of life?

Involving family and current care facility Signup and view all the answers

What can help reduce disorientation in a new environment for older adults?

Bright, contrasting colors in furniture Signup and view all the answers

How does the duration of depression typically manifest in older adults?

Mood changes over two weeks, often linked to life events Signup and view all the answers

Which of the following is NOT a common symptom of dementia?

Hallucinations Signup and view all the answers

What factor can influence a person's willingness to discuss mental illness?

The person's age and the age of the listener Signup and view all the answers

In which way is delirium different from depression in older adults?

Delirium has a reversible course when treated Signup and view all the answers

Study Notes

Childhood

WHO defines a child as someone aged 10-19 years old
Mental health services often expand this age range to 0-25 years old
10-20% of young people experience mental health conditions during their early life
Mental illness is holistic and affects all aspects of a child's life
Anxiety, depression and self-harm are the most common presentations
Healthcare workers should understand developmental milestones to engage with children appropriately

Impact of Development

Puberty impacts a child's ability to regulate emotions
Increased independence and decision-making can lead to social isolation
Schooling pressures, peer pressure and risk-taking all impact mental health

Risk Taking

Risk-taking is a normal part of self-identity exploration in youth
Binge drinking, reckless driving, smoking, illicit substance use, and risky sexual activity are common
These behaviors can be harmful for those with predisposing genetic factors
Can be maladaptive coping strategies for those experiencing emotional distress

Indicators of Potential Mental Health Struggles

Duration and intensity of adverse emotions
Functional impairment
Sudden changes in behavior
Isolation and withdrawal
Extreme emotional reactions
Regression to younger behaviors
Persistent fear or worry
Tics or repetitive behaviors
School refusal
Self-harm or suicidal thoughts
Excessive concern about appearance
Perfectionism

Impact of Technology

9/10 of 14-17 year olds have a mobile phone
Benefits include increased social connectedness
Risks include cyberbullying, peer pressure and overdependency on being "liked"

Older Adults

Typically considered anyone over 65 years old
Referrals come from community, care facilities, or intrahospital transfers
Care is more complex due to decline in independence
15% of people over 60 experience a mental disorder
Comorbidities like pain, loss of independence and social isolation are linked to poor mental health

Common Mental Health Presentations in Older Adults

Schizophrenia/Schizoaffective Disorder
Bipolar Affective Disorder
Depression and Anxiety
Cognitive Impairments, including Dementias

Older Adults: Schizophrenia

Defined by both positive and negative symptoms:
- Positive symptoms include delusions and hallucinations
- Negative symptoms include social withdrawal, impaired motivation, and poor sleep
Presentation is similar to that of younger adults
Special considerations for older adults:
- Long-term impact of antipsychotics on their physical health
  - Increased risk of stroke
  - Increased risk of cardiac illness

Older Adults: Bipolar Affective Disorder (BPAD)

Characterized by extreme mood changes with phases of depression and mania
Long-term use of mood stabilizers:
- Prolonged lithium use can lead to decreased kidney function

Older Adults: Depression, Anxiety, and Suicidal Ideation

Often related to grief or a sense of despair
Tied to experiences of loss like health, loved ones, physical mobility, and independence
Major life changes like retirement, changes in finances, and transitions into care facilities can contribute

Older Adults: Risks

Older males are more likely to complete suicide than any other age group
Youth suicide rate: 1 in every 200 attempts result in death
Older adult suicide rate: 1 in every 3 attempts results in death (American Association of Suicidology, 2014)

Long-term side effects of medications
Ability of the patient's body to process medications (consider impaired liver functioning, etc.)
Increased sedation increases the risk of falls

Cognitive Impairment vs. Dementia

Cognitive impairment is identified by poor performance on objective cognitive assessments indicating a decline in performance
Dementia is diagnosed with significant difficulties in daily life that interfere with independence caused by cognitive impairment.

Alzheimer's Disease:

Accounts for 70% of Dementia diagnoses
Caused by death of brain cells in the outer layer of the brain involved in memory, language and judgement.
Progressive symptoms:
- Apraxia: Difficulty with movements
- Aphasia: Difficulty with language (speech)
- Anomia: Difficulty finding words to use
- Agnosia: Difficulty identifying people or objects
- Amnesia: Difficulty with memory

Impact on Communication

Dementia negatively impacts a person’s ability to communicate
- Confusion/memory impairment
- Disorientation to time, place, and person
- Inability to express their needs
- Aphasia (common in worsening Alzheimer’s Disease)
When unable to express their needs, people become:
- Frustrated and sometimes aggressive
- Fearful or embarrassed

Getting to Know Your Patient

A holistic understanding of the individual is essential when dealing with cognitive impairment.
Involve families in care planning.
Learn patient preferences:
- Morning or afternoon shower? Tea or coffee? Favorite foods?
- Likes and dislikes
- Ways they express themselves

Importance of Knowing Your Patient

Knowing your patient facilitates care.
They are less likely to be fearful and frustrated because they feel safe.
It is easier to build a trusting rapport.

Verbal Communication

Short, simple sentences are key.
Offering too many choices can cause confusion.
One person talking at a time, giving clear directions to the individual.
Be aware of tone of voice, as patients can pick up on frustration.

Non-Verbal Communication

Be aware of your patient’s non-verbal cues:
- Body language
- Cues (hunger, thirst, toileting, pain)- Important to know your patient.
Touch is vital in caring for people living with cognitive impairments:
- Providing comfort during times of crisis
- Assisting with ADLs

Environment

New environments can be distressing and disorienting.
Use familiar items in bed space.
Reduce bed movement.
Consider color differences in furniture and flooring.
Use dementia-friendly signage (large font and clear pictures).

Patient-Centered Care

Goals of care: End-of-life care/palliative care.
Involve family.
Involve the patient where appropriate and possible.
Involve the current care facility.

Dementia, Delirium, and Depression

Feature	Dementia	Delirium	Depression
Onset & Duration	Slow deterioration over time (months to years)	Sudden onset (hours or days)	Mood change over 2 weeks, possibly linked to a life event or loss
Course/Progression	Slow and progressive cognitive decline (non-reversible)	Sudden, short, and fluctuating (reversible when underlying cause is treated)	Fluctuations (reversible with correct treatment)
Signs and Symptoms	Wandering, agitation, difficulty with word recall. Fluctuations in symptoms.	Restlessness, fluctuations in agitation, appetite, and mood changes. Hallucinations and disorganised thinking.	Withdrawn, hopelessness, concentration changes.

Older Adults: Delirium Screening

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Importance of Age

Mental illness was once more taboo, and this should be considered in interactions.
Willingness to discuss thoughts and feelings depends on both the person's and the caregiver’s age.
Language used should be appropriate for the individual.

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Description

Explore the multifaceted aspects of childhood mental health, including definitions, statistics, and the impact of development. Understand how factors like puberty and risk-taking behaviors influence mental well-being among young people aged 0-25. This quiz highlights the importance of recognizing and addressing mental health conditions in youth.