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Questions and Answers
Cognitive behavioural methods, medication, or a combination of the two are used to treat OCD in adults.
Cognitive behavioural methods, medication, or a combination of the two are used to treat OCD in adults.
True
Exposure and response prevention (ERP) is not the cornerstone of psychological therapies for children with OCD.
Exposure and response prevention (ERP) is not the cornerstone of psychological therapies for children with OCD.
False
Both SSRIs and clomipramine are associated with side effects, even though they are more effective than placebo.
Both SSRIs and clomipramine are associated with side effects, even though they are more effective than placebo.
True
In the UK, clomipramine is frequently used for the treatment of OCD in people under 18 years of age.
In the UK, clomipramine is frequently used for the treatment of OCD in people under 18 years of age.
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The combined treatment in one trial showed over 50% remission rate in children and adolescents with OCD.
The combined treatment in one trial showed over 50% remission rate in children and adolescents with OCD.
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Long-term maintenance therapy is rarely necessary for managing OCD.
Long-term maintenance therapy is rarely necessary for managing OCD.
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Separation anxiety disorder is typically diagnosed after the age of 6 years.
Separation anxiety disorder is typically diagnosed after the age of 6 years.
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Children with separation anxiety disorder are concerned about harm befalling their attachment figures in a realistic manner.
Children with separation anxiety disorder are concerned about harm befalling their attachment figures in a realistic manner.
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Separation anxiety disorder can affect social functioning significantly.
Separation anxiety disorder can affect social functioning significantly.
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A generalized disturbance of personality development is not a diagnosis of separation anxiety disorder.
A generalized disturbance of personality development is not a diagnosis of separation anxiety disorder.
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Children with separation anxiety disorder tend to have undisturbed sleep patterns.
Children with separation anxiety disorder tend to have undisturbed sleep patterns.
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Physical symptoms of separation anxiety disorder in children may include stomach ache and headache.
Physical symptoms of separation anxiety disorder in children may include stomach ache and headache.
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Sydenham's chorea is associated with an autoimmune disorder following a group A beta-haemolytic streptococcal infection.
Sydenham's chorea is associated with an autoimmune disorder following a group A beta-haemolytic streptococcal infection.
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The overall prevalence of OCD in young people up to 18 years of age is around 5-7%.
The overall prevalence of OCD in young people up to 18 years of age is around 5-7%.
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Rates of OCD are higher in younger children and decline with age.
Rates of OCD are higher in younger children and decline with age.
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Tic disorders are one of the common comorbid conditions in childhood-onset OCD, with a prevalence rate of 30%.
Tic disorders are one of the common comorbid conditions in childhood-onset OCD, with a prevalence rate of 30%.
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OCD in childhood has a generally poor prognosis, persisting in almost half of cases.
OCD in childhood has a generally poor prognosis, persisting in almost half of cases.
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The poorest outcomes for childhood-onset OCD are predicted by later age of onset and good initial response to treatment.
The poorest outcomes for childhood-onset OCD are predicted by later age of onset and good initial response to treatment.
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First-step management of childhood OCD involves informing the child, parents, and teachers about the disorder and allowing time for discussion of the implications.
First-step management of childhood OCD involves informing the child, parents, and teachers about the disorder and allowing time for discussion of the implications.
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Treatment for obsessional symptoms that occur as part of an anxiety or depressive disorder is directed to the primary disorder.
Treatment for obsessional symptoms that occur as part of an anxiety or depressive disorder is directed to the primary disorder.
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The prevalence of PTSD in children exposed to potentially traumatic events is around 40%.
The prevalence of PTSD in children exposed to potentially traumatic events is around 40%.
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Repeated or chronic trauma in childhood, especially of an interpersonal nature, is referred to as complex trauma.
Repeated or chronic trauma in childhood, especially of an interpersonal nature, is referred to as complex trauma.
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Longitudinal studies have shown that 50-60% of children with PTSD can continue to suffer from the disorder in adulthood.
Longitudinal studies have shown that 50-60% of children with PTSD can continue to suffer from the disorder in adulthood.
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Treatment for PTSD in children closely resembles the treatment for adults.
Treatment for PTSD in children closely resembles the treatment for adults.
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OCD in childhood is typically characterized by obsessional thoughts about contamination and the need for symmetry.
OCD in childhood is typically characterized by obsessional thoughts about contamination and the need for symmetry.
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Children with OCD always display only one form of symptom, either obsessions or compulsions.
Children with OCD always display only one form of symptom, either obsessions or compulsions.
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The genetic contribution to OCD is decreased when there is a comorbid tic disorder.
The genetic contribution to OCD is decreased when there is a comorbid tic disorder.
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Normal children’s repetitive behaviors, such as avoiding cracks in the pavement, cannot be called compulsive because the child struggles against them.
Normal children’s repetitive behaviors, such as avoiding cracks in the pavement, cannot be called compulsive because the child struggles against them.
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Obsessive-compulsive disorder (OCD) is typically developed in late childhood and early adolescence.
Obsessive-compulsive disorder (OCD) is typically developed in late childhood and early adolescence.
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Exposure to trauma in childhood is associated with a narrow range of psychiatric outcomes in adulthood.
Exposure to trauma in childhood is associated with a narrow range of psychiatric outcomes in adulthood.
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Approximately 10% of 7-11 year old children experience separation anxiety disorder.
Approximately 10% of 7-11 year old children experience separation anxiety disorder.
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Separation anxiety disorder in children can be caused by experiencing a high number of everyday stressors.
Separation anxiety disorder in children can be caused by experiencing a high number of everyday stressors.
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Children with separation anxiety disorder may develop generalized anxiety disorders in adulthood.
Children with separation anxiety disorder may develop generalized anxiety disorders in adulthood.
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Anxiolytics are never used in the treatment of separation anxiety disorder.
Anxiolytics are never used in the treatment of separation anxiety disorder.
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Phobic anxiety disorder in children often involves fear of animals, insects, darkness, school, and death.
Phobic anxiety disorder in children often involves fear of animals, insects, darkness, school, and death.
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Social anxiety disorder of childhood rarely begins before the age of 6.
Social anxiety disorder of childhood rarely begins before the age of 6.
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Sibling rivalry disorder includes signs of extreme jealousy or rivalry in relation to a newborn sibling.
Sibling rivalry disorder includes signs of extreme jealousy or rivalry in relation to a newborn sibling.
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Symptoms of post-traumatic stress disorder in children include nightmares, flashbacks, and avoidance of trauma-related stimuli.
Symptoms of post-traumatic stress disorder in children include nightmares, flashbacks, and avoidance of trauma-related stimuli.
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Behavioral therapy techniques can play a significant role in treating separation anxiety disorder.
Behavioral therapy techniques can play a significant role in treating separation anxiety disorder.
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Most childhood phobias do not improve without specific treatment.
Most childhood phobias do not improve without specific treatment.
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Study Notes
Separation Anxiety Disorder
- Separation anxiety disorder is a fear of separation from attached people that is greater than normal and persists beyond the usual preschool period.
- Onset is before the age of 6 years.
- Diagnosis is not made when there is a generalized disturbance of personality development.
- Children with this disorder are excessively anxious when separated from parents or other attachment figures and are unrealistically concerned about harm befalling them or leaving the child.
- Symptoms include:
- Refusing to sleep away from attachment figures
- Disturbed sleep with nightmares
- Clinging to attachment figures by day, demanding attention
- Anxiety manifested as physical symptoms (stomach ache, headache)
Treatment Options
- Cognitive behavioral methods, medication, or a combination of both can be used to treat separation anxiety disorder.
- Exposure and response prevention (ERP) is a cornerstone of psychological therapies for children with OCD.
- Involving the family in treatment is important, and about 30% of children will not respond to treatment.
Separation Anxiety Disorder: Epidemiology, Aetiology, and Prognosis
- Epidemiology: 5% of 7-11 year old children experience separation anxiety disorder.
- Aetiology: May be triggered by a frightening experience, family conflicts, or overprotective parents.
- Prognosis: The disorder often improves over time, but may worsen if there is a change in the child's routine.
- Some children may go on to develop generalized or other anxiety disorders in adulthood.
Phobic Anxiety Disorder
- Phobic anxiety disorder is similar to specific phobia in adults.
- Phobias are common in childhood and most commonly involve animals, insects, darkness, school, and death.
- Prevalence of severe, persistent phobias decreases as children grow older.
- Most childhood phobias improve with a firm and supportive approach from parents.
- Behavioral treatment can be helpful if the phobia does not improve on its own.
Social Anxiety Disorder of Childhood
- Begins before the age of 6, involving anxiety with strangers that is greater or more prolonged than the typical fear of strangers seen in the second half of the first year of life.
- Children with this condition often have an inhibited temperament from infancy.
- Fear is centered primarily on adults or other children, interfering with social interaction.
- Treatment is similar to that used for other childhood anxiety disorders.
Sibling Rivalry Disorder
- Diagnosis is made in children who exhibit extreme jealousy or rivalry in response to a new sibling, starting soon after the sibling's birth.
- Symptoms are more pronounced than typical rivalry seen in siblings.
- Children with this condition may show hostility, violence, and regressive behavior, including tantrums to gain attention.
- Treatment involves dividing parental attention fairly, setting clear boundaries, and supporting each child's feeling of being valued.
Post-Traumatic Stress Disorder (PTSD)
- Can occur in children who experience trauma, leading to symptoms similar to those seen in adults.
- Symptoms include:
- Disturbed sleep
- Nightmares
- Flashbacks
- Avoidance of trauma-related stimuli
- Behavioral problems
- Developmental regression
- Physical symptoms
- Generalized anxiety
- Aetiology: Encounter with an exceptionally severe stressor, such as natural disasters, war, physical or sexual abuse, violence, or serious injury.
- Prognosis: Exposure to trauma in childhood is associated with a broad range of adverse psychiatric outcomes in adulthood.
- Management: Treatment resembles that for adults, including trauma-focused cognitive behavior therapy (TF-CBT), eye-movement desensitization and reprocessing (EMDR), narrative exposure therapy (NET), and supportive counseling.
Obsessive-Compulsive Disorder (OCD)
- OCD is a complex disorder characterized by the presence of obsessions (unwanted, repetitive, or intrusive thoughts) and compulsions (unnecessary repetitive behaviors or mental activities).
- OCD is common in childhood and adolescence, and is a common cause of distress for children and adolescents.
- Clinical features:
- Typically develops in late childhood and early adolescence
- Obsessions and compulsions resemble those in adults
- Most common obsessions concern contamination, accidents, or illness affecting the patient or another person
- Symptoms often change as the child grows older
- Epidemiology:
- Overall prevalence of OCD in young people up to 18 years of age is around 1-3%
- Males have an earlier age of onset
- Associated disorders:
- Tic disorders (30%)
- Major depression (26%)
- Specific developmental disabilities (17%)
- Simple phobias, ADHD, conduct disorder, and separation anxiety disorders
- Prognosis:
- OCD in childhood has a generally poor prognosis, persisting in almost half of cases
- 50% of adults with OCD report that their symptoms started in childhood
- Poor outcomes are predicted by earlier age of onset, comorbid psychiatric illness, and poor initial response to treatment
- Management:
- Inform the child, parents, and teachers about the disorder
- When obsessional symptoms occur as part of an anxiety or depressive disorder, treatment is directed to the primary disorder
- True obsessional disorders of later childhood are treated along similar lines to adults
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Description
A psychological disorder characterized by excessive fear of separation from loved ones, affecting social functioning, with onset before age 6.
