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Behavioural Disorders
Behavioural Disorders
Behavioural Disorders
CLASSIFICATION
BEHAVIOURAL DISORDERS ARE CLASSIFIED IN THE LARGE GROUP OF F90-F98. THIS GROUP CONSISTS OF: F90 Hyperkinetic disorders F91 Conduct disorders F92 Mixed disorders of conduct & emotions F93 Emotinal disorders with onset specific to childhood F94 Disorders of social functioning with onset specific to childhood & adolescence F95 Tic disorders F98 Other behavioural & emotional disorders with onset usually occuring in childhood & adolescence
a "mental restlessness; - 1917 - 1918 (epidemic of encephalitis lethargica) & 1919 to 1920 (pandemic of influenza from): "brain damage; - mid-20th century : "minimal brain damage", "minimal brain dysfunction", "learning/behavioural disabilities" and "hyperactivity". 1968 (DSM-II): "Hyperkinetic Reaction of Childhood 1980 (DSM-III):"ADD (Attention-Deficit Disorder) with or without hyperactivity." 1994 (DSM-IV):AD/HD 2000 (DSM-IV-TR): ADHD
TERMINOLOGY Brain Damage Minimal Brain Damage. Minimal Brain Dysfunction, Hyperkinetic Behavior Syndrome, Psychoneurological Learning Disorder, Hyperexcitability Syndrome, Minimal Brain Injury, Minimal Chronic Brain Syndrome, Neurophrenia, etc. (USA : 50 Term)
ETIOLOGICAL FACTOR Specific etiology of ADHD is still unknown symptoms starting before seven years of age, and it affects about 5-9% of school-age children. BRAIN DAMAGE minimal & soft, during fetal & perinatal period: Mayority of ADHD structural damage In neurological damage e.c injuries , but ADHD NEUROCHEMICAL FACTOR Hypotetic speculative: Adrenergic & dopaminergic system NEUROPHYSIOLOGICAL FACTOR Growth spurts of brain development at the age of: 3 10 months; 2 4 year ; 6 8 year; 10 12 year; and 14 16 year. symptoms of ADHD temporarily appear Abnormal non specific disorganized EEG is specific in little children.
Diagnostic guidelines Cardinal features are : 1) impaired attention, & 2) overactivity; both should be evident in more than one situation;
DD/-Mixed disorders: Pervasive Develop. Disorders (PDD) takes precedent when they are present -as a symptome of anxiety or depressive disorders -in acute onset is more probably due to reactive disor. (psychogenic or organic), manic state,schizophrenia, or neurological disase (e.g. rheumatic fever)
Excludes: -anxiety disoders (F41.- or F93.0) - mood (affective disorders (F30-F39) - PDD - schizophrenia (F20.-)
CLASSIFICATION OF F90 HYPERKINETIC DISORDERS F90.0 Disturbance of activity & attention F90.1 Hyperkinetic conduct disorder F90.8 Other hyperkinetic disorders F90.9 Hyperkinetic disorder, unspecified
INTRODUCTION......
the social recognition of childhood as a special phase of life with its own developmental stages, starting with the neonate and eventually extending through adolescence; The term 'child psychiatry' (1899 in French) was used as a subtitle in Manheimer's monograph Les Troubles Mentaux de L'Enfance; 1930s, medication in the treatment of children also began: Charles Bradley was the first to use amphetamine for brain-damaged and hyperactive children; In 1930 the first 'pediatric psychiatry clinic' was established in Baltimore, headed by Leo Kanner. In 1933 the Swiss Moritz Tramer (1882-1963) was probably the first to define the parameters of child psychiatry in terms of diagnosis, treatment, and prognosis within the discipline of medicine,. In 1934, Tramer founded the Zeitschrift fr Kinderpsychiatrie (Journal of Child Psychiatry), which later became Acta Paedopsychiatria; The first use in English of the term "child psychiatry" occurred when Leo Kanner published his textbook under that name in the USA in 1935 In the United States, Child and Adolescent Psychiatry was established as a recognized medical speciality in 1953 with the founding of the American Academy of Child Psychiatry, but was not established as a legitimate, board-certifiable medical speciality until 1959; The child-saving movement emerged in the United States during the nineteenth century and influenced the development of the juvenile justice system. The first juvenile court which appeared in Chicago in 1899
DD/ Conduct dis. overlaps with other conditions. The existence of emotional dis. of childhood (F93.-) should lead to a diagnosis of mixed dis.of conduct & emotions (F92.-) If a case also meets the criteria for hyperkinetic dis.(F90.-) that condition should be diagnosed instead Excludes: - conduct dis. associated with emotional dis. (F92.-) - ADHD (F90.-) - mood (affective) dis.: mania or depression (F30-F39) - PDD F84.-), & - schizophrenia (F20.-).
Violence against family members (but not others) & deliberate fire-setting confibed to the home are also graounds for the diagnosis.
Diagnosis guidelines F91.1.... Offending is characteristically (but not necessarily) solitary. Typical behaviours comprise: bullying, excessive fighting, and (in older chidldren) extortion or violent assault; excessive level of disobedience, rudeness, uncooperativeness, and resistence to authority; severe temper tantrums & uncontrolled rages; destructiveness to property, fire-setting, & cruelty to animals & other children. Some isolated children, however, become involve in group offending. The nature of the offence is therefore less importantin making the diagnosis than the quality of personal relationships. The disorder is usually pevasive accross situations but it may be most evient at school; specificity to situations other than the home is compatible with the diagnosis. Includes : - conduct disorder, solitary aggressive type; - unsocialized aggressive disorder
Frequently, this behaviour is most evident in interactions with adults or peers whon the child knows well, and signs of the disorder may not be evident during clinical interview. The key distinction from other types of conduct disorder is the absence of behaviour that violates the law and the basic rights of others, such as theft, cruelty, bullying, assault, and destructiveness. The definite presence of any of the above would exclude the diagnosis. However, oppositional defiant behaviour, as outlined in the paragraph above, is often found in other types of conduct disorder. If another type (F91.0 F91.2) is present, it should be coded in preference to oppositional defiant disorder.
Excludes: conduct disorders including overtly dissocial or aggressive behaviour (F91.0 F91.2).
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