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Types of specific phobias
Phobias of the natural environment
Phobias of a variety of situations
Some are universal
Usually isolated disturbances that do interfere with one's life and rarely require treatment. Some persist into adulthood
Phobias of the natural environment
May spread by psychological contagion in families
Water, heights and storms
may interfere with a child's dental, physical and psychiatric care. Frequently familial and associated with fainting.
Children who are mute at school but speak normally at home
Probably a form of social phobia
The agoraphobia equivalent of childhood
Caused by fear of crowds or due to separation anxiety disorder
Separation anxiety disorder
Specific to childhood
Child develops intense anxiety to the point of panic, as a result of being separated from a parent or another loved one
Types of children who get separation anxiety disorder
children who are conscientious and well behaved and come from close-knit families
When separation anxiety disorders develop
-Acutely after a psychological stress
-After a medical conditon
-Just out of the blue
Somatic symptoms of school phobia
headaches, stomaches, dizziness and other pains and aches; fatigue
may try to sleep with parents or close to their room
Mothers of children with separation anxiety disorder
20% patients mother is also depressed
clings to child as much as he is to her
Traits linked with the development of anxiety disorders in childhood
Behavioural inhibition with shyness, fear and a tendency to withdraw in response to new situations
Behaviour therapy or CBT
Patient encouraged to gradually face the phobic object
Signs of depression in the young
usually withdraw from their friends, spend most of their time alone listening to music or watching TV, cling to their parents, are reluctant to go to school, drop out of sports and do poorly in their studies.
Depression and somnia/appetite
Adolescents with depression usually eat more and sleep more
Rarely see classical insomnia (early wakening)
Spend most of weekend in bed
Children with dysthymia
show more general social impairment than those with major depression
more likely to be seen as being 'bad' children
Complications of depression
disruption of social life (no friends), deterioration of academic achievement, poor school attendance, poor work record, alcoholism and drug abuse, neglect of associated medical illness, eating disorders and suicide.
Morbidity of adolescent depression
Significantly lower educational achievement and social class
More likely to miss work
72% had one or more major depressions during follow up
significantly more hospitalizations and more impairment in their work, leisure, social and family life
Mortality of adolescent depression
26.1% of patients made their first suicide attempt,
23.3% had made repeated suicidal attempts
7.7% had killed themselves
First, any associated GMCs or SA
Outpatients with psychotherapy, antidepressants, or both
Usually use SSRIs
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