Child Psychiatry

Child Psychiatry

The practice of child psychiatry differs from that of adult psychiatry in four important ways:

. Children seldom initiate the consultation. Instead, they are brought by a parents, or another adult, who thinks that some aspect the child's behavior or development is abnormal. Whether a referral is sought depends on the attitudes and tolerance of these adults, and how they perceive the child's behavior. Healthy children may be brought to the doctor by overanxious and solicitous parents or, teachers, whilst in other circumstances severely disturbed children may be left to themselves. A related factor is that psychiatric problems in a child may be a manifestation, of disturbance in other members of his family. When a child's problems have previously been contained within the family or school, the child may be referred when another problem, which reduces their capacity to cope with the child, arises in the family or school.

. The child's stage of development must be considered when deciding what is abnormal. Some behaviors are normal at an early age but abnormal at a later one. For example, repeated bedwetting may be normal in a 3-year-old child but is abnormal in a child aged 7. Also, the child's response to life events changes with age. Thus separation from the parents is more likely to affect a younger than an older child.

. Children are generally less able to express themselves in words. For this reason, evidence of disturbance often. comes from observations of behavior made by parents, teachers, and others. These informants often give differing accounts, in part because the child's behavior often varies with his circumstances, and in part because the various informants may have different criteria for abnormality. For this reason, informants should be asked for specific examples of any problem they describe, and asked about the circumstances in which it has been observed.

. Medication is used less in the treatment for children than in the treatment of adults. Instead, there is more emphasis on working with parents and the whole family, reassuring and retraining children, and coordinating the efforts of others who can help children, especially at school. Thus multidisciplinary working is even more important in child than in adult psychiatry. Consequently, treatment is usually provided by a team that includes at least a psychiatrist, psychiatric nurses, a psychologist, and a social worker.

© 2005, www.depression-guide.com All rights reserved.