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Chapter 21. Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence

Amy M. Ursano, M.D.; Paul H. Kartheiser, M.D.; L. Jarrett Barnhill, M.D.
DOI: 10.1176/appi.books.9781585623402.309549

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Excerpt

In recent years, it has become increasingly recognized that many psychiatric disorders have their onset in youth. Like many experiences of childhood, these disorders can have enduring effects, and they may affect an individual's sense of satisfaction with relationships, occupation, or self and ultimately play a significant role in the development of adult psychopathology. Variations in the presentation of psychiatric diagnoses can often be attributed to an individual's developmental stage. In fact, disorders such as separation anxiety or elimination disorder represent normal behavior at an early age, although continued symptoms inappropriate to a patient's developmental level become diagnosable and thereby a focus of treatment. Despite limited research, we have effective treatments for many childhood psychiatric illnesses. Child development and child psychiatric treatment are discussed elsewhere in this volume (see Chapter 7, "Normal Child and Adolescent Development," by Gemelli, and Chapter 36, "Treatment of Children and Adolescents," by Crawford et al.).

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TABLE 21–1. DSM-IV-TR disorders usually first diagnosed in infancy, childhood, or adolescence
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TABLE 21–2. DSM-IV-TR diagnostic criteria for mental retardation
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TABLE 21–3. Clinical features of mental retardation
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TABLE 21–4. DSM-IV-TR diagnostic criteria for reading disorder
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TABLE 21–5. DSM-IV-TR diagnostic criteria for mathematics disorder
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TABLE 21–6. DSM-IV-TR diagnostic criteria for disorder of written expression
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TABLE 21–7. DSM-IV-TR diagnostic criteria for developmental coordination disorder
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TABLE 21–8. DSM-IV-TR diagnostic criteria for expressive language disorder
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TABLE 21–9. DSM-IV-TR diagnostic criteria for mixed receptive–expressive language disorder
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TABLE 21–10. DSM-IV-TR diagnostic criteria for phonological disorder
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TABLE 21–11. DSM-IV-TR diagnostic criteria for stuttering
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TABLE 21–12. DSM-IV-TR diagnostic criteria for autistic disorder
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TABLE 21–13. DSM-IV-TR diagnostic criteria for Rett's disorder
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TABLE 21–14. DSM-IV-TR diagnostic criteria for childhood disintegrative disorder
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TABLE 21–15. DSM-IV-TR diagnostic criteria for Asperger's disorder
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TABLE 21–16. DSM-IV-TR diagnostic criteria for attention-deficit/hyperactivity disorder
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TABLE 21–17. Psychiatric disorders often associated with attention-deficit/hyperactivity disorder
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TABLE 21–18. Differential diagnosis of attention-deficit/hyperactivity disorder (ADHD)
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TABLE 21–19. Differentiating attention-deficit/hyperactivity disorder (ADHD) from bipolar affective disorder
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TABLE 21–20. Secondary effects of attention-deficit/hyperactivity disorder
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TABLE 21–21. Positive effects of psychostimulant treatment
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TABLE 21–22. DSM-IV-TR diagnostic criteria for conduct disorder
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TABLE 21–23. DSM-IV-TR diagnostic criteria for oppositional defiant disorder
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TABLE 21–24. DSM-IV-TR diagnostic criteria for pica
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TABLE 21–25. DSM-IV-TR diagnostic criteria for rumination disorder
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TABLE 21–26. DSM-IV-TR diagnostic criteria for feeding disorder of infancy or early childhood
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TABLE 21–27. Some common tics
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TABLE 21–28. DSM-IV-TR diagnostic criteria for tic disorders
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TABLE 21–29. Differential diagnosis of tics
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TABLE 21–30. DSM-IV-TR diagnostic criteria for encopresis
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TABLE 21–31. DSM-IV-TR diagnostic criteria for enuresis
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TABLE 21–32. DSM-IV-TR diagnostic criteria for separation anxiety disorder
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TABLE 21–33. DSM-IV-TR diagnostic criteria for selective mutism
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TABLE 21–34. DSM-IV-TR diagnostic criteria for reactive attachment disorder
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TABLE 21–35. DSM-IV-TR diagnostic criteria for stereotypic movement disorder
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Pervasive developmental disorders are neuropsychiatric disorders of development characterized by social, communication, and behavioral symptoms that vary in presentation and severity among individuals.

Conduct disorder and oppositional defiant disorder are heterogeneous, nonspecific diagnoses with likely multifactorial etiologies. Comorbid psychiatric diagnoses are common and require attention. Effective treatments incorporate cognitive skill development, parental training, and involvement of appropriate community systems.

Attention-deficit/hyperactivity disorder is a highly comorbid disorder and appears to be an enduring condition in some patients.

Current diagnostic criteria for learning disorders emphasize a lag in academic performance. Most state and federal guidelines define learning disorders as a discrepancy of 1.5 to 2.0 standard deviations between expected performance on standardized tests and measured intellectual abilities.

Stereotypic or repetitive behaviors may arise as part of normal development between 6 and 12 months of age.

A complete psychiatric examination of a child should include a complete medical evaluation and physical examination to assess for organic etiologies of presenting symptoms.

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