Chapter 17: The interface with the Child and Adolescent Mental Health Services (CAMHS) The National Inpatient Child and Adolescent Psychiatry Study by O’Herlihy et al (2001) established which of the following? Lack of emergency beds Dependence on secure facilities in private sector Insufficient number of beds Premature discharges Poor liaison with other services Prior to admission of a young person to a Psychiatric Intensive Care Unit which of the following issues should be considered? The use of a Police Protection Order Capacity to consent The restricted use of the Mental Health Act for under 18 year olds Legal issues to consent to admission Which of the following factors determine admission of adolescents with severe mental illness to inpatient services? Presence of severe learning disability Physical health problems Safety issues Family circumstances Availability of funding Evidence indicates that young people’s first access to mental health services is delayed for up to 1-2 years … True False In childhood and adolescent schizophrenia which of the following are preferred pharmacotherapy treatments? Haloperidol Olanzapine Risperidone Clozapine Lithium Which of the following procedures should occur when admitting a young person to a Psychiatric Intensive Care Unit? Involve social services when planning to discharge Use seclusion and restraint as first line of treatment to ensure safety Ensure adherence to child protection policies Decision to discharge should involve parents and GP Adopt a flexible approach on the ward An assessment of self-harm in children and adolescents should include which of the following? Identification of predisposing risk factors Evaluation of circumstances of suicidal intent Psychometric testing Physical examination Mental state examination The Audit Commission report ‘Children in Mind’ (1999) stated that what percentage of children and young people will suffer with a mental health problem at some point in their life? 10% 20% 25% 35% 45% What is the name of the competence test which needs to be applied to children under 16 years old? General Gillick Vector Core Marion For attention deficit hyperactivity disorder which of the following are preferred pharmacotherapy treatments? Fluoxetine Methylphenidate Depakote Atomoxetine Dexamphetamine What percentage of children recover spontaneously from depression within three months? 5% 10% 15% 25% 40% Which of the following are clinical features of schizophrenia in childhood? Insidious onset Above-average IQ Poor premorbid functioning Predominantly positive symptoms Deterioration of social skills Which of the following are indications of serious suicidal intent? Preparations made in anticipation of death Seeking attention Timed so intervention likely Suicide note left Carried out in public According to Hollis (2000) which of the following are typically psychotic symptoms of child-onset in contrast to adult-onset schizophrenia? Disorganised behaviour More prominent positive symptoms Many well-formed persecutory delusions Hallucinations in different modalities Increased catatonic behaviour When opiate detoxification in adolescent substance misusers is necessary which of the following can be used? Lofexidine Methadone Lorazepam Buprenorphine Chloriazepoxide Considering fluoxetine use in depressive disorders in young people under 18 … Is the only Selective Serotonin Reuptake Inhibitor recommended It should be started at 20mg daily It should be used as first line treatment It has a recommended length of treatment the same as in adults It increases the risk of emergent suicidal thoughts Using case register data from Sweden Hollis (2000) established the prevalence for all psychotic disorders at age 13 to be 0.9 per 10 000 increasing to what at age 18? 2.8 9.2 17.6 24.7 32.3 The World Health Organisation’s multi-axial diagnostic model … Has six axes Includes an axis for family history of psychotic disorder Provides a map of archetypes Provides a cause for diagnosis Includes global assessment of psychosocial disability What percentage of children do NOT recover from depression after two years? 0-5% 5-10% 10-20% 20-30% 30-40% Girls have a higher rate of suicide in Britain per year compared to boys … True False Loading …
