Child and adolescent psychiatry : a developmental approach

590 Pages·2007·2.68 MB·English

by  Graham

OXFORD MEDICAL PUBLICATIONS
Child and Adolescent
Psychiatry: A Developmental
Approach
Fourth Edition
Oxford University Press makes no representation, express or implied, that the drug dosages
in this book are correct. Readers must therefore always check the product information and
clinical procedures with the most up-to-date published product information and data sheets
provided by the manufacturers and the most recent codes of conduct and safety regulations.
The authors and the publishers do not accept responsibility or legal liability for any errors in
the text or for the misuse or misapplication of material in this work.
Child and Adolescent
Psychiatry: A Developmental
Approach
FOURTH EDITION
Jeremy Turk
Professor of Developmental Psychiatry
Division of Clinical Developmental Sciences,
St George’s, University Of London, UK
Philip Graham
Emeritus Professor of Child Psychiatry
Institute of Child Health, University of London, UK
Frank C. Verhulst
Professor of Child and Adolescent Psychiatry
Erasmus University Medical Centre
Sophia Children’s Hospital, Rotterdam
The Netherlands
1
1
Great Clarendon Street, Oxford OX2 6DP
Oxford University Press is a department of the University of Oxford and furthers the University’s aim of excellence in
research, scholarship, and education by publishing worldwide in Oxford New York
Athens Auckland Bangkok Bogota Buenos Aires Calcutta
Cape Town Chennai Dar es Salaam Delhi Florence Hong Kong Istanbul
Karachi Kuala Lumpur Madrid Melbourne Mexico City Mumbai
Nairobi Paris Sao Paulo Singapore Taipei Tokyo Toronto Warsaw and associated companies in Berlin Ibadan
Oxford is a trade mark of Oxford University Press in the UK and in certain other countries
Published in the United States by Oxford University Press Inc., New York
© Oxford University Press, 2007
The moral rights of the author have been asserted
First published 1987
Second edition published 1991
Third edition published 1999
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any
form or by any means, without the prior permission in writing of Oxford University Press.
Within the UK, exceptions are allowed in respect of any fair dealing for the purpose of research or private study, or
criticism or review, as permitted under the Copyright, Designs and Patents Act, 1988, or in the case of reprographic
reproduction in accordance with the terms of licences issued by the Copyright Licensing Agency. Enquiries con-
cerning reproduction outside those terms and in other countries should be sent to the Rights Department, Oxford
University Press, at the address above.
This book is sold subject to the condition that it shall not, by way of trade or otherwise, be lent, re-sold, hired out, or
otherwise circulated without the publisher’s prior consent in any form of binding or cover other than that in which it
is published and without a similar condition including this condition being imposed on the subsequent purchaser.
British Library Cataloguing in Publication Data
Library of Congress Cataloging in Publication Data
Turk, Jeremy, Dr.
Child and adolescent psychiatry: a developmental approach/Jeremy Turk, Philip J. Graham, Frank C. Verhulst. -- 4th ed.
p.; cm.
Rev. ed. of: Child psychiatry/Philip Graham, Jeremy Turk, and Frank C. Verhulst. 3rd ed. 1999.
Includes bibliographical references and index.
1. Child psychiatry. 2. Adolescent psychiatry. I. Graham, P. J. (Philip Jeremy) II. Verhulst, Frank C. III. Graham, P. J.
(Philip Jeremy). Child psychiatry. IV. Title.
[DNLM: 1. Mental Disorders. 2. Adolescent Development. 3. Adolescent. 4. Child Development. 5. Child. 6. Infant.
WS 350 T939c 2006]
RJ499. G716 2006
618. 92'89--dc22
2006031709
Typeset by SPI Publishers Services, Pondicherry, India
Printed in Great Britain on acid free paper by Biddles Ltd., Guildford, Surrey
ISBN-13: 978-0-19-852612-4 (pbk.: alk. paper)
ISBN-13: 978-0-19-921669-7 (hardback: alk. paper)
13579 10 8642
Preface to the fourth edition
For this fourth edition, lead authorship has been transferred from Philip Graham to
Jeremy Turk, with Frank Verhulst continuing to complete the trio of authors. The orienta-
tion of the book has been adapted deliberately in order to make it of greatest interest and
use not only to child and adolescent psychiatrists and other mental health professionals,
but also to community and developmental paediatricians, hospital paediatricians, general
practitioners, and clinical and educational psychologists. We hope that many others, such
as medical students, clinical medical officers, medical and psychiatric social workers,
nurses, and general, and learning disability psychiatrists, will also find it helpful. The level
of the book has been pitched deliberately to be suitable for those with an elementary as
well as a more advanced knowledge of child and adolescent mental health. We have tried
to bear in mind the very different settings in which professionals dealing with children
and families may carry out their work. As a consequence we hope that the book provides
a pragmatic account of how to help children and young people who have emotional,
behavioural, and developmental difficulties in the real world.
As a consequence of our shift in emphasis, the sections on classification and epidemiol-
ogy have been refined, and the entire text has been updated in order to present a state-
of-the-art account of evidence-based clinical practice in the field of child and adolescent
mental health. In the section on physical conditions, we are aware that, especially with
rarer disorders, many clinicians such as family doctors, clinical medical officers, and child
psychiatrists (as well as non-physicians such as psychologists and social workers) will find
it helpful to have an introductory resumé of the physical aspects of the condition before
the psychosocial aspects are discussed. Therefore we have included a certain amount
of such information. However, it should be emphasized that this book is in no way a
substitute for a textbook of paediatrics. We hope that it will be seen as complementary
to such textbooks, filling out in more detail aspects of paediatric care which have so far
received less attention than the prevalence of psychosocial disorders in childhood sug-
gest that it should.
We would like to thank all those with whom we have discussed ideas, who have influ-
enced our thinking, and who have supported us more generally, especially our clinical
colleagues, trainees, and the children and families we continue to see in clinical practice.
We would also particularly like to thank those who have commented on sections of the
book: Mike Patton, Cathy Taylor, Alison Wintgens, and Vicky Turk.
London J.T.
and Rotterdam, P.G.
May 2006 F.V.
This page intentionally left blank
Contents
1 Introduction 01
1.1 Overview 01
1.2 Theories of development and its disorders 02
1.3 Family infl uences 13
1.4 Classifi cation and prevalence of psychiatric disorders 18
1.5 Assessment and diagnosis of psychiatric disorders 25
1.6 Psychological assessment 37
2 Familial infl uences 45
2.1 Familial roles and responsibilities 45
2.2 Physical abuse 46
2.3 Munchausen syndrome by proxy 51
2.4 Neglect 54
2.5 Emotional abuse 55
2.6 Sexual abuse 58
2.7 Outcome following child maltreatment 62
3 Neurodevelopment and neuropsychiatric disorders 65
3.1 Motor development and disorders of movement 65
3.2 Normal language and speech development 72
3.3 Intelligence and learning disorders 89
3.4 Social development and antisocial behaviour 115
3.5 Attention and attention defi cit hyperactivity (hyperkinetic) disorder 130
3.6 Pervasive developmental disorders 140
3.7 Sensory development 151
3.8 Chromosomal abnormalities 158
3.9 Disorders of the central nervous system and muscle 169
3.10 Metabolic disorders: neurodevelopmental aspects 188
4 Developmental psychopathology 191
4.1 Pregnancy and delivery 191
4.2 Attachment and attachment disorders 195
4.3 Feeding, feeding problems, and disorders of growth 201
4.4 Sleep and its disorders 216
4.5 Emotional development and disorders of mood 221
4.6 Bowel and bladder control 247
4.7 Prepubertal sexual development 259
viii CONTENTS
5 Adolescence and psychiatric disorders often
beginning in adolescence 265
5.1 Adolescence 265
5.2 Sexual development in adolescence 267
5.3 Early pregnancy 270
5.4 Anorexia nervosa 271
5.5 Adult-type psychiatric disorders 278
5.6 Psychoses 293
5.7 Drug use and abuse 302
5.8 Personality disorders 311
6 Child–adult continuities in psychiatric disorders 313
6.1 Introduction and defi nitions 313
6.2 Findings 314
7 Psychosocial aspects of physical disorders 317
7.1 Links between psychological factors and chronic
physical disease 317
7.2 Prevalence of chronic disorders 318
7.3 The child with a physical disorder 319
7.4 Impact on parents 322
7.5 Impact on the siblings 327
7.6 Principles of psychosocial management 327
7.7 Hospitalization 333
7.8 Care of the child with a terminal illness 337
8 Psychological aspects of specifi c physical conditions 341
8.1 Perinatal loss 341
8.2 Sudden infant death syndrome (cot death) 342
8.3 Injuries to children 344
8.4 Infections and immunodefi ciency disorders 350
8.5 Physical malformations 358
8.6 Metabolic and endocrine disorders: psychosocial aspects 361
8.7 Blood disorders 368
8.8 Leukaemia and other childhood cancers 372
8.9 Respiratory disorders 376
8.10 Genitourinary disorders 384
8.11 Gastrointestinal disorders 387
8.12 Congenital heart disease 389
8.13 Skin disorders 392
8.14 Juvenile chronic arthritis 395
CONTENTS ix
9 Prevention and treatment 397
9.1 Preventive approaches 397
9.2 Treatment 405
10 Services 459
10.1 The estimation of service needs 459
10.2 Health services for children with mental health problems 459
10.3 Social services and child protection 470
10.4 School infl uences and special education 483
References 489
Index 551