Friday, December 31, 2004

Child Psychiatry

A typical encounter for a child psychiatrist is to see a child brought in by his mother for behavioral problems. In these cases, the most important question to ask is, "When was the divorce/separation/affair?" If the parents are divorced/separated, the child psychiatrist should next ask the mother if she has a boyfriend who might possibly be sexually/physically/emotionally abusing the child. Asking these simple questions provides key diagnostic information in many child psychiatry cases.
And if the father is the one bringing in the kid, then that kid really has problems.
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Disclaimer: I am a general adult psychiatrist. I do not like children that much (except for my own). I am probably a little cynical from my experiences as a resident.
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This post was inspired by the Dec 30 post on Mental Notes.
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Comments are welcome

11 comments:

Dreaming again said...

Since you've said comments are welcome, I'm going to comment.
I need to print your blog on this off and take it to my sons neurologist and tell him : "This is why I keep stalling on going to the child psychiatrist/psychologist"

My sons both have Tourette's Syndrome and Obsessive Compulsive Disorder, one has severe ADHD, one has borderline (and I mean BORDERLINE) ADD. (every evaluation by every person, the T.O.V.A. all came back at exactly the lowest number that would give the diagnosis of ADD ..so borderline, as borderline as it gets!). The oldest is extremely gifted, the youngest has an IQ of 78 and is in special education.
The oldest is being medically treated for the TS and the OCD, but not the ADD.
The youngest is being medically treated for the ADHD and the TS, but not the OCD (he became manic on Paxil, his OCD is, in my opinion, not severe enough to risk another paradoxical reaction to the SSRI's to try another one, he does VERY well with behavior modifications and allowing substitutions for his OC's ..so why medicate? Teachers, who don't want to give him 2 min to align the pencils on his desk, feel differently, they want him medicated.)

My oldest has SOME social misfit problems, he just doesn't quite fit in. He's funny, outgoing, and friendly, quick to forgive and willing to give anyone a chance. Problem is, he's so bright, so intelligent, half the kids his age don't know what he's talking about, you add the behavior quirks, they have to get past ... not a whole lot of kids have been willing to give him a chance.

My youngest has very strange social skills for a child with a lower than normal IQ, who's been held back a grade, with ADHD and TS and OCD. His skills, are above average ...for his AGE ...figure that one out! Makes it really fun trying to get him to be interested in reading when Clifford the Big Red Dog is difficult, but no 13 year old boy with interests of a 13 year old likes Clifford! yikes!

So .. the neuro, because these disorders cause soooo very many problems in adolescence wants my kids to see a psych ... I have good kids. Behavior? Yea, but you know what? I have friends with 'typical' kids who have more trouble than we do!! We need medication management! The behavioral stuff, we're figuring out, and doing a darn good job. My oldest son was homeschooled for all but 1st and 5th grade (his intelligence and OCD made being in school very difficult, even the school said homebound him, so we homeschooled him!), but when he started high school this fall, things went smoothly, and I'm getting emails telling me what a great kid he is and they wish all their kids were like him.

I don't want to take them to a psych who's going to say ... when was the divorce/affair yada yada yada to find out that we've been married since 2 years before the first kiddo was born and still are. But ..we've also been pretty sick... I've got lupus and myasthenia gravis ..it hit the day my oldest was born. I've been in and out of the hospital 22 times in their lives. My husband had polio. I don't want their disorders that are being very well managed to get blamed on health issues that have nothing to do with it.

Sometimes, parents can handle these things, with a little medical management ...

Anonymous said...

Hi Blogger,

I've seen this post before but important things are always worth reminding. After all, repetition is the mother of learning.

Anonymous said...

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Anonymous said...

Hi Blogger,

Thanks for the post, looking forward to more great stuff.

Anonymous said...

Hi Blogger,

Thanks for the post, looking forward to more great stuff.

Anonymous said...

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Warmest regards,
Hoe Bing

Anonymous said...

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Warmest regards,
Hoe Bing

Anonymous said...

Hi Blogger,

Sounds great.

Anonymous said...

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