Updated: 12/2/2020

Other Early Onset Disorders

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Snapshot
  • A 13-year-old is brought into clinic by his parents.  He has been suspended from school 10 times for stealing from other students and beating up children smaller than him.  They describe his performance in school as quite poor and state that he does not have any friends.  Recently they found him trying to drown the families housecat Nimsy.  Serum lead level in this patient is undetectable.
Conduct Disorder
  • Must be in a patient that is < 18 years old
    • Considered a precursor to antisocial personality disorder
  • Pervasive behavior that violates serious social norms on a regular basis   
    • e.g., continually breaking the law
    • conduct disorder > 18 years old is classified as antisocial personality disorder diminished emotional style in interpersonal relationships suggests a more severe disorder with worse response to treatment
Snapshot
  • A 16-year-old girl is brought to your clinic by her parents.  Her parents state that she needs medication as she is unruly, a trouble maker and too difficult to parent.  The girl is on the honor roll and is an athlete on the track team.  That being said she often intentionally breaks her curfew, and is dating a 35-year-old disc jockey, to the dismay of the family.  The parents described her as getting into yelling matches with them regularly, and she recently got her ears among other body parts pierced despite her parents explicitly forbidding this type of behavior.
Oppositional Defiant Disorder
  • Regular hostile and defiant behavior towards authority figures
    • no serious violation of social norms 
    • less severe than conduct disorder
    • rather than criminal behavior, these individuals tend to defy authority figures such as teachers and parents
  • Grouped into 3 types
    • angry/irritable mood
    • argumentative/defiant behavior
    • vindictiveness
Snapshot
  • A 7-year-old recently switched from being home schooled and is now attending Beaver Elementary.  He was sent home on his first day because of abdominal pain, knee pain, and a headache.  After this day, he has been in the nurse's office every day requesting to go home because of different symptoms.  His symptoms never exist on the weekends when he is home, but sometimes they resurface when he has a babysitter take care of him.
Separation Anxiety Disorder
  • Classified as a type of anxiety disorder
  • Overwhelming fear of leaving home or separation from person (e.g., a parent)
    • may result in:
      • persistent attempts to avoid school
      • feigning of symptoms for attention
  • Most common onset is between 7-9 years of age
  • To diagnose in adults symptoms must last > 6 months
  • Treatment 
    • cognitive behavioral therapy
    • play therapy, family therapy
 

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