15 - Medical psychiatric conditions

Summary

Introduction

Over the past 15 years, changes in the approach to psychiatric diagnosis among both children and adults have been paralleled by relatively major changes in the approach to treatment. As outlined in the preceding chapters, these changes are perhaps most visible in the realm of psychopharmacology. Medications are recognized as a viable treatment for a growing number of psychiatric disorders in both children and adults. Preceding chapters discuss the direct use of biologic treatments in children, which almost exclusively includes medications. The current chapter, in contrast, deals with more indirect applications that have resulted from the overall change in modern thinking about childhood psychopathology. These changes have resulted from increasingly closer alliances among child psychiatry, developmental psychology, and pediatric subspecialties, including developmental pediatrics and pediatric neurology.

This chapter is devoted to an examination of the implications these fields carry for child psychiatry while considering the relationship between medical and psychiatric syndromes in children. Three specific topics will be briefly reviewed. First, the chapter will review evidence regarding the association between psychiatric and medical disorders in children. This section of the chapter will outline the specific medical and psychiatric disorders which tend to co-occur, focusing mostly on illnesses of the central nervous system (CNS). Secondly, the chapter will highlight some of the more recent advances in pathophysiology, resulting largely from integrative research among psychiatric and medically or neuroscience-oriented research groups.