This annual report - Taranaki District Health Board

Common Mental Health Disorders in Children 0–14 YearsThe following sections consider the features, epidemiology and treatment of three of themost commonly seen disorders in CAMHS: Attention Deficit Hyperactivity Disorder,Oppositional Defiant Disorder and Conduct Disorder. They also provide an overview ofinfant mental health, an area receiving increasing attention as a result of researchhighlighting the importance of the mother-infant relationship for the development of socialand emotional wellbeing and the prevention of behaviour disorders that may lead to schoolfailure followed by unemployment, mental illness, chronic health problems and criminalityin adult life.Attention Deficit Hyperactivity Disorder (ADHD)FeaturesThe core symptoms of Attention deficit Hyperactivity disorder (ADHD) are hyperactivity,inattention and impulsivity. The DSM-IV criteria for a diagnosis of ADHD are grouped intothese three categories and three subtypes of ADHD are defined [402]:1. Combined Type: having at least 6 inattentiveness items plus at least 6hyperactivity/impulsivity items2. Inattentive Type: at least 6 inattentiveness items3. Hyperactive/Impulsive Type: at least 6 hyperactivity/impulsivity itemsSymptoms must have been present for at least six months and be causing significantImpairment in social, academic or occupational functioning and be present in two or moresettings and inappropriate to the child’s developmental level and not better accounted forby another mental disorder. At least some symptoms causing impairment must have beenpresent before the age of seven years.The DSM-IV criteria are:Inattention: Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or otheractivities Often has trouble sustaining attention on tasks or play activities Often does not seem to listen when spoken to directly Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in theworkplace (not due to oppositional behaviour or failure to understand instructions). Often has trouble organizing activities Often avoids, dislikes, or does not want to do things require sustained mental effort for a long period of time(such as schoolwork or homework) Often loses things needed for tasks or activities (such as toys, school assignments, pencils, books, or tools) Is often easily distracted by extraneous stimuli Is often forgetful in daily activities.Hyperactivity: Often fidgets with hands or feet or squirms in seat Often gets up from seat when remaining in seat is expected, in the classroom or other situations Often runs about or climbs when and where it is not appropriate (adolescents or adults may feel veryrestless) Often has trouble playing or enjoying leisure activities quietly Is often "on the go" or often acts as if "driven by a motor" Often talks excessivelyImpulsiveness: Often blurts out answers before questions have been finished Often has trouble waiting his/her turn Often interrupts or intrudes on others (example: butts into conversations or game)Other children often perceive children with ADHD to be irritating or immature and oftenavoid them or tease them because of their socially inappropriate behaviour, low frustrationtolerance, difficulty following rules, bossiness and intrusiveness [403].In-Depth Topic: Mental Health Issues in Children - 377