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Child and Adolescent Psychiatry

Child and Adolescent Psychiatry is a branch of medicine that revolves around the mental well-being of a child. It is the study, analysis, and treatment of the emotional, mental and behavioural disorders of childhood. Child Psychiatry consists of the diagnosis, treatment, prevention and rehabilitation of behavioural disturbances and psychiatric and developmental disorders in the young.

Importance of Child Psychiatry

Mental health is an essential part of a child’s overall health. It’s a very complex interactive relationship with physical health and the environment. As a parent, you play a very crucial role in your kid's mental health. 

You, as a parent, must create a safe environment at home, while helping them build strong, caring relationships. You must help children and young adults develop self-esteem and confidence. However, children often get triggered by certain external factors and develop child psychological problems which ultimately ruin their mental health; this is where Child Psychology helps. 

Everyone wants their child to have a healthy development, both physically and mentally. but often parents fail to understand why a child behaves the way they do. Sometimes they are too shy to play with others, or sometimes they are hyperactive and out of control.

They often behave aggressively without any proper reason. A child's behaviour is a symptom, either of a normal stage in development or a sign of an abnormality.

Be patient with your children while dealing with such symptoms. If your child is struggling, then it is crucial for you to adopt the traits of compassion and patience.

Be empathetic to calm their temperament. In case your child's behaviour is too disruptive and holds back their education or day to day activities or if they become violent, then it is time to talk to a professional child psychiatrist. 

Child psychology helps to analyze the subconscious and conscious childhood development, along with different kinds of psychiatric assessments that help to treat mental health conditions. 

At Cadabams, the Child Psychiatry wing has tight-knit support of psychologists who manage all the assessments and psychosocial support that is needed for a child or adolescent, and the family.

Common Mental Disorders Among Children

It is unlikely that a child (below 5 years of age) will exhibit serious mental health issues, but here are few disorders in children and their symptoms to help you understand whether they are struggling in their day to day life - 

Anxiety Disorders

Anxiety is the body's response to a certain situation. Primarily, it is a response to stress about what's about to happen next? It is okay to feel anxiety once in a while, but if the feeling of fear is intense, debilitating and persists for a long time, then it is a sign that your child needs help. Different types of anxiety include:

  • General Anxiety - Being extremely worried about normal things like having exams. 
  • Separation Anxiety - Being afraid when away from parents
  • Phobias - Having extreme fear in a situation or about a specific thing such as closed or dark room, fear of insects or visiting a stranger.
  • Social Anxiety - Being very afraid of crowded places, even schools. 
  • Panic Disorder - Having repeated episodes of sudden, unexpected, intense fear. It includes symptoms as troubled breathing, heart pounding, feeling dizzy, shaky, or sweaty.
  • Illness anxiety disorder - An obsessive and irrational worry about having a serious medical condition.

Attention-Deficit / Hyperactivity Disorder (ADHD)

It is a mental health disorder that can cause above-normal levels of hyperactive and impulsive behaviours. Children with ADHD often have trouble focusing attention on a single task or sitting still for long periods of time. 

Symptoms of ADHD include - 

  • having trouble focusing or concentrating on tasks
  • being forgetful about completing tasks
  • loses things necessary for tasks and activities (books, pens, etc.)
  • does not seem to listen when spoken to directly
  • being easily distracted
  • often has trouble organizing tasks and activities
  • having difficulty sitting still
  • interrupting people while they’re talking
  • often fidgets with or taps hands or feet, or squirms in seat
  • tend to interrupt or intrude on others

Oppositional Defiant Disorder (ODD)

Children with ODD are more likely to act oppositional or defiant around people they are close to, such as parents. The exact cause of ODD is unknown. 

Examples of ODD behaviours include - 

  • being angry or losing one’s temper
  • arguing with adults or refusing to comply with adult’s requests
  • Always questioning rules and refusing to follow them
  • resentful or spiteful
  • deliberately annoying others or becoming annoyed with others
  • blaming other people for one’s own mistakes or misbehaviour
  • frequently demonstrating an angry attitude
  • speaking harshly or unkindly to others
  • behaviour seeking revenge

Autism Spectrum Disorder (ASD)

ASD is a pervasive neurological developmental disability that hampers normal brain development. This condition affects speech and nonverbal communication, social skills, cognition, and behaviour. 

Some common symptoms include - 

  • Difficulty in forming meaningful sentences while talking. 
  • At an early stage of infancy, they may not display any anticipatory posture or smile for being picked up by an adult. 
  • Difficulty in hearing
  • Extremely sensitive to smell, touch, taste, sound, light, and colour
  • Difficulty in following directions or instructions
  • Activities are generally rigid, repetitive, and monotonous

Eating disorders

Eating disorders are defined as constant worry about weight and weight loss, and/or unsafe eating and dieting habits. 

Such disorders include - anorexia nervosa, bulimia nervosa, and binge-eating disorder.

  • Anorexia Nervosa - People with Anorexia Nervosa have an intense fear of gaining weight and have a distorted perception regarding weight. This disorder is characterized by abnormally low body weight.
  • Bulimia Nervosa - Commonly called as Bulimia, is a serious life-threatening eating disorder. They tend to secretly binge eat large amounts of food with a loss of control over the eating and then purge, trying to get rid of the extra calories in an extremely unhealthy way.
  • Binge Eating Disorder (BED) - It is a type of feeding and eating disorder that’s now recognized as an official diagnosis. People with BED tend to eat much more rapidly than normal until they are uncomfortably full. They eat alone due to feelings of embarrassment and shame or have feelings of guilt or disgust with self.

Post-Traumatic Stress Disorder (PTSD)

PTSD is a mental health condition that's triggered by a terrifying event. Children react to violence, abuse, injury, or any traumatic events differently. They often show prolonged anxiety, nightmares, emotional distress, distressing memories, and disruptive behaviours. Symptoms can vary over time or vary from person to person

  • Recurrent, unwanted distressing memories of the traumatic event
  • Trying to avoid thinking or talking about the traumatic event
  • Negative thoughts about yourself, other people or the world
  • Being easily startled or frightened
  • Reliving the traumatic event as if it were happening again (flashbacks).

Learning and Communication Disorders

In such conditions, the child faces problems while storing and processing information, as well as, relating their thoughts and ideas. Some of the symptoms of learning and communication disorders are - 

  • Difficulty telling right from left
  • Reduced vocabulary in comparison to other children of the same age
  • Reversing letters, words, or numbers, after first or second grade
  • Difficulty in recognizing patterns or sorting items by size or shape
  • Not speaking at all
  • Limited word choice for his or her age
  • Trouble grasping simple directions or naming objects

Signs and Symptoms of Mental Health Disorders in Children

Watch out for the following signs and symptoms which are characterized as child psychology behaviours and need a pediatric psychiatrist immediately. 

Young Children

  • Throw frequent tantrums - regular refusal to go to school, go to sleep, etc.
  • Always irritable 
  • Persistent disobedience or aggression (longer than 6 months) and provocative opposition to authority figures
  • Often talk about fears or worries / have frequent nightmares
  • Frequent complaints about headaches or stomach aches with no proper medical cause
  • Hyperactive (except when they are watching videos or playing video games)
  • Fidgeting- constant movement beyond regular laying, with or without difficulty paying attention
  • Sleep too much or too little or seem sleepy through the day
  • Have difficulty interacting with others and making friends
  • Not interested in playing outdoors
  • Repetitive actions or checking things regularly out of fear that something bad may happen.
  • Poor grades in school despite trying very hard
  • Threatens to harm or kill oneself

Pre-Adolescents and Adolescents

  • Have experienced a recent decline in grades
  • Inability to cope with problems and daily activities
  • Marked changes in sleeping and/or eating habits
  • Fear gaining weight, or diet or exercise excessively
  • Extreme difficulties in concentrating that get in the way at school or at home
  • Spending more time alone, and avoiding social activities with friends or family
  • Depression showed by sustained, prolonged negative mood and attitude, often accompanied by poor appetite, and difficulty sleeping, along with suicidal thoughts 
  • Engage in self-harm behaviours or  have suicidal thoughts
  • Severe mood swings
  • Strong worries or anxieties that get in the way of daily life, such as at school or socializing
  • Repeated use of alcohol and/or drugs or smoking

Some of the subspecialties of Child and Adolescent Psychiatry include:

Abnormal child psychology: Treating children suffering from psychological disorders including anxiety, mood and personality disorders, emotional disorders such as phobias, disruptive behaviours, bedwetting, separation anxiety

Adolescent psychology: Adolescent clients between the ages of 12 and 18 who suffer from psychological illness or distress including eating disorders, depression or anxiety, teenage coping issues, and anti-social behaviour

Developmental psychology: Study of childhood development in various spheres such as that of cognitive development and psychosocial development

Behavioural medicine: It is the science of changing behaviour for a more positive, healthy & happy life. It addresses disruptive behaviours, attention-seeking behaviours to be changed into more positive and better behavioural habits

At Cadabams Hospitals, a few of the typical tasks our child psychologist conducts include:

  • Diagnosing and treating learning/developmental disabilities
  • Behaviour modification
  • Administering psychological tests
  • Conducting scientific research on childhood development
  • Working with a health care team to create a unique treatment plan for a client

Types of Psychotherapy Treatment for Children and Adolescents

Mental health symptoms and Behavioral problems can keep children and adolescents from leading a happy and successful life. Psychotherapy is a type of psychiatric treatment used primarily for Child and Adolescent Psychiatry. It involves therapeutic conversations and interactions between a child, it's family and caregivers and a therapist or child psychologist.

Child counselling and Psychotherapy helps  diagnose the disorder, resolve problems, modify behaviour, and make positive changes in their lives. There are several types of psychotherapy involving various techniques, approaches, and interventions. Often a combination of different psychotherapies and medications helps to overcome a disorder.

Cognitive Behavioural Therapy (CBT)

It is an evidence-based therapy and helps to reduce distress and improve the ability to function. CBT is used for several disorders. CBT helps a child understand, examine and change the way they think (cognitive), act (behaviour) and feel (emotionally and physically).

CBT is an effective treatment for depression, anxiety, eating disorders, low self-esteem, anger problems, substance use problems, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD) and symptoms.

Dialectical Behavioural Therapy (DBT)

DBT is a subspeciality of cognitive-behavioural treatment. It involves an individual therapy session on a regular basis and a skills group session every week for at least 6 months. The skills group therapy focuses on - 

  • Mindfulness skills - to manage attention
  • Emotional Regulation Skills - to manage and cope with emotions
  • Interpersonal Skills - to deal effectively with others
  • Distress tolerance skills - to tolerate emotional distress

DBT is used to treat older adolescents who have chronic suicidal feelings/thoughts, engage in intentionally self-harmful behaviors.

Emotion-focused Therapy (EFT)

Emotions, an important part of the disorder, are the main focus in this treatment. This therapy helps understand how to deal with emotions and emphasizes on the self and the importance of past relationships. Children with psychiatric issues tend to avoid emotions and pretend that everything is okay.

This leads to a huge gap between self and emotional needs which aren't met. EFT is especially effective for challenges and disorders like moderate depression, the effects of childhood deprivation or abuse, interpersonal problems, eating disorders, and couples & relationship difficulties.

Family Therapy

This therapy analyzes the psychological problems between the child psychological problems and their families. This treatment also revolves around the interactions among family members as a part of therapy. Family therapy is especially effective for individuals with eating disorders, problems with substance use, problems with anger or oppositional behaviours, anxiety and obsessive compulsive disorder, and youth with medical illness. 

Play Therapy

As the name suggests, this therapy gives a child a caring and safe environment to play. Though play therapy, children and young adults express their experiences and feelings, increase self-awareness, develop social skills, deal with emotional problems, and learn to cope with the symptoms of depression, anxiety, trauma and stress.

Mindfulness-based Therapies

Mindfulness is paying attention. Mindfulness helps to change negative behaviours, manage difficult emotions, reduce suffering, improve self-awareness, and also increase empathy. The goal of mindfulness is to focus on observing a situation rather than reacting to someone and accepting it without judgement. There is ample evidence which shows that children who practiced mindfulness reported higher wellbeing and lower stress scores. 

Psychodynamic Therapy

Unconscious mind holds onto painful feelings and memories that are too difficult for the conscious mind to process. These memories of childhood lead to developing defences such as denial to hide these experiences from themselves.

Psychodynamic therapy focuses on how childhood memories or trauma can affect a child's development. This psychotherapy  therapy focuses on increasing self awareness, examining thoughts and feelings, becoming more resilient, and being adaptable.

Psychotherapy for Parents and Young Children

There are various types of treatment for parents and young children which focuses on strengthening the bond between parent and child. It includes exercises of keeping children safe, listening to children and spending time with them, providing affection, order, and consistency, setting and enforcing limits for children and monitoring friendships children make.

Psychotherapy for parents and young children include therapies like Circle of Security Parenting, Parent-Child Psychotherapy, Modified Interaction Guidance (MIG), and Child-Parent Relationship Therapy.

About Cadabams Hospital

Cadabams is one of the best Child Counselling and Child Psychiatry hospitals in Bangalore. We offer multi-speciality mental health care for children and adolescents. We offer all kinds of well-integrated services that constitute a team of trained and experienced professionals, specializing in different child care disciplines.

Cadabam's Hospitals integrate a holistic approach in child and adolescent psychiatry. At Cadabams, Psychiatry and Neurology specialists consider the biological, psychological, and social factors associated with children and their parents. The child psychiatrist conducts a detailed diagnostic examination to evaluate the current problems with attention to physical, genetic, developmental, emotional, cognitive, educational, family, peer, and social components.

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doctors | Child and Adolescent Psychiatry

Dr. Vishal Kasal

Vishal Kasal
MBBS (Psychiatry), M.D.(Psychiatry)

Consultant Psychiatrist

Dr. Mala Murlidhar

MALA MURLIDHAR
PH.D. (Clinical Psychology), MS (Clinical Psychology), BA (Psychology)

Consultant Clinical Psychologist

Dr. Raja Mahabaleshwar Hiremani

Raja Mahabaleshwar Hiremani
MBBS, M.D. (Psychiatry), NIMHANS, FRANZCP (AUS)

Consultant Psychiatrist

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