Pediatric Mental Health and Diseases

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    Mental health is a constant balance and flexible harmony with oneself and the environment. The definition of mental health for adults is generally also accurate for children.
    However, considering that the child has a constantly developing and changing structure, it is necessary to use different criteria in the definition. Therefore, the evaluation of mental health in children depends on knowing in detail the mental qualities that appear during developmental stages. Due to the volatile nature of childhood, seeing them as young adults not recognizing their problems can negatively affect mental health.
    Today, child and adolescent mental health and diseases, in other words, the branch of child and adolescent psychiatry, is a rapidly expanding branch of science all over the world and also in Turkey. It has been defined by the European Association of Medical Professionals as “prevention, diagnosis, and treatment of mental health problems in children under 18 with medical methods, standards, and approaches by specialist physicians”.
    The task of the child and adolescent mental health and diseases department
    Considering its scientific content, it is a biological science in terms of examining genetic, physiological, biochemical, neuroendocrine features, prenatal and postnatal developmental characteristics; social science with its research on interpersonal relationships and interaction styles, child-rearing attitudes, familial and environmental factors starting from the very early period; education and behavioral science in terms of evaluating and shaping the behavior of children, adolescents, and families. It is the science of preventive medicine in terms of taking the necessary precautions for the development of healthy individuals and to treat the psychological problems that occur in childhood before they become widespread.
    In the child and adolescent psychiatry outpatient clinic of our hospital, children and adolescents aged 0-16 years are examined. Mental problems that negatively affect social, family, and academic functionality. If a mental disorder is detected after the necessary psychometric examinations are performed, the appropriate treatment method (individual psychotherapy, medication, play therapy) is determined and applied children can benefit from it both physiologically and psychologically.
    Mental disorders in children and adolescents
    Mental disorders in children can be difficult to define for parents. As a result, many children who might benefit from treatment may not get the help they need. It is important to learn how to recognize the symptoms of mental illness in children and how you can help them. Some of the mental disorders seen in children and adolescents;
    • Attention deficit hyperactivity disorder (ADHD)
    • Learning difficulties
    • Common Developmental Disorders (Autism spectrum disorder)
    • Mental retardation
    • Oppositional defiant disorder (ODD)
    • Behavioral disorder
    • Anxiety disorders
    • Tic disorders
    • Depression
    • Bipolar disorder
    • Speech disorders
    • Enuresis (bottom wetting)
    • Encopresis (poo incontinence)
    • Eating disorders
    • Sleeping disorders
    • Gender identity disorders
    • Alcohol and substance use disorders
    • Early-onset schizophrenia
    • Impulse control disorders
    • Adjustment disorder
    What are the symptoms of mental illness in children?
    Symptoms that your child may have if he/she suffers from a mental health disorder include:
    • Persistent sadness – two or more weeks
    • Avoiding social interactions
    • Talking about hurting or harming himself/ herself
    • Talking about death or suicide
    • Nervous bursts or extreme irritability
    • Out-of-control behavior that can be harmful
    • Being moody
    • Changes in eating habits
    • Weight loss
    • Trouble sleeping
    • Frequent headaches or stomach pains
    • Difficulty concentrating
    • Changes in academic performance
    • Running away from school
    Treatment methods used in child and adolescent psychiatry
    If you are concerned about your child’s mental health, consult your child’s doctor, and explain your concerns. Talk to your child’s teacher, close friends, relatives, or caregivers to see if they notice a change in your child’s behavior. Share this information with your child’s doctor. After a detailed story, the doctor will also meet with your child and make certain tests and decide on the appropriate treatment method. Treatment methods applied in our department;
    • Pharmacotherapy (drug therapy)
    • Individual psychotherapy (cognitive, behavioral and psychoanalytic, supportive)
    • Game therapy
    • Group therapy
    • Family therapy
    Tests in child and adolescent psychiatry
    Mental health problems in children are diagnosed and treated based on the signs and symptoms and how the condition affects the child’s daily life. After talking to the family and the child, the doctor creates a test battery according to the situation. Tests that can take place in the battery are;
    • WISC-R intelligence test
    • Stanford Binet intelligence test
    • Denver II developmental screening test
    • Beier sentence completion test
    • Good Enough-Harris draw a person test
    • Bender Gestalt visual perception motor test
    Psychological evaluation in children and adolescents
    The psychological evaluation includes the evaluation of the child or adolescent in terms of mental, emotional, behavioral, social, and language development, individual characteristics, and various skills (problem-solving, motor skills, academic skills, etc.). It constitutes an important part of the psychiatric evaluation of the child or adolescent and provides quantitative information about the child’s condition by combining the information obtained from the medical history, clinical observations, and conversation.
    Through psychological assessment, it is possible to better understand the strengths and weaknesses of children and adolescents, to find possible causes of complaints, and to determine the appropriate approach for treatment.
    Tests applied to children and adolescents are divided into two main groups:
    • Development and intelligence tests
    • Projective tests
    Weschsler intelligence scale for kids (WISC-R)
    It is an individual intelligence test applied to determine the mental performance of the 6-16 age group. The test consists of two parts, verbal and performance, and each part consists of 6 subtests, one backup, and 5 main tests.
    It is an individual test and is administered to a person in one session. The questions of each subtest are directed to the child following the instructions and the child is asked to answer these questions. The test takes 1.5-2 hours. It is the intelligence test with the highest validity and reliability among the skill and intelligence tests used in our country. Official schools and institutions that provide education to gifted children only accept students according to WISC-R test results. Besides, it includes learning disabilities, distraction and attention span detection, and skill analysis.
    Stanford-Binet intelligence test
    It is an individual intelligence test for children aged 2-6. It takes about 30 minutes for young children and an hour or a half for older ones. The 15 different subtests of the Stanford-Binet test are designed to measure four types of mental abilities that are considered indicators of intelligence. These are verbal judgment, abstract/visual judgment, quantitative judgment, and short-term memory.
    Denver II developmental screening test
    It is a screening test used in the developmental evaluation of children aged 0-6. Denver developmental screening test, are used throughout Turkey since 1996.
    Denver II is used to detect possible developmental problems in children with a healthy appearance. It provides assessment in three main areas;
    Screening healthy-looking children in terms of possible problems
    Provides the opportunity to objectively identify functions suspected of developmental retardation,
    Monitoring babies with risk factors (such as prenatal problems, low birth weight, preterm birth, multiple pregnancies, the developmental problem in the family, birth with assisted reproductive techniques, etc.)
    BILNOT (neuropsychological test for cognitive potentials) battery
    This test measures most of the cognitive processes including attention, visual-spatial perception, learning, memory, exploration, and general ability. This battery contains 4 tests; marking, digit sequence learning, Stroop, and line direction determination tests.
    Marking Test
    Cognitive features this test measures are visual-spatial perception, continuous attention, visual scanning, agility, reaction speed, and spatial neglect.
    Digit Sequence Learning Test
    The cognitive characteristics it measures are memory and learning.
    Stroop test TBAG Form
    Cognitive features that it measures are the ability to change perceptual set-up under disturbing, focused attention and suppress a habitual behavioral pattern, and the ability to do the unusual.
    Line Direction Determination Test
    Cognitive features that it measures are visual-spatial perception and orientation.
    Bender Gestalt visual engine detection test
    This test is applied to individuals aged 5-11 years. It is used to detect retardation, regression, loss of function, and organic brain damage in the visual-motor perception of intelligence. It consists of 9 shapes and the person is asked to draw these shapes. The visual-motor perception score of the person is calculated by scoring each difference of the shapes seen and drawn differently. The test time is not limited.
    Projective tests
    These are tests that the child can answer unlimitedly using a limited structure and vague stimuli. These are tests that aim to evaluate the individual characteristics of children and adolescents, their social adaptation, their way of coping with stressful situations, their mental conflicts, emotions, and self-perceptions, with the help of tools that reflect their inner world indirectly such as stories and pictures.
    Sentence completion test
    It is applied to children between the ages of 8-16. It can be applied individually or to a certain group. The child is asked to complete the missing sentences by reading the instruction. The child reflects his / her interests, attitudes, expectations, troubles, feelings, and thoughts by completing the missing sentences in this test.
    Child perception test (CPT)
    It is applied to children between the ages of 3-12. It was developed from the idea that children identify with animals and can tell better stories for animals.
    Goodenough Harris man boot test
    The test, which is applied to children between the ages of 7-9, aims to measure intelligence development through the picture drawn by the child.
    Gazi-Bayer picture interpretation test
    Symonds Test

    Pediatric Mental Health and Diseases Doctors

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