Monday, May 11, 2009

Diagnostic simplicity: All treatments fall into these categories.

In children, most psychiatric issues fall into one of the categories listed below. In a way it is an over simplification but a useful one. There can be one or more of these symptom clusters present.

1. Impulse control issues either due to ADHD or affective impulsivity.
2. Emotional dyscontrol or affective dysregulation. This includes depression, mania and other non specified mood dysregulation.
3. Thinking problems that include thought disorders and other psychotic symptoms.
4. Anxiety related symptoms and disorders.

Now all psychotropic medications used in children address any or all of the catogories above irrespective of the diagnosis. The diagnosis is very important when clear and can be used to guide prescribing of medications safely. Many times in younger children the ability to make a clear diagnosis is very difficult. It is during such times or until more better better diagnostic methods are available that one can go back to a simpler way of thinking while prescribing for symptoms that don't meet a particular category, but only after all non pharmacologic methods have failed.

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