pediatrics
Overview of Psychiatric Disorders in Children and Adolescents
Evaluation
Evaluation of psychiatric symptoms in children and adolescents differs from that in adults in important ways: Developmental context is critically important in children. Behaviors that are normal at a young age may indicate a psychiatric disorder if present at an older age. Children exist in the context of a family system, and that system has a profound effect on their symptoms and behaviors; normal children living in a family in which violence and Overview of Substance Use may superficially appear to have one or more psychiatric disorders. Children also exist in the context of environmental stressors (eg, COVID-19 pandemic, military conflict). The resultant disruption of critical routines and isolation from extended family, peers, teachers, and cultural and religious groups have a significant impact, especially on the most vulnerable groups ( Children often do not have the cognitive and linguistic sophistication needed to accurately describe their symptoms. Thus, the clinician must rely very heavily on direct observation corroborated by observations of other people, such as parents and teachers. In many cases, developmental and behavioral problems (eg, poor academic progress, delays in language acquisition, deficits in social skills) are difficult to distinguish from those due to a psychiatric disorder. In such cases, formal developmental and neuropsychologic testing should be part of the evaluation process. Because of these factors, evaluation of children with a psychiatric disorder is typically more complex than that of adults. However, most cases are not severe and can be competently managed by an appropriately trained primary care practitioner. However, uncertain or severe cases are best managed in consultation with a child and adolescent psychiatrist. 