Understanding a patient’s history provides insight into their coping mechanisms, unresolved issues, and patterns of abnormal behavior, which can help reduce further risks. While a formal childhood diagnosis isn’t always necessary, asking about past symptoms, significant events, and factors that have helped can be valuable when treatment isn’t effective. The following information offers an overview of common mental health disorders in children and symptoms to consider in such cases:
Pediatric Mental Health Diagnoses
While children can develop some of the same conditions as adults, such as anxiety, depression, and OCD, there are also several mental health disorders that specifically develop during childhood.
- Avoidant-Restrictive Food Intake Disorder (ARFID): ARFID is an eating disorder characterized by the persistent refusal to eat specific foods or refusal to eat any type of food due to a negative response to the color, texture, or smell of certain foods. Additionally, individuals may refuse to eat out of fear of becoming sick or the fear of choking on food. This disorder is not characterized by the obsession with body shape or weight, but rather is the disinterest and avoidance of certain foods. This disorder can result in excessive and unhealthy weight loss, malnutrition, or nutritional impairment.
- Pica: Pica is an eating disorder formally recognized by The DSM-5 as the persistent ingestion of non-edible substances for at least one month at an age when this behavior is considered developmentally abnormal (at least two years of age). Common substances a child with this disorder will ingest include ice, clay, lead, dirt, sand, stones, paint chips, coals, chalk, wood, light bulbs, needles, string, cigarette butts, and wire. Pica is most frequently diagnosed in children, however, it is the most common eating disorder in individuals with developmental disabilities.
- Pediatric Bipolar Disorder: When a child has bipolar disorder, they experience extreme shifts in mood in behaviors that can result in a high, known as a manic episode, or a low, known as a depressive episode. Bipolar disorder is more likely to emerge in the late teen years or in early adulthood, but children as young as six years of age can experience it as well. Bipolar disorder is estimated to occur in 1-3%of youth, the majority of whom are adolescents rather than children.
- Disruptive Mood Dysregulation Disorder (DMDD): DMDD is a condition in which a child is chronically irritable and experiences frequent, severe temper outbursts that seem out of proportion to the situation at hand. Children diagnosed with DMDD struggle to regulate their emotions in an age-appropriate way. In between outbursts, they are irritable most of the time. DMDD is a somewhat new diagnosis that more accurately represents the symptoms of children who were previously diagnosed with pediatric bipolar disorder, even though they did not experience the episodic mania or hypomania characteristic of bipolar disorder. It is only diagnosed in children aged 7-18.
- Attention Deficit Hyperactivity Disorder (ADHD): ADHD is a developmental condition of inattention and distractibility, with or without accompanying hyperactivity. There are three basic forms of ADHD described in the DSM-5: inattentive, hyperactive-impulsive, and combined. The symptoms of ADHD and mania or hypomania associated with bipolar disorder are sometimes very similar. Kids might show distractibility, talkativeness, difficulty maintaining attention, or loss of social functioning. Clinicians must assess whether it is one condition or whether the disorders are co-occurring. The treatment for ADHD is a stimulant, which can worsen manic episodes in children with bipolar disorder, so it’s important to rule out bipolar disorder before treating ADHD.
- Oppositional Defiant Disorder (ODD): ODD is a recurrent pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness toward authority figures lasting at least six months. This behavioral disorder usually manifests before eight years of age. It is more commonly seen in boys before puberty but is equally prevalent in boys and girls after puberty. This differs from DMDD because children with ODD have irritable or inappropriate outbursts that are specifically targeted toward certain authority figures such as parents and teachers. Children with ODD are commonly on their best behavior around other individuals, which can cause a lot of stress for the parents.
- Separation Anxiety Disorder (SAD): Separation anxiety disorder is characterized by persistent and excessive anxiety during impending separation from the primary caretaker. Other symptoms include repeated nightmares involving the theme of separation, complaints of physical symptoms when separated from major attachment figures, and reluctance to go to school or engage in social activities. To meet the criteria for diagnosis, SAD must cause severe impairment in social, occupational, or academic settings. Early and traumatic separation from the mother, father, or other caretaker is known to be a risk factor for the development of separation anxiety in children.
–National Alliance on Mental Illness
| Psychiatric Disorder | Age of Onset, Per DSM-5 |
|---|---|
| Intellectual Disability | Infancy (usually evident at birth) |
| ADHD | Early Childhood (by age of 12) |
| Schizophrenia | 18-25y for Men & 25-35y for Women |
| Major Depression | Late Adolescence-Young Adulthood |
| Dementia | Most Common >85y |
Additional Information and References
Common Disorders: a quick DSM-5 review of psych diagnosis that’s frequently seen in children, and the following are simple guides and topics about personal experiences for treating these main disorders:
- ADHD: some factors to consider for treating ADHD and prescribing medications. Check out some ADHD treatment charts.
- ASD: simple key points about treatment & developmental disorder information & resources
- IED/Conduct Disorders/ODD: basically anger/aggression/violence with kids and teens
- DMDD: discussing the considerations of treatment and distinguishing it from other disorders
