Child and Adolescent Psychiatry

Attachment Disorders 147 of social responsiveness and reciprocity in a foster placement points to an attachment disorder rather ...

148 Chapter 17 which is only reliable under the age of 2 years anyway. It is important to take a careful history from multiple i ...

Attachment Disorders 149 between the child and his or her current caregiver should be carried out, looking for insensitive and i ...

150 Chapter 17 disorders seem particularly likely to interfere with friendships and intimate relationships; somewhat less likely ...

CHAPTER 18 Enuresis Though enuresis is sometimes considered a psychiatric disorder, with some parents imagining that it is due t ...

152 Chapter 18 Nocturnal enuresis Primary and secondary Children and adolescents are said to have primary enuresis when they hav ...

Enuresis 153 enuresis; these studies have implicated different chromosomal sites in different families. This may reflect the exi ...

154 Chapter 18 2 One third of nocturnal enuresis involves bladder over-activity or in- stability. Pointers to this include: smal ...

Enuresis 155 Behavioural measures Rewards It is important that parents do not inadvertently reward and thereby reinforce enuresi ...

156 Chapter 18 for older and highly motivated children is dry-bed training, which is an intensive form of behavioural therapy th ...

Enuresis 157 Diurnal enuresis As already noted, diurnal enuresis is rarer than nocturnal enuresis. In the Isle of Wight study, 2 ...

158 Chapter 18 3 Enuresis causes psychiatric problems. Several studies have shown that suc- cessful treatment or natural remissi ...

CHAPTER 19 Faecal Soiling Children have normally acquired reliable bowel control by the age of 3 or 4, though they may still hav ...

160 Chapter 19 involved, since (unlike enuresis) there is a high chance that psychological problems have either contributed to t ...

Faecal Soiling 161 fears openly and sympathetically, without ridicule. The fears themselves can be addressed through appropriate ...

162 Chapter 19 there are three possibilities. First, psychiatric disorders could lead on to soiling, though follow-up studies pr ...

CHAPTER 20 Sleep Disorders Sleep problems are relevant to child and adolescent mental health pro- fessionals because there is a ...

164 Chapter 20 Box 20.1Sleep structure Awake REM Non-REM Cycles Bedtime Morning ** Notes: REM=Rapid Eye Movement: the phase of ...

Sleep Disorders 165 Box 20.2Good sleep hygiene Daytime Avoid naps, particularly late in the day. Regular exercise (but not too ...

166 Chapter 20 These are presentations, not diagnoses. Making a diagnosis requires a detailed clinical history and may also requ ...