Child and Adolescent Psychiatry

Assessment 7

individuals do exist. Thus you may see pure emotional symptoms in
generalised anxiety disorder, pure behavioural symptoms in socialised
conduct disorder, and pure relationship difficulties in disinhibited at-
tachment disorder. Pure developmental delays, such as primary enuresis,
receptive language disorder or specific reading disorder are not usually
seen by child and adolescent psychiatrists in the absence of other symp-
toms. However, children presenting with ADHD may seem to have fairly
pure delays in the development of attention and activity control.
Most of the children and adolescents seen by psychiatrists have symp-
toms from two or more domains. For example, individuals with conduct
disorder also commonly have emotional symptoms, peer problems, and
developmental delays, such as specific reading disorder or hyperactivity
(see Box 1.1).

Box 1.1Syndromes can involve one symptom domain or many

(1) Socialised conduct disorder

(2) Conduct disorder with emotional, peer and reading problems

No

relationship

difficulties

Conduct

problems

Poor peer

relations

Conduct

problems

No

emotional

symptoms

No

developmental

delay

Depression

Specific

reading

disorder

Autism provides another illustration of symptoms in multiple domains.
The core symptoms of autism span two domains, with characteristic
patterns of relationship problems and developmental delays (as well as
developmental deviance and rigidity). In addition, autistic individuals