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Overview of Mental Health Disorders in Children

By Josephine Elia, MD, Professor of Psychiatry and Human Behavior, Professor of Pediatrics;Attending Physician, Sidney Kimmel Medical College of Thomas Jefferson University;Nemours/A.I. duPont Hospital for Children

Several important mental health disorders, such as depression, anxiety disorders, and eating disorders, often start during childhood and adolescence. Schizophrenia typically starts anytime during the middle of adolescence through young adulthood (into a person's mid-30s). Some disorders, such as autism, start only during childhood.

With a few exceptions, symptoms of mental health disorders tend to be similar to feelings that every child experiences, such as sadness, anger, suspicion, excitement, withdrawal, and loneliness. The difference between a disorder and a normal feeling is the extent to which the feeling becomes so powerful as to overwhelm and interfere with the activities of normal life or cause the child to suffer. Thus, doctors must use a significant degree of judgment to determine when particular thoughts and emotions stop being a normal component of childhood experience and represent a disorder.

Disruptive behavioral disorders affect mainly behavior. The behavior is not intentionally disruptive but may disturb others, including teachers, peers, and family members. These disorders include

Neurodevelopmental disorders affect both mental health and overall development in children. These disorders include

Autism spectrum disorders may involve some combination of impaired social relationships, a restricted range of interests, abnormal language development and use, and, in some cases, intellectual impairment. Rett syndrome, a genetic disorder, causes some similar symptoms, including difficulties with social skills and communication.

Diagnosis

  • Observations

  • Sometimes specialized interview and assessment tools

No test can confirm the diagnosis of a mental health disorder. Doctors rely on an interview with the child or adolescent and observations of parents and teachers and on those made during the office visit to help determine whether a mental health disorder is present. Sometimes doctors refer the child to a mental health care practitioner who is trained to diagnose and treat mental health disorders in children and adolescents. These practitioners may use specially designed interview and assessment tools to evaluate the child.

Doctors may do blood tests to check for neurodevelopmental disorders, such as Fragile X syndrome, Rett syndrome, and DiGeorge syndrome.