Name: Nur A’isyah Binti IdrisID No.: 082012100068

*other behavioral & emotional disorder with onset occurring in childhood & adolescence

*Contents

*Nonorganic encopresis*Nonorganic enuresis*Stereotyped movement disorder*Speech disorder*Feeding disorder of infancy & childhood*Pica of infancy & childhood

Nonorganic enuresis*Repetitive voiding of urine,

either during day/night, at inappropriate places*Enuresis is diagnosed only

after 5 year of ageCan be either: *primary type*Secondary typeEtiology:*Exact cause not known*Genetic factor*Psychosocial*Emotional disturbances*Insecurity, sibling rivalry,

death of parents

*Organic cause: worm infestation, spina bifida, neurogenic bladder, UTI, DM, seizure disorder.

*Treatment:*Restriction of fluid intake after

8PM*Bladder training during daytime*Interruption of sleep before the

expected time of bed wetting*Conditioning device*Supportive psychotherapy*Pharmacotherapy: imipramine,

diazepam, anticholinergic, amphetamines, placebos

Nonorganic encopresis*Repetitive passage of faeces at inappropriate time & place, after bowel control is physiological possible*Occurring after the age of 4 years*> common in male*Tends to remit with increasing age & by the age of 16*Can be either:*Primary *SecondaryEtiology :*Inadequate, inconsistent toilet training*Sibling rivalry

*Maturational lag*Emotional disturbances*Mental retardation*Childhood schizophrenia*Autistic disorder*Organic causes: fecal incontinence, hirschsprung’s

disease, overflow diarrhea with constipation, hypothyroidism, IBS, neurological lesions.

Treatments:*Preventive*Toilet training*Behavioral therapy*Psychotherapy, imipramine

Stereotyped movement disorder

*Intentionally & repetitively produced but serve no constructive or socially acceptable function.

*Common habit disorder: thumb sucking, nail biting, pulling out of hair, head banging, teeth grinding, picking of nose, biting parts of the body, skin-scratching, body rocking, breath-holding, swallowing of air

Treatment:*Behavioral modification*Treatment of underlying psychopathology

Speech disorder*Stuttering disorderCharacterized by:*Disturbed fluency & rhythm of speech*Intermittent blocking*Repetition of words rapidly*Prolongation of sounds*Associated anxiety or distress

Dd(x): cluttering.*Stuttering: person aware of

difficulty in speech*Cluttering: person unaware

of abnormal speech patternTreatment:*Behavior modification

technique*Relaxation therapy,

individual therapy, group therapy.

Pica of infancy & childhood

*Persistent eating of non-nutritive substances*Most commonly in mentally

retarded children*May also occur in children

of normal intelligence.

Factor:Poor supervisionMental retardation

Management*Reinforcement of

other behavior*SSRI*Dentist therapy*Iron supplement

Feeding disorder of infancy & childhood*Of varying manifestation* Involve refusal of food &

extreme faddiness in the presence of an adequate food supply, a reasonably competent care giver & absence of organic disease*Minor difficulties in eating*Diagnose: difficulties clearly

beyond the normal range*Dd(x):

organic diseaseAnorexia nervosa & other eating disorderBroader psychiatry disorderPicaFeeding difficulties & mismanagement

Management: Feeding therapy Feeding tube

*ICD-10, page 224-226*A short textbook of psychiatry, Niraj ahuja, seventh edition

*Referrences

*Thank you