Child and adolescent psychiatry and psychotherapy deals with the diagnosis, therapy and prevention of mental illnesses and behavioral disorders in childhood and adolescence. With the help of medical and psychological procedures, the mental health of patients is to be established and maintained.
What is child and adolescent psychiatry and psychotherapy?
Child and adolescent psychiatry and psychotherapy is concerned with the diagnosis, treatment, and prevention of mental illness and behavioral disorders in childhood and adolescence. Child and adolescent psychiatry and psychotherapy is an independent medical specialty. It deals with the research, diagnosis and therapy of mental illnesses and social abnormalities in adolescents. The prevention of mental illness is also one of its core tasks. To achieve these goals, child and adolescent psychiatric and psychotherapeutic practice draws on findings from medicine, biology and psychology. These are used for the treatment of mental, psychosomatic and neurological disorders, for intervention in cases of conspicuous social behavior and for rehabilitation in addictive disorders. Children and adolescents are defined here as boys and girls as well as adolescents up to the age of 18. In exceptional cases, child and adolescent psychiatrists and psychotherapists may also treat older adolescents. These have either completed a medical degree with further training in a child and adolescent psychiatric clinic or a degree in psychology or pedagogy and subsequent training. Accordingly, a distinction must be made between treatment by a physician and by a psychotherapist.
Treatments and therapies
The basis of diagnostics in child and adolescent psychiatry and psychotherapy are two international manuals. These are catalogs of known clinical pictures that contain a classification, definition, and brief description of these diseases. These are the ICD (English abbreviation for “International Statistical Classification of Diseases and Related Health Problems”) and the DSM (English abbreviation for “Diagnostic and Statistical Manual of Mental Disorders”). As extensive as they are in the field of mental illnesses in children and adolescents, the treatment spectrum of this specialty is equally diverse. First of all, intelligence deficits and states of dementia, which can already occur in children and adolescents, fall into this spectrum. These can be related to developmental disorders such as dyslexia, dyscalculia and dyscalculia, whereas dyslexia and dyscalculia cannot be inferred from reduced intelligence. Motor disorders can also have psychological or psychiatric causes. In the field of hyperkinetic disorders, particular mention should be made of attention deficit disorder (ADHD), which is controversial among scientists and was diagnosed in over 600,000 children and adolescents in Germany alone in 2011 and is usually treated pharmacologically. Tics can also occur in childhood and adolescence, as well as typical behavioral problems that can be accompanied by self-injurious behavior. In the case of disturbed speech behavior, child and adolescent psychiatrists and psychotherapists work together with speech therapists and speech therapy pedagogues. Other disorders include autism and other perceptual and communication disorders. Schizophrenia can also occur in childhood and requires psychiatric and psychotherapeutic treatment. Affective disorders include manic and bipolar disorders in addition to depression. Similarly serious can be personality disorders, disorders of social as well as sexual behavior. In childhood and adolescence, anxiety and obsessive-compulsive disorders as well as stress disorders may occur. These may or may not be associated with traumatic experiences. Finding out their cause and remedying them is also one of the tasks of psychiatrists and psychotherapists who specialize in this age group. Another problem that practitioners often face is eating disorders such as anorexia and bulimia, as well as obesity. Also common at this age are addictive disorders.
Diagnosis and examination methods
Child and adolescent psychiatry and psychotherapy is interdisciplinary.This means that scientific knowledge from different fields flows together here, and different diagnostic and therapeutic approaches coexist, complement each other and can compete with each other. The basis of diagnostics in the field of child and adolescent psychiatry and psychotherapy is the medical history interview, the medical examination and psychological testing procedures. The anamnesis is understood to be the history of the illness. Since children and adolescents are often not able to describe this, the caregivers play a decisive role. In the course of the anamnesis, not only is the reason for the examination established, but the physician or psychologist also formulates the questions for the further examination steps, which are decisive for the selection of the medical and psychological test procedures. The medical examination can make use of different procedures depending on the course of the anamnesis interview. The physical examination by the physician and the determination of the patient’s laboratory values is only the first step; imaging procedures such as computer tomography and functional magnetic resonance imaging may also be used. Once a diagnosis is established, child and adolescent psychiatrists and psychotherapists have a variety of testing procedures and therapies open to them, such as drug treatment, depth psychological or behavioral therapy. Treatment with psychotropic drugs can only be carried out by the physician. Frequently used are drugs from the group of stimulants, antidepressants and neuroleptics. Pharmacotherapy is rarely the only measure; it is supplemented by conversation-based and behavioral procedures. In addition, systemic family-based approaches are of great importance in this area. The focus is not only on the child or adolescent concerned. Rather, his or her behavior within the family constellation, in the school and private context is considered. The therapy of children and adolescents can take place as an inpatient, in specialized psychiatric clinics, or as an outpatient. The legal basis for the work of child and adolescent psychiatrists and psychotherapists is laid down by law in the Child and Youth Welfare Act (KJHG) and the Mental Health Act (PsychKG), among others.
