Anxiety and Separation Disorders
IWK Health Centre and Dalhousie University, Halifax, Nova Scotia, Canada.Pediatrics in Review (Impact Factor: 0.82). 10/2011; 32(10):440-5; quiz 446. DOI: 10.1542/pir.32-10-440
• Based on strong research evidence, anxiety disorders are the most common psychiatric illness in children and adolescents. • Based on some research evidence, the neurobiology of anxiety disorders is linked to dysregulation in the fear and stress response system in the brain. • Based on strong research evidence, separation anxiety disorder is one of the most common causes of school refusal, and addressing both the function of the behavior and returning to school as soon as possible is recommended. (7)• Based on strong research evidence, CBT is the first-line treatment for anxiety disorders in children and adolescents. • Based on strong research evidence, SSRIs are effective for treatment of moderate-to-severe anxiety disorders in children and adolescents.
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ABSTRACT: Streptococcal infections in children rarely lead to neuropsychiatric manifestations referred to as pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections. The common sequelae include tics, Tourette's syndrome or obsessive-compulsive disorder. Rare presentations may include separation anxiety disorder, body dysmorphic disorder and attention deficit hyperactivity disorder. We present a case of a 10-year-old child that presented primarily with abrupt onset of separation anxiety without any other neuropsychiatric manifestations such as tics or obsessive-compulsive symptoms. Streptococcal infections may present with varied neuropsychiatric manifestations in the pediatric age group and one needs to be more vigilant in cases that have an abrupt onset and unusual presentation. A high index of suspicion is important to diagnose such cases and provide them with a timely treatment.
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ABSTRACT: School refusal brings children into conflict with the immediate family, the school, and the community, thus affecting their social and psychological well-being. School refusal may be an emotional problem of the child that is closely associated with unresolved dependency relationships, usually with the mother. The nature of this pathology can be meaningfully understood from a psychoanalytic perspective, which is presented in this article, accompanied by a case presentation. Central to this pathology are hostility issues expressed in transference and counter-transference, which often perplexes adults who are close to the child. Parents, educators, and health care professionals might overlook the actual emotional cause of the problem and respond with anger, forcing the child to return to school. However, school refusal requires comprehensive psychosocial interventions at the individual level and at the level of relationships among the child, the family, and the school.