Child Psychiatry

places despite having normal bowel control. Most children are faecally continent by the age of 3 years. At 8 years, 2% of boys and 1% of girls have encopresis. This may be due to inadequate toilet training or may have a psychological cause with the behaviour representing the child’s feelings of anger or regression at a time of stress. Constipation with overflow incontinence is the main differential diagnosis to be excluded.

Adolescence

Adolescents have difficult social and emotional issues to deal with. For example, there is frequently conflict over the degree of independence they wish to and are allowed to have from their parents. The peer group becomes very important and influential, and can provide valuable support for individuals to try new things away from the family. They can also arouse a great deal of anxiety about rejection from the group, and may promote delinquent behaviour. Development of sexual relationships is another potential source of confusion, anxiety and conflict.

The pattern of psychiatric disorders changes as children become adolescents. There is a marked increase in depressive disorder, particularly in girls, and schizophrenia becomes much more common in late adolescence. Problems with alcohol and drug abuse and eating disorders also tend to emerge at this time. Development disorders have usually resolved.

Reference:

1. Steple D. Oxford Handbook of Psychiatry, Oxford University Press, 2006

2. Smith G et al. Key topics in Psychiatry. Bios scientific publisher limited, 1996.

3. Boyle D, Davies S. Psychiatry, Mosby’s crash course 2002

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